The Inside Press

Magazines serving the communities of Northern Westchester

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Calling all Mini Chefs

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 New Fiddleheads Cooking Studio Ignites Culinary Curiosity For the Littlest Food Explorers

PHOTO COURTESY OF RENANA SHVIL

Fiddleheads Cooking Studio has been transforming children’s attitudes towards food through its unique approach to cooking education and kitchen science since 2016. With a mission of “growing the next generation of food explorers,” the studio is differentiated by a belief that children of all ages can be joyful participants in the kitchen. Having enjoyed success in Pound Ridge, Fiddleheads is moving to a new, expanded studio in Mount Kisco this March. The studio offers after-school programming, birthday parties, mini camps and private in-home instruction for both children and adults all in a rustic, remote farm-like setting.

With more than ten years of experience as a cooking instructor, owner Renana Shvil, explains her philosophy saying, “Talking with children about making healthier choices for meals and snacks should be a constant, engaging process. From getting acquainted to the bare ingredients to enjoying the finished product, each activity represents a learning opportunity.” Fiddleheads Cooking Studio is the result of that vision, born by melding Renana’s passion for food education with her background as a preschool instructor.

During lessons, Renana guides students through an exploration of healthy, delicious seasonal ingredients. Children discuss the items laid before them and are encouraged to touch, smell and taste everything. As they work together to create the dish, students learn how to use kitchen tools safely and they enjoy eating the final product as a community, sharing their thoughts about the meal’s flavor and texture.

To celebrate the launch of the new studio location, Fiddleheads will host a special series of $1 March classes leading up to the official launch of the Spring term in April. To learn more and view the full schedule, visit fiddleheadscookingstudio.com. Classes will be offered for children ages 18 months to 16 years. Family cooking classes and adult classes are also available.

Preventing & Recognizing Concussions: Keeping Your Young Athlete Safe

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(L-R): Lisa Rusch, PT, DPT, GCS, Chari Hirshson, PhD and Sarah Todd, PT, DPT, CLT
PHOTO BY CAROLYN SIMPSON, DOUBLEVSION PHOTOGRAPHERS

With the 53rd Super Bowl behind us and a spike in media coverage on NFL players and concussions, the 2017 season saw the highest rate of diagnosed concussions (291) in NFL players in a six-year period, according to the NFL and Quintiles, an independent third-party company. Although 2018 figures showed a 29 percent decrease in the number of concussions, it still remains a serious health problem for players.

Although NFL players may be at a higher risk for sustaining a concussion, which medical researchers refer to as a type of traumatic brain injury (TBI), they are not the only athletes experiencing concussions. Many high school athletes and younger ones are also suffering from concussions in our towns and the problem seems to be county-wide. In fact, in 2016 the former County Executive Rob Astorino formed the Westchester County Concussion Task Force to address the problem.

In observance of Brain Injury Awareness Month in March coinciding with the spring sports season kicking into high gear, Inside Press spoke with leading medical practitioners at Northern Westchester Hospital (NWH) to separate fact from fiction when it comes to concussion prevention, treatment and management.

Changing Perceptions About Concussions

When many people think of concussions, they think of an athlete on a football field who perhaps has lost consciousness. While losing consciousness can certainly be a symptom of concussion, there are a host of other concussion symptoms and they don’t necessarily present themselves at the time of injury. Concussions are a type of brain injury that results from a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move back and forth. This back and forth movement can cause the brain to bounce around in the skull which can result in stretching or damaging brain cells. Many health professionals classify concussion as a mild TBI (traumatic brain injury) because the injury is usually not life-threatening and in most cases, symptoms resolve on their own. However, some patients have lingering symptoms that require treatment from a specialist trained in concussion management.

Ryan Esposito sustained a concussion falling off his scooter without a helmet

Chari Hirshson, PhD is a neuropsychologist with NWH who specializes in brain injury and treats both adults and children (ages 8 and up) who have sustained a concussion. According to Dr. Hirshson, who sees her patients at the hospital’s Ambulatory Care Center at Chappaqua Crossing, “concussion symptoms vary from patient to patient,” she explains. “It is important to take a multi-disciplinary approach with patients that have lingering symptoms because their symptoms can be multifaceted, encompassing physical, emotional and cognitive realms,” adds Lisa Rusch, PT, DPT, GCS, a Supervisor in the Concussion Rehab Program at NWH.

Acknowledging that concussions can be diagnosed by urgent care specialists, pediatricians or in the ER, an MRI or CT scan rarely shows signs of concussion. “Most of the time, these tests come back normal. It is not like with an X-ray that shows a broken bone. This can make it difficult to gauge the severity of the injury,” says Dr. Hirshson.

Varying Symptoms

Patients with a concussion can experience observable signs such as:

  • Appearing dazed and confused
  • Forgetting instructions
  • Moving clumsily
  • Answering questions slowly
  • Losing consciousness (even briefly)
  • Showing mood, behavior or personality changes
Ryan recovering from his concussion. PHOTOS COURTESY OF FAINE ESPOSITO

Patients with a concussion may also report these symptoms:

  • Headache or “pressure” in the head
  • Nausea or vomiting
  • Balance problems or dizziness/blurred vision
  • Bothered by light or noise
  • Feeling sluggish, hazy, foggy or groggy
  • Confusion, concentration or memory problems
  • “Feeling down,” irritable or anxious
  • Changes in sleep patterns

Some patients do not exhibit any symptoms until a few hours or even a few days after the injury. That was the case with Ryan Esposito, an Armonk child who decided to take his scooter down the porch and ride it without a helmet and unsupervised when he was five years old. He fell down the stairs by his driveway and while his head was bruised and bloody, he did not exhibit any concussion symptoms that afternoon upon examination by a pediatrician. “The doctor did not want to give him an MRI because he was so young but told us to take him to the ER if he starts vomiting,” recalls his mother Faine Esposito. Sure enough, at midnight Ryan started vomiting and was taken to NWH and diagnosed with a concussion.

Falls: A Leading Cause of Concussion

Despite many people believing that contact sports are a leading cause of concussion in children, more than 55 percent, in children up to 14 years old, are actually due to falls like Ryan’s. Hirshson adds, many of her adult patients sustain their concussion as a result of falls which could have been easily prevented. “I’ve seen falls resulting in concussion from women wearing jeans that are too long, or men who are carrying messenger bags with a strap that is too long and they trip. These injuries are not related to football, or skiing. These are things that can happen in everyday life,” she says.

Nevertheless, sports-related concussions due to being struck by an object or person is the second-leading cause of concussion in youth, accounting for 24 percent of cases in children up to 14 years old. In addition, 71 percent of sports and recreation-related TBI emergency department visits are among patients 10-19 years old. According to 2017 statistics from the US Centers for Disease Control and Prevention (CDC), 15 percent of high school students have had one or more concussions and 6 percent experienced two or more as a result of either playing a sport or being physically active. The rates were higher among males and the more sports a child played the higher the prevalence of concussion. Even more troubling was the fact that 40 percent of high school athletes reported that their coach was unaware of their symptoms. The researchers also found that some high school athletes tried to hide their symptoms from their coaches so that they would not get reduced playing time.

“I’ve seen falls resulting in concussion from women wearing jeans that are too long, or men who are carrying messenger bags with a strap that is too long and they trip. These are things that can happen in everyday life,” Hirshson says. PHOTO BY RAWPIXEL ON UNSPLASH

Gender Disparities in High School Athletes and Concussion Prevalence

There also appears to be a gender disparity in terms of the prevalence of concussion when high school athletes of both genders are playing the same sport. Females are more likely to suffer from concussion when playing soccer, basketball and lacrosse. Some of the reasons may be due to proper safety equipment. Boys are required to wear helmets in lacrosse while girls are not. Lauren Dinhofer, a senior who plays varsity lacrosse at Horace Greeley High School feels that helmets for her teammates should not be mandatory. “The use of helmets for me gives off the idea that girls are more protected, so you can be more aggressive on the field. However, helmets for girls don’t really have adequate materials for protection. Unlike boy helmets, girl helmets are soft and won’t make a difference against a check to the head. They invite more contact instead of offering protection.” But Melissa Mykytiuk, an Armonk mother of three boys who played lacrosse and ice hockey fervently disagrees. “Why don’t girls who play lacrosse wear helmets? Those sticks and balls are hard. It’s crazy to me.”

The Road to Recovery: Part 1: Return to School

Many of the patients who visit Dr. Hirshson or Rusch have been referred by a physician or a pediatrician. With a comprehensive approach tailored so that each patient can return to school and/or play, the team in the Concussion Management Program at NWH offers physical therapy, speech therapy, occupational therapy and neuropsychology. A coordinated team with their colleague Sarah Todd, PT, DPT, CLT who is the manager of Outpatient Rehabilitation Program at the hospital’s Chappaqua Crossing site, demonstrates why specific training in concussion management and a multi-disciplinary approach to care is critical to successful treatment. They often find a patient will seek treatment for one symptom, for example balance disturbance, and upon evaluation and assessment, additional effects of the concussion, such as memory issues, are uncovered and able to be treated.

Dr. Hirshson specializes in neuropsychology. The neuropsychological tests she performs can last from 4-8 hours and are designed to assess a patient’s cognitive strengths and weaknesses. “Typically, we don’t do neuropsychological testing until three months post-injury if cognitive symptoms have lingered,” explains Dr. Hirshson. If necessary, Dr. Hirshson will help young students manage their symptoms post-concussion before that 3-month period and help them transition back to school. The rigorous demands of high school, college applications and entrance exams can be very taxing on a student with lingering concussion symptoms. In certain cases and upon Dr. Hirshson’s clinical observations, some students may require support from the school, and she will work with the district to advocate for this, if necessary.

It is really important for a student suffering from concussion to get what medical professionals call adequate “cognitive rest” because this helps the brain recover. For example, if a student has an important test coming up, studying for it uses a lot of brain power and instead of using that energy for the brain to recover, it gets depleted which can ultimately delay recovery. Dr. Hirshson assesses each student and makes recommendations for returning to school on an individual basis “Take your cues from your kids,” advises Mytkiuk. Each of her three sons had a different recovery time from their concussion. “It’s frustrating because you don’t have control over when your kid’s brain gets better.”

Dr. Hirshson always tells her patients, “Don’t do something that doesn’t feel good. Don’t look at a screen if it hurts your head. Slowly build up tolerance. If you got a concussion over the weekend skiing, then don’t play soccer on Tuesday. Allow yourself the proper time to recover.”

Road to Recovery: Part 2: Return to Play

While the priority for all students recovering from concussion is to get them to return to school, for high school athletes returning to the field is often a main goal of recovery. With more than 4,000 New York based students under 19 treated at hospitals for sports-related traumatic brain injuries, following a return to play protocol is very important. In 2013, all states were mandated to pass laws to address concussion management in school athletics.

NY state school nurses, certified athletic trainers, coaches, and physical education teachers are mandated to complete sports concussion management training every two years. In addition, in both the Byram Hills School District and the Chappaqua Central School District, high school athletes undergo IMPACT (Immediate Post Concussion Assessment & Cognitive Testing) pre-season for a baseline assessment and upon returning to the field. Not all New York State school districts conduct IMPACT testing. Before a student returns to play, they must have medical clearance from a physician permitting it.

While Dr. Hirshson helps students return to the classroom, Rusch and Todd help students return to athletic endeavors. They help students suffering from symptoms such as neck pain, vestibular (inner ear) dizziness or disorientation and provide therapy to help them strengthen their eyes or restore equilibrium in addition to several other modalities. Todd often works on improving the vestibular system which can affect balance. “We retrain and recalibrate the vestibular system with dynamic exercises such as hopping on one foot on a foam board,” explains Todd. “We are part of that return to play conversation with the athletic trainers. We ensure that the athlete takes on exercises with increasing intensity in a controlled setting and then we make recommendations regarding return to play,” notes Rusch. “Interestingly, the research is indicating that patients who sustain a concussion are three times more likely to sustain a lower extremity injury of the knee or lower leg,” adds Todd.

“Each specific discipline that is part of the Concussion Management Program uses measurement tools to identify symptoms, measure their severity and develop a plan to progress so that patients return back to school and/or the field,” sums up Todd. “Because each concussion and its symptoms are unique, see a medical professional with credentials in concussion management who understands all the nuances,” advises Dr. Hirshson.

Ryan like most concussion patients had his symptoms resolve quickly and is now a happy six-year old back to playing on scooters and riding bikes. “But he remembers the injury and tells all his friends to be careful and of course wear a helmet,” his mother adds.

Helpful Helmet Tips

While there is no such thing as a “concussion-proof helmet,” the CDC notes that a proper fitting helmet can protect from a serious brain injury. Todd, who herself is a triathlete says that “helmet manufacturers are studying the dynamics of concussion and improving their designs based on the research.” As the biking season gears up, the CDC recommends the following tips when purchasing a helmet. The CDC also offers sports-specific guidelines for helmets available on www.cdc.gov/headsup.

Start with the Right Size

  • Bring the bike rider with you to assess fit.
  • Measure the child’s head size.
  • Sizes vary from brand to brand, so look at the helmet’s fit and sizing chart.

Get a Good Fit

  • The helmet should fit snugly all around with no spaces between the foam and bike rider’s head.
  • Ask your child how the helmet feels. A too tight helmet can cause headaches.
  • Have your child wear the hairstyle they will be wearing to ride the bike. If a long-haired child cuts their hair short, adjust the helmet accordingly.
  • The helmet should not rest too high or too low on the rider’s head.
  • Make sure your child can see straight forward and side to side.
  • The side straps should make a “V” shape under and slightly in front of the bike rider’s ears.
  • Chin straps should be centered under the bike rider’s chin and fit snugly so that no more than one or two fingers fit between the chin and strap.

Take Care of the Helmet

  • Check for damage. Do not use a cracked or broken helmet or one that is missing parts.
  • Clean it only with warm water and mild detergent.
  • Keep the helmet away from direct sunlight and do not store in a car.
  • Do not decorate with stickers or paint as this could affect the helmets safety.

Look for Labels

    • Have the date of the manufacture in case of a recall.
    • Purchase a helmet that is US Consumer Product Safety Commission (CPSC) certified.

 

Replace the helmet if it is damaged and has been involved in a crash!

Source: CDC Heads Up campaign

Helping Children in their Hour of Need

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An oftentimes overlooked portion of the population exists mere miles away from the borders of Armonk. The Bedford Hills Correctional Facility is a maximum security prison that houses approximately 1,000 adult females. Armonk resident Joscelyn Read is working alongside organizations such as Hour Children to enhance the quality of life for the mothers within these walls and the children they’ve left beyond the bars.

Building Bridges Through Bars

Hour Children works to nurture relationships between incarcerated mothers and their children with the belief that a strong family connection maximizes a child’s stability and a woman’s chances of success upon reentry. The organization’s mission immediately resonated with Read, who acknowledges that it doesn’t always elicit that reaction, saying, “It’s a population that people don’t want to think about. They assume the prisoners did something bad and should be there. But, in truth, having met these women, many are lovely. They are human beings who often feel terrible about their actions. With a twist of fate, anyone could be in their position. I believe in second chances.”

Describing herself as someone who “likes to get in the thick of things,” Read makes good on those words by regularly opening the doors of her home to the children of women within the confines of Bedford Correctional. “I can’t imagine anything more difficult than having a parent in prison. For the past year and a half, I host two sisters four times a year for three to four nights while they visit their mom in prison from 9 a.m. to 3 p.m.,” she explains. “It’s the only way for them to keep the connection with their mother alive. Beyond that, I get the opportunity to be a positive influence in their lives and it gives their guardian, in this case the maternal grandmother, a break during which they know the children are in a safe place.”

The Innocence of Children

Of her role, Read says, “The biggest question I get is whether I feel nervous about having these kids in my house. People would be surprised that despite the stark socioeconomic differences, these girls are just like every other kid. They love playing with Legos, watching Nickelodeon and going to the movies. They’re innocents. What sets them apart is their strength. To travel by van six hours or more to see your mom while staying at a stranger’s home is the definition of bravery.”

The sisters aren’t the only children benefitting from the experience. “My children, ages seven and eight, see the girls as friends and love when they visit,” Read says. “They’ve also learned that there are children who don’t have the material possessions and support system that they have. This past summer, we even picked the girls up for their visit early so that they could join us at Hershey Park.  We are teaching that kindness is not the exception –it’s the expectation.”

“The biggest question I get is whether I feel nervous about having these kids in my house. People would be surprised that despite the stark socioeconomic differences, these girls are just like every other kid. They love playing with Legos, watching Nickelodeon and going to the movies. They’re innocents. What sets them apart is their strength. To travel by van six hours or more to see your mom while staying at a stranger’s home is the definition of bravery.” – Joscelyn Read

Though the Read family strives to fill these visits with fun and laughter, the true purpose is never far from the peripheral. “There’s excitement to see their mother, but also a sadness as reality hits that they haven’t seen her in three to four months. They cry thinking about continuing this pattern for another four years as she serves her sentence. The last day is always the most emotional. They want to keep seeing their mom and they like staying at my house where they not only have their own beds, but their own rooms as well–luxuries they don’t have at home,” Read states.

Paying It Forward

The statistics for the children of Hour Children are grim. Read reports that children whose mothers are in prison have a much lower college rate versus those whose fathers are in prison. She hopes to crack a dent in that rate, saying, “These girls have to go to college. I love to mentor because I know firsthand how strong an impact it can have on a child’s future. Growing up, I was a little sister in the Big Brothers, Big Sisters program. My mom wasn’t stable and my “big sister” was so important. We would do little activities like make dinner or go bowling. Just having someone show interest in my life was huge and formative. I will absolutely stay in touch with these girls beyond their time in the program. I will be there to make sure they keep their lives on track. I’m paying it forward.”

To find out more about the organization, visit www.hourchildren.org.

Bronx Lacrosse Greeley Alumn’s Efforts to Empower Students In the Classroom & On the Field

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PHOTOS COURTESY OF DAN LEVENTHAL

Horace Greeley grad Dan Leventhal (‘10) loves lacrosse. He played it in high school and continued on at Tufts University, where he won a national championship and majored in sociology. Now, he’s brought his favorite sport to the South Bronx, where he says it has the power to change the lives of local kids for the better, both on the playing field and in the classroom.

Leventhal spent some time in Israel after graduating from college and from there, he joined Teach for America and was assigned to The Highbridge Green School, a middle school in the South Bronx. He just finished his third year there teaching math to eighth graders.

In 2015, Leventhal decided to start a lacrosse program at the school, and he launched it in the spring of 2016, at Highbridge Green, a school he says is located in the poorest congressional district in America.

“The kids all love lacrosse,” Leventhal said. “In the South Bronx, everyone’s playing basketball. It gives them uniqueness and a chance to differentiate themselves. It’s a fast-paced sport, combinging basketball, football and soccer,” Leventhal added.

“These kids have so much going on at home,” he added. “This gives them a release.” And that’s what Leventhal’s aim is: to help the lacrosse scholars, as they are called, deal with their lives successfully.

And Leventhal said so far, outcomes of program participation have shown positive results, including better attendance, punctuality and higher achievement in various markers of reading and math learning on average when Bronx Lacrosse scholars are compared with other students at Highbridge Green. In order to participate in the program, a certain grade point average is required, Leventhal said. “I don’t think that’s a coincidence,” the principal of The Highbridge Green School has said of the achievements of the Bronx Lacrosse scholars.

Last spring and fall, a girls’ program was added at The Highbridge Green School and there’s also a Bronx Lacrosse program now at another local middle school.

While lacrosse is a spring sport, Bronx Lacrosse has the student athletes training in the fall also, Leventhal said, and even during the summer. “What we’ve done this summer is gotten our kids scholarships at different lacrosse camps. It’s a great opportunity for them,” he said, adding that next year Bronx Lacrosse will be looking for even more camp opportunities and also aiming to find sponsors to help foot the bill for the kids to go on fall trips to play lacrosse with teams from other programs. Bronx Lacrosse has already traveled to Connecticut and to Chappaqua.

“It is a lacrosse organization, but the mission is to keep kids out of the streets and create positive outcomes,” Leventhal said. “It’s an organization that aims to empower youth in the classroom and on the field.” To that end, Bronx Lacrosse has two full-time program coordinators besides Leventhal.

Anyone interested in the initiative can watch Highbridge: A Bronx Lacrosse Story on YouTube and check out the program’s website at bronxlacrosse.org.

This past year, besides growing his organization and teaching math,  Leventhal played in the World Lacrosse Championship as a midfielder for Israel’s team, which placed 7th of 45. “Some of our games were on ESPN so it was exciting for the kids to watch me,” Leventhal said. “And make fun of me.”

Most funding for the program currently comes from money distributed from each school’s principal as well as from NYC’s after-school program, Leventhal said, but as he transitions to full-time with Bronx Lacrosse he will be focusing on developing other fundraising sources.

Of his latest plans, Leventhal said “Fundraising is a major priority. We’re going to have a big fundraiser, probably next spring.” Leventhal said his desire to give back is motivated in part by his upbringing in Chappaqua. “I had a lot of opportunity growing up,” he said. “My parents always got me whatever I needed for sports. That’s our goal here–to make these things accessible to these kids.”

Safeguarding Your Child’s Health at School

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As summer comes to a close, local parents can be found buying notebooks, pencils and clothes and getting ready for the changes in routines and activities that a new school year brings. But what about safeguarding the health of children returning to school?

Along with new challenges and commitments can come new exposure to all kinds of viruses, not to mention that plague of camps and classrooms alike: lice. According to Dr. Ellen Lestz, a pediatrician with White Plains Hospital Physicians Associates in Armonk, weather changes such as those experienced in our area in the fall cause viruses to be more prevalent, and “your standard communicable things” are the most common at back-to-school time: Viruses that cause maladies such as colds, coughs and gastrointestinal problems.

Handwashing Is Key

Dr. Lestz said handwashing is the “most important” defense. Noting that many classrooms have hand sanitizer available, she stressed that children should clean their hands before lunch or a snack. “It’s good when teachers reinforce this at the beginning of the year,” she said, “and when they teach children how to cough and sneeze appropriately.”

Kids and adults alike should sneeze or cough into their elbows, not their hands, and if a hand is accidentally used to stifle a cough or a sneeze, handwashing should follow right away.

Lestz also pointed out that students need a nutritious diet and enough sleep to remain healthy, and she recommended that parents work on changing sleep schedules about a week in advance of the school year, back to school-year timeframes.

“I think that will kind of prime their immune systems,” she said.

Keeping Lice at Bay

As far as lice goes, Lestz said that while probably more common at camp, it can be a problem at school as well. Besides the usual admonitions not to share hats or combs and to keep long hair back, Lestz said there’s not a lot of evidence that over-the-counter products advertised to repel lice actually work.

But when a kid does have lice, Lestz said it can be a good idea to call on a lice professional. Besides great combouts, these lice-eradication experts are good at communicating to parents and children the steps they need to take in order to prevent recurrence. “They’re so, so thorough,” Lestz said.

The National Association of School Nurses (NASN) also recommends that parents review proper hygiene to prevent the spread of infections before school starts, and parents should know their school’s policy regarding when to keep sick kids home.

Parents should also have child care plans for sick children if needed, and in addition to required up-to-date vaccines, the NASN Back-to-School family checklist also recommends flu vaccinations. Of course, parents should communicate any health concerns or issues their children have with school nurses.

Other ways of preparing for optimal mental and emotional health may include getting youngsters back in touch with school friends after a summer apart. Lestz suggested arranging a few playdates. And to avoid anxiety, make sure all summer assignments are completed, if possible, with time to spare. “If your child’s nervous, understand their feelings and have open communication with them,” Lestz added.