The Wake Area Telehealth Collaborative

Helping Children with Special Needs
October 2008
In This Issue
Dyslexia Update
Wake County Services and Resources Webpage
WATCH Program Updates
Employment Opportunities
Spina Bifida Resources
Stress Relief Tool Kit
Save the Dates
WATCH Summite Results
Spina Bifida Videconference Review
The Honours Tournament Update
Research and Resources
Upcoming WATCH Professional Development Sessions
Fun at Marbles
Something to Brighten Your Day
WATCH Numbers for   
August and September

Members continued to be busy during the months of , despite summer vacations.
Videoconferencing was utilized  6 times in August and September. once  for educational purposes,  once for networking purposes, twice for administrative purposes and twice for videoclinics.
65 people attended these sessions.  Evaluations show the average satisfaction and comfort  level scored a 4.2  out of 5.0. Those involved in the educational session all strongly agreed that the session provided them with new knowledge applicable to their work. 
Dyslexia Update and Resources
by, Terri Pratt, White Plains Children's Center 

Do you know a child with Dyslexia?  If so, be assured that he or she can learn to read fluently.  Children with Dyslexia can learn to read well, but they need a multi-sensory approach, using a variety of tactile activities.  This can be done by drawing letters/words in sand or carpet, tracing letters through a screen or writing on a gel pad.

Dyslexia is neurological difference in brain structure and processing.  This difference affects reading, writing and spelling.  Some signs of Dyslexia are difficulty rhyming, difficulty spelling, difficulty naming letters and sounds, and a family history of learning disorders.  While learning to read is challenging for children with Dyslexia, they are often gifted in music, art, design, math, physics or athletics.

Dr Samuel Orton, a neuro-psychiatrist, was a pioneer in focusing attention on reading failure.  In the 1920's he formulated a set of teaching principles that continue to work very well with children diagnosed with Dyslexia.  Both the Wilson Reading System and the Susan Barton Reading System use
these principles in their instructional materials.

With a knowledgeable teacher and a multi-sensory approach to reading, children with Dyslexia can learn to read fluently.  As with any learning disability, early intervention is best.  For more information parents or teachers an research Dyslexia, Orton-Gillingham, Wilson Reading System, or Susan Barton
Reading System.
Wake County Services and Resources for Children Birth-Five Webpage TR
We now have 51 programs included in the Services and Resources webpage. 
Is your agency one of them? 
For more information or to obtain an enrollment form contact Juliellen at

WATCH  Program Updates

Developmental Therapy Associates invites you to
Save the Date!
Date: October 25, 2008 (8:30am - 4:30pm)
Course: Evidenced-Based Practice of Sensory Integration
Presenter: Teresa May-Benson, Sc.D, OTR/L
Location: McKimmon Center, Raleigh, NC

For more information visit DTA's webpage at or call 919-493-7002.
Pediatric Therapy Associates will be hosting their annual Fall Festivals the week of October 27-30th. Festivals will take place all week, as patients come in for therapy in the Raleigh, Cary, Garner, and Holly Springs offices. The Wake Forest location will be hosting an evening festival from 6-7:30 on Wednesday the 29th. Games, goodies, and costumes are all part of the fun!

Learning Together offers services for families with children experiencing difficulties with transitions, relating to peers, showing affection, processing language and following directions.  For more information call 919.856.5386 or go to their website.

anna and units 
Employment Opportunities
Learning Together is an inclusive Developmental Day Center with a 5 Star rating from the Division of Child Development and a national accreditation from the National Association for the Education of Young Children (NAEYC). We are currently seeking a teacher licensed by the Department of Public instruction in Birth - Kindergarten or who is immediately eligible for B-K licensing.
A minimum of two years of experience with you children (3-5yrs), preferably with developmental delays, is required. Please send cover letter and resume to

Wake County Public School System is seeking a Physical Therapist. 

The position is for a 12 month full time position helping children with disabilities from ages 3-22 years working in the natural environment of the school setting.
If interested contact  
Janet O'Neal at or 919-858-1642. 
Community Partnerships, Inc. has an opening for a full time Occupational Therapist.  Contact Kathi Gillaspy at with questions or resumes.

Wake County Area Resources and Information

Wake County LICC Family Resource Fair
Parents Come Get the Scoop!
Join other parents and early intervention professionals working together to serve the special needs of your young child. Find activities, support, services, and more for your birth-five year old child. There will be representatives from leisure and recreation activities, support groups, advocacy, assistive technology, child care, education, play groups and more. Refreshments will be served and children are welcome.

The event will be held at Laurel Hills Community Center at 3808 Edwards Mill Road in Raleigh, NC.
Call 856.7789 with questions or to RSVP.

Start Time: 9:00 AM
End Time: 11:30 AM

is a support group for families with children with HYDROCEPHALUS who live in the Wake County area.  The group
meets for family outings and to offer support.
The next planned activity is trick-or treating! If interested, contact the roup coordinator, Alice ( or call her cell phone at 539-6648.  

Developmental Discoveries is offering  Relationship Development Intervention informational session on Tuesday October 21st, 2008.
The RDI® Program is:

- parent-based intervention program where parents are provided the tools to effectively teach Dynamic Intelligence skills and motivation to their child.
-a method that measures and begins at the edge of each person's capability and then carefully but continually raises the bar.
Sessions will be held at 103 Salem Towne Court, Apex, NC  from 6:30pm-8pm.  Interested parents can email or call 418-7175.
Abilitations Children's Therapy & Wellness Center presents:
A soccer league for children with special needs
(no limitation on physical or developmental level) 
2009 Winter Co-Ed Soccer League
Ages 5-12
January 4 - February 22
Sundays, 2-3 PM
Location:  MVP Sports Center at The Factory MVP Sports Center
1839-360 S. Main St.
Wake Forest, NC 27587

Registration Fee: $75 per player
Teams meet 1x/week for practice and games.  MVP requires all players to have shin guards & flat soled shoes.
This league has been formed by Abilitations Children's Therapy.  Please contact either Jennifer Mock or T.R. Goins at (919)844-6611 for more information.  Do not contact the MVP Sports Center. 

Artistic Gymnastic School offers gymnastic classes for children with special needs (preschool and school age classes).  The cost for 6 sessions is $100.00.  Call 919.772.9463 or got to http://www.ArtisticGynmnastic.US for more information.
Emergency Stress Relief Tool Kit

The Real Simple website offers these preventive measures to save yourself time and a few headaches. 
I've embellished on a few...
  1. Keep stamps on hand.
  2. Keep a few extra dollars and spare change stashed in a safe place in your car.
  3. Always have a good book or magazine nearby.
  4. Stash an umbrella in your office and your car.
  5. Don't wear tight pants or uncomfortable shoes.
  6. Keep snacks in your office drawer or work bag to avoid getting too hungry.
  7. Keep Band-Aids and Tylenol in the same drawer with your snacks.
  8. Always put your keys away in the same place.  Make sure a trusted neighbor has an extra set.
  9. Make at least one friend in your neighborhood (so you can give them your keys!)
  10. Make your bed every morning (or better yet, have your spouse do it!)
  11. Make lists.
  12. Never let your gas level fall into the "empty zone." (Remember, you have a few $$ stashed in your car so you can at least get a gallon or two.)
  13. Go to bed 30 mn. earlier than usual.
  14. Wake up 15 mn. earlier than usual.
  15. Find ways to laugh at yourself.
Upcoming Events: 
Thursday, October 23rd - PTA videoclinics
Friday, October 24th- "Transition from Hospital to Home"  WATCH videconference session.  1:00-3:00
Friday, November 14th-  "Risk Factors, Outcomes and Services for Premature Infants"  WATCH videconferecen session.  1:00-3:00
Friday, November 21st- PTA videoclinics
Friday, November 21st-  Cerebral Palsy WATCH videoconference session
Tuesday, December 2nd-
Wake County LICC Family Resource Fair at Laurel Hills Community Center
Friday, December 5th-
"Teaching Functional Communication to Children with Autism" WATCH videoconference session.  12:30-2:30
Monday, December 8th-
Leo M. Croghan conference
Friday, December 12th
"An Introduction to Mindfulness"  WATCH videoconference session
For more information on any of these sessions and for more professional development opportunities check out the TelAbility calendar.
Join Our Mailing List
Hello WATCH Members!
Better late than never, right?  The last two months were filled with two successful WATCH Summits, the Honours Tournament and several informative videoconference sessions.
This newsletter features feedback from the Summits, a review of Dr. Alexander's Spina Bifida presentation, descriptions for several upcoming WATCH videoconference sessions, many WATCH Program updates, along with several Wake County area resources.  We are lucky to have so many services available and a great collaborative and community in which to share them all.  Many thanks to Terri Pratt, Gerry Highsmith, and our other contributors. 
Happy reading!
WATCH Summit Results
On September 3rd and 5th the WATCH Project hosted a WATCH Summit.  Fifty engaged, energetic and committed participants offered there thoughts, ideas, and hopes for the WATCH Collaborative.  Below is a short recap of what was discussed.
When asked "What is WATCH?", participants used words like:  innovative, a reliable source of information, trusted, a model collaborative, cost effective, family friendly, generous, easily accessible, time effective, supportive, interesting, consumer driven, helpful, fast, a networking system, provider of training and education, a place to identify central and common themes, a linking system, a great example of capacity building, and a way to build leadership skills. 
Several examples of great WATCH experiences were mentioned.  Participants cited the generous, fast and incredible helpful responses from the WATCH listserv; the passion and caring they sense in the community; the ability to work with other providers on planing WATCH sessions; increased enthusiasm and learning among their staff; recognizing member's receptivity to new ideas; an increase in referral patterns to appropriate providers; and the ability to create a "virtual team" and problem solve with multiple providers as just a few of their personal stories.
 Participants were overwhelmingly committed to finding ways to expand and extend WATCH beyond our 2010 funding from the John Rex Endowment.  Ideas included seeking out other funding sources such as Kate B. Reynolds, the State legislature, NCPC/Smart Start, corporate sponsorship, and WATCH Membership fees.  
As WATCH grows and expands, participants wanted to ensure that the core values and standards of the collaborative remain in-tact and are defined by the community, not outside sources.  There is a desire to include more programs (such as Wake County Human Services, Governor Morehead Preschool and private practices) and more physicians, specialists and educators.  Participants would like to see videoconferencing resources used to conduct IFSP, IEP and transition meetings.  They also see potential in using videoconferencing for mentoring relationships,  for providing "best practice" sessions, offering professional and family support groups, and increasing care coordination efforts among doctors, specialists and service providers.  There was also great enthusiasm and support for using videoconferencing as a tool to expand professional development opportunities within Wake County and across the state network.  Several specific national and international experts were mentioned as possible speakers.  Members would also like to see WATCH educational sessions from their desktop or laptop computer when not able to attend on site and when more than 4 sites would like to be involved.  Participants would also like sessions archived on the TelAbility website for easy viewing at a later date. 
So what are the next steps??  Summit participants outlined the following strategies:
1.  Secure a reliable and affordable tech support provider.  Glowpoints, a video communications company, was offered as a viable option.
2.  Seek out additional funding sources.
3.  Ask each WATCH Site to consider its financial ability to contribute to the future of WATCH.
4.  Leverage resources with partnering projects and agencies (such as Young Child Mental Health Collaborative, Wake County LICC, Wake County Smart Start, WATCH Sites)
5.  Encourage parent participation in educational sessions and look into using videoconferencing as a way to enhance parent support groups.
6.  Research ways to provide CEUs for WATCH educational sessions.
In order to put these steps into action we need YOUR help.  Please continue to talk within your agencies about ways to financially support WATCH beyond 2010.  Continue to share WATCH resources with new parents and providers.  Talk with other networks of which you are a part about ways WATCH could help expand and enhance those missions. 
We will continue to need your help in developing professional development sessions and support groups.  We need you  to feel confident enough to take the bold step to be the first to hold an IFSP meeting or transition meeting via videoconference.  We need you to keep contributing to the listserv and newsletter.  Please let us know what you feel energize and empowered to do through WATCH.
We thank everyone who participated in the Summit for the time and energy and we thank the entire WATCH Community for your commitment.
WATCH Videoconference Review: 
Spina Bifida: Update 2008 with Dr. Alexander, M.D., Director of the Spina Bifida Clinic at the University of North Carolina at Chapel Hill (UNC), written by Geraldine Highsmith, PT, Pediatric Therapy Associates
On September 19, 2008, participants at four Telability Sites gathered together across WakeCounty to hear Dr. Joshua Alexander, MD, Director of The Spina Bifida Clinic at the University of North Carolina at Chapel Hill (UNC) give an exceptional presentation on Spina Bifida for the pediatric therapy community of WakeCounty. The presentation covered the following topics:
· Spina Bifida: A description including the history, prevalence, incidence, etiology and outcomes for children born with Spina Bifida.
·  Prenatal diagnosis and current medical options for intervention during gestation
· Incidence of Spina Bifida which is the second most common physical disability in childhood. Of 1000 live births nationwide, 1 child will be at risk for Spina Bifida. Of 1000 births in North Carolina, 1 to 2 children will be at risk for Spina Bifida.
·Those of Irish, German or Hispanic descent are at increased risk.
·In North Carolina, Latinos are twice as likely as other groups to have a child with Spina Bifida
·There is a decreased risk in Asians and Pacific Islanders
Why does Spina Bifida occur?
Four causes of neural tube defects including Spina Bifida, as discussed by Dr. Alexander were:
1.      Polygenic inheritance
2.       Environmental influences (nutrition, diabetes, heat  and valporic acid use)
3.      MTHFR (the official name of this gene is 5,10-methylenetetrahydrofolate reductase). A variant of the MTHFR gene may increase the risk of certain types of birth defects such as Spina Bifida.
4.      Folic Acid (Folic acid, also known as vitamin M and Folacin and Folate are forms of water-soluble Vitamin B9. These occur naturally in food and can be taken as supplements. Folate gets its name from the Latin word folium ("leaf").  To reduce the risk of neural tube defects by 50 to 70%, the recommendation is for every woman of childbearing age to take folic acid equal to 400 micrograms every day.

The prenatal diagnosis of a neural tube defect is obtained through testing of the Alpha-fetoprotein (AFP is a molecule produced in the developing embryo and fetus) in amniotic fluid at 16 to 18 weeks of gestation.  If the AFP level is elevated, then Acetycholinestrerase (AChE) may be useful as a second test in providing a prenatal diagnosis of a neural tube defect. According to Morrow, McNay and Whittle (1991), ultrasound scanning had a 98% sensitivity and a 100% specificity for neural tube defects.1
If a neural tube defect is confirmed, the choices are termination of the pregnancy, fetal surgery to attempt to correct the defect during the time of gestation and the option for a C-section delivery followed by corrective surgery within the first 24 to 48 hours after birth.
The outcomes in a child with a neural tube defect include issues secondary to lack of afferent (sensory) transmissions reaching the brain and the lack of efferent (motor) transmissions reaching the muscles from the brain.  The clinical manifestations of the interrupted nerve transmissions include spastic or flaccid muscle tone, muscle weakness, decreased sensation, neurogenic bowel and bladder and vasomotor dysfunction. The patterns of dysfunction may not be symmetric. Secondary conditions may include: fractures, charcot joints, hip dislocation, scoliosis, kyphosis, foot anomalies, pressure ulcers, burns, obesity, precocious puberty, UTI's (urinary tract infections), hydronephrosis, latex allergy, tethered cord, rotator cuff tears, CTS (carpal tunnel syndrome) and ulnar neuropathy.

With all of the worries and considerations for dysfunction, it is not a surprise that there is increased family stress, sibling stress, increased family dysfunction resulting in divorce, and a loss in family income.  A team approach with the child's needs and the family's priorities being included should happen from day one. With Dr. Alexander taking a lead role this will always be a focus of the team. 
1 Morrow, R.J. , McNay, R.B., Whittle, M. J. (1991). Ultrasound detection of neural tube defects in patients with elevated maternal serum alpha-fetoprotein. Obstetrics  & Gynecology, 78,1055-7.

***33 people attended this session and 21 evaluations were completed. 100% of the participants were comfortable attending the session and agreed the session provided them with new knowledge and skills. All participants were satisified with the videoconference session.

A total of $1178 dollars and 36 hours of travel time was saved by hosting this session via videconference.

Jenn and EthanThank you to everyone who helped honor Jennifer and Ethan Pfaltzgraff and support the TelAbility/ WATCH program by contributing to the 7th Annual Honours Tournament.   

We are still waiting on the total amount raised, but we are grateful for EVERYONE'S generousity.  All procedes raised through the tournament will go directly to the TelAbility/WATCH Project. 

Specials thanks  and gratitude to the following individual donors:
*Albert & Suzanne Failla, Allentown, NJ
*Marie Hughes
In honor of her daughter & grandson,
Jennifer & Ethan Pfaltzgraff
*Jim Michels, New Milford, CT
*Paul & Susan Thananopavarn, Chapel Hill, NC
*Sang Hee Kim & In Soo Jang, Durham, NC
*Craig & Anna Troutman, Raleigh, NC
*Roof Engineering, Inc., Raleigh, NC
*Darryl & Dionne Lester, Raleigh, NC
*Joseph Dew & Myra Teasley, Morrisville, NC
*Kenneth & Laura Fischler, Raleigh, NC
*Harold & Diane Thoman, Raleigh, NC
*Justin & Nicole Caldwell
*Valerie & Andrew Wilson
*Nell Barnes
*Dr. Alisha Davis
*Nell & Cynthia Chamblee
*Juliellen & Mark Simpson-Vos
*Dr. Joshua Alexander
*Natasha Adwater
*Terry Wilson
*Carl M. Smith, MD
Rogers & LaPan Architecture & Engineering
Abilitations Children's Therapy, Raleigh, NC
Wake County LICC
UNC Healthcare
Dept. of Prosthetics & Orthotics
Tony Hall & Associates, Chapel Hill, NC
North Chatham Inv, Chapel Hill, NC
Blake & Associates
TransLife Services
Eye Institute of NC
Sir Walter Chevrolet

We were honored to have Jennifer and Ethan be the faces and ambassadors for TelAbility and WATCH!
WATCH Research and Resources Update 
Medicaid DME Update:
Proposed Policy:  The proposed Medicaid Durable Medical Equipment (DME) clinical coverage policy for crutches, canes, walkers and gait trainers has been posted on DMA's web site for review and comment. Crutches and walkers can be covered for children and adults. Gait trainers will only be covered for children up to 21 years of age. Once this policy is finalized, requests will be sent to EDS rather to DMA as a non-covered service.  Reimbursement rates will be set once the policy is finalized.

Be sure to note what is required in the letter of medical necessity.

Click this  link  to find the policy. Comments can be submitted until October 31.


(Posted Sept. 4, 2008) A new study provides further proof that measles vaccine has no link to autism spectrum disorder, debunking a theory that has persisted for more than a decade.
Scientists examined bowel tissues from 25 children with autism and gastrointestinal (GI) disturbances for the presence of measles virus, and compared the results to biopsies from 13 children who have GI disturbances but not autism. Children with autism were no more likely to have measles virus in their bowels. Nor did researchers find any relationship between the timing of the measles, mumps, rubella (MMR) vaccine and children developing GI problems or autism.
"This study adds a critical piece to the mountain of evidence that MMR vaccine does not autism," said Renee R. Jenkins, MD, FAAP, president of the American Academy of Pediatrics. "We are hopeful these results will put this theory to rest. Parents should feel confident this life-saving vaccine has been thoroughly researched and found to be safe."
The research was published in PLoS One, the peer-reviewed, online journal of the Public Library of Science. The study was funded by the U.S. Centers for Disease Control and Prevention through the American Academy of Pediatrics.  
Sept. 3, 2008 -- News release on study from Mailman School of Public Health, Columbia University
Sept. 3, 2008 - CNN report on the study
Sept. 3, 2008 - Associated Press report on the study
For more infomation click here.

-- Gerri Mattson, MD, MSPH Pediatric Medical Consultant North Carolina Division of Public Health

Visit Our Sponsor
Many thanks to the John Rex Endowment for their continued support of the WATCH Program into 2010!

Upcoming WATCH  Professional Development Sessions: 

Caring for the Premature Infant-Transition from Hospital to Home on Friday, October 24th from 1:00-3:00.  Learning objective for this session are as follows:
This session will be led by Cindy Redd and Ann Elmore of the Wake Med Hospital to Home Intervention Project and a panel of parents coordinated through Tara Bristol of the March of Dimes Family Support Program at UNC Hospitals. 
This is the first session of a 3 part series on caring for the Premature Infants.  The second session will  focus on Risk Factors, Services and Outcome for premature infants.  It will be held on November  and will be led by Dr. Melissa Johnson of Wake Med.  The third session will focus on Family Centered Care and Routine Based Assessment.  The date for that is yet to be determine.
To register for the October 24th or November sessions contact Juliellen at
Cerebral Palsy:  An Update and Overview for Parents and Practitioners to be held on Friday, November 21st from 1:00-2:30.  This session will be led by Dr. Joshua Alexander, TelAbility Program Director.  The learning objectives will include:  understanding the definition of cerebral palsy, identifying common types and distributions of cerebral palsy,  understanding functional classification system ratings for children with cerebral palsy, knowing common secondary conditions associated with CP, developing an approach to care of the child and their family, becoming familiar with resources for children with CP and their families

To register for this session contact Juliellen at
Teaching Functional Communication to Children with Autism to be held on Friday, December 5th from 12:30-2:30.  This session will be led by Cassy Gayman and Katie Cole of the Mariposa School.   The goal of the videoconference is to discuss how ABA is used to teach children with Autism.  Mariposa focuses specifically on the application of B.F. Skinner's analysis of Verbal Behavior to teach functional language.  This discussion will include a description of the effective teaching procedures implemented in ABA/VB based instructional program. 
Learning Objectives will include:
-What is pairing and why is it used?
-What is manding, when and why is it taught?
-Describe errorless learning.
-Why is it important to mix and vary verbal operants?
-What are DTT and NET and how are they used in a VB based program?
-Describe data collection procedures in a VB program.
To register for this session contact Juliellen at
An Introduction to Mindfulness to be held on Friday, December 12th from 12:30-2:30.  This session will be led by Will Frey, a Mindfulness Instruction for the Program of Integrative Medicine at UNC-CH.  This is a follow up session to the Caring for the Caregiver session held this past summer.  The Mindfulness session will provide participants with an introduction to this stress relieving practice.  There will be an overview of the key concepts and time to practice the techniques.  If people are interested we are willing to look into offering this as a weekly series. 
To register for the December 12th session contact Juliellen at
Sensory Processing Disorder Question and Answer- Date still to be determined.  This session will be led by the staff at Developmental Therapy Associates.  More details will be available in the December newsletter.
Marbles Family Fun Night 
for kids with special needs and their families!
Through a community wide collaborative, the museum will be open one (1) evening a month specifically for children with special needs and their families.  The next Family Fun Night is scheduled for Wednesday, .  You can find out more information about Family Fun Night and the Marble's exhibit's on the Marbles website.   
The evening times will be from 5:30-8:00 pm.   Marbles Kids' Museum is located at 201 E. Hargett Street, Raleigh.  The cost is $5 per person or $20 per family.

proudly partnering with:
Triangle Down Syndrome Network
Wake County Cerebral Palsy Support Group
Wake County LICC (Local Inter-Agency Coordinating Council)
Wake County SEPTA (Special Education PTA)


Something To Brighten Your Day
I received this story from a WATCH Member about a month ago.  It literally brought tears to my eyes.  While there is a religious undertone (which I'm hoping doesn't offend anyone), I think it really speaks to the innate goodness in us all.  I hope it brightens your day and helps you realize all the big and small ways your service and caring has an impact on the children and families in your life.
 " Our 14 year old dog, Abbey, died last month.The day after she died, my 4 year old daughter Meredith was crying and talking about how much she missed Abbey. She asked if we could write a letter to God so that when Abbey got to heaven, God would recognize her. I told her that I thought we could, so she dictated these words:

Dear God,

Will you please take care of my dog? She died yesterday and is with you in heaven. I miss her very much. I am happy that you let me have her as my dog even though she got sick.

I hope you will play with her. She likes to play with balls and to swim. I am sending a picture of her so when you see her you will know that she is my dog. I really miss her.

Love, Meredith

We put the letter in an envelope with a picture of Abbey and Meredith and addressed it to God/Heaven. We put our return address on it. Then Meredith pasted several stamps on the front of the envelope because she said it would take lots of stamps to get the letter all the way to heaven. That afternoon she dropped it into the letter box at the post office. A few days later, she asked if God had gotten the letter yet. I told her that I thought He had.

Yesterday, there was a package wrapped in gold paper on our front porch addressed, 'To Meredith , in an unfamiliar hand. Meredith opened it. Inside was a book by Mr. Rogers called, 'When a Pet Dies.' Taped to the inside front cover was the letter we had written to God in its opened envelope. On the opposite page was the picture of Abbey & Meredith and this note:

Dear Meredith,
Abbey arrived safely in heaven.

Having the picture was a big help. I recognized Abbey right away.

Abbey isn't sick anymore. Her spirit is here with me just like it stays in your heart. Abbey loved being your dog. Since we don't need our bodies in heaven, I don't have any pockets to keep your picture in, so I am sending it back to you in this little book for you to keep and have something to remember Abbey by.

Thank you for the beautiful letter and thank your mother for helping you write it and sending it to me. What a wonderful mother you have. I picked her especially for you.

I send my blessings every day and remember that I love you very much.

By the way, I'm easy to find; I am wherever there is love.