National Autism Awareness Month

Cornerstone Family Healthcare Pediatrician, Dr. Alicia Pointer, DO

As we observe April as National Autism Awareness Month, one of Cornerstone’s pediatricians, Dr. Pointer, answered some frequently asked questions about the disorder and how to help your child if you suspect signs or symptoms.

What is autism?

Autism, or autism spectrum disorder, is a condition that affects children’s social skills, communication and behavior. It is made up of a spectrum of symptoms meaning that some children are affected differently than others. For example, some children with autism may have normal language development while others may rarely speak.

What are the symptoms of autism?

Many children with autism have normal motor skills and growth. Initially, they may seem to have typical development. Some early signs of autism include:

  • Speech or language delay
  • Loss of milestones
  • Does not respond to her name
  • Does not look at things that parent is looking at
  • Does not try to get parent to look at things that are interesting to him
  • Does not point
  • Difficulty making friends or interacting with other children
  • Overly sensitive to sounds, smells or touch
  • Does not do imaginative or pretend play
  • Frequent repetitive movements such as rocking or hand flapping
  •  Trouble understanding others’ facial expressions or feelings
  • Poor eye contact or too much eye contact

How is autism diagnosed?

There is no single test for autism. Autism cannot be diagnosed with a blood test or brain scan. A pediatrician, developmental specialist, neurologist or psychiatrist can diagnose autism by talking to you and your child and observing your child in the office. There are some developmental tests and screening tools that can help diagnose autism or rule out other diagnoses. Your child’s pediatrician will likely do an autism screening called the MCHAT at 18 months and 2 years old.

How is autism treated?

There is no single treatment or medicine for autism. Instead, the treatment of autism involves addressing a child’s individual challenges. There are several interventions that may help children with autism improve their language, social and self-care skills. Early Intervention is a program for children up to age 3 who have developmental delays. It provides in-home services such as speech therapy, occupational therapy or physical therapy based on a child’s needs. There are other specific therapies such as Applied Behavioral Analysis (or ABA) that help children improve the way they interact with other people. The local school system may provide services for school-age children.

What should I do if I am worried about my child’s development?

Trust your instincts and talk to your pediatrician. Children develop at different paces so a child may seem delayed compared to some peers but still be meeting milestones for her age. Also, some behaviors, such as head banging when frustrated or hand flapping when excited, are commonly seen in typically developing children who do not have autism. The earlier you talk to your pediatrician, the sooner your child can get the intervention and support that he needs.

Where can I find more information?

The following websites have helpful information about autism that is written for parents by experts:

CDC-Learn the Signs. Act Early.


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Finding Hope Through Health Education

Annia Reyes, Health Education Coordinator

Imagine you are an individual who lives without a car in an area with limited public transportation and work a minimum wage job that does not offer health insurance benefits. After 10 years of not going to see a doctor because it was not in the budget, you go to the doctor and get diagnosed as pre-diabetic. This means that you are on the path of becoming diabetic, if you do not change your habits to live a healthier lifestyle.

This brings up questions such as: how are you going to obtain fresh fruits and vegetables without a car? How are you going to pay for regular doctor visits to keep an eye on your health without health insurance? Working a minimum wage job will not provide enough money to keep your home and make healthy meals every night, especially without the knowledge of understanding how to give your body exactly what it needs. Where do you begin in managing your health?

Communities served by health centers are in areas where access to healthcare is limited. These communities suffer from a host of obstacles, known as health disparities, which impact individuals’ health and life in general. Healthcare disparities refer to differences in access to or availability of facilities and services.

Patient education is the process by which health professionals and others impart information to patients and their caregivers that will alter their health behaviors or improve their health status. At Cornerstone Family Healthcare, health educators host several programs that offer opportunities to teach patients with chronic diseases how to develop healthier daily routines and control their conditions. Some of the programs offered aside from one-on-one sessions include:

  • Living Well with Diabetes
  • Tobacco Cessation
  • Healthy Heart
  • Managing Your Health (Chronic Disease Self-Management)
  • Free Farm Stand
  • And more…

In health education programs, patients often walk in feeling overwhelmed with whatever is going on in their life and when they leave they feel empowered to conquer the obstacles they are facing.

There can be an overwhelming sense of defeat and a “why is this happening to me” attitude when a patient is first diagnosed with a chronic condition. As the participants talk to one another in the health education programs, they realize that there are many people who are going through the same thing and there are people out there who want to help; patients have constant support from providers, peers, and staff.

Mary Macdonald has been with Cornerstone for over 25 years participating in the Living Well with Diabetes and Managing Your Health education programs. “I don’t know what I would do without these classes,” said Macdonald. “They gave me the zest to fight my illness, taught me how to manage my health, and gave me an outlet to be around people going through the same thing.”

What many people do not understand is how they can benefit from participating in these programs. The information presented not only includes education about how to change your lifestyle habits, but it also includes an array of other benefits. It is not a room where people sit and get lectured on a regular basis because it is an interactive session. These programs include real people who share their difficulties in life, and in return they make relationships with one another, build trust, and find a place that is safe to open up about their feelings. At the programs, participants also receive free fruits and vegetables to take home.

Macdonald met her best friend in Cornerstone’s Living Well with Diabetes health education course. The two have built a special bond through spending time together in the 12-week course. They practice the recipes learned in class and find constant support in one another to get through their struggles.

Research shows that people are more likely to implement a change in their behavior if they talk about it in a group. Not only do the programs change behavior, but it also changes patients’ perspective about their situation. Often times, when many participants graduate from the program they are empowered to give back to their community by volunteering to help people who are in similar situations to theirs.

MacDonald is a regular volunteer at Cornerstone’s free farm stand held at the Newburgh Armory. Not only does she enjoy the vegetables she receives there, but she also enjoys seeing her friends from the programs and helping her community all at the same time.

Health educators begin to learn about the patients and begin to understand them and their needs a little bit better every time they see one another. Health educators are able to connect patients in their programs to other resources in the community, and services such as Care Coordination at Cornerstone Family Healthcare. Care Coordination is a free program that focuses on your specific needs as a patient and makes managing your health a lot easier.  Care Coordination services help patients to overcome obstacles that contribute to health disparities, such as lack of housing, transportation or connection to childcare, which can get in the way of achieving good health.  A few examples of services they provide include:

  • Helping patients set and reach health goals
  • Make and confirm doctor appointments
  • Secure transportation to and from the appointment
  • Monitor prescriptions
  • Coordinate lab testing
  • Linking patients to resources like housing, education, employment, and support groups

Partnering with Care Coordination and other area resources, Cornerstone’s Health Education Department assists patients on a much deeper level than education alone. One of the main goals of health education is to be a dynamic part of the integration of what it means to be healthy and to work with other departments to overcome the health disparities many people face in low socio-economic communities.

Macdonald came into class thinking that diabetes was a death sentence because of family history with the disease. “Cornerstone saved my life,” said Macdonald. “They really saved my life.”

Cornerstone Family Healthcare, Crystal Run Health Care, RECAP, and St. Luke’s Cornwall Hospital will be hosting a conference “Health Follows Wealth?” on April 7, 2017 to discuss the link between poverty and health outcomes. It is imperative to understand how one’s health is the nucleus that affects all other areas of life of a productive life. The goal of this discussion is to increase access to high-quality care, reduce barriers to receiving care, and ensure that all people are heard. For more information on the event please email

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Sound the Alarm: National Diabetes Alert Day

Held March 28, 2017, American Diabetes Association Alert Day is a day to sound the alarm about the prevalence of type 2 diabetes in American adults. An estimated 86 million Americans have prediabetes, and 90 percent of them don’t know they have it. Prediabetes can lead to type 2 diabetes and its many serious complications. It’s crucial for people to know their risk because prediabetes can be reversed with healthy food choices, weight loss, exercise, other lifestyle changes and medication.

Each year on the last Tuesday of March, American Diabetes Association Alert Day encourages everyone to take the Type 2 Diabetes Risk Test and participate in workplace-friendly activities that will teach them about reversing the risk for diabetes.

Cornerstone Family Healthcare hosts a weekly 12-week diabetes self-management program called Living Well with Diabetes to educate and assist patients with managing their diabetes, symptoms, and to help in keeping track of health goals. The ultimate goal of this program is to get diabetic patients to a point in their life where it is much easier for them to manage their condition on their own with confidence.

During the weekly sessions, the program works with patients with the following:

  • Check in with a health care provider and nutritionist
  • Peer support
  • Check in on self-management goals
  • Exercise such as Zumba, chair yoga, walking, tai chi
  • Stress reduction guided exercise
  • Healthy snacks
  • Free fruits and vegetables
  • Health related information to help participants stay on track with their goals and better manage diabetes or prediabetes
  • Assistance with making appointments to medical care

Living Well with Diabetes also hosts guest speakers such as Cornerstone’s Optometrist, the Cornell Cooperative Extension, and Shoprite’s Registered Dietitian for a grocery store tour.

Eligible participants may receive:

Upon completion of the program, participants receive a Certificate of Achievement on Personal Diabetes Management.

The next session of the program will begin in May 2017. Please call (845) 563-8043 or visit for more information!

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Spring is near! Do you suffer from allergies?






Monica Francis, PA

Runny nose. Itchy watery eyes. Sneezing, sneezing, and more sneezing. It doesn’t have to be this way though. There are ways to manage the health of yourself and your family for allergy season.

Common seasonal allergies are the body’s allergic response to an outside allergen. Grass, pollen and mold are the most common triggers of seasonal allergies. Spring allergies begin in February and last until the early summer.

Climate conditions such as humidity, wind, and rainfall can affect different allergen levels.

Allergies are usually self-diagnosable. Symptoms include sneezing, runny nose, red, watery, and itchy eyes. People may also experience pain in the ear, nasal congestion, loss of smell, redness, runny nose, post-nasal drip, sneezing, or stuffy nose. The eyes may become itchy, puffy, red, or watery. It is also common to start breathing through the mouth or wheezing, coughing, fatigue, headache, itching, phlegm, or throat irritation.

There are more than 3 million cases per year in the United States of seasonal allergies. They can be treated with common over-the-counter antihistamines. Self-care includes avoiding allergens and nasal washing with saline water/spray. Severe allergies may require consulting with your doctor and possibly skin testing to find out about specific allergens and how to better treat them.

Medical treatments include prescription antihistamine decongestants and in some cases a procedure called desensitization which reduces allergic reactions by gradually increasing doses of the substance causing the reaction by injection. Consult with your primary care physician who may refer you to an allergy and immunology doctor, pulmonologist or otolaryngologist for further evaluation and treatment.

You may also call Cornerstone Family Healthcare at (845) 563-8000 or visit for more information.

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A Balanced Bite for Spring

Registered Dietician Barbara Moschitta, MPS, RD, CDN 

Spring is less than two weeks away, so get your kitchen ready with some healthy, vibrant meal ideas!


Grilled Salmon Fillets, Asparagus and Onions






Nutrients per Serving:

  • 255 Calories
  • 8g Total Fat
  • 1g Saturated Fat
  • 35g Protein
  • 8g Carbohydrates
  • 86mg Cholesterol
  • 2g Dietary Fiber
  • 483mg Sodium

Dietary Exchange: 1 Vegetable and 4 Meat

Makes 6 servings


  • ½ teaspoon paprika
  • 6 salmon fillets (6-8 ounces each)
  • 1/3 cup bottled honey-Dijon marinade or barbecue sauce
  • 1 bunch (about 1 pound) fresh asparagus spears, ends trimmed
  • 1 large red or sweet onion, cut into ¼-inch slices
  • 1 tablespoon olive oil
  • Salt and black pepper


  1. Prepare grill for direct cooking. Sprinkle paprika over salmon fillets. Brush marinade over salmon; let stand at room temperature 15 minutes.
  2. Brush asparagus and onion slices with olive oil; season to taste with salt and pepper.
  3. Place salmon, skin side down, in center of grill rack. Place asparagus and onion slices around salmon. Grill, uncovered, 5 minutes. Turn salmon and vegetables. Grill 5 to 6 minutes more or until salmon flakes when tested with fork and vegetables are crisp-tender. Separate onion slices into rings; serve over asparagus.


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Advocacy Day 2017

Advocacy is an activity by an individual or group which aims to influence decisions within political, economic, and social systems and institutions. Grassroots Advocacy brings arguments for or against a specific issue directly to legislators and government officials. Government officials gain a deeper understanding of how issues affect the people of their district/state. An opportunity to influence decisions and be involved in a process for change.

What is Advocacy Day?

New York’s stated priority is to transform the health care system by providing access to high-quality, coordinated care through the integration of primary care and other community-based care; however, there has not been an equitable investment in the community-based health care sector to support this work.

Since 2014, 6% of the $2.8 billion allocated for healthcare transformation has gone to non-hospital community-based health care providers, including FQHCs. Community-based providers need access to resources to support transformation activities including integration of services, reimagined care coordination models in preparation for value based payment, modernization and expansion of facilities, and solidification of new and existing partnerships to address social determinations of health.

On Advocacy Day, New York health centers go to Albany to explain to our government officials the importance of health centers, what our mission is, and how we are working toward the same goal of transforming the health care system.

When is Advocacy Day?

Monday, March 6, 2017.

How can I advocate for health centers?

Even the people that support community health centers, but can’t attend in Albany have many options as to how to reach out to our elected officials and advocate!

Here are a few ways you could participate:

  • Utilize social media
  • Make an appointment to meet with local officials
  • Advocate in groups
  • Attend Town Hall meetings
  • Write a letter
  • Make a phone call

When speaking with elected officials, we have heard that making a phone call and an appointment to speak face-to-face are the most effective methods for advocating.

Using your voice and telling your story about how important community health centers are to you is what we need! Knowing how they have helped people in the community is what Advocacy Day is all about!

For more information about community health centers and Cornerstone Family Healthcare, please visit:

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Yong-Suk Zarski, PNP, DNP

What are Anxiety Disorders?

Anxiety is a normal emotion and is essential to our existence.  Everybody becomes anxious when they face difficulties or problems.  Commonly, anxiety is provoked when we feel something threatens our existence, security and self-identity. Examples include separation from our loved ones, fear of disapproval or humiliation, emotional or physical pain, loss of our function or job and fear of death.  We begin to experience anxiety when we are aware of our existence and consequently the vulnerability of self-preservation starting in early childhood.  Therefore, most anxiety disorders develop in childhood and can persist if not treated.  There are also various levels of intensity from mild to severe to full panic attacks.  These levels of anxiety are expressed differently through physical, behavioral, and emotional reactions.  A mild level of anxiety helps us to focus, motivate, and promote our growth.  However, when the level of anxiety becomes excessive, severe and chronic, it becomes debilitating, impacts our relationships and impairs our daily lives at work and school.

Signs and Symptoms of Anxiety Disorders

Anxiety disorders are a cluster of psychiatric disorders with symptoms that can present differently from person to person.   Despite various forms of anxiety disorder, there are shared symptoms including excessive fear, excessive anxiety, and related avoidance behaviors.  Generally, anxiety provokes physical, behavioral and emotional reactions.

Common physical symptoms of anxiety include:

  • Palpitations, headaches, or chest discomfort
  • Dizziness, nausea,  diarrhea, or sweating
  • Shakiness, difficult breathe, feeling of numbness or muscle tension
  • Fatigue or sleep trouble.

These symptoms are more characteristic in a person with panic episodes.  Emotional reactions include:

  • Difficulty controlling the anxiety
  • Irritability and restlessness
  • Lack of concentration
  • Feeling nervous and anxious
  • Feeling that awful things might happen in the future

These symptoms are easily recognized in a person with generalized anxiety disorder. The behavioral symptoms of anxiety which you can easily recognize in a person with a social anxiety disorder include:

  • Fear of objects, people or places
  • Obsessive or compulsive behaviors
  • Avoiding the public so a person does have to face the fear of being negatively judged, rejected or criticized by others. 

Treatment Options: Medication and Cognitive Behavioral Therapy

Anxiety disorders are usually treated with medication, therapy or both.  Presently, the treatment of anxiety can be quite effective if the therapy is combined with medication.

When to seek professional help?

When your anxiety symptoms become excessive and your reactions cause extreme distress or disrupts your daily life, it is critical to seek professional help. The earlier you receive the treatment, the quicker you can begin managing your anxiety. 

If you believe you are experiencing any of these symptoms please consult with a physician. You can also call Cornerstone Family Healthcare at (845) 563-8000 to make an appointment with a behavioral health specialist.

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How does stress affect your body?

We have all felt the impact of stress on our body one time or another whether we realized it or not. The Oxford dictionary defines “stress” as a state of mental or emotional strain or tension resulting from adverse or demanding circumstances. Below you will find a few examples of ways stress impacts your body.

Your Immune System

People under chronic stress are more susceptible to viral illnesses like influenza and the common cold. It increases risk of other opportunistic diseases and infections. It can also increase the time it takes to recover from illness or injury.

Your Muscular System

Under stress, your muscles tense up to protect themselves from injury. You’ve probably felt your muscles tighten up and release again once you relax. If you’re constantly under stress, your muscles don’t get the chance to relax. Tight muscles cause headaches, back and shoulder pain, and body aches.

Your Digestive System

Stress causes your liver to produce extra blood sugar (glucose) to give you a boost of energy. Unused blood sugar is reabsorbed by the body. If you’re under chronic stress, your body may not be able to keep up with this extra glucose surge, and you may be at an increased risk of developing type 2 diabetes.

The Center for Disease Control (CDC) lists common reactions to a stressful event as:

  • Disbelief and shock
  • Tension and irritability
  • Fear and anxiety about the future
  • Difficulty making decisions
  • Feeling numb
  • Loss of interest in normal activities
  • Loss of appetite
  • Nightmares and recurring thoughts about the event
  • Anger
  • Increased use of alcohol and drugs
  • Sadness and other symptoms of depression
  • Feeling powerless
  • Sleep problems
  • Headaches, back pains, and stomach problems
  • Trouble concentrating

Make sure you take time for yourself one in a while to avoid stress and figure out what works for you to relieve stress. If you believe that you are suffering from these symptoms, consult with your physician or call Cornerstone Family Healthcare at (845) 563-8000 to make an appointment today.

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Heart Disease Awareness

February is Heart Disease Awareness Month. About 610,000 Americans die from heart disease each year—that’s 1 in every 4 deaths. High blood pressure, high LDL cholesterol, and smoking are key heart disease risk factors for heart disease. About half of Americans (49%) have at least one of these three risk factors. If you have a medical condition like diabetes or are physically inactive, you can be at a higher risk of heart disease.

What can you do to make your heart healthy?

No Smoking: If you don’t smoke, don’t start. You should avoid secondhand smoke as best as you can.  Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot.  Atherosclerosis is a disease in which a waxy substance called plaque builds up in the arteries. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.

Healthy Diet: Choosing healthy meal and snack options can help you avoid heart disease. You should eat foods low in saturated fats, trans fat, and cholesterol can help prevent high cholesterol. For example, eating fish, fruits, vegetables, and whole grain foods can help your heart stay healthy. Something as simple as changing out white bread to whole wheat bread, using whole wheat pasta instead of regular pasta, and cooking brown rice instead of white rice can make your heart healthier.  Limiting salt in your diet also can lower your blood pressure. All these small changes to your diet can lead you to a life without heart disease.

Physical Activity: Physical activity can help you maintain a healthy weight and lower your blood pressure, cholesterol, and sugar levels. There are many types of exercise to keep your healthly depending on your physical capability. You can  go on a brisk walk or a similar moderate intensity workout. You could break it into 10-minute increments, 3 times a day. If you are physically able to run, 1 hour and 15 minutes would be enough every week for your aerobic workout. It is recommended that you do a muscle-strengthen activities on 2 or more days a week that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

Limit Alcohol Intake: Avoid drinking too much alcohol, which can raise your blood pressure. Men should have no more than 2 drinks per day, and women only 1. High blood pressure, heart disease, stroke, liver disease, and digestive problems are just a few of the long-term health risks that are associated with drinking.

Before starting any new diet and exercise program, please check with your doctor and clear any exercise and/or diet changes with them before beginning.

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Dental Hygiene for Children








Alban Burke, DDS, FACD

Every February is National Children’s Dental Health Month and time to remind everyone of the importance of dental care for our kids.

Did you know that according to the Centers for Disease Control and Prevention almost 20% of children between 2 and 19 have untreated cavities and that more than 50 million school hours are lost yearly due to dental pain?

Dental problems can contribute to poor eating habits due to pain, loss of sleep due to pain and loss of confidence due to the inability to talk or smile. This is why it is important to keep your teeth healthy and practice good eating habits.

When should I bring my child to see a dentist?

As soon as the first baby tooth appears so you can discuss proper brushing and the use of a smear of fluoridated toothpaste twice daily.

How can I keep my child’s teeth healthy?

Brushing for 2 minutes 2 times a day and visiting your dentist 2 times a year will make a huge difference in your child’s dental health.

Tips for keeping a healthy mouth?

  • The major enemy is SUGAR. The sugar in juice, formula and breast milk starts the cavities process in infancy.  For this reason, put babies to bed with a bottle of water only and limit the use of sippy cups with anything other than water at bedtime. Sugar is all around in children’s diets and giving teeth a bath in sugar is a sure way to get cavities.
  • Brush, brush, brush! Brush teeth for 2 minutes 2 times a day.
  • Go to the dentist twice a year.
  • Don’t let your young children brush their own teeth. Keeping your child’s teeth healthy is really a parent’s job until at least 10 years of age. Yes, they want to do it themselves at a pretty young age but really do not have the hand coordination to brush well until about 10 years of age. Parents have to check, at least nightly, and go over missed areas.

Every Tooth Counts; Drive for A Mobile Dental Van

In honoring our mission of providing quality, comprehensive, primary and preventative health care, the health center is looking to grow with a Mobile Dental Van.
This van would help conquer two obstacles: cost and accessibility. Many individuals in our community do not have the funds to cover dental visits so they simply stop going. Access to transportation is a major problem in our community; those who need and want to go to the dentist are not able to because they physically cannot get there.


Cornerstone Family Healthcare has three dental offices- two in Newburgh and one in Goshen.

We can help you keep your children’s teeth healthy. To make an appointment, please call (845) 563-8000.

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  • Blog Authors

  • Providers involved include:

    Monica Francis, PA

    Avi Silber, MD, FAAP
    Tracy Lucas, FNP
    Adeola Ayodeji, MD, FAAP

    Chanchal Singh, MD
    Sneha Shrivastava, MD
    Penelope Guccione, FNP

    Julie A. O’Connor, CM, LM, MS
    Marian Seliquini, CM, LM, MS

    Koreen E. Thomas, FNP
    Andrea Giovinazzo, FNP-C

    Kate Michalak L.Ac., RPAC

    Alban Burke, DDS

    Neha Dada, O.D.

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