our journey of literacy and community impact

In December 2024, the Montgomery County Imagination Library celebrates an incredible milestone—5 years of delivering the joy of reading to children across our community! Since 2019, the program has partnered with Dayton Children’s Hospital as its affiliate, providing access to high-quality, age-appropriate books to children ages 0-5, completely free of charge. 

What began as a vision to improve early childhood literacy has blossomed into a community-wide effort, reaching thousands of families. In the last five years, we’ve seen firsthand how the simple act of receiving a book in the mail can spark a lifelong love of reading in children. 

The excitement of opening the mailbox and discovering a new story to share at bedtime is more than just a routine—it’s an opportunity for families to bond, create lasting memories and build a foundation for future learning success.

the power of books for kids

The impact of the Imagination Library is undeniable. Research has shown that early exposure to books helps develop critical language and cognitive skills in young children, preparing them for kindergarten and beyond.

For many families, this program has made books more accessible, bridging the gap for children who might not have easy access to reading materials at home. 

But we can’t do it alone. As a community, we rely on the generous support of donors, volunteers and partners who believe in the power of books to shape a child’s future. To help us mark this special occasion, we invite you to join us in continuing this mission. Your donation to the program through the Dayton Foundation helps us deliver books to more children for years to come. For just $66, you can provide a child with books for 5 years—an investment that will spark a lifelong love of reading and learning. 

Donate today through the Dayton Foundation to support the Montgomery County Imagination Library. Click the link and use fund name: 1614 Montgomery County Imagination Library. 

join us in celebrating this milestone

As we reflect on the past five years, we want to express our deepest gratitude to the families, community partners and donors who have made this journey possible. Together, we’ve helped build a brighter future for the children of Montgomery County, one book at a time. 

Here’s to many more years of fostering a love of reading and making a lasting impact in our community. Thank you for being a part of this incredible journey! 

One of the most critical aspects of any surgery is anesthesia. Putting kids asleep and ensuring they stay asleep through surgery and wake up safely is a delicate balance that the anesthesiology team at Dayton Children’s manages each day with surgery patients.

The anesthesiology team at Dayton Children’s prepares for and treats each child and their unique needs. For Pedro and Augusto, the same rules applied.

All of the anesthesiologists at Dayton Children’s are pediatric board certified and only take care of children. Children have very different physiology as they grew from infants to adults. Therefore, they need an anesthesiologist who is trained in their special needs and how their bodies react differently to medications typically used during surgery.

Once the team knew the boys were coming to Dayton for surgery, the preparations began. We sat down with Dr. Sean Antosh, MD, pediatric anesthesiologist and lead for all things anesthesia when it came to the twins, to learn more about his approach for this case.

Tell us about the team involved in Pedro and Augusto’s care.

There was a dedicated team of six anesthesiologists and four nurse anesthetists who donated their time for the cases. The team rotated from case to case and I lead the team for every anesthetic.

Teams were always separated by blue and grey, to make sure we had a dedicated team per twin. We needed to have two anesthesia setups for every anesthetic, to include ventilators, medications, medication machines, etc. Additionally, we always had to be prepared for emergency separation if there was an issue where one or both twins needed resuscitation. 

What planning did you have to do prior to the surgeries?

The team planned for more than a year through extensive literature review of previous craniopagus twins and their anesthesia management. 

We also discussed with colleagues at other institutions about how they have taken care of similar patients in the past. 

How was medical imaging involved?

We created detailed step-by-step plans to walk through the anticipated course of events. We also conducted multiple practice sessions for each imaging study due to changes in location and setups.

During the first several anesthetics, we tested how long it took for a medication given to one twin to reach the other twin. This allowed us to determine the extent of the blood connection between the two and how each affected the other’s anesthetic. 

How did you practice in case of an emergency?  

At the core of our training were departmental and hospital wide mock codes to practice resuscitating the twins in case of an emergency.

A new “code blue double” was developed to notify the team that a code blue requiring more resources than typical was occurring. Specific color-coded team member role stickers were developed to facilitate the resuscitation of the twins and throughout the twin’s hospital stay, two defibrillators were always available at bedside, in case they were needed. 

watch the connected documentary

To learn more about Pedro and Augusto, watch the connected documentary today.

Boys beat the odds time and time again to be separated in a two-year, multi-surgery process

• In a groundbreaking, unprecedented series of surgeries, twin boys joined at the head were separated successfully.
• This type of connection is one of the rarest conditions; this surgery greatly enriches the slim body of knowledge available on successful separation for this condition.
• Extensive collaboration and planning helped give these boys the chance at more fulfilling and enriching lives.

Dayton Children’s Hospital premieres the hour-long documentary connected: the seemingly impossible separation of Pedro and Augusto, that follows the separation journey of the conjoined twins.

The 5-year-old boys came to Dayton Children’s in July 2021 joined at the top of the head with a 90 degree turn, classified as craniopagus O’Connell class III.

The condition is incredibly rare with an estimated 50 craniopagus twins born every year, with only an estimated 15 of those surviving more than a few months. The boys were separated over the course of two years and four major surgeries and returned home to their native country of Guatemala in June 2023.

“While we all fell in love with Pedro and Augusto during their time here, we are excited for them to return to their home country and culture,” says Ben Goodstein, vice president and chief ambulatory officer. “We will continue to keep an eye on them as their recovery process continues and enjoy their bright future ahead.”

The documentary chronicles the two years that surgeons and staff spent preparing and executing the series of separation surgeries for this rare and complex condition.

The documentary was produced and directed by Flyback Productions, a Chicago-based production company.

watch the trailer

“There is very little research or practical knowledge in medical literature about how to separate craniopagus twins, especially those who are connected at this angle,” says Robert Lober, MD, PhD, pediatric neurosurgeon for Dayton Children’s. “This documentary shows the real, sometimes overwhelming process of preparation, discovery and decisions that we went through for these boys, hopefully helping others born with this condition in the future.”

“While we prepared diligently, there were still surprises,” says Christopher Gordon, MD, chief of craniofacial and plastic surgery at Dayton Children’s. “Through it all, the boys were incredibly strong and their safety was our utmost concern.”

“The boys will steal your heart with their sweet giggles and dance parties,” says Elise Huntley, certified child life specialist. “They were incredibly strong – and sassy!”

the separation

Less than a third of craniopagus twins survive the first 30 days of life. Pedro and Augusto proved strong in beating those odds, but they were already starting to show signs of medical distress from sharing blood, brain and body functions.

Their family prayed for a way they could be separated, but it didn’t look likely. There have been very few surgeries on this type of connection and very little data available to gauge the likelihood of a successful separation.

After extensive testing, study and review, Drs. Lober and Gordon determined separation would be possible in a series of surgeries. The Dayton Children’s board of trustees agreed to the humanitarian effort that brought the boys to Dayton.

After two years, four surgeries and help from more than half a dozen organizations, the boys were officially separated at 5:43 am on April 8, 2022.

our deepest gratitude

Dayton Children’s thanks the world-class staff who dedicated their skills, minds and hearts to Pedro and Augusto. Our deepest gratitude also goes to the organizations without which this surgery would not have been possible:

• Kettering Health Network
• Hospital Roosevelt, Guatemala City
• The Connor Group
• 3D Systems
• Hologic
• Hope for Home Ministries 

The boys begin the next chapter of their lives back home in Guatemala as separate individuals but remain connected to the lives they touched here.

“Pedro and Augusto are forever in our hearts and will always have a second home in Dayton,” says Deborah A. Feldman, president and CEO for Dayton Children’s.

conjoined twin fast facts

The type of connection, the degree of connection, the sex of the children and their age at the time of the surgery make this one of the rarest separation surgeries in the world.

• Only an estimated 50 craniopagus conjoined twins are born every year. That’s 5% of all conjoined twins. Normally only 15 live longer than a month after birth
• Only 30% of conjoined twins are male
• Only 1 in 200,000 live births are conjoined twins

Do you ever ask yourself, “How do I motivate my teen?” Or maybe you’d say your teen is plenty motivated – to spend as much time as possible playing video games and to avoid undesired tasks like cleaning their room! Maybe you’ve tried offering incentives like hanging out with a friend, or maybe you’ve tried taking away privileges, like screen time.

Although these strategies can help short-term to increase motivation, it’s likely not kept up over time. This may be because teens go through a developmental shift from being motivated by external sources to being motivated by internal sources. What does that mean?

• External sources: Things like extra allowance, access to the family car, screen privileges
• Internal sources: Becoming good at something, achieving milestones related to future goals

External rewards will give your teen some momentum and are a starting point. But, they likely will not sustain motivation in the same way that internal sources will.

In other words, how do I get my teen to want to do better for themselves? 

1. Talk with your teen to find things they’re interested in and explore those. For example, maybe your teen’s school performance leaves something to be desired, but they want to go to a certain college. To help create internal motivation, you and your teen may meet with admissions from that college. They learn the GPA and course requirements for admission, and know that they have to achieve those to be accepted into that school. That desire to achieve their goal of being accepted is intrinsic motivation.
2. Set up your teen to experience positive learning experiences and successes. During the teenage years, executive functions are still developing. These executive functions play a large role in long-term motivation. Help increase self-motivation and influence further brain development by:
   • Recognizing your teen’s strengths
   • Relate current information to personally relevant material and situations
   • Set achievable goals that allow your teen to see progress. For instance, teens required to read a book each month can divide the number of pages over 20 days, write the pages on a chart and mark them off each day to observe their progress. Recognizing and seeing progress may help to increase your teen’s perseverance.
3. Balance necessary tasks with exploring personal interests. Help your teen find purpose in doing the “mundane” things they have to do, like doing chores or getting a job. Earning a paycheck is an external motivator. But also encourage your teen to explore their interests. This will help them develop a sense of independence and be more of an internal motivator. 
4. Allow teens to set time to accomplish goals and responsibilities.  Allowing teens to manage their time shifts the responsibility from parent to teen. Parents can provide specific expectations about what needs to be completed and a deadline for when it must be done. As teens demonstrate increased responsibility, they can be rewarded with additional desired privileges. 
5. Make room for open discussion. Explore with your teen other factors that might be impacting their motivation or perseverance. Encourage conversations about the possibility of depression symptoms, bullying and academic or extracurricular pressures. Provide support, if needed, in these situations. Consider scheduling with a therapist if it seems like there is something underlying your teen’s low motivation.

By allowing your teen more autonomy, setting achievable goals that result in positive learning experiences, connecting current demands with their personal interests and shifting the responsibility from parent to teen, you may help your teen experience a renewed sense of motivation and perseverance!