Pediatric Meltdown: Recent Episodes

Lia Gaggino

Tune in to Pediatric Meltdown and listen to experts provide insights and strategies on a wide variety of behavioral health and mental topics anytime and anywhere that fits your busy schedule. Guests include published researches, primary care colleagues, therapists, educators, parents and even patients. Caring for children and teens with major meltdowns, depression, suicidal ideation, anxiety, school struggles to name a few along with a myriad long list of behavioral and mental health concerns is daunting and most of us did not receive formal training in residency to prepare us to meet this need. Access to child psychiatry nationally is limited and in some regions just not available at all and as a result we must often provide what can only be called psychiatric care for our pediatric patients. In an effort to increase our understanding of behavioral and mental health assessment and treatment, we attend conferences, read articles, and participate in webinars. You can now add Pediatric Meltdown; the podcast dedicated to children's emotional well-being. Providing behavioral health care at its best is collaborative and connecting with others across disciplines enriches and enhances the care we provide. In the words of Maya Angelou "Do the best you can until you know better. Then when you know better, do better." Let's do better together!

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How do we address the often-overlooked sexual health needs of individuals with Autism Spectrum Disorder (ASD)?

Dr. Zakia Alavi, a seasoned child and adolescent psychiatrist specializing in pediatric mental health and developmental disabilities, joins Dr. Lia Gaggino to unpack this critical yet often neglected aspect of care for individuals on the autism spectrum. Drawing from her extensive experience in child and adolescent psychiatry, Dr. Alavi reveals the patterns she's observed in patient referrals, particularly concerning autism and behavior problems, including inappropriate sexual behavior. This frank discussion covers everything from understanding puberty in children with autism to addressing the complex challenges surrounding sexuality education for neurodivergent individuals.

Dr. Alavi emphasizes the need for tailored sexual health curricula and the importance of behavioral therapy for youth with autism to manage sexuality-related issues. She also touches on the pressing concern of victimization of youth on the autism spectrum and the role of promoting comprehensive sexual education for these youth..

Listen in and discover why Dr. Alavi believes sexuality is not just a basic human need, but a fundamental right for all, regardless of their neurodevelopmental status, including those with neurodevelopmental disorders like ASD.

[00:33 -10:59] Autistic Traits and Abuse Risk

  • Explores the higher risk of abuse due to social awareness and communication deficits in youth with autism.
  • Non-verbal children or those who misinterpret situations are especially vulnerable.
  • Defines sexual awareness as understanding feelings, desires, and sexual situations.
  • Highlights the struggle of youth on the autism spectrum in independently navigating sexual awareness.

[11:00 - 22:49] Discussion on Sexual Awareness

  • Defines sexual monitoring as understanding others' impacts on one's sexuality.
  • Emphasizes the importance of sexual assertiveness and consciousness for protection.
  • Single parents, in particular, may struggle with providing comprehensive sexual education.
  • Suggests the presence of another person during these discussions for better handling.

[22:50 -28:59] Victimization and the Role of Media

  • Notes the heightened risk of victimization, especially among females with autism spectrum disorders.
  • Emphasizes the need for protective measures and greater awareness.
  • Role of parents and educators in continual skill-building around privacy and sexual norms.
  • Suggests personalized approaches tailored to each child's level of understanding.

[29:00 - 32:13] Sexuality as a Human Right:

  • Encourage self-reflection about perspectives on sexuality for oneself and others.
  • Highlight the importance of helping children achieve their fullest potential in all aspects.
  • Reiterates the significance of protecting neurodiverse youth from victimization through education.
  • Encourages proactive approaches to ensure youth understand and navigate normal sexual behaviors

[32:14 - 40:00] Closing segment Takeaway

You can reach Dr. Zakia Alavi

LinkedIn: linkedin.com/in/zakia-alavi-7289a9118

Links to resources mentioned on the show

  • Socio-sexual functioning in autism spectrum disorder: A systematic review and meta-analyses of existing literature Grace I P Hancock 1, Mark A Stokes 1, Gary B Mesibov Socio-sexual functioning in autism spectrum disorder: A systematic review and meta-analyses of existing literature - PubMed (nih.gov)
  • Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence - a population-based prospective twin study. Ohlsson Gotby V, Lichtenstein P, Långström N, Pettersson E Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence - a population-based prospective twin study - PubMed (nih.gov)
  • Sexual knowledge and victimization in adults with autism spectrum disorders. Brown-Lavoie SM, Viecili MA, Weiss JA. Sexual knowledge and victimization in adults with autism spectrum disorders - PubMed (nih.gov)
  • Association of autistic traits in adulthood with childhood abuse, interpersonal victimization, and posttraumatic stress. Roberts AL, Koenen KC, Lyall K, Robinson EB, Weisskopf MG. Child Abuse Negl. 2015 Jul;45:135-42. doi: 10.1016/j.chiabu.2015.04.010. Epub 2015 May 6. PMID: 25957197; PMCID: PMC4784091. Association of autistic traits in adulthood with childhood abuse, interpersonal victimization, and posttraumatic stress - PubMed (nih.gov)
  • Sexuality and Relationship Education for Children and Adolescents with Autism Spectrum Disorders 1st Edition by Davida Hartman Sexuality and Relationship Education for Children and Adolescents With Autism Spectrum Disorders: Hartman, Davida: 9781849053853: Amazon.com: Books
  • Maggio MG, Calatozzo P, Cerasa A, Pioggia G, Quartarone A, Calabrò RS. Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue. Brain Sci. 2022 Oct 24;12(11):1427. doi: 10.3390/brainsci12111427. PMID: 36358354; PMCID: PMC9688284. Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue - PubMed (nih.gov)
  • What's Happening to Tom?: A Book About Puberty for Boys and Young Men with Autism and Related Conditions (Sexuality and Safety with Tom and Ellie) by Kate E. Reynolds What's Happening to Tom?: A book about puberty for boys and young men with autism and related conditions (Sexuality and Safety with Tom and Ellie): Reynolds, Kate E., Powell, Jonathon: 9781849055239: Amazon.com: Books
  • Things Ellie Likes: A Book About Sexuality for Girls and Young Women with Autism and Related Conditions (Sexuality and Safety with Tom and Ellie) by Kate Reynolds Things Ellie Likes: A book about sexuality and masturbation for girls and young women with autism and related conditions (Sexuality and Safety with Tom and Ellie): Reynolds, Kate E., Powell, Jonathon: 9781849055253: Amazon.com: Books

Other episodes you may like:

Episodes - Pediatric Meltdown

  1. Sexual Assault Services: Supporting Victims

  2. Fetal Alcohol Spectrum Disorders: Recognition Matters

  3. Parenting the Neurodivergent Child: What Pediatric Clinicians Need to Know

Key quotes for Twitter:

"We have to keep in mind that kids on the spectrum are not going to be able to navigate this landscape. This is so complex, and that they are going to need help with that."..Dr. Zakia Alavi on understanding sexual sensuality

"So, this sexual consciousness is linked with sexual assertiveness. Right? Because you feel a certain way and then you have to be assertive to express that this is what I feel and this is what I need, and this is where I'm going to go with that”…Dr. Zakia Alavi on sexual consciousness and assertiveness

FULL TRANSCRIPTS AVAILABLE UPON REQUEST

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Things Ellie Likes: A Book About Sexuality for Girls and Young Women with Autism and Related Conditions (Sexuality and Safety with Tom and Ellie)
What's Happening to Tom?: A Book About Puberty for Boys and Young Men with Autism and Related Conditions (Sexuality and Safety with Tom and Ellie)

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Vaccine Hesitancy and Refusal: Fact and Emotion

Have you ever wondered why vaccines spark such strong opinions, even as they play a pivotal role in infectious disease prevention and public health response?

Join Dr. Lia Gaggino and guest Dr. Robert Frenck as they unravel the complexities of vaccine hesitancy in our pandemic-prepared world. They delve into how the effectiveness of the COVID-19 vaccine and childhood vaccinations paradoxically fuels skepticism, and how public health communication strategies can bridge the gap between medical professionals and parents.

Dr. Frenck shares real-life stories and explains the benefits of childhood vaccinations, emphasizing straightforward conversation to discuss childhood vaccines including the COVID-19 vaccine, side effects, and the importance of herd immunity. Discover strategies for overcoming vaccine hesitancy and infectious disease outbreak management—listen now to rethink your understanding of vaccinations, their role in our society, and their impact on vaccine preventable disease outbreaks..

[00:33 -16:05] Vaccine Hesitancy and Public Health Challenges

  • Infectious diseases like respiratory illnesses, diarrheal diseases, and malaria are still leading causes of death in children globally.
  • Vaccines play a crucial role in protecting communities through herd immunity.
  • Skipping vaccines can have a significant impact on disease transmission and outbreaks.
  • Healthcare providers have an ethical duty to make recommendations and address vaccine hesitancy.

[16:06 - 26:41] Public Health Challenges: Overcoming Politicization and Misinformation

  • Recognize that infectious diseases do not discriminate based on political affiliation, race, religion, or other factors.
  • Address the concerning trend of public health becoming a political issue, rather than a matter of keeping everyone healthy.
  • Combat the misconception that vaccine-preventable diseases are gone or no longer a threat.
  • Highlight the need for expertise, coordination, and preparedness in public health responses to infectious diseases.

[26:42 -35:33] Mandatory Vaccination Policies for Healthcare Workers

  • Prioritizing workplace safety for patients, especially those with compromised immunity
  • Addressing concerns about mixed messaging from unvaccinated healthcare providers
  • Considering vaccination as a fundamental requirement for healthcare professions
  • Highlighting the ethical responsibility to protect vulnerable populations

[35:34 - 56:57] Pandemic Challenges: Adapting Medical Practices and Communication

  • Acknowledging the need to alter recommendations as new data emerges during a rapidly evolving pandemic situation.
  • Emphasizing the critical role of healthcare professionals as experts and trusted sources of information during public health crises.
  • Highlighting the ethical responsibility of leaders and public figures to prioritize public health over personal or political gain.
  • Underscoring the value of respectful dialogue, finding common ground, and starting from areas of agreement in addressing divisive issues.

[56:58 - 1:09:23] Closing segment Takeaway

You can reach Dr. Frenck

LinkedIn @Robert Frenck

Links to resources mentioned on the show

AAP Immunization Resources for Parents: https://www.aap.org/en/patient-care/immunizations/resources-for-families/?srsltid=AfmBOoqg265BoRsy-0HpDCWbRYTpOz0szrKiXfvGA6INfQPq9_cWXle4

AAP Immunization Resources for Clinicians on Vaccine Hesitancy: AAP Vaccine Hesitancy Guides for Clinicans

Other episodes you may like:

Episodes - Pediatric Meltdown

  1. Schizophrenia: Recognizing the Early Symptoms

  2. Early Child Development: Pandemic Impact and Reasons for Hope with Dr. Colleen Kraft

  3. Social Media: What are our kids up to and should we be worried?

Key quotes for Twitter:

"There's been study after study to show that the most respected source of information is your healthcare provider, that people come to us to take care of their children because they trust us."... Dr. Frenck on why you should trust your healthcare provider

"So to me, this was like the bottom of the 9th inning, 7th game of the world series, and you hit a walk off grand slam."... Dr. Frenck on how the COVID-19 Vaccine Was Developed So Quickly

FULL TRANSCRIPTS AVAILABLE UPON REQUEST

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Have you ever wondered how missing a few school days could dramatically alter a child's future?

In this eye-opening episode of Pediatric Meltdown, host Dr. Lia Gaggino and guest Dr. Heidi Schumacher unravel the staggering disparities in school quality and attendance amplified by the pandemic. As a general pediatrician and health policy advocate, Heidi discusses the urgent need for systemic support, the hidden toll of chronic absenteeism, and the crucial interventions needed to ensure educational equity.

While truancy often leads to punitive measures, chronic absenteeism requires a supportive and compassionate approach to unveil the deeper health and social issues behind missed school days. Pediatricians can play a transformative role by addressing these needs early, fostering environments where every child thrives. Are you curious about the actionable steps you can take to combat chronic absenteeism in your community? Listen to this episode now and empower yourself to make a difference!

[04:39 -15:21] Understanding Chronic Absenteeism in Schools

  • Chronic absenteeism differs from truancy and includes both excused and unexcused absences.
  • Chronic absenteeism is defined as missing about 18 school days a year, or approximately 10% of the school year.
  • The response to chronic absenteeism is more supportive rather than punitive, focusing on understanding and addressing family challenges.
  • Economic impacts of absenteeism include affecting educational opportunities and potential long-term financial stability.

[15:22 - 26:48] The Critical Role of Health Professionals in Boosting School Attendance

  • Clinical visits offer an opportunity to discuss the importance of regular school attendance with families.
  • Some clinics are piloting the addition of questions about missed school to pre-visit questionnaires or child check-ups.
  • By understanding the reasons behind missed school days, health practices can address specific needs that may hinder attendance.
  • Collaborating with school nurses and advocating for more healthcare resources in schools can improve attendance and engagement.

[26:49 -35:25] Addressing Barriers to School Attendance through Health and Community Support

  • Factors such as toxic exposures, food insecurity, and lack of reliable transportation are identified as key barriers that affect school attendance.
  • The lack of reliable electricity, food, and secure housing strongly correlates with issues in school attendance.
  • Pediatricians are encouraged to inquire about school attendance when they encounter social drivers or chronic conditions in children.
  • Understanding attendance patterns helps identify disparities in educational access related to health and social determinants.

[35:26 - 45:46] The Importance of School Attendance and Engagement Strategies

  • The Everyday Counts Summit emphasized the need for federal investments to support school reengagement and consistent attendance.
  • Leveraging pandemic recovery funds for enhancing school attendance and engagement has been a focus for many states.
  • Collaborative partnerships between government entities and organizations, like the American Academy of Pediatrics, are crucial.
  • Evidence-based interventions and localized data analysis are essential for closing equity and opportunity gaps.

[45:47 - 54:28] Closing segment Takeaway

You can reachDr. Heidi Schumacher

linkedin.com/in/heidi-schumacher-md-3504433

Links to resources mentioned on the show

AAP Policy Statement – The Link Between School Attendance and Good Health AAP PS on School Attendance

Every Day Counts Fact Sheet: https://www.whitehouse.gov/briefing-room/statements-releases/2024/05/15/fact-sheet-biden-harris-administration-announces-new-actions-and-resources-for-increasing-student-attendance-and-engagement-as-part-of-the-white-house-every-day-counts-summit/

School Attendance – What Every Parent Needs to Know Healthy Children.org School Absenteeism and What Parents Need to Know

Other episodes you may like:

Episodes - Pediatric Meltdown

145 Youth Opioid Use Disorder: What Primary Care Needs to Know

142 Difficult Childhood Behaviors: Meeting the Challenges of Parenting

129 Adolescent Confidentiality: To Share or Not to Share

Key quotes for Twitter:

"So now nationwide, about a quarter of students are chronically absent, meaning missing about a month or more of school."... Dr. Heidi Schumacher on the Chronic Absence in Schools

"If you focus on regularly getting to school as a marker of need, that can help you say, well, what role do we as the health care sector play, but what role can the school play?"....Dr. Heidi Schumacher on identifying unmet needs for the child who is chronically absent

FULL TRANSCRIPTS AVAILABLE UPON REQUEST

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Have you ever wondered how ancient practices like mindfulness and the Pranayama breathing technique could revolutionize the high-stress environments like the NICU?

In this episode, Dr. Nitin Ron, a neonatologist with a unique perspective, shares his journey of integrating meditation and compassionate care into his medical practice. From scaling Mount Everest to working in an art museum, Dr. Ron's multifaceted experiences have shaped his approach to healing. Discover how these techniques not only benefit patients but also provide crucial stress relief for healthcare workers, particularly during the challenging times of COVID-19. Learn about the science behind these practices and their potential to prevent burnout in medical professionals. This episode offers a rare glimpse into the transformative power of combining ancient wisdom with cutting-edge medicine, promising a new era of holistic healthcare that nurtures both patients and caregivers alike.

[05:42 -17:20] Awareness and Resilience in Pediatric Healthcare

  • Babies demonstrate an inspiring ability to have present moment awareness, even in challenging medical situations.
  • Healthcare professionals can find inspiration by observing the strength and resilience of babies in the NICU.
  • The ability of infants to smile despite medical interventions serves as a powerful lesson in maintaining a positive outlook.
  • The practice of pediatrics is referred to as a "calling" rather than just a job, emphasizing its profound impact on practitioners.

[17:21 - 23:54] Ancient Breathing Practices Meet Modern Medical Science

  • Pranayama, an ancient Indian breathing technique, has similarities with modern high-altitude acclimation methods
  • Research presented at the Pediatric Academic Society's meeting compared ancient pranayama to current medical science
  • The book serves as a textbook for meditation and pranayama research, as well as a practical guide
  • The project brought together contributors from four different countries, showcasing global collaboration in healthcare

[23:55 -44:47] COVID-19 Pandemic: Lessons in Isolation and Community Support

  • The pandemic highlighted the negative effects of isolation on human well-being
  • Children were particularly affected by the inability to see friends and grandparents
  • The crisis emphasized the crucial role of community in maintaining hope and mutual support
  • The experience reinforced the importance of human connection and support systems in healthcare

[44:48 - 55:17] Mindfulness and Meditation in Healthcare: Practical Applications

  • Even 3 minutes of watching thoughts without reacting can be beneficial
  • Regular practice of meditation helps maintain mental equilibrium, like a movie screen unaffected by the images
  • The intention to meditate and practice self-care is 95% of the journey towards happiness
  • Research shows brainwaves start changing in 6 weeks with just 8 minutes of practice once a week

[55:18 - 59:34] Closing segment Takeaway

Links to resources mentioned on the show

Book - Pranayam Breathing: Techniques for Health, Healing and Tranquility

Pranayam Breathing Techniques for Health, Healing and Tranquility: Dr. Pralhad Ron|Dr. Nitin Ron: Amazon.com: Books

Spiritual teacher: Ramana Maharshi

Links to some of Dr. Nitin Ron’s TED Talks:

  1. Saving Babies with Science and Kindness:

https://youtu.be/jGcL_nFDXGE

  1. Meditation and Science: Stories from a Newborn Intensive Care Unit and Mt. Everest:

https://youtu.be/PjgsreLQRPwBook - Pranayam Breathing: Techniques for Health, Healing and Tranquility

Pranayam Breathing Techniques for Health, Healing and Tranquility: Dr. Pralhad Ron|Dr. Nitin Ron: Amazon.com: Books

Spiritual teacher: Ramana Maharshi

Links to some of Dr. Nitin Ron’s TED Talks:

  1. Saving Babies with Science and Kindness:

https://youtu.be/jGcL_nFDXGE

  1. Meditation and Science: Stories from a Newborn Intensive Care Unit and Mt. Everest:

https://youtu.be/PjgsreLQRPw

Other episodes you may like:

Episodes - Pediatric Meltdown

  1. Recognizing Burnout in Healthcare: Strategies for Self-Care

  2. Burnout Prevention: A 15-Minute Game Changer

  3. Physician Wellness: Find Your ‘One Thing

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"We are talking 8 minutes of mindfulness meditation once a week. And at the end of 6 weeks, we decided to crunch the results including the surveys, including the EEGs. And even with this tiny little bit of meditation, the burnout seems to be improving.".... Dr. Nitin Ron on the benefits of Mindful Meditation

"Between every stimulus and response, you know, there is a space. In this space, we have the power to give our response, and in our response lies our growth and our freedom."....Dr. Nitin Ron on the secret of emotional resilience

FULL TRANSCRIPTS AVAILABLE UPON REQUEST

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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What happens when personal trauma intersects with professional purpose in the world of child psychiatry?

Discover the compelling story of Dr. Nancy Rappaport, who turned the tragedy of losing her mother to suicide into a life-long commitment to prevent similar losses in others. This podcast episode explores the intricate links between personal history and professional practice with a focus on child and family psychiatry. It illuminates the often-overlooked nuances of family dynamics, the importance of understanding children's challenging behaviors, and the sensitive discourse surrounding suicide prevention. The conversation unearths how small moments of humanity in therapy can bridge profound professional gaps and reinforce the resilience required in dealing with complex familial issues. Listeners will leave with a renewed understanding of why appropriate conversation about suicide is a poignant necessity in both clinical practice and families. Listen now to uncover insights that might just redefine the approach to mental health support.

[03:43 -12:26] Child Psychiatry & Personal History

  • September marks Suicide Prevention Awareness Month, underscoring the episode's thematic urgency.
  • Discussion on how her experiences informed her choice to focus on child psychiatry.
  • Importance of not using stigmatizing language like "committed suicide."
  • Emphasis on reducing stigma and opening dialogues about suicide.

[12:27 - 22:00] Trauma, Suicide, and Professional Development in Child Psychiatry

  • Personal experiences with trauma and loss can influence a therapist's approach to working with children and families
  • The saying "when someone dies by suicide, they take their skeleton and put it in your closet" highlights the complex impact on survivors
  • Shifting from individual therapy to family therapy can provide new insights into family dynamics and behaviors
  • Balancing personal emotional experiences with professional rigor is crucial in the field of child psychiatry

[22:01 -32:46] Childhood Behavior and Parenting Challenges

  • Strategies for pediatric clinicians dealing with suicidal patients.
  • The role of programs like the National Alliance on Mental Illness in aiding families with psychiatric issues.
  • The importance of local resources, like those in Boston, for mental health support.
  • Encouragement for clinicians to remind patients of their value, especially post-suicide attempts.

[32:47 - 41:46] Childhood Behavior and Parenting Challenges

  • The behavior code was written drawing on that was published in 2012. It's been on the bestseller of Harvard Ed Press for about 8 years.
  • It was written about angry kids, oppositional kids, kids with sexualized behavior, and kids with withdrawn behavior.
  • As parents, you're doing this dance, and then it's not perfect. Sometimes you step on each other's toes, but there is this room for repair.
  • You have to have a lot of humility when working with parents because Yes. We all are doing the best we can.

[41:47 - 48:19] Closing segment Takeaway

You can reach Dr. Nancy Rapaport

Email: nancy@nancyrapaport.com LinkedeIn: https://www.linkedin.com/in/nancy-rappaport-md

Links to resources mentioned on the show

Her website: https://www.nancyrappaport.com/

Dr. Nancy’s Books:

In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother’s Suicide

https://a.co/d/e3yxBD6

The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students. https://www.amazon.com/Behavior-Code-Practical-Understanding-Challenging/dp/1612501362

Other Books mentioned

To Scared to Cry by Lenore Terr: https://www.amazon.com/Too-Scared-Cry-Psychic-Childhood/dp/0465086446

Ghosts in the Nursery by Selma Fraiberg pdf: https://frcnca.org/wp-content/uploads/2017/03/Ghosts-in-the-nursery-paper-copy.pdf

Why People Die by Suicide by Thomas Joiner: https://www.amazon.com/Why-People-Suicide-Thomas-Joiner/dp/0674025490

Agencies:

NAMI – National Alliance on Mental Illness: https://www.nami.org

AFSP – American Foundation for Suicide Prevention: https://afsp.org

Other episodes you may like:

Episodes - Pediatric Meltdown

  1. Understanding Challenging Kids: The Behavior Code

  2. Suicide Prevention That Works: The Zero Suicide Framework

  3. Youth Suicide Prevention: Building Community Coalitions

  4. Suicide Prevention - Hope and Resilience: My Sister’s Story

Key quotes for Twitter:

"If you don't tell the child, then you run the risk of them overhearing it and you not being in control of the narrative."... Dr. Nancy Rappaport on what to tell the children

“Suicide is the tip of the iceberg. Often there's a lot more information.”.... Dr. Nancy Rappaport on Suicide Prevention Awareness

FULL TRANSCRIPTS AVAILABLE UPON REQUEST

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students
Why People Die by Suicide

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Have you ever wondered what keeps pediatricians going despite the challenges of modern healthcare? In this episode of the Pediatric Meltdown podcast, host Dr. Lia Gaggino celebrates four years of insightful conversations while going into the heart of pediatric practice. She talks about the delicate balance between technology and human connection, emphasizing the importance of creating space for magical moments with patients. From the joys of a baby's laughter to the struggles with electronic health records, Lia paints a vivid picture of the pediatric landscape. As she reflects on the evolution of her podcast and the field itself, one question emerges:

How can we preserve the magic of pediatrics in an increasingly technology driven world?

[00:33 - 03:02] Celebrating Four Years of Pediatric Insights

  • Reflection on the podcast's 4-year journey and growth
  • Gratitude for amazing guests and their contributions
  • Acknowledgment of initial challenges in podcast production
  • Introduction of the concept "joy of pediatrics" and "magic in the room"

[03:06 - 08:12] Balancing Technology and Patient Care

  • Importance of creating time for meaningful patient interactions
  • Challenges of electronic health records vs. paper charts
  • Encouragement to look away from screens during consultations
  • Hope for future improvements through AI scribing technology

[08:11 -10:19] Fostering Professional Growth and Community

  • Upcoming national meeting in Orlando for pediatric professionals
  • Invitation for listeners to connect with Lia at the event
  • Encouragement to find and create magical moments in practice
  • Teaser for interesting upcoming podcast guests

Links to resources mentioned on the show

Podcast Production

MouthyBroadMedia.com

Social Media Management

EC8Consulting@gmail.com

AAP

aap.org

2024 Practical Pediatrics CME Course - San Diego, CA2024 Practical Pediatrics CME Course - San Diego, CA | shopAAP

MIAAP

MIAAP

Other episodes you may like:

Episodes - Pediatric Meltdown

  1. Social Media and Families: Creating Culturally Relevant Content

  2. Social Media Dangers: Protecting and Educating Youth

Key quotes for Twitter:

"And I have to say, there was a lot of stuff I didn't know. Some of the episodes were pretty rough, but I have had just the most amazing guests."... Dr. Lia Gaggino reflecting on four years of the Pediatric Meltdown podcast.

"The AAP is the best because it is pediatricians. It's us. And there is just nothing better than being with other people who love children and love thinking about ways to make their world better and how to do a better job.".... Dr. Lia Gaggino reflecting on the importance of pediatricians connecting

FULL TRANSCRIPT WILL BE AVAILABLE UPON REQUEST

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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What if the key to being a better doctor lies in not being a doctor all the time?

Dr. Lia's solo episode of Pediatric Meltdown highlights the critical need for healthcare professionals to cultivate interests and experiences beyond their medical careers. She draws parallels to Mr. Rogers' iconic routine of changing into a cardigan, symbolizing the vital separation between work and personal life. From the joy of reading non-medical literature to the perspective-altering power of travel, Dr. Lia offers a blueprint for a more balanced, fulfilling life. She doesn't shy away from addressing the challenges of maintaining this balance but insists on its necessity. With practical advice and heartfelt wisdom, this episode is a wake-up call for healthcare professionals everywhere: Your life's story shouldn't be written solely in the pages of medical charts.

[01:21 -02:20] Life outside medicine: Why it's important

  • Set clear boundaries between work and personal life
  • Maintain balance to prevent burnout in medical career
  • Importance of having interests beyond healthcare

[02:21 - 08:10] Physician self-care: Reading and traveling experiences

  • Make time for non-medical reading, even in snippets
  • Travel to gain new perspectives and experiences
  • Don't postpone personal experiences for a "magical time"

[08:11 - 13:08] Work-life balance for healthcare professionals: Relationships

  • Nurture relationships outside the medical field
  • Make time for people despite demanding work schedule
  • Balance professional commitments with personal life

Resources mentioned on the show

aap.org

Other episodes mentioned on the show:

https://pediatricmeltdown.com/episodes

  1. Recognizing Burnout in Healthcare: Strategies for Self-Care

172 Burnout Prevention: A 15-Minute Game Changer

108 Physician Moral Injury: Healing the Healer

76 Pediatric Practice: Find Your Balance

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"There is just so much more to talk about than medical cases."... Dr. Lia Gaggino on Imposter syndrome in the medical field”... Dr. Lia Gaggino on the importance on non-medical friendships

"I've had a book group for going on 30 years, and there are 4 of us that are still from the original group. I love it. It's mostly to just see my friends and have great food and some wine."..Dr. Lia Gaggino on interests outside of the medical books.

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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Are you feeling overwhelmed by the constant need to prove your medical expertise?

In this week’s episode, Dr. Lia talks about the challenges and anxieties surrounding board certification for pediatricians, particularly focusing on the evolution of the MOCA peds program. She shares personal experiences with various certification methods, from proctored exams to open-book tests, highlighting the stress and self-doubt that often accompany these processes. The importance of continuous learning in the medical field is also mentioned, recommending resources like pediatric board review materials and various CME opportunities. You’ll hear Dr. Lia will also touch on the prevalence of imposter syndrome among medical professionals, reassuring listeners that it's normal to not know everything and encouraging them to ask for help when needed. Ultimately, she advocates for a balanced approach to professional development, acknowledging both the necessity of expertise and the reality of human limitations in medical practice.

[2:54 -05:07] The Evolution of Board Certification Methods

  • Proctored exams: Anxiety-inducing and challenging to concentrate
  • Open-book tests: Time-consuming but aligned with real-world practice
  • Return to proctored exams: Disliked by many professionals
  • MOCA Peds: A modern, quarterly assessment approach

[5:08 - 07:14] Navigating MOCA peds and Continuous Learning

  • Utilize pediatric board review materials for preparation
  • Approach questions as real-life cases, not trick questions
  • Take advantage of the 5-minute time limit per question
  • Embrace continuous learning through various CME opportunities

[07:15 - 12:30] Expanding Mental Health Knowledge in Pediatrics

  • Seek out mental health sessions at national conferences
  • Attend specialized mental health conferences for pediatricians
  • Consider long-term training programs like the REACH Institute
  • Utilize resources from AAP and ACAP for ongoing education

Resources mentioned on the show

MOCA-PBR www.pediatricsboardreview.com

Neuroscience Education Institute https://www.neiglobal.com/

REACH https://thereachinstitute.org/

nncpap.org

aap.org

aacap.org

AAP National Conference https://aapexperience.org/

Other episodes mentioned on the show:

https://pediatricmeltdown.com/episodes

  1. Physician Wellness Coaching: Proven Benefit!

  2. Anxiety? Inattention? Depression?: Prescribe Nature! Dr. Stacy Beller Stryker

  3. Pediatric Practices: Find Your Balance

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"You can't be a pediatrician, a nurse practitioner, or a PA without knowing stuff. I mean, you didn't just get there by accident. You didn't fool everybody."... Dr. Lia Gaggino on Imposter syndrome in the medical field

"I love MOCA peds. I think it's a great way to do board certification".. Dr. Lia Gaggino on Pediatric board certification

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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Have you ever wondered what parents truly desire from their pediatricians?

In this week's episode of Pediatric Meltdown, Dr. Lia goes into the heart of parental needs, drawing from her 34 years of experience and insights gleaned from her podcast interviews. She explores the universal desire for reassurance, the challenges of modern parenting in the age of social media, and the importance of fostering positive childhood experiences.

Dr. Lia emphasizes the critical role of relational health in supporting families, especially those facing adversity. She reminds us that the most powerful tool in a pediatrician's arsenal isn't fancy gadgets or cutting-edge treatments, but the ability to listen and validate parents' experiences. From navigating preschool expulsions to dealing with developmental milestones, this episode offers a compassionate perspective on the complexities of raising children. Whether you're a healthcare professional or a parent, this episode promises to leave you with valuable insights and a renewed appreciation for the power of human connection in pediatric care. Remember, in the journey of parenting, you're not alone – and sometimes, that's the most important message of all.

[0:00 -01:46] Observations from a Seasoned Pediatrician: Parental Needs

  • Episode focuses on what parents want most from pediatricians
  • Addresses the pressure parents face, especially from social media
  • Emphasizes that fancy gadgets aren't necessary; however, relationship with the baby is key

[1:47 - 17:48] Reassurance: The Foundation of Parent Support

  • Parents need reassurance that they're not failing
  • Importance of praising parents for their efforts
  • Reminder that the parent-child relationship is more important than material things

[17:48 - 18:29] Navigating Challenges: A Collaborative Approach

  • Addresses issues like preschool expulsions and daycare problems
  • Encourages pediatricians to "ride the ride" with parents
  • Suggests calling in reinforcements when needed (e.g., social work, community mental health)

[18:30 - 26:14] Building Relational Health and Positive Experiences

  • Focuses on fostering positive childhood experiences
  • Explains how supportive adults can help children overcome adversity
  • Emphasizes teaching parenting skills, as they're not innate

Resources mentioned on the show

https://www.healthychildren.org

The Healthy Children Podcast: Healthy Children (pod.link)

Other episodes mentioned on the show:

https://pediatricmeltdown.com/episodes

  1. Functional Neurologic Disorders: Recognition and Management

  2. Beyond Trauma: Strengthening the Caregiver-Infant Dyad

  3. Migraine Headaches: Assessment, Management and Relief

  4. The Mysteries of Abdominal Pain: Disorders of the Gut-Brain Interactions

  5. Chronic Pain Syndromes: Assessment and Management

  6. Palliative and Hospice Care: A Conversation on Grief and Joy

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"Vaccines are the most important public health endeavor that has ever occurred that has improved the lives of children and adults."... Dr. Lia Gaggino on the importance of Vaccines

"Be careful about what you see on social media because there will be some people that are touting, stuff like, this is the only way they can only have homemade organic food. And that's great if that's what you wanna do, but, you know, not everybody has the time or access to those sorts of things."....Dr. Lia Gaggino on the truth about feeding children

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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What if you could revolutionize healthcare communication for diverse communities with just a 90-second video?

That's exactly what Dr. Ripudaman Singh Minhas and his team are doing with their innovative approach to health education. Imagine a world where families can access vital health information in their native language, delivered by someone who looks like them and understands their cultural nuances. From TikTok-style snippets to in-depth Instagram lives, this initiative is breaking down barriers and building trust across various cultural and linguistic groups. With a focus on accessibility, hope, and cultural representation, they're transforming how health information is shared and received. By leveraging the power of "trusted messenger models" and collaborating with community advisory boards, they ensure that their content resonates deeply with their target audiences. From pediatricians to psychologists, a diverse team of over 60 clinicians volunteer their expertise to create content that's not just informative, but also engaging and culturally sensitive. This groundbreaking approach isn't just changing how we communicate health information – it's potentially saving lives, one short video at a time.

[02:06 -09:46] Cultural Representation in Online Health Resources

  • Created resources that were culturally responsive and adapted, translated where needed
  • Aimed to build rapport and trust, answering questions families had
  • Applied the trusted messenger model to an online space
  • Each channel has healthcare providers on screen who are from the communities they serve, communicating in bilingual channels where appropriate

[09:47 - 17:07] Social Media for Public Health: Innovative Content Strategies

  • Most videos are TikTok-style, 90 seconds long, offering quick bites of health content
  • Longer content, up to 45 minutes, delves into specific topics like speech delay or summer safety
  • Content is community-led, responding to questions and analytics from social media
  • Videos feature practitioners from the community, speaking in their native language

[17:08 - 21:26] Expanding Digital Health Education for Youth and Diverse Communities

  • Goal to create more channels and content for families in over 40 countries
  • Plans to develop content specifically for grandparents and fathers
  • Implementation of the Digital Health Youth Fellowship Program
  • Training young content creators on video creation, self-care, and critical information appraisal

[21:27 - 33:48] Social Media Impact on Pediatric Health Education

  • The project has seen significant impact in terms of audience reach and engagement.
  • Research is being conducted to evaluate how the project impacts parenting journeys.
  • A study is examining how social media was used as a tool in the resettlement process for families displaced by the war in Ukraine.
  • The project aims to do "microdoses of positive pediatric content" amidst other content families are scrolling through

[33:49 - 40:23] Closing segment Takeaways

Links to resources mentioned on the show

Newsletter Sign Up: Our Kids Health

Website: Our Kids Health - Our Kids Health

LinkedIn: www.linkedin.com/company/our-kids-health

Twitter/X: Our Kids' Health (@Our_KidsHealth) on X

Our Chapters: Our Kids' Health Network | Instagram | Linktree

Support our Work: Our Kids Health Hospital initiative

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Cultural Competency: Health Equity and Outcomes

  2. Social Media Dangers: Protecting and Educating Youth

  3. American Indian/Alaskan Native Youth: Beyond Adversity

  4. Racism, Medicine, and Transformation: Eliminating Health Disparities and Systemic Inequalities

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"We have a study right now through our Ukrainian Kids Health Channel looking at the experiences of families who were displaced during the onset of war in Ukraine and how social media was used as a tool as a part of the resettlement process with young children, and we're learning some really wonderful things about how we can leverage social media for good.".. Dr. Ripudaman Singh Minhas on how social media supports parenting

"When there's information that's coming out from mainstream institutions, there may be mistrust, it may be harder for families to take in that information as well." .. Dr. Ripudaman Singh Minhas on overcoming mistrust in healthcare

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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What life-saving benefits can psychopharmacology offer for mental health disorders postpartum?

In this week’s episode of Pediatric Meltdown, Dr. Lia Gaggino unravels the intense highs and lows of perinatal mood and anxiety disorders (PMADs), as she bravely shares her own struggles and triumphs. She highlights the crucial red flags that every parent and healthcare provider should recognize as well as practical strategies from top experts to enhance your clinical practice and better support families navigating this emotional landscape. With this useful advice and resources, Dr. Gaggino provides a beacon of hope and understanding for both healthcare professionals and new parents. Curious to discover the one tip that can transform your postpartum experience? Click here to learn more!

[0:04 - 06:07] Introduction to Perinatal Mood and Anxiety Disorders

  • The host recounts her personal experience with PMADs during her residency.
  • Discusses the struggle of timing motherhood with professional life.
  • The emotional and logistical challenges of pregnancy, delivery, and motherhood.

[06:08 - 13:12] Postpartum Challenges: Real-life Experiences

  • The intense anxiety and feelings of incompetence in the early postpartum period.
  • Support system breakdown: How a lack of nurturing support impacted mental health.
  • The importance of seeking professional help and the stigma surrounding it.

[13:13 - 17:03] Tools and Strategies for Managing PMADs

  • Routine screening for risk factors using tools like the Edinburgh Postnatal Depression Scale.
  • Normalizing conversations about PMADs with new parents and their partners.
  • Encouraging healthcare providers to ask the right questions to identify at-risk parents.

[17:04 - 22:38] Empowering Parents and Clinicians

  • The impact of social media and unrealistic expectations on new mothers.
  • Practical advice for partners and extended family members to support postpartum parents.
  • A call to action: Encouraging listeners to share their experiences and support each other.

Links to resources mentioned on the show

  • Edinburgh Postnatal Depression Scale: (https://psychology-tools.com/epds/)

  • Postpartum Support International: (https://www.postpartum.net)

  • Books by Karen Kleiman: (Amazon.com)

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Cultural Competency: Health Equity and Outcomes

175 Beyond Trauma: Strengthening the Caregiver-Infant Dyad

161 Menstrual Equity Changes Lives: The Power of Day

147 Racial Discrimination and Black Infant Morbidity and Mortality

134 Early Childhood Education: Empowering Parents

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"Because the reality is medication for mental health disorders can be life saving.".. Dr. Lia Gaggino on medication and postpartum depression

"Babies eat, sleep, cry, and poop. They don't smile at you to thank you. There's just not much interaction to begin with, and for some people, that's really hard."....Dr. Lia Gaggino on the reality of early parenthood

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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Have you ever wondered what it truly takes to support perinatal mental health in our communities?

This week’s episode goes into just that, featuring expert Kristina Ledlow, who emphasizes the power of community in addressing mental health needs for new mothers. Kristina and Dr. Lia explore the revolutionary risk assessment tool developed by Nancy Roberts, stressing the importance of concrete data in securing sustainable funding and resources. They discuss key strategies for overcoming perinatal mental health disparities, such as finding champions and building coalitions. Christina shares her vision of establishing a perinatal and infant mental health center, aiming to prioritize this crucial issue on both national and international levels. The conversation also explores the negative effects of healthcare silos and the transformative impact of interdisciplinary teamwork.

Furthermore, they tackle pressing issues like social media pressures, mommy shaming, and the fear surrounding perinatal mental health medications. Christina provides invaluable insights into creating a postpartum plan, leveraging support systems, and the indispensable role of partners. From online support groups through Postpartum Support International (PSI) to dedicated resources in multiple languages, this episode is a comprehensive guide to improving perinatal mental health for all.

[05:27 -14:30] The Importance of Community and Data

  • Risk Assessment Tool: Discussion on Nancy Roberts’ risk assessment tool, highlighting the significance of obtaining tangible numbers and statistics.
  • Championing the Cause: Finding champions, leveraging clout, and building coalitions are essential for addressing perinatal mental health disparities.
  • Sustainable Funding: Emphasizes the need for sustainable funding beyond grants.
  • Communication and Collaboration: Impacts of interdisciplinary teamwork in healthcare, importance of breaking down silos.

[14:31 - 23:38] The Role of Therapy and Medication

  • Medication During Pregnancy: Concerns about medication during pregnancy and the benefits of therapy and medications in treatment.
  • Postpartum Plan: Creating a postpartum plan prioritizing sleep, nutrition, and support from visitors.
  • Online Support Groups: Availability of online support groups through PSI, offering spaces of unconditional acceptance and healing.
  • Mental Health Hotline: Use of resources like PSI's consult lines and maternal mental health hotlines that support in various languages.

[23:39 - 34:13] Addressing Disparities and Systemic Racism

  • Systemic Racism's Impact: Impact of systemic racism, lack of healthcare access, and generational trauma.
  • NICU Family Stress: Stress experienced by families of color in NICUs and the need for inclusive care.
  • Healthcare Professional Support: Role of healthcare professionals in supporting parents and infants, involving families in decision-making.
  • PSI Support Groups: Online support groups for partners, LGBTQ+ individuals, and Spanish-speaking groups for better inclusivity..

[34:14 - 46:19] Building a Community-centric Postpartum Program

  • Local and National Aspirations: Sharing aspirations for establishing a local perinatal and infant mental health center and advocating on a larger scale.
  • Postpartum Challenges: Common challenges for new parents: lack of sleep, postpartum expectations, and pressures from social media.
  • Postpartum Planning: Encouragement to create a postpartum plan and make use of resources like the free postpartum planning class.
  • Role of Partners: Discussing the critical role of dads and partners in supporting new mothers and planning.

[46:20 - 54:50] Closing segment Takeaways

Links to resources mentioned on the show

Postpartum Support International – PSI https://www.postpartum.net

PSI Perinatal Consultation Line: https://www.postpartum.net/professionals/perinatal-psychiatric-consult-line/

PSI call or text support line – 800-944-4473, Spanish language line available for text 901-203-7773

National Network of Child Psychiatry Access Programs (many have perinatal support as well). www.nncpap.org

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Cultural Competency: Health Equity and Outcomes

175 Beyond Trauma: Strengthening the Caregiver-Infant Dyad

161 Menstrual Equity Changes Lives: The Power of Day

147 Racial Discrimination and Black Infant Morbidity and Mortality

134 Early Childhood Education: Empowering Parents

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

“Knowing that I'm not alone is so helpful. And I think the extraordinary piece of it for me on a personal level is that I have also found a lot of healing in these groups."... Kristina Ledlow on unconditional acceptance and healing

"We were able to demonstrate that need in our community by first starting out with a community support group."...Kristina Ledlow on the power of community

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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How can primary care providers better educate themselves about functional neurologic disorders to reduce stigma and support quicker treatment for their patients?

Ever wondered why some neurologic symptoms defy typical diagnostic tests? This week's episode of Pediatric Meltdown will talk about this mystery with guests Dr. Sarah Dixon and Dr. Alex Gamber, two experts in pediatric neurology. Through their expert insights, you'll learn about the difference between epileptic seizures and FND spells, and the importance of therapeutic approaches like cognitive behavioral therapy. With actionable advice for primary care providers and families alike, this episode is a treasure trove of knowledge. Learn about innovative treatment strategies and why understanding both the psychological and neurobiological aspects is so essential. Curious to know the ultimate strategies for tackling FND symptoms? tap on PLAY to discover the key clinical pearls now!

[04:31 -14:11] Defining Pediatric Functional Neurologic Disorders (FND)

  • FND is a group of conditions causing nervous system symptoms without structural abnormalities.
  • They result from malfunctions in how information is transmitted and received in the brain.
  • The symptoms do not arise due to any other neurologic disorder.
  • It represents an undamaged brain experiencing processing issues.

[14:12 - 25:52] Diagnostic Approaches for Functional Neurologic Disorders in Pediatrics

  • Subconscious learned motor patterns play a significant role in FND.
  • Resting state functional connectivity MRI studies show increased connectivity between emotional processing centers and motor control networks in FND patients.
  • Functional movement disorders, including functional tremor and tics, exhibit distinct physical exam findings.
  • Neurologists heavily rely on physical exam findings to diagnose functional disorders.

[25:53 - 34:46] Understanding Psychogenic Non-Epileptic Spells in FND Management

  • Addressing the need for effective treatment interventions.
  • Ensuring that patient and family concerns are acknowledged and managed.
  • Importance of patient education in understanding their condition.
  • Strategies for managing subacute subconscious pressure or stress in patients.

[34:47 - 45:48] Effective Communication in Diagnosing Pediatric FND

  • Emphasize the importance of clear and compassionate communication when suspecting Functional Neurologic Disorder (FND) in pediatric patients.
  • Highlight how setting the stage correctly can significantly influence the patient's treatment, prognosis, and overall improvement.
  • Include educational information in the referral note to neurology, detailing the basics of FND diagnosis and the treatment plan.
  • Use the referral note to walk through clinical reasoning and explain the natural history of FND.

[45:49 - 54:16] Closing segment Takeaways

Links to resources mentioned on the show

Taking Control of Your Seizures: Workbook

Joel M. Reiter, Donna Andrews, Charlotte Reiter, W. Curt LaFrance, JR

https://www.amazon.com/Taking-Control-Your-Seizures-Treatments/dp/019933501X

Neurosymptoms.org

FNDhope.org

Epilepsy Foundation: https://www.epilepsy.com/stories/truth-about-psychogenic-nonepileptic-seizures

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. PANDAS and PANS: Non-pharmacologic Treatment

  2. PANS and PANDAS (pt 2 of 2

152 The Mysteries of Abdominal Pain: Disorders of the Gut-Brain Interactions

125 Tic Disorders: TikTok Tics

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

“This is a true entity that exists on a neurobiologic chemical level, but we just aren't using these types of diagnostic tools in common practice to reach this diagnosis."...Dr. Sarah Dixon on the science behind FND diagnosis

"Functional tremor is pretty easy to distinguish for us in the office from other causes of tremor that are more insidious and would warrant imaging."... Dr. Alex Gamber on understanding functional tremors

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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This week we’re tackling the critical issue of child sexual abuse prevention. The conversation goes into various aspects, including the prevalence of sexual abuse among children and the different levels of sexual behaviors in children—normative, cautionary, and problematic. Understanding these distinctions is essential for proper management and intervention. Special guests, experts Dannielle Kostrab-Boyd and Sherri Killiah, who work with sexual assault services, share invaluable insights. They reveal alarming statistics and underscore the pediatricians' role in preventing abuse through early intervention. We also highlight the need for open communication on body safety, urging parents to create a safe and trusting environment for their children.

The episode provides an in-depth look at the services offered by Sexual Assault Nurse Examiners (SANE), covering the meticulous process of forensic examinations in child abuse cases. The discussion underscores the critical need for a compassionate and non-judgmental approach to both care and communication. By fostering open lines of communication and ensuring education on body autonomy for kids, we aim to arm parents, healthcare providers, and specialized services with the tools needed to effectively address and prevent child sexual abuse. To understand the collective effort required to support and protect the most vulnerable members of our society, just tap on “play”

[02:58-17:33 Importance of Recognizing Child Sexual Abuse

  • Prevalence of Child Sexual Abuse: 1 in 10 children will experience sexual abuse before the age of 18, a statistic likely underestimated.
  • Age Range of Affected Individuals: Victims can range from as young as 5-6 weeks to 96 years old.

  • Levels of Sexualized Behaviors:

  • Normative: Voluntary, infrequent, easily redirected behaviors with familiar children.

  • Cautionary: Behaviors occurring in inappropriate places, increasing in frequency and involving technology.

  • Problematic: Behaviors involving self-harm, coercion, and inappropriate sexual content for the child’s age.

[17:34 - 32:25] Emotional and Psychological Impact of Abuse

  • Behavioral Changes: Indicators include regression, depression, anxiety, and fear.
  • Physical Symptoms: Nightmares, bedwetting, and advanced sexual knowledge are common signs.
  • Educational and Social Challenges: Difficulties in school performance and peer relationships.
  • Clinical Guidance: Clinicians should prioritize open communication, ask about behavioral changes, and provide a private space for discussions.

[32:26 - 48:19] The Role of Pediatricians in Prevention

  • Resource: Pediatricians should ensure prevention information is accessible in waiting rooms, including books and posters.
  • Building Trust: Establish a safe, trusting relationship with both caregivers and children.
  • Body Autonomy : Encourage expectations for body autonomy and offer choices during examinations, especially private areas.
  • Correct Terminology: Using correct medical terminology and explaining the necessity of examinations to create a safe space

[48:20 - 51:01] Available Resources and Support Services

  • SANE Program: Regional program providing specialized medical and forensic exams, victim advocacy, provides empowerment-based care, emotional support, and follow-up for survivors.
  • 24-Hour Crisis Line: Immediate support available through a crisis hotline.
  • Comprehensive Services: Individual, family, and group counseling, children’s advocacy center, and prevention programming.
  • National Resources: Accessing services through national organizations and text messaging options for wider reach.

[51:02 - 58:07] Closing segment Takeaways

Links to resources mentioned on the show

International Association of Forensic Nursing

https://www.forensicnurses.org/

Academy of Forensic Nursing

https://www.goafn.org/

International Association of Forensic Nurses - Research.Educate.Lead

RAINN: National Hotline 1-800-656-4673, RAINN | The nation's largest anti-sexual violence organization and online.rainn.org (chat)

National Sexual Violence Resource Center: www.nsvrc.org

National Children’s Alliance: Homepage - National Children's Alliance (nationalchildrensalliance.org)

National Children’s Advocacy Center: www.nationalcac.org

Darkness To Light: Resources - Darkness to Light (d2l.org)

The Mama Bear Effect: Home - The Mama Bear Effect

The National Center on the Sexual Behavior of Youth: www.ncsby.org

Office for Victims of Crime Training and Technical Assistance: www.ovcttac.gov

Michigan Resources:

SAS Business office (269) 245-3925

SAS 24/7 crisis-line: 1-888-383-2192

State Sexual Assault Crisis Hotline: 855-864-2374, 855-VOICES4

Michigan Coalition Ending Domestic and Sexual Violence: https://mcedsv.org

Michigan Victim Advocacy Network: https://mivan.org

Children’s Advocacy Centers of Michigan: https://cacmi.org

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Healthy Social Media Use: A Doctor's Perspective!

  2. Social Media Dangers: Protecting and Educating Youth

  3. Social Media: Guidance for Youth and Families

  4. Social Media and Kids: The Big Picture

  5. Child Abuse and Neglect: Asking the Hard Questions

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"1 think that I really like about the RAINN's contact information is that they also have a chat option, and a text messaging option. So for people that are not comfortable speaking the words or calling a number, they can also just text or chat to get those resources or the support that they need.".. Sherri Killiah on Tech savvy support

"Anytime a survivor or victim goes in to make a police report that they have the option to have that victim advocate present for them.".. Dannielle Kostrab-Boyd on supporting survivors every step of the way

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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In this milestone episode of Pediatric Meltdown, host Dr. Lia Gaggino takes a few minutes and celebrates an incredible achievement—reaching episode #200 and marking nearly four years of engaging, insightful, and impactful discussions centered on children’s mental health and emotional well-being. She expresses profound gratitude to her global audience, spanning six continents, and reflects on the journey that has brought her and her listeners to this point.

Dr. Gaggino reminisces about some of her favorite episodes and gives thanks to her mentor Mark Sloane who inspired her venture into mental health. She also extends her appreciation to the many pediatricians, mental health clinicians, and parents who have contributed to the podcast, advocating for better mental health care for children.

In closing, Dr. Gaggino encourages listeners to continue their journey together, emphasizing the unique position they hold in making a positive impact on children's lives. She invites them to explore her new initiative, the Building Better Workflows podcast and workbook, and hints at future episodes filled with practical strategies and heartfelt conversations.

Referenced in this Episode :

https://pediatricmeltdown.com/episodes

01 Words Matter- Talking about Weight and BMI

02 Caring for Children in Foster and Kinship Care with Moira Szilagyi

03 Pediatric Hero: Building Safe Spaces for Kids Emotions with Dr. Mark Sloane

29 Goldilocks, Tigger and Eeyore: Regulation and Childhood Behaviors

128 Trauma and Resilience: “Connect Before You Correct”

114 Palliative and Hospice Care: A Conversation on Grief and Joy

Building Better Workflows Podcast

Building Better Workflows

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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Imagine a world where children with OCD and Tourette’s can manage their symptoms without relying solely on medications. In this episode of Pediatric Meltdown, we explore innovative interventions like Habit Reversal Training and ERP Therapy that offer new hope for young patients. Dr. Lia’s guest is a listener’s favorite, Dr. Colleen Cullinan. She has a gift for taking you inside the child’s mind and telling you exactly what they’re thinking. She’ll talk about the profound impact of intentional, compassionate care and the crucial role of family support in the treatment process. Tune in to discover effective strategies for tackling the emotional and psychological struggles these children face and how these methods pave the way for lasting improvements.

[03:13 -17:21] Understanding Isolation and Negative Reinforcement in Mental Health

  • Concept of breaking the cycle of negative reinforcement and the importance of compassionate interventions.
  • Connection between emotional regulation in various scenarios and therapies like cognitive behavioral therapy and acceptance and commitment therapy.
  • Discussion on how the brain’s problem-solving nature struggles with internal experiences, leading to anxiety.
  • Therapies offer solutions that counter the brain's intuitive problem-solving approach.

[17:22 - 29:42] Exposure and Response Prevention (ERP) for OCD

  • Emphasis on intentionally facing fears without engaging in compulsive behaviors.
  • Insights into how ERP can be rewarding for families affected by OCD.
  • Challenges and solutions in treating internal obsessions and related mental compulsions.
  • Significance of ERP in helping individuals understand their fears are not dangerous.

[29:43 - 41:52] Nonpharmacologic Therapies for OCD, Tics, and Tourette's

  • Overview of therapies like exposure and response prevention, habit reversal training, and comprehensive behavioral intervention for tics.
  • Discussion of the non-logical and visceral nature of these behaviors and breaking the cycle of negative reinforcement.
  • Strategies for managing compulsive skin picking, including competing responses and awareness.
  • Practice and gradual exposure to triggers as critical parts of treatment.

[41:53 - 55:12] Resources and Tools for Comprehensive Behavioral Intervention for Tics

  • Introduction to CBIT as a detailed treatment involving awareness building and breaking down tics.
  • Challenges in finding CBIT-trained therapists and resources to locate such providers.
  • Mention of the Tourette Association of America and the TLC Foundation for Body Focused Repetitive Behaviors.
  • University training programs in clinical psychology as potential access points for therapists trained in habit reversal training.

[55:13 - 59:58] Closing segment Takeaways

Links to resources mentioned on the show

International OCD Foundation: https://iocdf.org

Tourette’s Association of America: https://tourette.org

TLC Foundation for Body-Focused Repetitive Behaviors https://www.bfrb.org

AACAP Facts for Families OCD: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Obsessive-Compulsive-Disorder-In-Children-And-Adolescents-060.aspx

Other episodes with Dr. Cullinan you may like:

https://pediatricmeltdown.com/episodes

120 ADHD: Part 4 Executive Function (pt4)

119 ADHD Part 3: Executive Function (pt3)

109 ADHD Symptoms: Executive Functions Part II

088 ADHD: Strategies for Boosting Executive Function

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

“Tics and Tourette's are very difficult. Of all of these disorders that we're talking about, which I think are all sort of habit-ish disorders, we're going to pick a label, which is not perfect, but it's the one I've selected at this moment."...Dr. Colleen Cullinan on the difficulty of treating these type of disorders

"A body focused; repetitive behavior can take up to 40 weeks to break. It requires a tremendous amount of practice, and I don't know if you've ever tried to teach a child anything. But if they're not motivated, they're not going to be into it.".. Dr. Colleen Cullinan on breaking long-term habits in children

*Transcript of Episode Available upon email request -* gagginol@gmail.com ****

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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In this second part of a 2-part series from last week’s show, host Dr. Lia talks with Dr. Erica Greenberg about some of the surprising research looking at the association between autoimmune and inflammatory conditions and higher rates of OCD. Dr. Greenberg discusses the neuroscience around OCD from genetic to environmental factors, and the puzzling overlap of symptoms in disorders like Tourette's and OCD. She stresses the crucial need for interdisciplinary research to shed further light on these intricate associations.

You’ll get insights into why certain treatments are recommended with caution and why controversy still remains around PANDAS and the desperate need for collaboration and comprehensive research to truly understand these complex conditions. You’ll also hear about the role of stress-induced inflammatory responses and how they render some individuals more susceptible to immune-related dysfunctions, shedding light on the significant impact of environmental factors like lead exposure on basal ganglia circuitry. Dr. Lia’s conversation with Dr. Greenberg reveals the interconnected nature of disorders such as OCD, Tourette syndrome, and other neuropsychiatric ailments, underscoring the necessity for further research.

Conversations like these illuminate the path forward, emphasizing that the key to understanding and treating these conditions lies in collaborative research efforts across various disciplines.

[01:46 -12:40] Understanding PANDAS and PANS Origins and Symptoms

  • PANDAS is specifically linked to post-infectious streptococcal etiology.
  • PANDAS involves the sudden onset of tics and/or OCD.
  • PANS shares a similar characteristic of sudden, rapid onset of a complex of symptoms.
  • Importance of understanding the specific triggers and symptoms associated with both PANDAS and PANS.

[12:41 - 23:32] Understanding the Clinical Outcomes of PANS/PANDAS Treatment

  • Sudden onset of symptoms such as tics, OCD, and separation anxiety is notable in these conditions.
  • Some children experience complete recovery back to baseline after antibiotic treatment within a week.
  • There is ongoing research into the different potential clinical courses following a PANS/PANDAS diagnosis.
  • Emphasis on the importance of recognizing and understanding the diverse range of clinical outcomes.

[23:33 - 35:37] Genetic and Environmental Influences on OCD and Tourette Syndrome

  • Studies show significant associations between OCD, Tourette syndrome, and increased rates of throat infections.
  • Research indicates higher odds ratios of developing OCD and Tourette in youth with infection histories.
  • A dose-response relationship exists between strep infections and OCD/Tourette symptom severity.
  • Studies find higher rates of autoimmune disorders in individuals with OCD and Tourette and their family members.

[35:38 - 48:00] Key Information and Challenges Surrounding PANS and PANDAS

  • Need for more thoughtful, nuanced, safe, appropriate information for parents.
  • There's evidence that PANS and PANDAS have a more negative impact on families compared to typical OCD
  • OCD and Tourette syndrome develop slowly, while PANS and PANDAS show abrupt changes.
  • Families face significant trauma, especially when providers dismiss their concerns.

[48:01 - 55:17] Closing segment Takeaways

Links to resources mentioned on the show

Erica Greenberg, MD PANDA AND PANS Presentation Swipe Files

https://docs.google.com/presentation/d/1Y_uVCLAjkTyZmPXnCSYCF5fg5eztefAH/edit?usp=sharing&ouid=116318706458170612793&rtpof=true&sd=true

Treatment of PANDAS and PANS: a systematic review

https://drive.google.com/file/d/1mpi3BSX2qQ-zHFpX9a5yNMUWDHkyC7hU/view?usp=sharing

Specialty knowledge and competency standards for pharmacotherapy for

adult obsessive-compulsive disorder

https://drive.google.com/file/d/1AExt8PTbVbwBYXgWqxwI_bcW8T04yA62/view?usp=sharing

JAP Treatment Guidelines

JCAP Treatment Guidelines - Part I–Psychiatric and Behavioral Interventions https://drive.google.com/file/d/15fgJGFDZ-tf8wmbgAihXoIU6OGR1oyB8/view?usp=sharing

JCAP Treatment Guidelines - Part II–Use of Immunomodulatory Therapies

https://drive.google.com/file/d/1NT0RLn4xp1nT7h0_n5u4MyGcTDcaXW_2/view?usp=sharing

JCAP Treatment Guidelines - Part III–Treatment and Prevention of Infections

https://drive.google.com/file/d/1DGUxCxkol8LFdKyzAYRNHIeVhO1RMqzp/view?usp=sharing

Quote from Christopher Pittenger, MD, Ph.D.

“The nature of this immune dysregulation, whether it exists in all patients or in a subset, whether it is causally associated with disease onset or progression, and whether it is a specific cause of disease, a nonspecific exacerbating factor, or an epiphenomenal, consequence of other pathophysiological events remain unclear”.

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Tics, Tourette’s and OCD

  2. Explosive Outbursts in Kids: Guide to Diagnosis and Treatment

  3. ADHD: Strategies for Boosting Executive Function

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"If in the setting of a traumatic event, if one has an inflammatory response, we know that stress does that, and these kids may be more vulnerable to immune related dysfunction in the setting of stress responses."... Dr. Erica Greenberg on the link between trauma and OCD

"And I think when you think that a child's disruptive behavior is because they're trying to manipulate you, you immediately stop being curious and you feel punitive.".... Dr. Erica Greenberg on Understanding PANDAS/PANS Diagnosis

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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How do mental compulsions, such as intrusive sexual thoughts and reassurance-seeking behaviors, manifest in children with OCD?

What are some common co-occurring conditions with OCD in children, and how do they complicate diagnosis and treatment?

These questions are answered in this week's episode of Pediatric Meltdown, where Lia sits down with child psychiatry expert Dr. Erica Greenberg to unravel the complexities of obsessive-compulsive disorder (OCD) in children. Dr. Greenberg shares her journey into child psychiatry and sheds light on the diagnostic criteria for OCD, the common and individual themes that kids with this condition struggle with, and the impact OCD has on their lives. Erica explains the common categories like contamination and intrusive thoughts and dispels myths regarding the treatment and prognosis of pediatric OCD. By discussing various treatment strategies, from exposure response prevention therapy to medication options, this episode underscores the importance of comprehensive care. For parents and caregivers, recognizing the early signs and seeking appropriate treatment can make all the difference in a child's developmental journey. Curious about an unconventional strategy that’s making waves in OCD treatment? This episode is the ultimate guide!

[03:22 -18:14] OCD Symptoms in Children: Key Diagnostic Criteria and Common Presentations

  • To diagnose OCD, a child must have obsessions and/or compulsions, which are often both present.
  • Obsessions are unwanted, repetitive, intrusive ideas, thoughts, images, or urges that cause significant distress.
  • Compulsions are behaviors, either mental or physical, performed to get rid of the distress caused by obsessions.
  • Examples of mental compulsions include body checking and repetitive counting to alleviate intrusive thoughts.

[18:15 - 28:13] Impact of OCD on Daily Life and Family Dynamics

  • OCD can consume significant time daily, impacting children’s social and developmental trajectories.
  • Children may miss social cues or avoid activities due to obsessions, leading to social withdrawal and alienation.
  • Constant reassurance seeking from peers can alienate children, exacerbating their fears of social rejection.
  • OCD affects families, often leading to strained relationships and the need for family involvement in therapy.

[28:14 - 37:32] Medication Treatment for Pediatric OCD: Key Insights

  • SSRIs are the main medication used to treat OCD in children, with common choices including fluoxetine, sertraline, and escitalopram.
  • Studies show that most of the beneficial effects of SSRIs can be observed within the first 2 to 4 weeks of treatment.
  • Higher doses of SSRIs may be necessary for some children, but it's important to monitor for any side effects, especially activation symptoms in younger kids.
  • The combination of fluvoxamine and clomipramine may be beneficial, though fluvoxamine is not inherently superior to other SSRIs for OCD treatment.

[37:33 - 55:37] The Relationship Between Tourette Syndrome and OCD in Children

  • Tourette syndrome involves at least two motor tics and one vocal tic for a duration of at least a year, which can overlap significantly with OCD symptoms.
  • Tics are suggestible and can be simple (e.g., shoulder shrug) or complex (e.g., more deliberate movements or sounds), making them sometimes hard to distinguish from OCD compulsions.
  • Up to 85% of individuals with Tourette syndrome have a co-occurring condition, with OCD being a common comorbidity.
  • The presence of tics often signals the need to monitor for other conditions such as ADHD, anxiety, mood dysregulation, and sensory hypersensitivity.

[55:38 - 01:02:21] Closing segment Takeaways

Links to resources mentioned on the show

Tourette Association of America: https://tourette.org

AACAP Resources Center: https://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Obsessive_Compulsive_Disorder_Resource_Center/Home.aspx

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Understanding Challenging Kids: The Behavior Code

133 Tantrums, Difficult Behaviors, “Red Alerts”: Using the “Smart Brain” for Problem Solving

125 Tic Disorders: TikTok Tics

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"The takeaway shouldn't be, like, the trauma leads, the trauma causes the OCD symptoms.".... Dr. Erica Greenberg on the relationship between trauma and OCD

"You don’t wanna push just for the sake of pushing to get to a high dose because OCD needs high doses. You wanna see something and then try to get to the lowest effective dose.".... Dr. Erica Greenberg on balancing medication for OCD

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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How can primary care providers and pediatricians play a role in educating families and children about the importance of sleep and identifying sleep issues early on?

Join Dr. Lia and her guest, Sleep expert, Dr. Jess Shatkin have the answers to that question and many more! This episode delves into various aspects of pediatric sleep health, from exploring pediatric sleep medications to offering practical tips on establishing solid sleep hygiene for kids. Understanding the intricate relationship between children's sleep disorders and their mental health is crucial for providing comprehensive care to children and adolescents. Dr. Jess's insights into the effectiveness of Cognitive Behavioral Therapy for Insomnia (CBTI) highlight effective treatment strategies that emphasize long-term well-being over quick fixes. By incorporating sleep education, implementing evidence-based approaches like CBTI, and advocating for holistic health practices, we can pave the way for a brighter, more well-rested future for our youth. Join us in unraveling the mysteries of pediatric sleep problems and mental health, and discover the transformative power of a good night's rest!

[03:13 -13:50] Understanding Pediatric Insomnia and Its Prevalence

  • Insomnia is identified as the most common pediatric sleep problem.
  • Highlighted the essential nature of sleep for both kids and adults.
  • Emphasis on the importance of routine for improving sleep in children.
  • Discussion emphasizes the various factors impacting sleep quality and quantity.

[13:51 - 29:50] Pediatric Sleep Hygiene and Its Limitations

  • Sleep hygiene is frequently discussed as an essential component of managing sleep problems.
  • The data supporting the effectiveness of sleep hygiene on its own is not promising.
  • Integrating sleep hygiene with CBTI can lead to better outcomes for children.
  • It’s crucial to combine different strategies to effectively manage pediatric sleep problems.

[29:51 - 38:21] Finding a Therapist for Cognitive Behavioral Therapy for Insomnia (CBTI)

  • It can be challenging to find professionals specializing in CBTI.
  • Resources for locating CBTI therapists may be limited.
  • Workshops on CBTI are conducted at annual conventions.
  • Preparing through sleep education is crucial for effective CBTI..

[38:22 - 58:42] Addressing Sleep Problems in Children with Psychiatric Disorders

  • Children often present with sleep issues when treated for other conditions like ADHD or depression.
  • Sleep problems are common among these pediatric patients, even if not the primary reason for consultation.
  • Many children are already deeply entrenched in sleep medication routines before they receive specialized care.
  • CBTI techniques in treatment routines for children suffering from psychiatric disorders is suggested.

[58:43 - 1:08:20] Closing segment Takeaways

Links to resources mentioned on the show

His website:Dr. Jess P. Shatkin - Home (drjesspshatkin.com)

Host of About Our Kids on Doctor Radio SiriusXM 110

FB: Facebook

X (Twitter) @‌DrJessPShatkin LInkedIn: linkedin.com/in/jess-shatkin-9a854232

Check out his music on Spotify, iTunes, YouTube, Amazon, Pandora, etc.

Books:

Child and Adolescent Mental Health

https://www.amazon.com/Child-Adolescent-Mental-Health-All/dp/1324031085/ref=monarch_sidesheet

Born To Be Wild - Why Teens Take Risks, and How We Can Help Keep Them Safe

https://www.amazon.com/Born-Be-Wild-Teens-Risks/dp/0143129805/ref=monarch_sidesheet

Other episodes you may like:

https://pediatricmeltdown.com/episodes

150 Integrating Behavioral Health: PCP Transformation!

  1. Trouble With a Child's Sleep? If They Snore, Do More! Dr. Hovig Artinian

  2. The 3 B's - Brain, Body, Behavior: Managing Anxiety

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"With CBTI, they have just as many or just as fewer awakenings in the middle of the night with CBTI as they do with sleeping medications, including the Z drugs and benzodiazepines."... Dr. Jess Shatkin on CBTI vs. sleeping medications: what's more effective?

"Aerobic exercise is as good for anxiety and depression, at diagnosable mild and moderate levels as is anything else we can do with therapy or medicine” … Dr. Jess Shatkin on the mental health benefits of exercise

*Transcript of Episode Available upon request*

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

Born to Be Wild: Why Teens Take Risks, and How We Can Help Keep Them Safe

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Summary:

In this special episode of Pediatric Meltdown where Dr. Lia shares personal insights and heartfelt reflections on the journey of parenting adult children and stepping into the joyous role of a grandparent. As Lia celebrates her birthday, she takes a moment to delve into the complexities and rewards of these intergenerational family relationships. Grandparenting tips are sprinkled throughout the episode, offering valuable advice to listeners who are navigating similar life stages. She emphasizes the importance of balancing advice and support for adult children, noting how her preferred approach is to offer help only when asked. Lia draws from one of her favorite books, "Walking on Eggshells, Parenting Your Adult Child," which underscores the wisdom of refraining from unsolicited advice and simply being present when needed.

This approach, she finds, is essential to maintaining healthy and respectful relationships with adult children. She candidly admits to having been a helicopter parent at times, but stresses that letting children face challenges and failures is crucial for their growth and independence. Lia's reflections eloquently capture the essence of parenting adult children by acknowledging that each generation might do things differently but with the same core love and intent. In essence, her stories remind listeners that letting go is part of the process, and it is often the hardest, yet most rewarding part of parenting adult children. Her reflections serve as a gentle reminder of the importance of savoring these precious intergenerational family relationships and the joy they bring, a fitting contemplation as she marks another year of her life's journey.

Bullet points of key topics

  • Reflections on Parenting and Grandparenting and the Impact on Mental Health
  • Parenting Adult Children and advice from her favorite book.
  • Respecting children’s different parenting methods.

Calls to action:

  • Click Here for your BBW Workbook
  • Click here for your Freebie #1
  • Click here for your Freebie #2
  • Book a Discovery Call Here

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Are you a pediatric care provider feeling overwhelmed by complex mental health cases? Discover a solution that’s transforming pediatric care in Michigan and beyond! In the latest episode of Pediatric Meltdown, Alyssa Wealty and Dr. Nasuh Malas teach us about the MC3 program (Michigan Child Collaborative Care) and how it’s making waves by providing tools like the Clinical Pearls educational series, that’s proving to be a lifeline for primary care providers who are grappling with mental health issues in young patients. From leveraging expert consultations to utilizing targeted educational resources, and handling cases of anxiety, aggression, or substance use, this episode is a gold mine for those on the front lines of pediatric health care. At the center of MC3’s offerings is the power of connection and education. Like addressing urgent mental health needs in pediatric settings or providing accessible educational tools like the Clinical Pearls video series. No matter where you are in your healthcare journey, the MC3 resources offer concise, expert-driven advice that can dramatically improve your care strategies. Interested in enhancing your clinical skills with quick, impactful lessons? Get your pen and paper ready. This episode is packed with information.

PRO Tip: These resources aren't limited to healthcare professionals; parents and educators can gain insights too!

[03:47 -09:04] Integrating Mental Health Education in Primary Care

  • Designed to deliver concise insights on common pediatric mental health conditions for primary care providers.
  • The program's educational component underscores the importance of mental health knowledge in primary care.
  • Enhances primary care providers' ability to diagnose and manage pediatric mental health.
  • Program grows to support schools and perinatal care providers for integrated mental health.

[09:05- 21:28] Clinical Pearls Series - A Resource for Pediatric Mental Health Education

  • "Clinical Pearls" features key learning videos on fundamental mental health topics.
  • The series includes a resource list and self-assessment for provider education.
  • It enriches learning with extra materials alongside the main videos.
  • The series is accessible globally, benefiting clinicians in Michigan and worldwide.

[19:18 -29:30] Advancing Primary Care through Educational Support and Teleconsultation

  • Primary care providers get guidance on conducting thorough evaluations with fellow mental health professionals.
  • Feedback from participants in the MC3 program informs the creation of practice-enhancing content.
  • Merging mental health and primary care responds to the need for increased support in managing pediatric cases.
  • The MC3 teleconsultation service outreach includes critical care points,like emergency rooms and schools.

[29:31 - 33:11] Closing segment Takeaway

Links to resources mentioned on the show

  • MC3: https://mc3michigan.org
  • MC3 Clinical Pearls: https://mc3michigan.org/clinical-pearls-video-series/

Other episodes you may like:

For all episodes, go to Episodes - Pediatric Meltdown

Ep #139 School Based Health: Literally Meeting Kids Where They Are!

Ep #128 Trauma and Resilience: “Connect Before You Correct”

Building Better Workflows Podcast

Building Better Workflows

Key quotes for Twitter:

"We have a lot of educational offerings as well as resources, so we are always looking for efficient ways to share that information. Obviously, email is a cheap way to do that."...Alyssa Wealty on the digital marketing that MC3 is utilizing

"A lot of our primary care providers are really leaning in despite some discomfort or limited training into caring for youth with mental health needs."... Dr. Nasuh Malas on the adaptability in primary care

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Tune into this week’s episode where we sit down with the Dr. Nancy Rappaport, who shares her groundbreaking approach to comprehending and managing children’s behaviors, including anxiety-related and oppositional tendencies as well as the theory of why stepping back as a parent and allowing your children to encounter and navigate challenges by themselves is crucial for their development. Dr. Rappaport provides an in-depth look at how structured environments and small rituals can significantly improve how children cope with everyday stresses and transitions. From addressing the influences of trauma to understanding normal age-appropriate curiosity, Dr. Rappaport provides a balanced perspective on navigating sensitive topics. She emphasizes the necessity of not misinterpreting behavioral cues, as they can vary significantly depending on a child’s personal experiences and challenges. Are you ready to learn how to respond playfully and effectively to children’s complicated behaviors? Tune in to gain unique strategies that could not only revolutionize your approach to parenting but alter how you perceive and interact with childhood behaviors forever!

[03:13 -19:31] Understanding and Managing Anxiety-Related Behaviors in Children

  • Discussion on how unstructured times, transitions, social demands, and unexpected changes can trigger anxiety-related behaviors in children.
  • Emphasis on the importance of creating structured environments during typically unstructured times to provide stability for anxious children.
  • Introduction of tools like emotional thermometers and comfort boxes to help children manage their anxiety.
  • Strategies for preparing anxious children for impending changes to reduce stress and behavioral issues.

[19:31 - 32:18] Addressing Oppositional Behaviors in Children

  • Exploration of the antecedents to oppositional behaviors, including environmental triggers and emotional distress.
  • The use of encouragement cards, affirmations, and undirected play to positively influence children's behaviors.
  • Importance of understanding the meaning behind behavior as a form of communication rather than simply reacting to the behavior itself.
  • Psychological insights revealing that a third of children who completed suicide had shown oppositional behaviors.

[32:19 - 46:04] Strategies for Building Rapport with Withdrawn Children

  • Not making assumptions about withdrawn behaviors, as these can vary drastically between children.
  • Insights into how parents' personal characteristics can influence their perception of a child's withdrawn behavior.
  • Methods for engaging withdrawn children in communication and activities at a pace comfortable for the child.
  • Highlighting the reasons behind withdrawn behavior, including possible underlying health issues or past traumas.

[46:05 - 50:06] Effective Use and Concerns of Medications in Managing Child Behavior

  • The use of stimulant medication and its effects on participation in regular classroom activities and field trips.
  • Overprescription of antipsychotic medications for behavior management and the ensuing need for skill-building and robust support systems.
  • Contrast between the child psychiatrists and pediatricians to behavior management and the synergies of their collaboration.
  • The value of pediatricians in the ongoing health and wellness journey of children, especially aligned with psychiatric insights.

[50:07 - 57:37] Closing segment Takeaways

Links to resources mentioned on the show

Her website: https://www.nancyrappaport.com/

Behavior Code resources: https://www.nancyrappaport.com/writing/books/

Youtube: https://www.youtube.com/channel/UC-XFOQcPLNFFUzWnUiuwrdQ

Books:

The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students. https://www.amazon.com/Behavior-Code-Practical-Understanding-Challenging/dp/1612501362

In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother’s Suicide

https://a.co/d/e3yxBD6

Ross Greene: The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children https://a.co/d/9PLG7cZ

Building Better Workflows Podcast

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Explosive Outbursts in Kids: Guide to Diagnosis and Treatment

  2. ADHD: Strategies for Boosting Executive Function

  3. The 3 B's - Brain, Body, Behavior: Managing Anxiety

Key quotes for Twitter:

“I don't think we do enough praising young people for the sacrifices that they were willing to make. That were sort of imposed on them. But, they stayed home sometimes for a year, 2 years to keep us safe”…. Dr. Nancy Rappaport on recognizing young people's contributions during the Pandemic

"And I think when you think that a child's disruptive behavior is because they're trying to manipulate you, you immediately stop being curious and you feel punitive.".... Dr. Nancy Rappaport on understanding childhood behavior

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Behavior Code: A Practical Guide to Understanding and Teaching the Most Challenging Students

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In this episode of Pediatric Meltdown, we dive into the complexities of disruptive mood dysregulation disorder (DMDD) and how the DSM-5's new classification aims to solve the puzzle of childhood bipolar misdiagnosis by distinguishing DMDD from other behavioral disorders like conduct disorder and oppositional defiant disorder. Join host Dr. Lia Gaggino and child psychiatry expert Gabreilla Carlson as they explore the intricate challenges of diagnosing and treating irritability and outbursts in children. This episode is essential for anyone struggling to understand or manage aggressive behavior in children, providing a roadmap to better interventions and outcomes. You’ll find that today’s discussion with Dr. Gabreilla will bring some much-needed clarity to the often-misunderstood world of Conduct Disorder.

[03:21-05:54] Understanding Disruptive Mood Dysregulation Disorder (DMDD)

  • Concerns of overdiagnosis of bipolar disorder in children as per changes in DSM-5.
  • Discusses the need for a "diagnostic home" for children exhibiting chronic irritability and frequent outbursts.
  • Differentiates DMDD from bipolar disorder, highlighting less episodic mood change and more persistent irritability.
  • Discusses using medical and psychiatric collaborative approaches for accurate diagnosis.

[05:55 - 18:49] Diagnostic Challenges in Pediatric Psychiatry

  • Explores the complexity of diagnosing behavioral disorders in children, stressing the influence of parental worries.
  • Differences between conduct disorder and oppositional defiant disorder in the context of purposeful aggression and core outbursts.
  • Highlights how the underestimation of trauma impacts behavioral assessments.
  • descriptive codes to assist in more accurate diagnosing, particularly in children with overlapping symptoms.

[18:50 - 33:15] The Role of Environmental Factors and Parental Involvement

  • Discussion on the triggers and antecedents in aggressive behavior management in pediatric patients.
  • Examines the impact of environmental factors, especially in relation to ADHD and pediatric bipolar disorder.
  • Highlights parental involvement as crucial in the management and treatment of behavioral issues.
  • The challenges of finding effective medication for aggression treating irritability specifically in relation to autism.

[33:16 - 4613] Resources and Treatment Approaches in Child Psychiatry

  • Details on Gabreilla's routine evaluation process including her developed rating scale ‘emo eye’.
  • The utility of the ACAP (American Academy of Child and Adolescent Psychiatry) Resource Center resources for clinicians and families. ACAP Resource Center
  • Talks about the necessity of evidence-backed treatment options and FDA approvals for therapy tools.
  • Covers the importance of educating parents using resources such as medication guides available through ACAP.

[46:14 - 55:23] Closing segment Takeaway

Links to resources mentioned on the show

AACAP Outbursts, Irriitability, and Emotional Dysregulation Resource Center:

https://www.aacap.org/AACAP/Families_Youth/Resource_Centers/AACAP/Families_and_Youth/Resource_Centers/Emotional_Dysregulation/Home.aspx

AACAP Parent’s Medication Guide: https://www.aacap.org/AACAP/Families_and_Youth/Family_Resources/Parents_Medication_Guides.aspx

AACAP Facts for Families: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Layout/FFF_Guide-01.aspx

ACCAP Emotional Outburst Inventory: https://www.aacap.org/App_Themes/AACAP/Docs/resource_centers/emotional_dysregulation/irritability%20questionnaire-parent_version.pdf

Other episodes you may like:

https://pediatricmeltdown.com/episodes

142 Difficult Childhood Behaviors: Meeting the Challenges of Parenting

134 Early Childhood Education: Empowering Parents

112 Schizophrenia: Recognizing the Early Symptoms

Key quotes for Twitter:

"So with conduct disorder, you have much more of instrumental or purposeful aggression."... Gabrielle Carlson on understanding conduct disorder

“With a bipolar disorder, you often have to follow the kid and and you get a family history, but you don't always have a good family history”….Gabrielle Carlson on the importance of family history

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Are you navigating the complex world of psychiatric medication management in primary care? Look no further! In this episode of Pediatric Meltdown Dr. Lia talks frankly about the hesitancy of pediatric clinicians to prescribe psychotropic medications as one of the biggest barriers to providing mental health care in pediatric settings. While she acknowledges that pediatricians are not child psychiatrists, Dr. Lia believes that pediatricians have the skills to address common mental health disorders including ADHD, anxiety and depression, and to do it well. She emphasizes the need to be mindful of suicide risk and to screen regularly for suicidal ideation, especially in patients with mental health disorders. And, always consider trauma when assessing for mental health and behavior concerns. When it comes to prescribing medications, get comfortable with a few SSRI’s and both stimulant and non-stimulant ADHD treatments, and before switching from one psychotropic to another, she advises maximizing dosing titration while simultaneously monitoring for side effects. Remember that in your role as a primary care provider, you have an incredible opportunity to impact the stability and quality of life for children facing mental health struggles. For more tips, expert advice and in-depth knowledge, don't hesitate to explore all of the resources available at pediatricmeltdown.com. Know better, do better!

[01:26 -03:50] Understanding the Role of Medication

  • Primary care providers don't need to be psychiatrists but should be equipped to prescribe SSRIs.
  • Familiarize yourself with a few SSRIs such as fluoxetine, escitalopram, and sertraline and understand their characteristics.
  • It’s vital to maximize doses carefully before switching between medications and to be aware of side effects.

[03:51 - 06:18] Navigating ADHD Medication Challenges

  • Not all cases of ADHD are straightforward; comorbid conditions can complicate diagnosis and treatment.
  • Stimulant medications can quickly indicate effectiveness; doses should be carefully adjusted based on response.
  • Monitoring for side effects such as appetite loss, weight changes, and sleep disturbances is necessary.

[06:19 - 10:44] Managing Complex Cases and Atypicals

  • Always explore the possibility of trauma influencing behavioral symptoms, as it can mimic various conditions.
  • Exercise caution when inheriting a patient on multiple medications; consult specialists rather than abruptly stopping treatment.
  • Monitor physical health markers when prescribing Atypicals like hemoglobin A1C, lipids, and prolactin levels, considering adjunctive treatments like Metformin.

Links to resources mentioned on the show

Episode #44 with Dr. Jeffrey Strawn. Anxiety Disorders in Children: Treatment Options https://pediatricmeltdown.com/44-anxiety-disorders-in-children-treatment-pearls/

Episode #37 with Dr. Lisa Horowitz. Screening For Suicide Risk Using the Ask Suicide Screening Questions Tool

https://pediatricmeltdown.com/37-screening-youth-for-suicide-risk-using-the-ask-suicide-screening-questions-tool/

Episode #132 with Dr. Brooks Keeshin. Psychopharmacology: Considerations Before Prescribing

https://pediatricmeltdown.com/132-psychopharmacology-considerations-before-prescribing/

Stephen Stahl’s Prescriber’s Guide

https://www.amazon.com/Prescribers-Guide-Stahls-Essential-Psychopharmacology/dp/1108926010

AACAP Facts for Families: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Layout/FFF_Guide-01.aspx

National Network of Child Psychiatry Access Programs www.nncpap.org/map

Key quotes for Twitter:

"I like Stephen Stahl's, “Prescriber's Guide”, and it's really got nice information.".... Dr. Lia Gaggino on her medication guide preference

"I think my biggest message to you about psychotropic medication is don't be afraid to prescribe."...Dr. Lia Gaggino advice to clinicians

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Hey, Healthcare Heroes, are you neglecting this critical aspect of your life?" In this episode of Pediatric Meltdown, host Dr. Lia Gaggino, teams up with the renowned psychologist Dr. Karen Doll to discuss the mental health strategies essential for every healthcare worker. This conversation is a game-changer as they talk about the systemic neglect that is pushing healthcare professionals to the brink, and the institutional changes urgently needed to address this perilous oversight. The impact of psychological fitness on both our personal and professional lives can no longer be an afterthought. Empowering medical professionals to not just survive, but thrive, is a cause we are passionate about here at Pediatric Meltdown. As we navigate the complex world of pediatric care, it's essential to remember that taking small steps towards improving our mental health can lead to significant changes in how we thrive at work. Are you ready to take those crucial steps to transform your daily routine into a journey to mental resilience with transformative effects on your professional and personal life? Don't leave your well-being to chance—discover the simple yet powerful techniques that can lead you to thrive.

[02:33 -16:05] Understanding the Mental Health Continuum

  • The significance of shifting from surviving to flourishing in the healthcare industry is stressed.
  • Psychological fitness and well-being are recognized as essential for personal and professional success.
  • navigating patient mental health concerns within the constraints of a busy healthcare practice.
  • the lack of slack in the healthcare system, putting additional pressure on practitioners.

[16:06 - 24:45] Strategies for Promoting Well-Being in the Healthcare Industry

  • Implementing strategies to manage work-related stress to prevent burnout.
  • Enhancing mental health and resilience through psychological fitness.
  • The importance of institutional changes and individual practices for healthier work environments.
  • Balancing life for healthcare professionals by managing energy and encouraging flexible work schedules.

[24:46 - 33:51] Combating Healthcare Burnout

  • Caregivers need to evaluate their own mental health to determine the most effective resilience-building strategies
  • AI tools must reduce administrative work and boost job satisfaction to better patient outcomes
  • Emphasizing the importance of feeling valued and having an impact on patients' lives.
  • Positive effects of cultivating calm and stability through mindfulness, meditation, and exercise are discussed.

[33:52 - 42:57] Empowering Healthcare Professionals

  • Fostering a sense of community and purpose as key to longevity and well-being
  • Flexibility Is crucial for future workspaces; organizations risk losing talent if they don't adapt.
  • Science-based mental exercises for enhancing mental health beyond standard wellness strategies are explored.
  • Healthcare professionals can promote agency by seeking collective support and managing energy and focus.

[42:58 - 49:16] Closing segment Takeaway

You can contact Karen

Instagram: @‌buildpsychologicalfitness

LinkedIn: https://www.linkedin.com/in/karendecesaredoll/

Links to resources mentioned on the show

Karen Doll Licensed Psychologist, Consultant & Coach

Book: Building Psychological Fitness: How High Performers Achieve with Ease

Building Psychological Fitness: How High Performers Achieve with Ease (Psychological Fitness (for individuals, professionals, organizations))

‌

Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference … Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference: Stephen Trzeciak, Mazzarelli, Anthony: 9781622181063: Amazon.com: Books

Other episodes you may like:

https://pediatricmeltdown.com/episodes

172 Burnout Prevention: A 15-Minute Game Changer

  1. Physician Wellness: Find Your ‘One Thing

  2. Physician Wellness Coaching: Proven Benefit!

Key quotes for Twitter:

"And beyond that there are all kinds of science based mental exercises that we can do to enhance mental health."... Dr. Karen Doll on enhancing mental health

"If you don't have control over the systemic issues, it's hard to thrive in a broken system."...Dr. Karen Doll on navigating systemic challenges

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Compassionomics (The Revolutionary Scientific Evidence that Caring Makes a Difference)
None

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Are you unwittingly overlooking a silent epidemic affecting newborns right under your nose? This game-changing episode of Pediatric Meltdown will redefine everything you thought you knew about molding young minds. We delve deep into the world of FASD (Fetal Alcohol Spectrum Disorders) and the critical need for timely screening at newborn visits. Hosted by Dr. Lia Gaggino, we dive into the transformative world of the oft-missed signs of fetal alcohol spectrum disorders and the life-altering implications they hold. Uncover the resources every parent and pediatrician should have at their fingertips, the surprising truth about the plasticity of the brain, and the lifeline that support groups offer to families navigating this challenging journey. It’s clear that understanding and addressing ND PAE requires ongoing effort and awareness. The valuable insights shared in this episode are bolstered by the wealth of resources and guidance provided by organizations such as the American Academy of Pediatrics (AAP). Through Pediatric Meltdown, we aim to bring this critical information to the forefront, equipping practitioners and families with the know-how to usher in positive change.

Tune in to hear how this episode promises to reveal a groundbreaking approach recommended by the AAP that could turn the tide in the ongoing battle against pediatric mental health challenges. Don't miss out – your next step in pediatric care innovation could be just one listen away!

[05:30-12:44] Understanding FASD and Its Impact

  • Definition and prevalence of FASD, including the sobering statistic that it affects 1 in 40 children.
  • Prenatal alcohol exposure significantly affects the brain, especially the hippocampus and amygdala, causing developmental challenges.
  • A look at the physical features associated with FAS, highlighting the preventability of this condition.
  • Recognizing FASD early is crucial for intervention and leveraging the brain's adaptability for better outcomes with help.

[12:45-22:14] Screening and Prevention Strategies

  • The necessity of nonjudgmental surveillance questions at newborn visits to screen for ND PAE.
  • discussing alcohol use with patients before and during pregnancy to avoid guilt and stigma affecting truthful disclosure.
  • The roles of obstetricians and pediatricians in fostering ongoing dialogues about the risks of alcohol consumption.
  • Prevention measures and education for adolescents and women of fertility age, aiming to mitigate the prevalence of FASD.

[22:15-34:09] Resources for Clinicians and Parents

  • Information on available resources from AAP, NOFAS, CDC, and NIMH for diagnosis and parental support.
  • Recommendations for referring to developmental behavioral pediatricians or child psychiatry access programs.
  • The utility of early intervention services for children with suspected ND PAE.
  • Advocation for parent support groups as a means of providing guidance and comfort

[34:10 - 50:48] Medications and Interventions

  • Discussion on medications used for FASD, with particular emphasis on ADHD and mood-stabilizing medications.
  • The debated effectiveness of non-stimulant medications like alpha agonists for children with ND PAE.
  • Tips on prescribing medications appropriately, with support from programs like ECHO.
  • Insights into the specific challenges faced by children with FASD, including attention to detail issues and difficulty with self-soothing.

[50:49 - 59:11] Closing segment Takeaway

Links to resources mentioned on the show

AAP Toolkit: https://www.aap.org/en/patient-care/fetal-alcohol-spectrum-disorders/

No-FAS, now FASDU: https://fasdunited.org

NIH Diagnosis Guidelines: https://www.nih.gov/news-events/news-releases/nih-releases-improved-guidelines-diagnosing-fetal-alcohol-spectrum-disorder

CDC Data: https://www.cdc.gov/ncbddd/fasd/facts.html

AAP Healthy Children Information for Parents: https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Fetal-Alcohol-Spectrum-Disorders-FAQs-of-Parents-and-Families.aspx

Key quotes for Twitter:

"Because if you only screen the people who are living in poverty, are only screening the people who have mood disorders, or that you perhaps suspect, you're gonna miss it.”… Dr. Susan Buttross on childhood disorder screenings

"And I'll say that that one thing that I just think has been a boom for all of us are the ECHO programs that are out there."... Dr. Susan Buttross on advancements in telemedicine

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you’d like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Think teen pregnancy rates are an unsolvable crisis? Think again! In this episode you’ll hear about the plummeting teen pregnancy statistics with the insight of pediatric veteran Dr. Pat Flanagan. With rates dropping a staggering 70% since the '90s, we unravel the intricate web of education, contraception, and internet resources that made this decline possible. Host, Dr. Lia Gaggino and Dr. Pat Flanagan, dive deep into the transformative power of integrated behavioral health within pediatric practice. It's evident that when we support early relational care and address social determinants of health, we can make a significant positive impact on the youngest members of our society. By providing teen moms and parents with the necessary resources, from social workers to family specialists, we foster resilience and pave the way for a healthier next generation. Don't miss out on the heartening stories of change and progress. Brace yourself for an all-inclusive conversation on the strategies that are shaping a new generation of informed, empowered young individuals–This episode serves as a beacon of hope - prepare yourself to be spurred into action.

[07:58 -12:44] Pediatric Behavioral Health Integration Strategies

  • Importance of identifying and addressing challenges before they become diagnosable conditions.
  • Screen for depression, anxiety, substance use, and social-emotional issues in teens and children.
  • Prioritizing toddlers' and preschoolers' social-emotional development for improved outcomes.
  • Recognizing the significance of maternal depression and its impact on pediatric care.

[12:45 - 18:22] Learning from Young Mothers: Lessons in Resilience and Capacity

  • Describes the inspirational aspect of watching young parents overcome challenges.
  • Paints a picture of the young mothers' journey from uncertainty to empowerment through their children.
  • Talks about the ability of young mothers to persevere despite difficult circumstances.
  • Reflects on the capacity of these mothers to manage their responsibilities and find happiness.s introduced.

[18:23 - 27:52] Funding and Sustainability of Pediatric Behavioral Health Services

  • Mental health care in pediatric practices relies on a hybrid funding model.
  • Billable diagnosis like substance use and mental health issues only fund a fraction of services.
  • Pediatric practices face more billing limitations compared to adult settings.
  • Funding issues aside, integrated behavioral health is crucial for comprehensive pediatric care.sitive outcomes.

[27:53 - 37:32] Integrated Behavioral Health Strategies in Pediatric Care

  • Integrated behavioral health is crucial, with an emphasis on prevention and early intervention.
  • Funding for integrated care is a common struggle, underscoring the need for sustainable models.
  • Major hospitals can back social workers despite hurdles.
  • The AMA's series on integrated behavioral health is an informative tool.

[37:33 - 44:04] Closing segment Takeaway

Links to resources mentioned on the show

Care Transformation Collaborative – Rhode Island (CTC-RI) https://ctc-ri.org

DULCE – Developmental Understanding and Legal Collaboration for Everyone https://cssp.org/our-work/project/dulce/

AAP Mental Health Practice Tools and Resources: https://www.aap.org/en/patient-care/mental-health-initiatives/mental-health-practice-tools-and-resources/

Integrated Behavioral Health In Primary Care by Hunter and Goodie https://www.amazon.com/Integrated-Behavioral-Health-Primary-Care/dp/1433823810

Other episodes you may like:

https://pediatricmeltdown.com/episodes

147 Racial Discrimination and Black Infant Morbidity and Mortality: Systemic Change Starts with You

129 Adolescent Confidentiality: To Share or Not to Share

50 Radical Change: Birthing Experience in the BIPOC Community

Key quotes for Twitter:

“To take care of the parents and the babies together, we have the special eye towards adolescence and adolescent development and kind of what that brought to the equation."... Dr. Flanagan on the importance of Behavioral Health in community support

"And then I think, the behavioral health part was absolutely the most important part of her work…. Dr. Flanagan on adolescent Parenting Challenges

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Integrated Behavioral Health in Primary Care: Step-By-Step Guidance for Assessment and Intervention

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Step into a world of innovation and growth as we delve into a special episode of Pediatric Meltdown, featuring our host, Dr. Lia Gaggino. The seasoned primary care pediatrician takes the helm as she embarks on a new direction in her endeavors to enhance pediatric mental health care. In this solo episode, she shares insights and challenges listeners to join her in a transformative journey. She’ll ask you to embrace the call to action as she reveals her upcoming projects designed to revolutionize pediatric mental health care. Let this solo episode serve as a rallying cry for pediatric clinicians to rise to the challenges of children's mental health. From insightful discussions with experts to the exciting new limited series podcast and companion workbook, she's shaping the future of pediatric mental health care and empowering clinicians to take their practices to the next level. So, I ask you…. are you ready to level up your practice and be part of this transformative journey?

[00:01:24] Challenges in Pediatric Mental Health

  • Increasing demands on children's mental health
  • Impact of social determinants of health
  • Rise of complex emotional issues such as cutting
  • Effects of social media on children's mental health

[01:25 - 04:43] Professional Growth and Mastery

  • Importance of continuous learning and professional growth
  • Overcoming challenges in adolescent mental health
  • Evolution of mental health treatment approaches
  • Using integrated behavioral health for improved patient care

[04:44 - 10:23] New Projects Announcement

  • Introduction to the limited series podcast: "Pediatric Mental Health: Building Better Workflows"
  • Details about the companion workbook accompanying the podcast
  • Opportunity for a 1 on 1 deep dive consultation
  • Sign-up for a discovery call to discuss pain points and strategies

[10:24 - 12:41] Closing Remarks and Podcast Information

  • Contact information for feedback and ideas for future podcasts
  • Website and social media links to stay connected
  • Gratitude for listeners and encouragement to share the episode
  • Special thanks to podcast contributors

Links to resources mentioned on the show

Lia’s Website:

https://www.PediatricMeltdown.com

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Social Media and Kids: The Big Picture

  2. ACES and the Power of Positive Relationships

  3. Burnout Prevention: A 15-Minute Game Changer

Key quotes for Twitter:

"My first presentation was called mad, bad, and sad girls, and I should have thrown in glad because so many girls are happy too."... Dr. Lia Gaggino on challenges in adolescent mental health

"And for those of us who have been doing this work for a long time, mental health has always been an issue. But it seems like now more than ever, the kids and their families need us." … Dr. Lia Gaggino on mental health crisis in youth

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Think health inequity doesn't affect you? Think again! This week's Pediatric Meltdown podcast tackles a topic that's more relevant than ever in today's diverse society. Host Dr. Lia Gaggino is joined by Dr. Julie Linton, a champion of health equity and a leading voice on child immigrant welfare. together, they will unravel the complex web of health care challenges for children of immigrant families. It's clear that Dr. Linton’s compassion and education are key in addressing the challenges faced by children in immigrant families. Her expertise underscores the importance of understanding the various aspects of immigration, from DACA to Temporary Protected Status, and how these legal designations impact access to healthcare. Tackling everything from the intricacies of asylum to the vital role of Federally Qualified Health Centers, we're reminded that every child deserves the opportunity to thrive, regardless of their background. Above all, the episode drives home the need for building workflows that support our diverse pediatric population with empathy and respect. Are you ready to become an advocate for change?

Don’t miss out on the opportunity to learn more by subscribing to the "Pediatric Mental Health Building Better Workflows Podcast" – because your next step in making a difference is just one listen away.

[06:25 -13:54] Systems and Advocacy for Young Newcomers

  • Highlights the wide-ranging complexities of immigration across the U.S., not just southern border issues.
  • Underlines the importance of robust data for grasping immigrant children demographics and needs.
  • Recommends utilizing the Casey Foundation's Kids Count data center for local immigrant family insights.
  • Accentuates the imperative of compassionate healthcare and the duty of providers to aid and champion immigrant families.

[13:55 -23:29] Food Assistance and Support Programs

  • Emphasizing the need to address basic necessities such as food for well-being.
  • Considering the direct link between health and access to adequate nutrition.
  • State-specific resources and support systems designed to assist in food provision.
  • Acknowledging the unequal availability of resources and the value of local insights for securing food aid.

[23:30 - 29:40] Legal Challenges in Mixed-Status Families

  • Eligibility for food aid programs can vary widely based on a family's immigration status.
  • The array of immigrant statuses affects the types of assistance open to children and families.
  • In areas with different funding, medical-legal partnerships are pivotal in providing necessary legal aid at no cost.
  • Legal aid limitations signify systemic hurdles impacting children's health rights.

[29:41 - 45:25] Healthcare Access for Immigrant Children

  • Highlights the barriers immigrant families face in accessing healthcare and insurance coverage.
  • Emphasizes the critical need for compassionate care specifically catered to the needs of immigrant families.
  • Outlines resources available to assist uninsured and mixed-status families in obtaining healthcare services.
  • Addresses the vital role of healthcare practitioners in advocating for policies that support the health of immigrant children.

[45:26 - 53:58] Closing segment Takeaway

Links to resources mentioned on the show

AAP Policy Statement, Providing Care for Children in Immigrant Families: https://publications.aap.org/pediatrics/article/144/3/e20192077/38449/Providing-Care-for-Children-in-Immigrant-Families

Annie E. Casey Foundation Kids Count: https://datacenter.aecf.org

Temporary Protected Status Countries: https://www.uscis.gov/humanitarian/temporary-protected-status

NILC Health Care Coverage Maps: https://www.nilc.org/issues/health-care/healthcoveragemaps/

CareRef: Guides clinicians through conducting a routine post-arrival medical screening of newly arrived refugees to the U.S., https://careref.web.health.state.mn.us/Tool

Policies of Exclusion: Implications for the Health of Immigrants and Their Children: https://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-040218-044115

Migration Policy: https://www.migrationpolicy.org/article/frequently-requested-statistics-immigrants-and-immigration-united-states#:~:text=Approximately%2018%20million%20U.S.%20children,and%2013%20percent%20in%201990.

Other episodes you may like:

https://pediatricmeltdown.com/episodes

185 Cultural Competency: Health Equity and Outcomes

161 Menstrual Equity Changes Lives: The Power of Days

151 American Indian/Alaskan Native Youth: Beyond Adversity

147 Racial Discrimination & Black Infant Morbidity: Systemic Change Starts with You

Key quotes for Twitter:

It should be a violation of patient protection. And so, there were some cases during the previous administration around concerns about hospitals calling immigrations and customs enforcement about families….Dr. Julie Linton on Patient Privacy and Immigration Enforcement:

"In an emergency setting, hospitals are required to abide by the EMTEL laws, which mean that they have to at least medically stabilize somebody with any type of emergent condition."... Dr. Julie Linton on access to emergency care.

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Think you know the secrets to pediatric mental health care? Well, this week’s episode will make you think again! Your host, Dr. Lia Gaggino, will dive deep into the nuanced world of cultural sensitivity in pediatric healthcare with the inspiring psychiatrist, Dr. Farah Abbasi. As an advocate for minorities and newcomers, Dr. Abbasi unpacks the layers of health disparities and speaks to the heart of cultural competency. Learn how to navigate the complex tapestry of identities you encounter in your practice and why understanding each child's background is crucial for effective treatment. By revealing her journey as an immigrant healthcare professional, and the challenges that come with assimilating into American culture, Dr. Abbasi highlights the significant need for a more inclusive and culturally nuanced approach to patient care. As we prepare for the launch of a new limited series podcast focused on revolutionizing mental health delivery, this dialogue with Dr. Abbasi is like obtaining a key to unlock the potential of culturally responsive care that honors the diversity of the young souls we serve. Get ready to unravel the secrets to cultivating a truly inclusive healthcare environment – your blueprint to becoming the healthcare provider of the future is just one click away!

[00:33 -10:54] Understanding Cultural Competence in Pediatric Mental Health Care

  • Respect and responsiveness to the whole person are highlighted as central to the concept of cultural competence.
  • A major challenge is how healthcare providers can develop cultural competence in their practice.
  • Cultural competence is more than just an understanding; it's about respecting and responding to every aspect of a patient’s identity.
  • There is a need for healthcare workers to recognize and address health disparities that stem from a lack of cultural competence.

[10:55 - 18:42] Cultural Humility in Pediatric Mental Health Care

  • Acknowledging that parenting beliefs and values can differ significantly, even within the same country.
  • The importance of understanding that cultural norms may vary widely among families.
  • Cultural humility involves checking one's biases and preconceptions at the door.
  • Recognizing that not every family seeks the traditional 'American Dream' and may have different aspirations.

[18:43 - 25:07] Enhancing Healthcare Inclusivity for Diverse Patient Backgrounds

  • It’s important that healthcare professionals approach each patient with an open mind and a respectful attitude towards the patient's entirety.
  • The effect of spirituality and faith on the healing and recovery process of patients.
  • Don’t assume a universal approach to parenting and healthcare that might not align with the cultural practices of all patients.
  • There are complexities and challenges faced by immigrants as they navigate a new healthcare system and the need for provider awareness.

[25:08 - 38:24] The Impact of Cultural Competence on Health Outcomes

  • Check your implicit bias and cultural blind spots in creating disparities in health outcomes.
  • Healthcare providers need to consider patients' complete cultural identity, including ethnic, religious, and immigration status.
  • Practical advice on how respect for cultural practices, like dietary preferences and religious beliefs, can improve patient experiences.
  • There is a need for connection and recognition of diverse cultural beliefs within healthcare, especially highlighted by global challenges such as pandemics.

[38:25 - 43:27] Closing segment Takeaway

Other episodes you may like:

https://pediatricmeltdown.com/episodes

163 Period Poverty and the Tampon Tax: The Audacity of Advocacy

161 Menstrual Equity Changes Lives: The Power of Days

151 American Indian/Alaskan Native Youth: Beyond Adversity

147 Racial Discrimination & Black Infant Morbidity: Systemic Change Starts with You

Key quotes for Twitter:

"Another piece that we assume everybody is, seeking this utopia, this American dream, but most of their refugees might not be here out of their choice”.… Dr. Farah Abbasi on the different reasons why people come to America.

"A lot of Muslim women complain to me that physicians never talk to them directly as if they’re not in charge of their health, that they are looking towards husbands, fathers, brothers, or whoever is accompanying them, thinking that they are not capable of making their own decisions..."... Dr. Farah Abbasi on the culture differences for women.

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Are Your Kids Being Left Behind in the Literacy Race? Find Out How Equitable Access to Reading Can Change the Game! Every child deserves a fair start in life, but the stark reality is that not every youngster is on an even playing field when it comes to early literacy. In this week's episode of Pediatric Meltdown, we dive into the revolutionary work of Reach Out and Read, a program determined to break down barriers and bring equitable access to reading materials to children across the nation. It's clear that the mission of Reach Out and Read reaches far beyond the pages of the books they distribute. Their dedication to fostering early literacy development and relational health within communities—especially those that are under-resourced and underserved—speaks volumes about their commitment to societal change. Lia’s discussion with Marty has highlighted the integrative approach of the program, merging healthcare visits with moments that fortify the bonds between parents and children. It is a poignant reminder that access to books is not a luxury, but a fundamental right that nurtures the mind and the heart. In a world where disparities define the future of so many young lives, Reach Out and Read serves as a beacon of hope, guiding families towards a horizon where every child's potential can be reached. Let's stand with them, as they turn the page on illiteracy and inequity, ensuring that no child is left behind in the vital narrative of their own education.

[03:20 -07:38]Reach Out and Read's Mission and Expansion

  • Aims to provide equitable access to children's books, focusing on underserved communities
  • Goal to reach 50% of all children under 5 in the United States by 2030
  • Over 8 million books distributed, reflecting the diversity of served communities
  • Special efforts for non-English speaking and rural areas to access healthcare and educational materials.

[07:39 - 19:51] The Role of Healthcare Providers in Early Literacy

  • Approximately 35,000 trained clinicians including pediatricians, family doctors, and nurse practitioners
  • Clinicians aid in bonding and developmental processes through well child visits.
  • Marty underscores the organic growth due to passionate healthcare providers
  • Training and opportunities for involvement available via the website and state affiliates.

[19:52 -31:23] Overcoming Challenges in Children's Literacy and Development

  • Emphasis on meeting specific community needs with a multi-pronged approach.
  • Discusses book banning and the necessity for diverse books appropriate for age 5 and under.
  • Use of TikTok series by pediatricians to provide educational materials in various languages.
  • Evidence indicating a positive effect on early brain development and preparing for school.

[31:24 - 42:09] Positive Impact and Future Goals of Reach Out and Read

  • Focus on building meaningful parent-child moments and strengthening relationships
  • Potential research partnership with Columbia University's School of Pediatrics
  • Program adjusts to support relational health and positive childhood experiences
  • Addresses health equity and contributes to lifting children out of poverty by empowering parents

[42:10 - 47:44] Closing segment Takeaway

You can reach Marty Martinez

Facebook: @reachoutandread

X (formerly Twitter): @reachoutandread

LinkedIn: @reachoutandread

Instagram: @reachoutandread

Links to resources mentioned on the show

https://reachoutandread.org/

https://reachoutandread.org/2023/08/07/new-peer-reviewed-study-shows-transformative-impact-of-reach-out-and-read/

FY23 impact (attached)

https://reachoutandread.org/why-we-matter/ (subpages are helpful here – impact, evidence)

https://reachoutandread.org/news-page/news/ (recent news coverage and press release)

Other episodes you may like:

https://swiy.co/PediatricMeltdownPodcast

Ep. 176 ACES and the Power of Positive Relationships

Ep. 150 Integrating Behavioral Health: PCP Transformation!

Ep. 143 Moral Injury and Well-being: Channeling Mr. Rogers

Key quotes for Twitter:

"The growth of Reach Out and Read has been fueled by passion—a passion to see children flourish regardless of their zip code." - Marty Martinez on the organic growth of the Reach Out and Read program.

"The beauty of a child's imagination is a testament to the power of stories. With every book we distribute, we see those imaginative sparks fly." - Marty Martinez on the effect that reading has on a child

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Are you worried about your kids' social media use? In this episode of Pediatric Meltdown, Dr. Lia Gaggino weighs in with her insights, thoughts and suggestions. From tackling the prevalence of smartphones among teens to navigating the digital world as a non-digital native, she presents practical strategies for parents and pediatric professionals. By being curious, nonjudgmental, and seeking to understand our children’s digital experiences, we can build trust and open lines of communication. Together, let's work towards creating a safer digital environment for the kids. Take a listen for more insightful content, and let's empower each other to make a positive difference in the digital world!

[01:34 -04:15] Navigating the Digital Landscape: Children's Online Behavior and Risks

  • Emphasizes the need for adults to understand and engage with what kids are doing online.
  • Explores the potential risks of social media use, including mental health implications.
  • Advocates for awareness and strategies to address sensitive topics like sexting.

[04:16 - 07:01] Literacy and Responsible Behavior: Educating the Youth

  • Suggesting that kids show the cool and positive aspects of their digital life to adults to bridge understanding.
  • Discussing the impact of social media on the mental well-being of children as a public health concern.
  • Promoting the idea that parents and caregivers should be role models for responsible digital behavior.

[07:02 - 09:57] Social Media Education and Resources for Family Safety

  • Social media can support educational and collaborative learning activities for children.
  • Online educational materials offer valuable, easily accessible information tools.
  • Resources are available to help families support children with ADHD through educational content.

[09:58 - 12:59] Navigating Digital Parenting Challenges

  • Recognize the necessity for parents to engage with their kids about their online activities.
  • Highlight the risk of normalizing mindless scrolling and unnecessary screen time.
  • Stress the significance of setting a good example by avoiding phones during family interactions

You can reach Dr. Gaggino

Facebook: Facebook

Instagram: @pediatricmeltdown

Website: PediatricMeltdown.com

Other episodes you may like:

https://pediatricmeltdown.com/episodes

Ep 182. Social Media Dangers: Protecting and Educating Youth

Ep 181. Social Media: Guidance for Youth and Families

Promotions

MC3 Clinical Pearls Video Series

https://mc3michigan.org/clinical-pearls-video-series/

National Network of Child Psychiatry Access Programs in the US

Map — NNCPAP National Network of Child Psychiatry Access Programs

Key quotes for Twitter:

"Despite the fact that some adults believe that the only way that we can protect kids is to ban them from TikTok or to never buy them a phone, I think the proverbial cat is out of the bag”…. Dr. Lia Gaggino on navigating the digital age and protecting youth

"You might learn something, and it might build some trust, and it really shows that we're interested in what they think and what they have to say.".... Dr. Lia Gaggino on bridging the generation gap

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Do you know what lurks behind every click and scroll in your child's digital playground?? Join host, Dr. Lia Gaggino and guest expert Dr. Ashvin Sood as they expose the alarming rise of cyberbullying among children. Where a simple 'like' can shape a child's self-worth, and a 'share' might lead to a spiral of anxiety. They’ll talk about the fine line between connection and addiction in the age of snaps, tweets, and likes, and find out how you can help your child navigate this complex landscape. Listen in as they do a deep dive into the intersection of social media and youth mental health, it's clear that there is a delicate balance between connection and caution. The concept of an electronic contract represents a pivotal step in managing our teens' screen time and setting clear boundaries. By facilitating an open dialogue and setting mutually agreed upon parameters, both parent and child can navigate the digital landscape with a shared understanding of what is acceptable online behavior. Make sure to catch Dr. Ashvin’s top strategies for harm reduction that every parent needs to know – it could be the conversation that changes everything for you and your teen.

[00:33 -10:26] Social Media's Influence on Youth Mental Health

  • Discusses the pervasive nature of social media and its role in the formation of adolescent identity.
  • Features the developmental and psychological needs shaping youth identity within online platforms.
  • Highlights possible mental health risks for children and teens from more online presence.
  • Notes how social media shapes young individuals' self-identity through creative outlets.

[10:27 - 19:04] Strategies for Safe Social Media Usage

  • Addressing delicate issues calls for tact to maintain open communication with youth.
  • The dialogue about harm reduction should focus on safety and informed decision-making rather than abstinence.
  • Creating a space where teenagers can talk openly about their experiences and questions regarding sex is crucial.
  • These talks prepare teens to responsibly handle risks linked to sexual behavior.

[19:05 - 28:55] Impact of Cyberbullying on Teen Mental Health

  • Discussed intense scenarios of cyberbullying leading to suicides among teenagers.
  • Analyzed a common form of cyberbullying: exclusion and group message targeting.
  • Considered the emotional toll on a teen waiting for peers' responses in a group chat.
  • Addressed the silent suffering and anticipation for social validation.

[28:56 - 40:34] Managing the landscape of Mental Health in the Digital Age

  • The child's online behaviors and the context of their chats were analyzed.
  • Specific concerns were picked out for discussion to address potential mental health issues.
  • The discussion offered strategies to lessen social media's harmful effects.
  • Specialized tools for assessing children's social media use in psychiatry were featured.

[40:35 - 46:19] Closing segment Takeaway

You can reach Dr. Ashvin Sood

akingControlz TikTok: https://www.tiktok.com/@takingcontrolz?is_from_webapp=1&sender_device=pc

PsychChild: https://www.psychchild.com/

Links to resources mentioned on the show

AACAP Screen Media Resource Center

https://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Screen_Media_Resource_Center/Home.aspx

SSM Health Treffert Studios

https://www.ssmhealth.com/treffert-center/resources/treffert-studios

Behind Their Screens

https://www.behindtheirscreens.com/

PsychChild: https://www.psychchild.com/

Other episodes you may like:

https://swiy.co/PediatricMeltdownPodcast

Ep 129 Adolescent Confidentiality: To Share or Not to Share

Ep 103 Talking to Teens and Parents: A Re-Frame with Dr. Ken Ginsburg

Key quotes for Twitter:

"Think of it as almost like a parent or clinicians Wikipedia guide to these games, and really trying to give you a nuanced approach to it." Dr. Ashvin Sood on the website psychchild.com

"If one profile goes down, they can use another profile. So it's not like it stops a particular bully and they kind of learn from it." Dr. Ashvin Sood on Cyberbullying in the Digital Age

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Are your kids glued to their screens? Discover the shocking effects of unlimited social media! Pediatric Meltdown is giving a wake-up call to parents navigating the treacherous waters of their children's online presence. This is the second installment of our series on social media and your children. Host Dr. Lia Gaggino and guest expert Dr. Jane Harness tackle the urgent matter of social media safety, sharing eye-opening insights and actionable advice. Jane's experience in child and adolescent psychiatry shines a light on not only setting digital boundaries but equipping our kids with the skills to surf the web with wisdom. This collaborative approach is not just about setting boundaries, but about building bridges between parents and children in the digital age. This episode will leave you with key insights on the vulnerabilities of the developing brain and social media. The conversation underscores the subtleties of cyberbullying and its potential grave consequences, reiterating the need for open, honest discussions to forge a safer digital landscape for our younger generation. From the importance of parents modeling healthy media use to leveraging reputable sources for combating misinformation, the discussion covers critical territories in a parent's finding their way through the social media maze. Remember that your approach to discussing media use with your children could change everything—it’s time to find out the cyber secret your kids might not even realize they're hiding.

[00:33 -12:21] Impact of Social Media Use on Youth Mental Health

  • Different types of social media platforms can have varying effects on the mental health of young people.
  • Social media use may contribute to feelings of anxiety, depression, and low self-esteem among youth.
  • The constant exposure to curated and idealized representations of others' lives on social media can negatively impact youth mental health.
  • Cyberbullying and online harassment are significant risks associated with social media use, leading to adverse psychological outcomes.

[12:22- 22:55] Understanding the Impact of Social Media on Youth

  • Kids have a good understanding of social media use and its effects on them.
  • Social media can be addictive and lead to loss of control if not used responsibly.
  • Unhealthy content consumption can have negative consequences on mental and emotional well-being.
  • Research shows that children are aware of the potential pitfalls of social media, including cyberbullying.

[22:56 -40:21] Insights from Text-Based Study on Youth Perspectives

  • Consider the importance of authenticity when using social media platforms
  • Discuss the potential consequences of oversharing personal information online
  • Explore the impact of social media on mental health and well-being from a youth perspective
  • Provide resources and guidance for new users to navigate social media safely and responsibly

[40:22 - 52:05] Strategies for Managing Social Media Use and Mental Health Impact

  • Setting shared goals to redirect focus away from excessive social media use
  • Acknowledging the importance of communication with friends and finding alternative ways to connect
  • Implementing limits and boundaries to ensure a healthy balance between online and offline activities
  • Recognizing the role of limits in creating a sense of safety for youth

[52:06 - 58:40] Closing segment Takeaway

Links to resources mentioned on the show

  • Here is the MyVoice study
  • "Youth Insight About Social Media Effects on Well/Ill-Being and Self-Modulating Efforts"
  • https://pubmed.ncbi.nlm.nih.gov/35691849/
  • AACAP Screen Media Resource Center:
  • https://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Screen_Media_Resource_Center/Home.aspx
  • Children and Screens:
  • https://www.childrenandscreens.com/
  • Family Media Plan:
  • https://www.healthychildren.org/English/fmp/Pages/MediaPlan.aspx?gclid=CjwKCAjw5MOlBhBTEiwAAJ8e1hJPqZ2l2Zmip9-lkL1NYwRFZUGuYUvGlaWAr1y8US0Wa1H5oxWMfRoCDzEQAvD_BwE
  • Dr. Sood’s PsychChild:
  • https://www.psychchild.com/
  • HEADS4 paper:
  • https://publications.aap.org/pediatrics/article-abstract/141/6/e20173655/37615/HEADS4-Social-Media-Screening-in-Adolescent?redirectedFrom=fulltext
  • On scripting for social media interviewing - Psychiatric Times:
  • https://www.psychiatrictimes.com/view/social-media-use-and-youth-mental-health-a-guide-for-clinicians-based-on-youth-voices
  • Webinar about social media and youth mental health:
  • https://www.youtube.com/watch?v=PR20eddFDbs&ab_channel=MichiganMedicine
  • Article related to that webinar:
  • https://www.michiganmedicine.org/health-lab/social-media-use-double-edged-sword-teens-what-can-caregivers-do
  • Video about practical setting changes youth can make:
  • https://medicine.umich.edu/dept/psychiatry/news/archive/202211/social-media-top-setting-tips-promote-positive-boundaries-mental-health-young-people
  • Articles about MyVoice study:
  • U of M: https://medicine.umich.edu/dept/psychiatry/news/archive/202211/many-young-people-recognize-negative-impact-social-media-have-considered-deleting-accounts
  • NPR: https://www.npr.org/sections/health-shots/2023/05/17/1176452284/teens-social-media-phone-habit
  • American Academy of Pediatrics caregiver website- multiple media topics:
  • https://healthychildren.org/english/family-life/media/pages/default.aspx
  • American Academy of Child and Adolescent Psychiatry Facts for Families- multiple media topics:
  • https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Layout/FFF_Guide-01.aspx
  • School social media educational programs: https://www.aap.org/en/patient-care/media-and-children/center-of-excellence-on-social-media-and-youth-mental-health/social-media-and-youth-mental-health-q-and-a-portal/tech-in-k-12-education-questions/
  • Surgeon General's Advisory:
  • https://www.hhs.gov/sites/default/files/sg-youth-mental-health-social-media-advisory.pdf
  • "Transgender Adolescents' Uses of Social Media for Social Support":
  • https://www.sciencedirect.com/science/article/abs/pii/S1054139X19304215
  • "Social Media Use and Health and Well-being of Lesbian, Gay, Bisexual, Transgender, and Queer Youth: Systematic Review":
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536523/

Other episodes you may like:

For all episodes, go to Episodes - Pediatric Meltdown

Ep #180. Social Media and Kids: The Big Picture

Ep #159 Youth Suicide Prevention: Safety Planning and Lethal Means Safety Counseling

Key quotes for Twitter:

"It's important to, Have those conversations as a family about what will be the times that will be screen free and try the best that they can adhere to those rules."... Dr. Jane Harness on Family screen time dynamics

“we've seen that in the mental health field that there's a lot of just information out there on social media related to mental health, and a lot of it can be taken out of context and then kind of applied in any way that could be potentially problematic."...Dr. Jane Harness on navigating health information on social media

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Are social media algorithms secretly manipulating what your kids see online? Pediatric Meltdown brings you an exclusive conversation with Dr. Jenny Radesky, where she sheds light on the alarming influence of social media algorithms on children's online experiences. Host Dr. Lia Gaggino and Dr. Radesky unravel the complexities of kids' tech use, from the dangers of unmonitored content to the pivotal role of parents in fostering digital literacy. Dr. Radesky presents compelling evidence about how digital platforms shape children's online experiences while advocating for greater parental awareness and legislative action. She highlights the urgent need for a healthier social media environment for kids and emphasized the significance of ongoing, open conversations about technology with children. Join us for an eye-opening exploration of social media's effects on youth mental health and the actionable steps we can take to create a safer online environment for kids.

[00:33 -12:40] Social Media's Role in Childhood Well-being and Online Safety Standards

  • The role of social media in shaping the health and development of children.
  • Consideration of social media design in terms of children's requirements and interests.
  • Acknowledgment of a need for universal best practices for social media platforms regarding youth.
  • Mention of a recent report highlighting the importance of social media guidelines to protect youth mental health

[12:41- 23:23] Social Media's Role in Youth Mental Health Concerns

  • Discussed the significant conversation happening around social media's impact on mental well-being.
  • Addressing the narrative that social media contributes to depression and anxiety among users.
  • Strategies to adjust settings and alter feeds to foster a more positive social media experience.
  • Highlighted the potential negative influence of dominant narratives widely accepted about social media.

[23:24 -33:47] Enhancing Online Safety for Children Through Legislation and Parental Involvement

  • Discusses laws aimed at regulating children's content and data collection
  • Highlights the importance of digital literacy and parental oversight for child safety online.
  • Explores the conflict between content regulation and free speech principles in the U.S.
  • Details the AAP's efforts to enhance children's online privacy and protection.

[33:48 - 41:52] Legislative Momentum for Children's Digital Safety

  • Potential legislative progress for child online safety laws, including COSA and updated COPPA regulations.
  • Explores public concern and political attention on social media's impact on children.
  • Highlights the uncertainty surrounding the enactment of new laws focused on children's digital privacy and safety.
  • Highlights broad support for legislative efforts addressing social media company concerns.

[41:53 - 42:57] Closing segment Takeaway

Links to resources mentioned on the show

www.aap.org/socialmedia (Center of Excellence website)

www.healthychildren.org/mediaplan (Family Media Plan tool)

American Psychological Association Health Advisory on Social Media Use in Adolescence (apa.org)

www.commonsensemedia.org/parents-ultimate-guides (has down to earth guides to the most popular social and gaming platforms)

Other episodes you may like:

For all episodes, go to Episodes - Pediatric Meltdown

Ep #139 School Based Health: Literally Meeting Kids Where They Are!

Ep #128 Trauma and Resilience: “Connect Before You Correct”

Key quotes for Twitter:

"It feels hard because these products were designed to keep you engaged. Longer time, come back and check more, see more ads, make more money for the company, collect more data about you and what you love and what you might click on next."— Dr. Jenny Radesky on The Impact of Technology on Child Well-being

"One of our goals is to build this guide of the different tools that already exist on the platforms so that if there are ways that you can turn off different settings, that will give you a little bit more control as a user."— Dr. Jenny Radesky on Online Safety and Regulation

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Did you know that 1 in 3 young people in the US have experienced or survived dating abuse? In a candid and crucial conversation on Pediatric Meltdown, host Dr. Lia Gaggino is joined by guest Dr. Lenore Jarvis to tackle the sensitive issue of adolescent relationship abuse (ARA). From identifying red flags to discussing prevention strategies and resources, this eye-opening episode provides essential insights for parents, educators, and healthcare professionals working with adolescents. Dr. Jarvis will take a deep-dive into the different types of ARA, the power dynamics at play, and the impact of abuse on mental and physical health will highlight the importance of documentation, trauma-informed care, and healing-centered engagement, emphasizing the holistic experience of addressing trauma. With the imperative need for universal screening and education, and the complexities of navigating disclosures and mandatory reporting, our episode provided essential guidance for healthcare professionals. This episode is another example of Dr. Gaggino’s never ending dedication to unravel critical issues affecting pediatric care, empowering clinicians to make a positive impact on the lives of young people.

[00:33 -15:23] Understanding the Impact of Adolescent Relationship Abuse (ARA) on Teen Health

  • Adolescents experiencing ARA are at an increased risk of contracting sexually transmitted infections (STIs).
  • Victims of adolescent relationship abuse may suffer from mental health issues, including depression.
  • There is a notable link between ARA and suicidality in teenagers, potentially leading to life-threatening situations.
  • Adolescent relationship abuse often leads to increased school dropout rates, affecting education

[15:24 - 27:55] Strategies for Healthcare Professionals to Support Teens in Abusive Relationships

  • ARA strategies must respect a teen's comfort and safety in sharing, not always certain in a clinic.
  • Adolescents' confidentiality is vital, needing careful management by healthcare workers.
  • Feelings of isolation and shame can deter teens from seeking help or revealing abuse.
  • Offering ARA resources during visits offers consistent support, regardless of disclosure.

[27:56 - 42:08] Effective Approaches to Adolescent Relationship Abuse Disclosure

  • Providers encourage teens to report abuse by discussing common issues.
  • Healthcare pros must immediately validate a teen's ARA disclosure.
  • Careful measures protect intimate violence reports in patient records.
  • Keeping the abuser from patient files is vital to the teen's safety and privacy.

[43:09 - 55:59] Implementing Early Educational Strategies for Healthy Relationships

  • Elementary education focuses on identifying traits of positive and negative friendships.
  • Teaching young kids about good relationship dynamics prepares them for future romantic talks.
  • Talks on healthy romance in adolescence build on earlier friend relationship lessons.
  • Early healthy relationship education equips children to handle teen romantic challenges.

[56:00 - 01:07:08] Closing segment Takeaway

Links to resources mentioned on the show

Healing Centered Engagement:

The Future of Healing: Shifting From Trauma Informed Care to Healing Centered Engagement

Local Resources

State Coalitions:

NCADV | National Coalition Against Domestic Violence

National Resources for Adolescents and Adult Allies

ARA:

National Dating Abuse Helpline 1-866-331-9474, chat online at loveisrespect.org, or test "loveis" to 22522

General ARA and healthy relationship information:

That's Not Cool

Break the Cycle:

Home - Break The Cycle

Cyber Abuse:

MTV | Reality TV Shows, Pop Culture & Music Videos

Sexual Assault:

National Sexual Assault Hotline: 1800-656-4673,

RAINN | The nation's largest anti-sexual violence organization

National suicide Prevention lifeline: 1800-273-8255 (TALK),

988 Suicide & Crisis Lifeline

The Trevor Project - Crisis & Suicide Prevention Lifeline for LGBTQ+ Youth:

The Trevor Project | For Young LGBTQ Lives , 1866-488-7386

It Gets Better Project:

Home Trans Lifeline:

Home - Trans Lifeline

Adolescent Reproductive and Sexual Health (including contraception options):

Bedsider:

Bedsider Birth Control Support Network

Advocates for Youth:

Advocates for Youth

Runaway Youth/Youth Abscondence: National Runaway Safeline:

National Runaway Safeline | National Runaway Safeline (1800-786-2929

Resources for Health Care Providers

Futures without Violence:

Futures Without Violence ,

Domestic violence survivor health, safety and empowerment - IPVHealth

Role of the Pediatrician in Youth Violence Prevention

Role of the Pediatrician in Youth Violence Prevention

Other episodes you may like:

https://pediatricmeltdown.com/episodes

110 LGBTQ+ Youth Sexuality: Inclusive Parent-Child Conversations

143 Moral Injury and Well-being: Channeling Mr. Rogers

158 Preventing Youth Suicide: Risk Assessment and Management

Key quotes for Twitter:

Perhaps the goal of addressing Intimate partner violence or adolescent relationship abuse in the clinical setting should not be disclosure or detection of abuse….Dr. Lenore Jarvis on adolescent Relationship Abuse Screening

But there are limitations to the universal screening approach. I think a big one is, a lot of these studies and clinical practices have occurred in adult settings, usually for women above the age of 18 in a place where you can get an individual alone and there are no mandatory reporting requirements…. Dr. Lenore Jarvis on the universal screening approach.

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/

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What is Trauma-Focused CBT?? Discover the Transformative Power of Trauma-Focused Therapy for Children in this Latest Pediatric Meltdown episode! Learn how Dr. Judith Cohen and her groundbreaking approach are revolutionizing children's mental health and trauma treatment. Delve into the impactful narrative of Trauma-Focused Cognitive Behavioral Therapy (TFCBT) as Dr. Cohen shares this expertise and the critical components of this life-changing therapy. From identifying trauma reminders to transferring agency to the child and parents, this episode is a must-listen for anyone passionate about pediatric mental health and trauma care. Join us as we unravel the intricacies of trauma therapy, uncover the key components of TF-CBT, and uncover the invaluable insights shared by Dr. Cohen in this enlightening discussion.

[00:33 - 32:48] Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) Explained

  • TF-CBT is a specific treatment developed for children and their families to overcome the impact of trauma.
  • It encompasses 9 components, encapsulated in the acronym 'PRACTICE'.
  • Practice of resiliency skills by children and their caregivers is emphasized outside therapy.
  • Resiliency skills are reinforced through consistent practice within therapy for children and families

[32:49 - 42:24] Supporting Trauma Therapists: Coping with Client Traumas

  • Therapists' personal trauma experiences can shape their treatment methods.
  • The burden of processing many children's trauma narratives weekly is challenging.
  • Therapists navigate their emotional health and children's varied trauma recovery stages.
  • Self-care and a compassionate medical community culture are crucial for therapists' longevity.

[42:25 - 50:43] Evidence-Based Psychotherapy as First-Line Treatment for Childhood Trauma

  • Trauma experiences directly influence the choice of treatment, with TF-CBT being the frontline option.
  • Prescribing medication is not recommended until a sufficient trial of psychotherapy has been conducted.
  • A good clinician will reassess and adapt TF-CBT techniques to suit each child's individual circumstances.
  • Psychotherapeutic intervention aims to resolve trauma-related difficulties stemming from the child's experiences.

[50:44 - 59:40] Advancements in Trauma Therapy Accessibility for Children

  • The national certification for TF-CBT practitioners enhances accessibility to qualified therapists.
  • The availability of certification sites as an important development over time.
  • Bridging the gap between pediatric care and specialized trauma therapy.
  • The integration of therapy directories into care plans makes it easier for clinicians to make informed referrals.

[59:41 - 1:05:03] Closing segment Takeaway

Links to resources mentioned on the show

National Child Traumatic Stress Network:

https://www.nctsn.org/interventions/trauma-focused-cognitive-behavioral-therap

The NCTSN Secondary Traumatic Stress are available here: https://www.nctsn.org/trauma-informed-care/secondary-traumatic-stress/nctsn-resources

Locate TF-CBT certified therapists here: https://tfcbt.org/therapists

Locate PCIT therapists here: https://www.pcit.org/united-states.html

Locate Child Parent Psychotherapy providers here: https://childparentpsychotherapy.com/resources/roster/

Other episodes you may like:

For all episodes, go to Episodes - Pediatric Meltdown

Ep 135 Physician Wellness: Find Your ‘One Thing

Ep 128 Trauma and Resilience: “Connect Before You Correct”

Ep 49 Infant Mental Health: Finding the Beautiful Moments

Key quotes for Twitter:

"I would say to anybody, if you have a chance to work with somebody instead of competing against them, do that. It's just been amazing."..Judith Cohen on the power of collaborative work

"And recalling these trauma memories helps them also to Remember their maladaptive cognitions."... Judith Cohen on Processing childhood trauma

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

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Get ready to unravel the complexities of childhood trauma as Pediatric Meltdown brings you an insightful episode featuring expert guests Dr. Brooks Keeshin and Dr. Jessica Griffin. Host Dr. Lia Gaggino will dive into the shifting paradigms from disease to trauma models, and the vital role of pediatricians in identifying and addressing traumatic stress in children. Uncover groundbreaking strategies for supporting children through trauma in this latest episode. prepare to dive deep into trauma-focused care and the 'three r's' approach to help pediatric clinicians navigate the complexities of children’s mental health. From the SEEK screen to evidence-based trauma treatments, you'll explore practical interventions and insightful discussions on addressing traumatic stress in pediatric care settings. Join us as we unravel the impactful dialogue between these esteemed experts and enter the world of child trauma and resilience to enhance your understanding of pediatric mental health.

[00:33 -18:47] The Role of Pediatricians in Early Trauma Intervention

  • A referral system to evidence-based treatment for traumatized children is described.
  • Despite systematic efforts, timely access to treatment for kids remains a challenge.
  • Pediatricians' interactions with families present chances for mental health education and support
  • Pediatricians play a critical role in the timely identification and management of child trauma.

[18:48 - 29:20] Supporting Child Resilience in Pediatric Mental Health

  • Pediatricians should focus on resilience for moderate symptoms.
  • Tailored mental health support benefits children with moderate symptoms.
  • Mental health support for non-severe symptoms underlines prevention.
  • Interventions for moderate symptoms bolster resilience and trauma management.

[29:21 - 40:07] Trauma-Informed Pediatric Care Strategies

  • Pediatricians can offer vital support to weary parents.
  • Trauma-informed care addresses child and caregiver needs holistically.
  • Employing 'three Rs' is crucial in caregiver engagement.
  • Normalizing caregiver experiences improves pediatric care's impact.

[40:08 - 53:45] Interventions and Resources for Pediatric Trauma Care

  • Pediatricians might refer to TFCBT without understanding its elements
  • Short-term methods are advised for mild trauma symptoms.
  • The Academy is creating pediatrician and caregiver resources.
  • Focus is on accessible support tools for children facing trauma.

[53:46 - 01:00:00] Closing segment Takeaway

Contacting Dr. Griffin:

Website: www.drjessica.com

Twitter: @TheDrJessica

Instagram:@dr.jessicagriffin

Facebook: Facebook

Books by Dr. Jessica Griffin

Childhood Trauma and Resilience, A Practical Guide

Relationship Rx: Prescriptions for Lasting Love and Deeper Connection.

Other resources mentioned

Care Process Model: https://intermountainhealthcare.org/ckr-ext/Dcmnt?ncid=529796906

Screening for Trauma in Pediatric Primary Care: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474707/

SEEK Parent Questionnaire: https://seekwellbeing.org/seek-materials/

Pediatric Traumatic Stress Screening Tool (PTSST) Ages 6-10: https://intermountainhealthcare.org/ckr-ext/Dcmnt?ncid=529794096

Pediatric Traumatic Stress Screening Tool (PTSST) Ages 11-18: https://intermountainhealthcare.org/ckr-ext/Dcmnt?ncid=529795279

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. Trauma-Informed Primary Care: Changing Culture

142 Difficult Childhood Behaviors: Meeting the Challenges of Parenting

112 Schizophrenia: Recognizing the Early Symptoms

Key quotes for Twitter:

"And of those potentially traumatic experiences, some kids will develop not just a toxic stress, but a very specific type of stress that is more defined as traumatic Astra."... Dr. Brooks Keeshin on addressing specific traumatic stress.

"It's not about what's wrong with Johnny. It's about what's happened to him."... Dr. Jessica Griffin on Pediatric Mental Health Interventions

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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In a world where pediatricians hold the key to promoting healthy relationships and emotional well-being, this latest episode delves into the transformative power of recognizing and addressing toxic stress in children. Join Dr. Lia Gaggino and renowned pediatrician, Andy Gardner, expertly navigates the terrain of primary prevention and the crucial role pediatricians play in shaping the future of our youth. This episode will uncover the secrets to safeguarding children's mental health and well-being. Lia as she explores Andy's insights on primary prevention, emotional management, and the profound impact of nurturing relationships. Discover how this episode sheds new light on the crucial role pediatricians play in building a foundation for children's long-term resilience and well-being.

[00:33 -15:01] The Importance of Primary Prevention in Child Development

  • Holistic public health must embrace both primary prevention and specific interventions.
  • Preventing toxic stress in kids is achievable with primary preventive measures.
  • Proactive public health advocates for relational health.
  • Preventing toxic stress and promoting relational health in public health are linked.

[15:02- 26:34] Building Trust in Pediatric Relationships

  • Trust in pediatric care involves the triad of parent, child, and healthcare professional.
  • Pediatricians must grasp family dynamics to offer thorough care.
  • Pediatricians juggle clinical record-keeping with fostering therapeutic bonds.
  • Trust is essential for effective treatments and a child's positive developmental path.

[26:35 - 46:17] Fostering Emotional Resilience in Parent-Child Dynamics

  • Encourage parents to engage with their child's emotions to minimize defensive actions.
  • Use trauma-focused CBT techniques to help children's emotional needs and behaviors.
  • Emphasize empathy and understanding in caregiving before immediate behavior correction.
  • Highlight the lasting advantages of parental emotional presence for a child's development.

[46:18 - 59:20] Enhancing Child Growth with Positive Parenting

  • Pediatricians champion positive reinforcement to enhance child strengths.
  • 'Catching children being good' boosts positive behavior and self-worth.
  • Aiming for ten praises per criticism sustains a positive parent-child bond.
  • Emphasizing children's strengths fosters better development and emotional control.

[59:21 - 01:05:17] Closing segment Takeaway

Links to resources mentioned on the show

AAP Preventing Childhood Toxic Stress Policy Statement - https://pediatrics.aappublications.org/content/148/2/e2021052582

AAP Trauma Informed Care in Health Systems Policy Statement - https://pediatrics.aappublications.org/content/148/2/e2021052579

Trauma Informed Care Clinical Report - https://pediatrics.aappublications.org/content/148/2/e2021052580

Thinking Developmentally by Andrew Garner and Robert Saul - https://shop.aap.org/Thinking-Developmentally-Paperback-en.aspx

ACES Anda/Felliti - https://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/

Christina Bethell:

JAMA Peds https://jamanetwork.com/journals/jamapediatrics/fullarticle/2749336

Health Affairs - https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05425

Ted Lasso! – Apple Plus streaming

Richard Rohr - https://cac.org/transforming-pain-2018-10-17/

Winston Churchill “The Darkest Hour” 2017 Movie

Other episodes you may like:

For all episodes, go to Pediatric Meltdown

Ep #169 Parenting the Neurodivergent Child: What Pediatric Clinicians Need to Know

Ep #142 Difficult Childhood Behaviors: Meeting the Challenges of Parenting

Key quotes for Twitter:

"And man, when you get that social smile, that's your first reward”... Dr. Andy Garner

"Once we get to a place we're relating and reasoning, but if we don't have that regulation to start with, we're not gonna get anywhere."... Dr. Andy Garner

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Join Dr. Lia Gaggino on Pediatric Meltdown in welcoming her guest, Dr. Ed Tronick. This episode unveils the transformative power of non-verbal communication between infants and caregivers, as explored through the lens of the 2-minute Still Face Experiment. Discover how Dr. Tronick's lifetime dedication to understanding these silent dialogues has reverberated, influencing fields as diverse as therapy and law enforcement. As they dive into the choreography of connection and disconnection between child and adult, you’ll gain an insight into how these foundational moments shape emotional health and interpersonal skills. Find inspiration in the poignant discussion that explores the very heart of childhood development and carries the promise of healthier futures through stronger relationships. Join us in acknowledging a legacy that continues to guide and inspire.

[00:33 -09:46] Adverse Childhood Experiences (ACEs) and Infant Mental Health

  • Explaining the types of adverse experiences that can impact infant and early childhood development.
  • How chronic stress can disrupt neural pathways and affect a child's emotional and physical health.
  • Strategies for caregivers to build resilience in infants facing adverse experiences.
  • The value of pediatricians in screening for ACEs and guiding caregivers to prevent toxic stress in infants.

[09:47 - 17:46] Exploring the Still Face Experiment and Infant-Caregiver Bonding

  • BSignificance of Early Interaction: How Caregiver Engagement Shapes Development
  • Repairing Broken Bonds: Responding to Infant Signals Post-Disruption
  • Decoding Infant-Caregiver Communication: Agency and Intent in Early Years
  • Strengthening Attachment: The Role of Positive Caregiver Behaviors in Secure Bond Formation

[17:47 - 27:59]Addressing ACEs and Toxic Stress in Early Childhood

  • Building a Supportive Network: The Critical Role of Pediatricians in ACEs Recognition
  • Empowering Caregiver Capacity: Tools for Mitigating Toxic Stress in Infancy
  • Resilience in the Wake of Adversity: Supporting Healthy Coping Mechanisms in Infants
  • Crafting a Secure Future: How Quality Infant-Caregiver Interactions Counteract Toxic Stress

[28:00 - 50:13] Advancing Development Through Caregiver-Infant Interaction Repair

  • The Dynamics of Emotional Recovery: Techniques for Reestablishing Secure Attachments
  • Encouraging Parental Agency: Empowering Caregivers in the Art of Interaction Repair
  • Breakthrough via Repair: The Crucial Role of Mending Disrupted Bonds in Infant Development
  • The Still Face Paradigm: Insights into Resilience and the Capacity for Relationship Repair

[50:14 - 56:31] Closing segment Takeaway

Links to resources mentioned on the show

Still Face Experiment Video:

Love Sense: from Infant to Adult (Sue Johnson and Ed Tronick) (youtube.com)

National Institute of Health article:

A Still-face Paradigm for Young Children: 2½ Year-olds’ Reactions to Maternal Unavailability during the Still-face - PMC (nih.gov)

Other episodes you may like:

https://pediatricmeltdown.com/episodes

142 Difficult Childhood Behaviors: Meeting the Challenges of Parenting

134 Early Childhood Education: Empowering Parents

112 Schizophrenia: Recognizing the Early Symptoms

Key quotes for Twitter:

"There are at least a couple of things you don't do as a pediatrician. 1 is you don't lecture. 2nd is you listen and respond in a way that's related to what the parent is concerned with… Dr. Ed Tronick

"How does the newborn and then the young infant make meaning about the world that they're in because meaning is the way one organizes one's experience."... Dr. Ed Tronick

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Listen to Dr. Gaggino reflect on 2023 and the journey that Pediatric Meltdown has led her on. As we come to the end of this episode, she wants to express her deepest gratitude to all the listeners who have been a part of the Pediatric Meltdown community. The magic of caring for kids and the belief that we can do better drives us forward. Your involvement in this podcast is invaluable, so keep tuning in, sharing, and downloading. Let's make 2024 a year of empowerment and growth for pediatric mental health. Together, let's make a lasting impact and create a world where every child's emotional well-being is valued and nurtured. Dr. Gaggino wants to thank you for being a part of this journey.

[00:33 -04:00] Reflections on 2023

  • Gratitude for vaccines and treatments
  • Recovery from COVID-19
  • Impact on children's mental health
  • Isolation's impact on children

[4:01 - 05:46] Insights and Adventures

  • Updates on family and grandchild's arrival
  • Enjoying time with daughter in Denver
  • Cherished memories from family parties
  • Travel adventures to New Orleans and Florida

[05:47 - 08:13] Cherishing Relationships

  • Coping with family health challenges
  • Acknowledging life's challenges and joys
  • Expressing gratitude for loved ones
  • Finding strength in family and friendships

[08:14 - 09:18] Podcast's Evolution and Future Plans

  • Introduction of a new website and merchandise
  • Introduction to the book club
  • Engaging with audience and listeners
  • Encouraging interaction and feedback

[09:19 - 12:05] Closing segment Takeaway

  • Anticipation for thought-provoking social media series
  • Announcement of new podcast mini-episode series
  • Overview of upcoming consulting opportunities

You can reach Dr. Lia Gaggino

Email: gagginol@gmail.com

Facebook: Facebook

Instagram: @PediatricMeltdown

LinkedIn: linkedin.com/in/lia-gaggino-md-faap-80322a31

Here are the 4 most downloaded episodes of 2023

https://pediatricmeltdown.com/episodes

1. 170 Bioethics in Pediatrics: Finding Your Way Through the Grey Areas

2. 171 Pharmacogenetics: Guiding Psychotropic Medication Rx

3. 173. Neurodivergent Youth: What Support Looks Like

4. 169 Parenting the Neurodivergent Child: What Pediatric Clinicians Need to Know

Key quotes for Twitter:

"I am really grateful to science and those incredible people who created this vaccine."... Dr. Lia Gaggino

"We need to elect adults who behave like adults. The adults we want our kids to be, not bullies, but instead thoughtful, fair, honest humans who want the best for each other."...Dr. Lia Gaggino

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Are you tired of sifting through endless articles for helpful tips on managing neurodiverse conditions like ADHD and autism? Look no further, as this episode of Pediatric Meltdown brings you a game-changing discussion on practical strategies for symptom control and fostering independence in neurodiverse children. In this episode, host Dr. Lia Gaggino and her guest, Noreen Russell, PhD shake up the conversation by debunking misconceptions, highlighting invaluable resources, and advocating for a more nuanced understanding of neurodiversity. Say goodbye to quick fixes and unattainable expectations as you dive deep into a comprehensive discussion on embracing individual needs. Get ready for a fresh perspective that challenges traditional approaches and empowers parents and professionals alike! Noreen's emphasis on avoiding blame and shame, normalizing neurodiversity, and promoting equity in addressing the needs of neurodiverse children resonates deeply. The emphasis on understanding, flexibility, and individualized approaches is crucial for supporting these children and their families. Her words remind us that it's crucial for professionals and parents alike to listen, acknowledge, and adapt when supporting these children. As we continue on this journey of advocating for neurodiversity, let's remember Noreen's words: "It's about doing the best we can and acknowledging the complexities of neurodevelopmental disorders, with empathy and understanding as our strongest tools.

[00:33 -12:17] Understanding Neurodiversity in Children

  • Definition: Explaining what it means to be neurodivergent.
  • Identifying Traits: Recognizing neurodiversity in behavior and learning.
  • Therapies and Interventions: Overview of effective treatments and strategies.
  • Inclusive Education: How schools adapt curricula to meet neurodiverse needs.

[12:18 - 26:59] Beyond "Quick Tips": Comprehensive ADHD Care

  • Multimodal Treatment: Combining therapy, medication (if necessary), coaching, and lifestyle changes.
  • Emotional Support: Prioritizing emotional well-being alongside behavioral management.
  • Educative Engagement: Teaching kids about their ADHD to foster self-awareness and self-management.
  • Community Resources: Leveraging support groups and educational resources for ongoing support.

[27:00 - 36:50] Achieving Balance: Week-to-Week Wellness Strategies

  • Cumulative Health: Examining how consistent health habits affect week-to-week performance.
  • Mental Health Awareness: Recognizing signs of stress or depression and taking timely action.
  • Nutritional Balance: Choosing foods that enhance cognitive function and mood stability.
  • Sleep Hygiene: Prioritizing restful sleep as a foundation for daily productivity.

[36:51 - 51:36] Maximizing Dedication with the 5-Minute Golden Rule

  • Quality Over Quantity: Understanding the benefits of short, meaningful connections with each child.
  • Individualized Attention: Tailoring weekend plans to cater to the unique interests of each child separately.
  • Parent-Child Bonding: Strengthening relationships through dedicated one-on-one time.
  • Daily Application: Using the golden rule beyond weekends for homework help or bedtime routines.

[51:37 - 56:35] Closing segment Takeaway

You can reach Dr. Noreen Russell

www.Facebook: Facebook

LinkedIn: linkedin.com/in/norrine-russell-820545184

Instagram: @russellcoachingllc

Links to resources mentioned on the show

Website:

Russell Coaching - Creating School Success for ADHD & Atypical St...

The Child Mind Website

Child Mind Institute | Transforming Children's Lives.

Ross Greene's Books:

The Explosive Child The Explosive Child: Greene, Ross: 9780063092464: Amazon.com: Books

Raising Human Beings Amazon.com: Raising Human Beings: Creating a Collaborative Partnership with Your Child (Audible Audio Edition): Ross W. Greene, Jonathan Todd Ross, Simon & Schuster Audio: Audible Books & Originals

Lost and Found and Lost at School Amazon.com: Lost at School: Why Our Kids with Behavioral Challenges are Falling Through the Cracks and How We Can Help Them (Audible Audio Edition): Ross W. Greene PhD, Nick Podehl, Brilliance Audio: Books

Bill Nason The Autism Discussion Page The Autism Discussion Page on the core... by Nason, Bill (amazon.com)

ADDitude Magazine:

ADDitude

Other episodes you may like:

https://pediatricmeltdown.com/episodes

Ep 169. Parenting the Neurodivergent Child: What Pediatric Clinicians Need to Know

Ep 121. ADHD Coaching: Moving the Success Needle

Ep 60. Advice to Clinicians from Individuals Living with Autism Spectrum Disorders

EP 28. Caring for Kids on the Autism Spectrum: What Parents Want and Need from Us

Key quotes for Twitter:

“Connected Coaching: "Our coaching method, Connected Coaching, is very concrete and immediate and practical."... Dr. Noreen Russell

"Inflexibility plus inflexibility equals explosive explosiveness."...Dr. Noreen Russell

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Raising Human Beings: Creating a Collaborative Partnership with Your Child
The Explosive Child

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As the holiday season approaches, it's crucial to address the emotional well-being of healthcare professionals. Host Dr. Lia Gaggino sits down with Ariel Lucas, a pediatric nurse practitioner, who shares her journey into the field and her personal struggle with exhaustion and emptiness. She opens up about the physical and emotional toll it took on her and how it affected her interactions with patients and loved ones. As a pediatric professional navigating personal and professional challenges, Ariel found solace and motivation during her cycling workouts, which ultimately led to a positive transformation in her mental health and outlook on life, not to mention her personal and financial stress, ultimately reclaiming her strength and vitality. Listen in as Ariel talks about her experience at a wellness retreat and the valuable lessons she learned about prioritizing self-care and kindness.This episode is a reminder for all healthcare professionals to take care of themselves so they can better care for others. Join Dr. Gaggino as she explores Ariel's journey from exhaustion to empowerment, and discovers the profound impact of self-care and physical activity on her personal and professional life.

[00:33 -07:28] The Importance of Self-Care

  • Defining what self-care actually means and busting common misconceptions about it being selfish.
  • Exploring different methods of self-care tailored to individual needs and lifestyles.
  • Discussing how caring for oneself provides the energy needed to help others effectively.
  • Tips for consistently incorporating self-care into your daily schedule without feeling guilt.

[07:29 -12:24] Striking a Work-Life Balance

  • Communicate boundaries to colleagues and stick to them.
  • Prioritize tasks to maximize productivity during work hours.
  • Integrate short breaks throughout the workday to reduce stress.
  • Ensure leisure activities are part of your weekly routine for relaxation.

[12:25 - 19:53] Inspiring Others by Example

  • Ariel serves as an example that even busy people can add wellness habits
  • She does weekly lunch workouts with some of the providers at her office
  • She goes on bike rides with some of the students she works with
  • Her openness to wellness has directly inspired a few people at her office

[19:54 - 29:17] Embracing Selflessness

  • Simple ways to incorporate selfless acts into everyday life.
  • The impact of volunteering and being part of collective goals.
  • How understanding and responding to the needs of others enhances personal growth.
  • Ensuring self-care to avoid burnout while helping others.

[29:18 - 34:35] Closing segment Takeaway

Links to resources mentioned on the show

Books Mentioned in the Episode

Choosing Wellness: Unconventional... by O'Grady, Eileen T (amazon.com)

Eat to Treat: A Three-Step Plan... by Berghoff, Maggie (amazon.com)

Other episodes you may like:

https://pediatricmeltdown.com/episodes

Ep154 The Joys and Challenges of Pediatrics: Gather Your Spoons!

Ep135 Physician Wellness: Find Your ‘One Thing

Ep116 Physician Wellness Coaching: Proven Benefit!

Key quotes for Twitter:

"If your cup is full, it overflows. So if you do that 1 thing, then you might find that you have enough energy for the next thing”… Nurse Practitioner, Ariel Lucas

"If we love ourselves well, we're loving others well”... Nurse Practitioner, Ariel Lucas

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Choosing Wellness: Unconventional Wisdom for the Overwhelmed, the Discouraged, the Addicted, the Fearful, or the Stuck
Eat Right for Your Inflammation Type: The Three-Step Program to Strengthen Immunity, Heal Chronic Pain, and Boost Your Energy

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Discover some eye-opening exploration of genetics, medication choices, and evidence-based practices in pediatric psychiatry! Join host Dr. Lia Gaggino and guest Dr. Lisa Namerow as they navigate the intricate world of pharmacogenomic testing, the impact on prescribing behavior, and the crucial relevance of genetic panels for pediatric patients. From the evolving landscape of pharmacogenomics to the challenges of interpreting genetic findings, this discussion sheds light on the pivotal role of nonpharmacologic options and the need for validated guidelines in treating pediatric anxiety and depression. The conversation between Dr. Gaggino and Dr. Namerow has shed light on the challenges and opportunities associated with pharmacogenomic testing in pediatric psychiatry. With the complexity of interpreting results and the risk of inappropriate medication choices, the field faces a critical juncture in the responsible adoption and implementation of genetic information. However, the lack of clear guidelines and the risk of misinterpretation highlight the need for caution in prescribing decisions. As we navigate this landscape, it is essential for providers to prioritize the validation of guidelines and the responsible use of genetic information to ensure the safe and effective treatment of pediatric anxiety and depression. Together, we can work towards a future where genetic testing enhances the care of pediatric patients facing mental health challenges.

[00:33 -12:41] The Conundrum of Genetics in Psychiatry

  • Genetics play a complex role in determining the right treatment for psychiatric conditions.
  • Non-specialists may struggle to fully comprehend the intricacies of genetic information.
  • The science of genetics in mental health treatment is fast evolving.
  • Genetic information can significantly alter clinical decisions in unexpected ways.

[12:42 - 28:33] Understanding Clinical Pharmacogenetics

  • Learn what pharmacogenetics is and how it impacts drug efficacy and patient safety.
  • Identify common drugs with known pharmacogenetic interactions.
  • Understand the importance of integrating pharmacogenetic information into clinical practice.
  • Stay updated on emerging research and its implications for personalized medicine.

[28:34 - 33:05] Moving Beyond the Binning Concept in Data Analysis

  • Embrace new frameworks for interpreting genetic testing results.
  • Develop a nuanced understanding free from oversimplified categories.
  • Foster continuous learning and adaptation in data evaluation methods.
  • Integrate complex data sets for a more personalized approach to healthcare.

[33:06 - 44:13] Utilizing Sequence to Script in Clinical Practice

  • Streamline patient information intake by inputting data into Sequence to Script.
  • Enhance patient interactions by leveraging generated scripts for more effective communication.
  • Document clinical reasoning meticulously when selecting treatment options based on script suggestions.
  • Improve the accuracy of allergy identification and management with advanced Sequence to Script outputs.

[44:14 - 51:44] Closing segment Takeaway

Links to resources mentioned on the show

Sequence 2 Script: www.sequence2script.org

Pharmacogenomics: An Update for Child and Adolescent Psychiatry https://experts.umn.edu/en/publications/pharmacogenomics-an-update-for-child-and-adolescent-psychiatry

Editorial: Beyond Red Light Green Light: https://europepmc.org/article/med/34767918

Child Psychiatry Access Programs by state: https://www.nncpap.org/map

Other episodes you may like:

https://pediatricmeltdown.com/episodes

Ep 45 Pharmacogenomics: How Genetic Testing Can Help Us

Ep 44 Anxiety Disorders in Children: Treatment Pearls

Key quotes for Twitter:

"Given the current evidence base, consider pharmacogenetic testing. If the medication that you have determined through your evaluation and evidence-based review has relevant gene medication associations, then consider pharmacogenetics."... Dr. Lisa Namerow on The Future of Pharmacogenetics:

"We know that if we see a kid who's being treated with Des Venlafaxine or Pristiq for depression or anxiety, that patient has gotten pharmacogenetic testing."... Dr. Lisa Namerow on Pharmacogenetic Testing

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Are you ready to dive deep into the Bioethical challenges that pediatricians encounter on a daily basis? Host, Dr. Lia Gaggino, talks with guests Dr. Lauren Azevedo and Dr. Naomi Laventhal about the difficult decisions and moral dilemmas that arise in outpatient and inpatient settings. From controversial topics like vaccine hesitancy and substance abuse to the delicate balance between autonomy and parental involvement, this episode leaves no ethical stone unturned. They’ll take you through their day as they navigate the treacherous terrain of consent, confidentiality, and decision-making in both outpatient and inpatient care. You’ll hear about scenarios of child abuse and custody disputes. It’s clear that navigating ethical challenges in pediatric care requires clear communication, and a commitment to finding common ground. By acknowledging the good intentions of all involved and embracing emotions as part of the decision-making process, we can work towards the best outcomes for our patients and their families. Remember, in the midst of the chaos, everyone is on the same team, fighting against disease, advocating for what is right, and ultimately delivering the best care possible. Stay strong, stay compassionate, continue to meet these challenges with empathy, integrity, and a commitment to the well-being of all patients.

[00:33 -18:25] Ethical Challenges in Pediatric Practice

  • Ethical dilemmas in divorce and custody disputes
  • Medication decisions when parents have opposing views
  • Navigating conflicting parental preferences
  • Creating a safe plan for the patient's well-being

[18:26 - 28:51] Effective Communication Techniques

  • Clarifying questions: asking for further information or examples to ensure understanding.
  • Empathy: showing understanding and validation of the speaker's emotions.
  • Non-verbal cues: using body language and facial expressions to convey interest and engagement.
  • Reflective responses: paraphrasing what the speaker said to confirm comprehension.

[28:52 - 38:38] Ways to Promote Independence in Children Without Disabilities

  • Foster critical thinking and decision-making in children.
  • Develop self-sufficiency by giving children responsibilities.
  • Build confidence and autonomy through involvement in decision-making.
  • Teach effective time management through scheduling and goal-setting.

[38:39 -55:16] Institutional Guidelines

  • Specific protocols and procedures for handling ethical issues within your institution
  • Information on who to contact and when for guidance and support
  • Training materials and resources for healthcare professionals
  • Case studies and examples of ethical dilemmas in your institution

[55:17-1:02:56] Closing segment Takeaway

You can reach Dr. Lauren Azevedo

LinkedIn: www.linkedin.com/in/azevedo6915

You can reach Dr. Naomi Laventhal

LinkedIn: www.linkedin.com/in/naomineoethics

Links to resources mentioned on the show

AAP statements from the Committee on Bioethics https://publications.aap.org/pediatrics/collection/528/Committee-on-Bioethics?autologincheck=redirected

AAP Resident Curriculum from the Section on Bioethics: https://downloads.aap.org/AAP/PDF/Bioethics-FullCurriculum.pdf

Books about Neonatal stuff:

  • Breathe, Baby, Breathe, by Annie Janvier (translated into English from French by Phyllis Aranoff and Howard Scoff)

Books about Pediatric Ethics:

  • Clinical Ethics in Pediatrics: A Case-Based Textbook by Doug Diekema and Mark Mercurio
  • Dominic Wilkinson and Julian Savulescu wrote a nice book after Charlie Gard – Ethics, Conflict, and Medical Treatment for Children

Moral Distress, Moral Residue and the Crescendo Effect. The original 2009 article has a pay wall but a nice commentary that applies this to the COVID-19 pandemic is here: https://deploymentpsych.org/blog/staff-perspective-moral-distress-residue-and-crescendo-effect-understanding-potential-impact

For more accessible books:

  • The Spirit Catches You and You Fall Down
  • The Immortal Life of Henrietta Lacks
  • Five Days at Memorial

Podcast (be in a place to listen to this one, it’s hard):

Hidden Brain - The Ventilator: Life and Death Decisions We Make at the End https://www.npr.org/2019/11/13/778933239/the-ventilator-life-death-and-the-choices-we-make-at-the-end

For fiction with good ethics themes:

The Descendants (2011 – apparently it’s also a book), the

TV Show “The Good Place”

The Cider House Rules (book over movie but both good!)

Local Websites:

CBSSM (U of M) https://cbssm.med.umich.edu/

Center for Bioethics and Social Justice (Michigan State) https://bioethics.msu.edu/

Study of Ethics in Society (Western Michigan Univ) https://wmich.edu/ethics/focus/biology-medicine

A2ethics https://www.a2ethics.org/

Other episodes you may like:

https://pediatricmeltdown.com/episodes

164 Protecting Innocence: Talking to Children About War

151 American Indian/Alaskan Native Youth: Beyond Adversity

147 Racial Discrimination and Black Infant Morbidity and Mortality: Systemic Change Starts with You

146 Racism, Medicine, and Transformation: Eliminating Health Disparities and Systemic Inequities

Key quotes for Twitter:

"I think common language, steering away from inflammatory words, and sometimes we lose a useful word because it becomes too toxic, even if it was a useful word." … Dr. Naomi Laventhal on the power of language

"So I think that this is a case where preparation is really important. Knowing what you're going into before you go into the room and having worked out some of those what's negotiable, what's non negotiables, and laying the groundwork for that.".... Dr. Lauren Azevedo on the importance of preparation

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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In a heartfelt conversation, host Dr. Lia Gaggino is joined by Julius Towers, a remarkable father and advocate who opens up about his personal journey raising twins with autism. From highlighting the importance of early testing to addressing equity and stigma, this episode sheds light on the realities faced by families of children with special needs. It’s clear that the journey of parenting a child with autism is filled with challenges and uncertainties. Pediatricians have a crucial role to play in supporting families dealing with autism. By providing clear and compassionate communication, offering guidance and resources, and advocating for their patients, they can make a lasting impact on the lives of these children and their families. Together, we can build a world that celebrates neurodiversity. Let us remember that every child deserves access to early intervention and support, and it is up to each one of us to ensure that no child with autism is left behind.

[00:33 -19:47] Early Identification is Key for Child Development

  • Early identification allows for timely access to necessary resources and therapies.
  • Parents should be encouraged to observe their child's developmental milestones and seek professional guidance if any concerns arise.
  • Early intervention services can significantly improve a child's overall development and future outcomes.
  • Building awareness about the importance of early identification can lead to better support systems for children and their families.

[19:48 - 30:02] Challenges Faced by Minoritized Populations

  • Underdiagnosis issues in minoritized populations
  • Reasons for missed or dismissed diagnoses
  • Impact of underdiagnosis on health outcomes
  • Addressing disparities in healthcare through awareness and education

[30:03 - 43:26] Managing overwhelming emotions

  • Acknowledge the emotional whirlwind that comes with seeking services
  • Try not to get caught up in thinking too far ahead into the future
  • Establish some emotional boundaries to prevent feeling overwhelmed
  • Seek out counseling or support groups to help navigate the journey

[43:26 - 59:24] Steps for Early Diagnosis and Support

  • Screen for developmental delays or disorders in children.
  • Provide prompt referral to early intervention programs and specialized services.
  • Educate parents and caregivers about available resources and support networks.
  • Continuously monitor and track progress to ensure appropriate interventions.

[59:25 - 1:05:48] Closing segment Takeaway

You can reach Julius Towers

Email: j.y.towers@gmail.com

LinkedIn: www.linkedin.com/in/juliustowers

Links to resources mentioned on the show

Autism Speaks Parent Guide: https://www.autismspeaks.org/tool-kit/parents-guide-autism

CDC ADDM Network Community Report : https://www.cdc.gov/ncbddd/autism/addm-community-report/index.html

Autistic Self Advocacy Network parent guide: https://autisticadvocacy.org/book/start-here/

The Harvard Mind Project: https://themindproject.us/neurodiversity

Other episodes you may like:

https://pediatricmeltdown.com/episodes

130 Rapid Whole Genome Sequencing: Unlocking a Puzzle

22 Pediatric Genetics and Behavioral Health: Implications for Testing

Key quotes for Twitter:

"The advocacy stuff, it comes to me relatively naturally. It's why I'm a good lawyer. And then being a good lawyer makes you a good advocate, sort of a positive feedback."... Julius Towers, single father of autistic twins

"And it is not equal between states or even between counties or even between boroughs in New York City.".. Julius Towers, single father of autistic twins talking on the disparity of resources

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.PediatricMeltdown.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Struggling with the pressures of a demanding medical career while balancing personal well-being and family life? In this compelling episode of Pediatric Meltdown, host Lia and guest Elise Fallucco dive deep into the challenges and triumphs of stepping away from clinical care. From the challenges of finding personal fulfillment amidst professional pressures to the profound impact of career decisions on reputation, this discussion provides a rare glimpse into the emotional rollercoaster of being a healthcare professional. They’ll talk about the impact of external judgments on the importance of aligning personal passions with professional choices. This conversation offers valuable wisdom for anyone seeking balance in their professional and personal lives. Their candid discussion about identity crises, career transitions, and the importance of aligning work with personal values resonates deeply. In a field where ambition often competes with personal well-being This episode of Pediatric Meltdown reminds us that prioritizing our own well-being is not only necessary but also courageous. The journey to understanding our own needs and making tough decisions may be daunting, but it's a vital step towards a fulfilling and sustainable career in medicine. Remember, finding joy outside of work is just as crucial as achieving professional success. Your well-being is non-negotiable, and prioritizing it is an act of strength and resilience.

[00:33 -16:09] Need for Self-reflection and Change

  • Not appreciating the opportunities and relationships
  • Difficulty in recognizing personal limitations and burnout
  • Realization that a change is necessary for personal growth
  • Encouragement and support from spouse to make a change

[16:10 - 26:11] Transitioning to New Opportunities

  • Smoothly transitioning from one position to another
  • Embracing the excitement of change and new challenges
  • Considering personal growth and development in career choices
  • Finding fulfillment in pursuing something wonderful elsewhere

[26:12 - 37:32] Struggles with Behavioral Health Work

  • Exhaustion from seeing a significant number of patients per day
  • Dealing with emotionally challenging narratives from patients
  • Lacking sufficient support in the field
  • Recognizing that the journey to success is rarely a straight line

[37:33 - 52:05] Elevating Physician Voices

  • Sharing Experiences: Gives pediatricians a platform to share their personal experiences
  • Impactful Discussions: Engages in conversations about factors that influence healthcare
  • Screenings and Resources: Offers screening tools, dosing cards, guidelines, and resources for healthcare professionals
  • Easy Access: Provides resources at the click of a button for immediate implementation in practice

[52:06 - 55:51] Closing segment Takeaway

You can reach Dr. Fallucco

Instagram: PsychEd4Peds (@psyched4peds) • Instagram photos and videos

Website: PsychEd4Peds.com

Podcast: PsychEd4Peds: child mental health podcast for pediatric clinicians (or wherever you find your podcasts!)

Other episodes you may like:

https://pediatricmeltdown.com/episodes

  1. The Joys and Challenges of Pediatrics: Gather Your Spoons!

135 Physician Wellness: Find Your ‘One Thing

116 Physician Wellness Coaching: Proven Benefit!

Key quotes for Twitter:

"I Was really starting to feel like I was stretched too thin and that I couldn't devote the time that I really wanted to each of those individual roles."... Dr. Elise Fallucco

"Pediatricians are not supported and trained to manage the huge onslaught of the child mental health crisis and the enormous volume of patients in their practice with Anxiety, depression, behavioral problems, ADHD."... Dr. Elise Fallucco

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Prepare to be thoroughly moved and enlightened in this groundbreaking episode of Pediatric Meltdown, as we unravel the deeply personal journey of a Mother and her daughter, exploring the intricacies of gender affirming care. From initial confusion and grief to unwavering support and acceptance, their story will challenge your preconceptions and inspire you to embrace empathy and understanding. Step into the shoes of this multiracial, adopted teenager who fearlessly stands tall amidst the challenges of living her true self. As they navigate through complex healthcare settings to championing understanding within conservative communities, their story will challenge your perspectives and ignite a flame of compassion within your heart. Join Dr Lia Gaggino as she takes us on this extraordinary exploration of gender identity, expanding your knowledge and empathy, one step at a time, above all, the unequivocal power of love in the face of adversity. In a world where the politicization and ignorance surrounding transgender identity and gender-affirming care persist, it is more important than ever for professionals in healthcare, mental health, and education to step up and provide the support and understanding that these individuals and their families so desperately need. Education, empathy, and open-mindedness are the key to dismantling the barriers and prejudices that stand in the way. Let us stand together, united in our commitment to acceptance, and ensure that every child has the opportunity to live as their true selves, free from judgment and harm. Together, we can make a powerful impact on the lives of transgender individuals and contribute to a more inclusive and compassionate society.

[00:33 -8:51] Early Signs of Gender Identity

  • Recognizing and supporting a child's exploration of gender identity from a young age
  • Understanding the developmental appropriateness of dress-up and self-expression
  • Lack of available information and resources for parents navigating gender identity discussions
  • The emotional journey of parents when their child begins to voice their gender identity
  • The importance of creating a safe and supportive environment for children to express their true selves

[8:52 - 15:33] Misconceptions about Hormone Treatment and Surgery for Transgender Youth

  • The misconception that all questioning children should immediately start hormone treatment
  • Addressing the false belief perpetuated by anti-trans voices
  • The importance of a thoughtful and informed approach to hormone treatment
  • The recognition that surgery is not the immediate goal for all transgender youth
  • Acknowledging progress made by clinicians in understanding transgender healthcare needs over the past decade

[15:34 - 26:46] Effects of the Politicization of Gender Affirming Care

  • Frustration and fear due to lack of understanding
  • Generalizations and ignorance surrounding transgender issues
  • Feeling marginalized and targeted
  • Access to gender affirming care and support
  • Psychological and emotional impact on the child and family

[26:47 - 39:21] Letting Your Child Be the Guide

  • A clinician in Chicago advised parents to let their child be the guide in their gender identity journey.
  • This approach may initially feel counterintuitive for parents, but it emphasizes the importance of listening to and supporting the child's self-discovery.
  • Many individuals identify as non-binary, which may not fit into traditional gender categories, but it is essential to validate their feelings and experiences.
  • Gender identity is not a trend but a deeply personal and authentic expression of self.
  • Allowing your child to guide their own gender identity can lead to a more positive and supportive parent-child relationship.

[37:22 - 45:25] Closing segment Takeaway

Links to resources mentioned on the show

Book* Amazon.com: This Is How It Always Is: A Novel (Audible Audio Edition): Laurie Frankel, Gabra Zackman, Macmillan Audio: Books

Crisis support: The Trevor Project lifeline 866-4-U- TREVOR. www.thetrevorproject.org

Family support: Rainbow Families www.rainbowfamilies.org

AAP Policy Statement: Ensuring Comprehensive Care and support for Transgender and Gender-Diverse Children and Adolescents https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for?autologincheck=redirected

Pediatric Meltdown episode #15 Caring for Transgender Youth With Compassion: What Pediatricians Must Know https://podcasts.apple.com/us/podcast/pediatric-meltdown/id1529656785?i=1000502571754

Other episodes you may like:

https://swiy.co/PediatricMeltdownPodcast

160 Youth Suicide Prevention: What About the Parents?

149 Management of Youth Depression: Beyond Medications

142 Difficult Childhood Behaviors: Meeting the Challenges of Parenting

Key quotes for Twitter:

"I think there were all lost feelings in the beginning, again, I think seeing her for the first five and a half years of her life, it kind of started to make sense to us”…Mother

"I think her understanding and her experience with adoption...She has hope with that, and she doesn't necessarily feel like a loss at this point with not being able to produce that."... Mother

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

This Is How It Always Is: A Novel

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Discover the untold stories of resilience, uncertainty, and emotional turmoil in the latest episode of Pediatric Meltdown! host Dr. Lia Gaggino is joined by The Women of the RoadMap Project; Dr. Carol Lannon, Dr. Lori Crosby, Robin Kinebrew, and Meghan Didier as they dive deep into the struggles and triumphs of parents navigating the complexities of their children's chronic diseases. From navigating hospital admissions to tackling the daunting tasks of missed homework, these parents courageously share their journeys of finding strength amidst the chaos of mental health. This episode will highlight how crucial it is for medical sub-specialists to care about the topic of mental health in pediatric patients with chronic illnesses. They’ll talk about the responsibility the sub-specialists have to recognize the connection between physical and mental health and to incorporate holistic approaches into their practice. By taking the time to listen, understand, and connect them with appropriate resources, sub-specialists can play a vital role in supporting their mental health journey. The Roadmap Project reminds us to strive to enhance our competence and confidence in addressing this important aspect of care because every child deserves comprehensive support, not just for their physical health, but for their Mental Wealth as well.

[05:21-21:07] The Origin of the Road Map Project

  • Initiated after a conversation with the American Board of Pediatrics in 2016
  • A collaborative effort between patients, families, and clinicians
  • Aims to improve the emotional health of patients and families with chronic conditions
  • Published using Google Docs and updated automatically every 5 minutes

[21:08 - 35:10] Subspecialty Responsibility and Competence in Addressing Mental Health

  • Approximately two-thirds of respondents believe that addressing mental health is the responsibility of their subspecialty.
  • Only 20% of graduating subspecialty fellows feel competent enough to address mental health.
  • Competence levels vary among different subspecialties, with cardiology and nephrology showing the lowest confidence levels.
  • The focus is on acknowledging, validating, and connecting individuals to appropriate mental health resources when needed.

[35:11 - 43:06] The Therapeutic Power of Asking

  • How the normalize-ask-pause-connect approach can enhance patient care
  • How asking can contribute to healing and understanding
  • The role of asking in therapy and self-reflection
  • The potential benefits of asking in various life situations

[43:07 - 1:01:45] Importance of Raising Awareness

  • Clinicians reporting significant changes in their practice approach
  • Creating a culture of continuous learning and professional development
  • Increasing awareness of the impact on patient care and outcomes
  • Empowering clinicians to prioritize emotional health in their practice

[1:01:46 - 1:09:00] Closing segment Takeaway

Links to resources mentioned on the show

You can reach The Roadmap Project

Website: Roadmap For Emotional Health

YouTube: The Roadmap Project - YouTube

Videos:

The impact of being Black while living with a chronic condition: Inpatient perspectives

Normalize+Ask+Pause+Connect by Dr. Erica Sood: Video Link and One Pager Link

Meg Didier Video: A Patient Shares How Clinicians Can Empower Patients by Asking About Emotional Health

Key quotes for Twitter:

"To tell your patients it's okay not to be okay, that there are lots of things that you're going through. You don't have to be Superwoman, Superman, super patient. I think it's important for them to relay that message to their patients, to their families. And, and it's okay to ask for help."... Robin Kinebrew on clinicians recognizing and validating patients/parents mental health

"I think that what I really want people to know is that my mental health has been much harder to manage than my physical health."...Meghan Didier on the importance of mental health in recovery

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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From Measles to Mass Epidemics: This episode is dedicated to a pediatrician's journey through medical challenges and advocacy. Join host Dr. Lia Gaggino this week, as she features heartfelt conversations with renowned pediatricians, Dr. Bravo and Dr. George Rogu. Listen in as they share personal stories from their medical careers and highlight the importance of preventive care. From preventing infectious diseases to the struggles of combating mental health crises, they stand at the frontline of pediatric care. Pediatricians feel their call of duty is to advocate for the health and wellbeing of their young patients. But pediatricians will say “we must never lose sight of why we chose this path in the first place. Our purpose is greater than any obstacle, and our dedication to the health and wellbeing of children is unwavering”. So, as they continue to stand strong, united in their mission, always remember that the impact that just one pediatrician can make extends far beyond the confines of a podcast episode, and together, their voices will be heard.

[00:33 -24:56] The Winding Path of Personal and Professional Growth

  • Herb's unconventional career path with unexpected turns
  • Motivation to create their own narrative
  • The dare that led to starting the podcast
  • Overcoming the challenge of being unheard and finding a voice

[24:57 - 33:14] Mental Health Crisis and the Need for Support

  • The rising rates of mental health issues among individuals, including children
  • Importance of early intervention and access to mental health services
  • Strategies for promoting mental well-being and resilience in families
  • Addressing the stigma surrounding mental health and promoting open conversations

[33:15 - 39:23] Addressing Pediatric Healthcare Challenges

  • Allocate budget to pay off pediatricians' student loans.
  • Provide financial aid to hospitals with pediatric beds.
  • Improve public health outcomes, not shift funding constantly.
  • Invest in pediatric healthcare to reduce respiratory illness risks and worries for families with young children.

[39:24 - 45:00] Importance of Pediatrician Voices at the Table

  • Pediatricians provide expertise on child health and development in decision-making.
  • They ensure children's unique needs are considered in policy and decision-making.
  • Pediatricians promote evidence-based practices for children's health and well-being.
  • Pediatricians educate parents and the public about child health issues.

[45:01 - 50:55] Closing segment Takeaway

You can reach Dr. Bravo and Dr. Rogu

Podcast: The Pediatric Lounge (buzzsprout.com)

LinkedIn: The Pediatric Lounge: Overview | LinkedIn

Instagram: @the_pediatric_lounge

Facebook: https://www.facebook.com/ThePediatricLounge

Substack: Pediatric Executive Development System | Substack

Links to resources mentioned on the show

Pediatric Lounge Podcast

Apple:https://podcasts.apple.com/us/podcast/cough-colds-cancer-and-chickens-with-dr-paul-offit-md/id1622652206?i=1000626836305

Spotify: https://open.spotify.com/show/7CVJ70ZAU6mNdsrJuS7Kcr?si=9e3d8690fcf54ffb

YouTube:https://podcasts.apple.com/us/podcast/cough-colds-cancer-and-chickens-with-dr-paul-offit-md/id1622652206?i=1000626836305

Other episodes you may like:

https://swiy.co/PediatricMeltdownPodcast

164 Protecting Innocence: Talking to Children About War

141 HIV Screening and Education: We Need to Do Better

137 Understanding Aggressive Behaviors: Who, What, Why, When and Where

Key quotes for Twitter:

"I think Chuck Chavanau. He's a brilliant pediatrician. He was extremely obsessive/compulsive. He would call the NiCU 4 times before he went to bed and he'd be like, yeah. Anything I need to know?” …Dr. Bravo talking about doctors who have made an impression on him in his early years

“...And he told me, George, never be afraid of giving medications. Never be afraid of the patient. We'll do whatever it takes to make the patient better”… Dr. Rogu talking about Dr. Jez, a Polish physician that had a great influence on him in his early years

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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The world weeps as innocence crumbles amidst the madness of war in Gaza and Israel. This is an impromptu episode based on the conflict in the middle east. Dr. Lia Gaggino unravels the profound impact on children who bear no responsibility for the conflict yet suffer its horrifying consequences of human depravity. She also shares the powerful guidance of renowned pediatric associations on how to soothe children, families, and ourselves amid the chaos and tragedy. As the world witnesses the horrors of armed conflicts and the devastating effect on innocent lives, we must pause and reflect. Dr. Lia offers indispensable insights and coping techniques to protect children's mental health worldwide. So, brace yourself for an emotionally charged discussion that demands our attention and humanity. Prepare to be moved, inspired, and called to action. Remember, together, we can heal, rebuild, and create a safer, more compassionate future for every child.

[00:33 -04:23] The Impact of Trauma on Children

  • Trauma bonds and the need for emotional support during times of crisis
  • The fight, flight, freeze response and its manifestation in the current situation
  • The importance of adults being emotional containers for children

[04:24 - 08:33] Strategies for Coping and Self-Care

  • The significance of sleep in maintaining emotional well-being
  • The consequences of exhaustion on our ability to be our best selves
  • The importance of staying informed without becoming overwhelmed

[08:34 - 11:01] Protecting the Innocence and Ensuring Safety

  • Advocating for moments of humanitarianism amidst the chaos
  • The responsibility to allow innocent children to flee to safety
  • The collective failure if any child is left unprotected

[11:02 - 13:19] The Dangers of Dehumanization and Othering

  • The link between dehumanization and the ability to harm others
  • The power of seeing a child's soul in their eyes to prevent harm
  • The unimaginable nature of the atrocities committed against children

You can reach Dr. Lia Gaggino

gagginol@gmail.com

Links to resources mentioned on the show

AAP Resources:

Academy’s policy statement, “The Effects of Armed Conflict on Children

For guidance on how to talk with children about what is going on in Israel and Gaza, see this HealthyChildren.org article.

For families about how to shield their children from traumatic events in the news and on social media go here.

AACAP Resources

  • AACAP Facts for Families, "Terrorism & War – How to Talk to Children”
  • AACAP Facts for Families, “News & Children”
  • AACAP Facts for Families, "Disaster: Helping Children Cope"
  • AACAP Disaster Resource Center
  • Disaster Liaison Network Resource Library
  • Terrorism & War Resource Library

Additional Resources

  • Talking to Children About War - The National Child Traumatic Stress Network (NCTSN)
  • Coping After Disaster - American Psychiatric Association (APA)
  • Suicide and Crisis Hotline: 988
  • Crisis Text Line: Text HOME to 741741
  • Disaster Distress Helpline – call or text 1-800-985-5990 (for Spanish, press “2”)

Key quotes for Twitter:

"Beware of social media, maintain routines, engage with your trusted family and community, manage the well-being of the adults ourselves and reach out to others when the overwhelm is too much”. … Dr. Lia Gaggino on self care during hard times.

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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What if one conversation in a bustling New York City restaurant could spark a movement in menstrual equity? You’re about to hear a story of passion, dedication, and the audacity of advocacy. In this episode of Pediatric Meltdown, your host Dr. Lia Gaggino sits down with special guest Anusha Singh, a medical student at Ohio State who is harnessing a powerful force of change. Together, they explore Anusha's journey as a student-turned-advocate, from organizing a press conference that caught the attention of five presidential candidates to testifying in front of lawmakers to repeal the tampon tax. Her dedication to addressing period poverty and fighting for change serves as a powerful reminder that one person's voice can spark a movement. So, let us take her example to heart and use our own voices, stories, and actions to break down barriers, challenge societal norms, and create a world where every person has access to the period products they need. Together, we can dismantle the stigma, create lasting change, and empower every individual to live their lives with dignity and respect.

[00:33 -10:39] The Global Issue of Period Poverty

  • Definition and scope of period poverty worldwide
  • Discussion on the prevalence of period poverty in developing countries
  • Examples of initiatives and organizations working to address period poverty globally
  • Impact of period poverty on education, employment, and overall well-being

[10:40 - 19:53] The Hidden Reality of Poverty

  • Many people are unaware of the extent of poverty that exists, as they may live in comfortable neighborhoods with well-maintained surroundings.
  • Communities living in poverty may be located in close proximity to more affluent areas.
  • Personal experiences, such as missing school due to lack of access to period products, can shed light on the challenges faced by individuals in poverty.
  • Testifying before lawmakers, regardless of age or background, can make a significant impact in addressing these issues.

[19:54 -25:59] Amplifying the Issue through Social Media and Personal Networks

  • Social media helped students generate awareness and discussion on the issue.
  • Social media's impact highlights its influence in modern activism.
  • Dialogue and personal experiences made a substantial impact on public perception.
  • Creating "noise" through various channels attracted attention from influential figures and organizations.

[26:00 - 32:13] Finding Information on Tampon Tax in Your State

  • Utilizing period.org's map
  • Exploring Bill Track 50 for legislation status
  • Peoria Law's website as another resource
  • Awareness raised by organizations like the American Academy of Pediatrics

[32:14 - 36:39] Closing segment Takeaway

You can reach Anusha Singh

Instagram: @anusha_sing

Links to resources mentioned on the show

HERE is the link for the movie trailer!

HERE is the link to my TEDx talk!

www.period.org

Bill Track 50 https://www.billtrack50.com

Days for Girls: https://www.daysforgirls.org

Celeste Mergen’s new book “The Power of Days”: Amazon.com: The Power of Days: A Story of Resilience, Dignity, and the Fight for Women's Equity: 9781637743744: Mergens, Celeste: Books

Other episodes you may like:

https://swiy.co/PediatricMeltdownPodcast

161 Menstrual Equity Changes Lives: The Power of Days

151 American Indian/Alaskan Native Youth: Beyond Adversity

Key quotes for Twitter:

"I will say, I shadowed some pediatricians yesterday...that was such an amazing experience of seeing how big advocacy is for them and how passionate so many pediatricians are. That was really amazing."...Anusha Singh on Passionate Pediatricians

"It follows my advocacy journey Along with another advocate, to pass legislation in Michigan to repeal the Michigan tampon tax."... Anusha Singh on The Power of Advocacy in Repealing the Tampon Tax

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Attention all parents, caregivers, and medical professionals! Are you ready to take control of pediatric migraines? Then tune in to the latest episode of Pediatric Meltdown with your host Dr. Lia Gaggino, as she teams up with migraine specialists Dr. Sarah Dixon and Dr. Emily Foxen Craft. From debunking common misconceptions to exploring the power of cognitive behavioral therapy, they have all the information you need to effectively manage migraines in children. The Pediatric Headache Echo program is not just a training program, but a game-changer in the world of pediatric headache and migraine care. By equipping primary providers with the knowledge, skills, and confidence to effectively treat and evaluate pediatric headache patients, they are revolutionizing access to high-quality care. In a world where medication and lifestyle modifications often take center stage, it's time to acknowledge the hidden potential of psychology in the pediatric headache and migraine area. By providing information, ideas, and referrals to trusted partners, healthcare professionals can tap into a rich resource that offers holistic support and complements existing treatment options. Let's shift the narrative and embrace psychology as an essential component of comprehensive care. Together, we can unlock the true potential within each patient, empowering them to live their lives free from the shackles of chronic pain. It's time to harness the power of psychology and make a lasting impact on the lives of children and teens with migraines.

[00:33 -13:55] Effective Communication Strategies

  • Importance of using visuals to demonstrate the treatment plan
  • Utilizing metaphors and analogies to enhance understanding
  • Step-by-step approach in explaining the treatment process to families
  • Addressing concerns about primary and secondary causes of headaches

[13:56 - 27:03] Understanding the Importance of Medication in Headache Management

  • Each treatment plan is individualized, considering factors such as age and other health considerations.
  • The approach to medication involves a more rigorous attention to pain hygiene, which may not always be prioritized in regular clinic visits.
  • Understanding the patient's barriers to making small lifestyle changes is a key part of the medication management process.
  • Follow-ups and referrals to specialized providers can help patients manage their medication more effectively.

[27:04 - 40:09] Benefits of Specialized Training in Pediatric Headache Treatment

  • Empowers participants to become experts in their own centers or communities
  • Increases confidence and competence in evaluating and managing pediatric migraines
  • Enables healthcare professionals to be the go-to person for headache-related concerns
  • Improves access to high-quality care for children and teens in their own communities

[40:10 - 47:27] Resources for Migraine Education and Support

  • Explore the American Migraine Foundation for comprehensive information
  • Utilize the timeline infographic to educate families about migraine headaches
  • Consider partnering with organizations to expand awareness and support
  • Share online tools for medication management and tracking

[47:28 - 54:20] Closing segment Takeaway

You can reach Dr. Emily Foxen Craft

DrEmily@pediatricpainbehavioralhealth.com

Links to resources mentioned on the show

International Classification of Headache Disorders (ICHD): https://ichd-3.org/1-migraine/

American Migraine Foundation Timeline of a Migraine Attack: https://americanmigrainefoundation.org/resource-library/timeline-migraine-attack/

University of Michigan Headache Referral Guideline: https://med.umich.edu/mott/pdf/headache-referral-guidelines.pdf

Pediatric Headache ECHO. http://www.pediatricpainbehavioralhealth.com .

Other episodes you may like:

https://swiy.co/PediatricMeltdownPodcast

139 School Based Health: Literally Meeting Kids Where They Are!

132 Psychopharmacology: Considerations Before Prescribing

77 Pediatric Hospitalist Perspective: Toxic Stress and Resilience

Key quotes for Twitter:

"You have so much power and opportunity to really shape a family's expectations and a family's openness and response to treatment"... Dr. Emily Foxen Craft on The Power of Communication in Pediatric Care

"The thing that differentiates the Migraine aura from an ischemic event is that migraine aura comes on gradually, and stroke symptoms or TIA symptoms come on in a hyperacute fashion."... Dr. Sarah Dixon

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Imagine a world where menstruation is not a taboo topic, but rather a catalyst for empowerment, education, and change. In this episode of Pediatric Meltdown, join host Dr. Lia Gaggino as she interviews Celest Mergen, a passionate advocate for menstrual equity and the founder of Days for Girls. Prepare to have your preconceptions shattered as Celeste reveals the transformative power of simply listening and inviting others to be part of the solution. From engaging communities worldwide to reinterpreting past traumas, every moment is an opportunity for change. Days for Girls is not just a movement for girls, but for everyone willing to stand up and make a difference. By providing sustainable menstrual care solutions and education, they are changing lives, breaking down barriers, and empowering individuals all around the world. Celeste's talks about her experience in Kenya, where conversation and understanding led to the laying down of knives and the preservation of rich traditions without harm. As we think about applying her methods to other world problems, the positive outcomes are endless. Together, let's listen, learn, and create a world where every voice is heard and every individual is empowered to make a difference.

[00:33 -22:42] Days For Girls: Breaking Menstrual Taboos

  • Introduction to Days For Girls: Days For Girls provides menstrual care products and education, giving women and girls access to menstrual equity, dignity, and opportunity.
  • Global Impact: It addresses the pervasive issue of menstruation taboos, affecting over 500 million people worldwide, by providing essential products and starting conversations.
  • The Power of Conversations: By breaking the silence around menstruation, Days For Girls helps eliminate stigma and empowers women and girls to manage their periods with confidence.
  • Design Evolution: Days For Girls continuously improves its washable pads, involving those they serve in the design process, holding two patents, and expanding their impact globally.

[22:43 - 37:11] Changing Culture

  • Recognize the need for change: Understand that cultural practices may be deeply rooted and ingrained in a community.
  • Avoid making people wrong: People resist change when they feel criticized or judged, so refrain from telling them they are wrong.
  • Invite participation: Encourage people to be part of the solution rather than imposing change on them.
  • Find common ground: Identify shared values or aspects of the culture that everyone can agree on

[37:12 - 46:22] Impact on Girls' Lives

  • Empowerment through writing articles and letters to magazines about body image representation.
  • Positive influence of American Girl magazine's focus on stories rather than body image.
  • The transformative effect of providing hygiene kits to girls in need.
  • Stories of girls experiencing newfound confidence and freedom with hygiene products.

[46:23 - 54:12] Availability of Menstrual Products

  • The Isle organization offers washable menstrual products
  • Cups and washable products are widely available online
  • Washable products can be found at various stores
  • Various options for washable menstrual products online

[54:13 - 57:49] Closing segment Takeaway

You can reach Dr.Celeste Mergen

Insta: https://www.instagram.com/celestemergens/rgens/

Facebook: https://www.facebook.com/celeste.mergens

LinkedIn: https://www.linkedin.com/in/celeste-mergens/

Links to resources mentioned on the show

Celest’s Book

https://hi.switchy.io/ThePowerOfDays

Other episodes you may like:

https://swiy.co/PediatricMeltdownPodcast

Ep 151 American Indian/Alaskan Native Youth: Beyond Adversity

Ep 146 Racism, Medicine, and Transformation: Eliminating Health Disparities and Systemic Inequities

Ep 111 Health is a Human Right: Why Are We Falling Behind?

Key quotes for Twitter:

“The power of invitation changes people's behavior, and that's how we've seen true transformation happen”...Celeste Mergen on how she’s learned to bring people together.

“Days for Girls is not just for girls. It's for anyone who stands up and says, 'I'm going to do something about this issue”... Celeste Mergen on who Days For Girls serves.

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Welcome to Pediatric Meltdown, the podcast where we discuss the unique challenges parents face when it comes to their child's mental health. Host Dr. Lia Gaggino teams up with guest Dr. Cynthia Ewell-Foster to tackle the pressing issue of suicide prevention and support for families. Learn how parents can better navigate this challenging terrain as they uncover the importance of community engagement, clear communication, and empowering parents to implement discharge recommendations effectively. You’ll hear about the vital role of caregivers, the role of firearm safety, and the remarkable impact of a supportive network in times of crisis. It is crucial for parents to be vigilant and proactive when it comes to their child's mental health. By utilizing the resources available, such as the toolkit provided by the Macomb County crisis center and participating in support groups like NAMI Washtenaw County parents group, parents can navigate the challenges with more confidence. Let's take action, reduce stigma, and create a world where every child feels heard, supported, and loved. Together, we can make a difference and save lives.

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.

[05:34 -15:13] Building Self-Efficacy and Capacity in Suicide Prevention

  • communication between systems create a seamless environment for providing comprehensive care to at-risk children.
  • initiatives should prioritize empowering parents, healthcare professionals, and stakeholders in suicide prevention.
  • Suicide prevention requires a multi-system approach involving emergency departments, therapists, and pediatricians.
  • Efforts should focus on building self-efficacy and capacity in different systems to address suicidal ideation in children.

[15:14 - 25:13] Cultivating Confidence and Empowerment within the Family Unit

  • Provide clear directions and support to help families believe in themselves
  • Encourage families to have confidence in their abilities to overcome challenges
  • Offer resources and tools to assist families in achieving their goals
  • Promote self-belief and resilience in families facing difficult situations

[25:14 - 37:25] Importance of Emotional Support for Parents After a Suicide Crisis

  • Establish a network of trusted adults who can provide emotional support to parents on a regular basis.
  • Encourage open communication and create a safe space for parents to express their feelings and concerns.
  • Provide resources and information about coping strategies and self-care to help parents navigate the emotional aftermath.
  • Offer professional counseling or therapy services to parents to address their own mental health needs.

[37:26 - 48:24] Strategies for Clinicians to Promote Safety and Mental Health

  • Secure firearms or remove them from homes.
  • Address medication safety and storage.
  • Manage access to dangerous objects.
  • Help patients connect with mental health professionals.

[48:25 - 57:27] Closing segment Takeaway

Links to resources mentioned on the show

Holding On To Life Toolkit: https://medicine.umich.edu/sites/default/files/content/downloads/macomb-county-cmh-holding-on-to-life-toolkit.pdf

NAMI support group: https://namiwc.org/about/mental-health-support-groups/

Youth Nominated Support Team:

King, C.A., Arango, A., Kramer, A., Busby, D., Czyz, E., Ewell Foster, C., & Gillespie, B.W. (2019). Association of the Youth-Nominated Support Team Intervention for Suicidal Adolescents With 11- to 14-Year Mortality Outcomes: Secondary Analysis of a Randomized Clinical Trial. JAMA Psychiatry, 76(5), 492-498. https://doi.org/10.1001/jamapsychiatry.2018.4358

Worsening Symptoms of Anxiety, Depression, and Sleep Problems in Caregivers Following Youth's Suicide-Related Emergency Department Visit: https://pubmed.ncbi.nlm.nih.gov/36691847/

Denise Ullem Blog: Casseroles for Depression (https://universalgrit.wordpress.com/2015/10/01/casseroles-for-depression/ )

Predictors of Parent Behavioral Engagement in Youth Suicide Discharge Recommendations: Implications for Family‐Centered Crisis Interventions: https://pubmed.ncbi.nlm.nih.gov/34136980/

Other episodes you may like:

https://swiy.co/PediatricMeltdownPodcast

Ep 159 Youth Suicide Prevention: Safety Planning and Lethal Means Safety Counseling

Ep. 158 Preventing Youth Suicide: Risk Assessment and Management

Ep. 96 AAP Blueprint for Youth Suicide Prevention: A Roadmap

Ep. 08 Screening Youth For Suicide Risk: Can it be done in a busy pediatric practice?

Key quotes for Twitter:

"And one of the things that we learned was just what you were mentioning that parents were coming into the emergency room, with expectations about what was gonna happen that were very different than what we thought we were going to do for their families."... Dr. Cynthia Ewell-Foster

"Getting out in front of that and setting appropriate expectations, increases people's self efficacy." ... Dr. Cynthia Ewell-Foster on building self efficacy for mental health

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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https://swiy.co/WhatAreYourThoughts

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.

Welcome to the Pediatric Meltdown podcast, where Dr. Lia Gaggino will take you into the world of pediatric care to tackle the most important topics that impact the well-being of our little ones. In today's episode, Dr. Gaggino and her guest, Dr. Alejandra Arango, explore the critical role of safety planning in preventing child suicides. Their heartfelt conversation takes a deep dive into the intricacies of safety planning within various settings, highlighting the effectiveness of individualized plans, coping strategies, and community crisis resources. Creating a meaningful safety plan in just 20 minutes is not only realistic, but essential in a primary care setting. By involving all staff, from doctors to nurses to administrators, we can truly make a difference in the lives of our children. Standardized screening protocols and readily accessible safety plans in medical records make the process more feasible. Remember, a safety plan is part of a comprehensive suicide prevention approach that includes screening, assessment, evidence-based interventions, and crisis support. A unified team will provide the support and resources needed to guide our young ones through the darkest times. So, grab your headphones and get ready to learn invaluable insights that will empower you to create safe environments for our young ones, ensuring their well-being and building a brighter future.

[05:58 -17:27] Importance of Tailoring Safety Plans to Individuals

  • The effectiveness of a safety plan is enhanced when the person themselves contributes ideas on how to distract or cope with distressing thoughts.
  • Safety plans should go beyond simply checking off boxes and should encourage open discussions about strategies for managing difficult situations.
  • Providers should actively engage with patients to understand their unique warning signs and triggers.
  • Safety plans should be regularly updated and revised to ensure they remain relevant and effective.

[17:28 - 28:24] Specificity in distraction strategies

  • Consider options like watching videos of cats, playing a specific video game, or listening to a certain song
  • Encourage team members to be specific about what engages them personally
  • Highlight the importance of finding activities that pull the brain's attention
  • Suggest coloring or other activities that require focus and concentration

[28:25 - 43:57] Safe Storage of Firearms and Medications

  • Proper storage methods for firearms, such as gunlocks or safes
  • Separating ammunition from firearms and keeping them in secure locations
  • Educating families on safe storage practices
  • Discussing potential barriers and feelings associated with safe storage
  • Including over-the-counter medications in safe storage practices

[43:58 - 55:06] Integrating Safety Plans into Medical Records

  • Standardized screening and assessment protocols for providers
  • Incorporating safety plans into the medical record system
  • Easy accessibility of safety plans for healthcare professionals
  • Streamlining the process of pulling up safety plans during consultations
  • Ensuring safety plans are readily available for problem-solving with the youth

[55:07 - 01:04:09] Closing segment Takeaway

Links to resources mentioned on the show

Stanley Brown Safety Plan...

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https://swiy.co/WhatAreYourThoughts

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.

In this thought-provoking episode, Dr. Lia Gaggino invites Dr. Lisa Horowitz back to the mic to discuss important aspects of suicide prevention programs and validation studies. They specifically focus on the role of pediatricians in identifying and supporting young people who may be at risk. They introduce the Brief Suicide Safety Assessment (BSSA), a tool that can help in these situations. Dr. Horowitz emphasizes the importance of using appropriate language when discussing suicidality with parents, offering a valuable perspective that can change how we approach this sensitive topic. This episode serves as a reminder of how crucial it is for caregivers to provide guidance, support, and reassurance to children, and to make them aware of available resources when facing challenges. Just like we talk to our children about topics such as safe sex or drugs and alcohol, discussing resilience should also be an ongoing conversation. Caregivers must equip children with coping mechanisms rooted in resilience to prepare them for the future. So together, let's create a community where children feel safe to ask questions, without fear of judgment or stigma. By investing time today in building resilient kids, we can nurture a generation capable of overcoming any hurdles they may encounter tomorrow.

[02:37 -12:30] Screening Practices and Feasibility Studies

  • Several studies demonstrate the feasibility of screening practices.
  • Screening can be effective in identifying acute and non-acute cases.
  • The fifth question in the screening process determines the acuity of the situation.
  • Comprehensive toolkits provide scripts and guidance for medical professionals.

[12:31- 23:41] Brief Suicide Safety Assessment (BSSA)

  • Specifically created with pediatricians in mind to aid in suicide risk assessment.
  • Aims to remind pediatricians about essential elements of the BSSA.
  • Serves as a middle step in the pathway of suicide screening programs.
  • Offers a triage of the screening process to further assess and prioritize patients.

[23:42 -31:52] Practical Next Steps

  • Determine urgency: Assess immediate need for intervention based on the frequency and severity of the thoughts
  • Provide support: Offer a listening ear and a calm presence to help the individual express their feelings and thoughts comfortably.
  • Safety measures: Talk about the importance of safety, including lethal means safety, especially when firearms are involved, to prevent any potential harm.
  • What’s next: Based on the assessment and discussion, determine the appropriate disposition or action plan to address the individual's needs effectively.

[31:53- 39:49] Importance of Taking Action and Finding Support

  • Emphasize the difference between doing nothing and doing something.
  • Stress that it is acceptable for plans to change if the initial approach is not working.
  • Assure individuals that there is a process and plan in place to keep them safe.
  • Offer the option for a follow-up call from your staff to inquire about their well-being, providing a sense of reassurance and support for parents.

[39:50 - 48:05] Closing segment Takeaway

Links to resources mentioned on the show

  • NIMH ASQ Toolkit: https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials
  • AAP Blueprint for Youth Suicide Prevention: https://www.aap.org/en/patient-care/blueprint-for-youth-suicide-prevention/
  • CDC Youth Suicidal Thoughts and Behaviors: https://www.cdc.gov/mmwr/volumes/72/su/su7201a6.htm#:~:text=Suicide%20is%20the%20third%20leading,was%209.0%20per%20100%2C000%20population.
  • Counseling Access to Lethal Means Safety CALM Course: https://sprc.org/online-library/calm-counseling-on-access-to-lethal-means-2/

Other episodes you may like:

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96 AAP Blueprint for Youth Suicide Prevention: A Roadmap

08 Screening Youth For Suicide Risk: Can it be done in a busy pediatric practice?

Key quotes for Twitter:

“ I think the worst thing that would happen is I asked you, I didn't really want to know, and now I need to send you somewhere else because I have no idea what to do." …. Dr. Lisa Horowitz on practicing your workflow in a case of an emergency

"So the BSSA, again, is the middle step of the pathway and I believe that makes or breaks your screening program."…. Dr. Lisa Horowitz on the different questions on the Brief Suicide Safety Assessment

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

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In this abbreviated episode of Pediatric Meltdown, Dr. Lia Gaggino celebrates 3 years of the Pediatric Meltdown podcast and opens up about the challenges and uncertainties that come with transitioning from a daily pediatric practice. Join her as she explores the psychological grief and identity crisis she faced when stepping away from patient care. Dr. Gaggino shares the realization that being a pediatrician goes beyond simply seeing patients in an office, reminding us that purpose and impact can take various forms. From her involvement with the American Academy of Pediatrics to her role as a consultant in a Child Psychiatry access program, she finds new avenues to make a difference in children's lives, and last but never least, this podcast that has reached listeners worldwide. The Heart of Pediatric Meltdown is the passionate conversations with all the high-profile experts that share time with Dr. Gaggino. They remind us that even in the face of uncertainty, we can find purpose, make a difference, and bring hope to the lives of our children. Dr. Gaggino wants to thank you so much for joining her on this incredible journey, and together, let's continue to create a world where every child's mental and emotional well-being is prioritized.

Other episodes you may like:

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107 Suicide Prevention That Works: The Zero Suicide Framework

114 Palliative and Hospice Care: A Conversation on Grief and Joy

Key quotes for Twitter:

"Not that I love social media so much, but I really want to spread the word about pediatric meltdown, and I hope you can help me do that.".... Dr. Lia Gaggino on the challenges of social media

"I want this podcast to be for all of you who take care of children."... Dr. Lia Gaggino on who would get the most out of the podcast.

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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In this thought-provoking episode of Pediatric Meltdown, host Dr. Gaggino welcomes special guest Dr. Polly Y. Gipson Allen as they do a deep dive into the world of trauma-informed care and its impact on primary care settings. Reflecting on personal experiences and societal awakenings brought about by the pandemic, they shed light on the psychological, physical, and spiritual effects of racial trauma and discrimination. From trauma-informed care to enhancing organizational capacity, the duo explores the various strategies and policies that can be implemented to create a culture of soul and self-care not only in clinical facilities, but also in schools as well. Join them as they share insights on building resilience, integrating mental health support, and the role of integrated care models in providing holistic patient care. It is time to prioritize the mental wellbeing of our patients and students and ensure that they have access to the resources and support they need. Let us be the voice that advocates for school-based mental health services and screenings, because every child deserves a caring and nurturing environment where they can thrive and grow. Together, we can transform our primary care settings into spaces that heal not just the body, but also the soul.

[00:33 -13:07] Trauma Prevalence and the 5 R's of Trauma Informed Care

  • The 1st R: Realizing the widespread impact of trauma and the potential paths for recovery
  • The 2nd R: Recognizing the signs and symptoms of trauma in patients and families
  • The 3rd R: Responding by integrating trauma knowledge into policies, practices, and procedures
  • The 4th R: Resisting re-traumatization within primary care settings
  • The 5th R: Promoting resilience and the ability to cope, adapt, and recover from trauma and stress

[13:08- 21:28] Identifying Trauma in Primary Care Settings

  • Assign champions within the clinic to facilitate the implementation of trauma screenings.
  • Ask a question like "Since the last time I saw you, has anything really scary or upsetting happened to you or your family?" to initiate the conversation on trauma.
  • Conduct brief screenings that take around 5 to 10 minutes to identify traumatic exposure or stress symptoms.
  • The purpose of universal screening is to guide clinical decision making and determine if further trauma assessment is required.

[21:29 -32:19] Integrated Care Models

  • Collaborating with clinical colleagues, behavioral health professionals, and social workers
  • Warm handoff process for seamless care transitions
  • Identifying primary care or behavioral health as the initiator of the brief screen
  • Focusing on holistic well-being and integrating mental and physical health

[32:20 - 43:30] Engaging the Community

  • Organize focus groups or community events to gather input and feedback on improving care
  • Collaborate with community members and leaders to form a planning committee for implementing changes
  • Address barriers to access such as transportation or lack of resources
  • Leverage community traumatic events to bring people together, raise awareness, and promote community support and resilience

[43:31 - 47:45] Closing segment Takeaways

Links to resources mentioned on the show

  • Resources:
  • https://www.nctsn.org/
  • https://seekwellbeing.org/

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Get ready for another thought-provoking episode of Pediatric Meltdown, the podcast that explores the untold stories and groundbreaking developments in pediatrics. Host Dr. Lia Gaggino sits down with Dr. Wendy Hunter, a remarkable pediatrician who has revolutionized the way pediatric care is delivered. Reflecting on Wendy's inspiring journey, we are reminded of the profound impact that social determinants of health have on pediatric patients' lives. As healthcare professionals, it is our duty to not only treat their physical symptoms but also understand their unique experiences and address the underlying issues. By incorporating trauma screening and fostering community partnerships, we can create a healthcare system that truly supports the holistic well-being of our patients. Let Dr. Hunter's story be a call to action for all of us to champion, change and prioritize the social determinants of health in our own practices. Let us all be inspired to make a difference in our own professions, and remember that even amidst the chaos, there is incredible power in staying true to our passions and values.

[00:33 -17:40] Community Outreach Programs on Trauma Awareness

  • Community-based organizations as partners in spreading health literacy and trauma information.
  • Bringing pediatricians to low-income housing communities, homeless shelters, and maternity shelters.
  • Using interactive sessions with families to discuss health topics and model reading practices.
  • Breaking down communication barriers and fostering trust by engaging with families in their own communities.

[17:41- 26:51] Training and Preparation for Asking ACEs Questions

  • Presentation on ACEs and specific scripting for introducing and discussing the screener
  • Utilization of Epic EMR with smart phrase scripting for easy reference during conversations
  • Orientation and training for office staff by the training staff
  • Front office trained on patient self-administered ACEs questionnaire on tablets or mobile devices

[26:52 -37:45] Workflow Process for Screening a Four-Year-Old

  • Introduce the pearls questionnaire as part of the routine well visits for children at the appropriate age.
  • Ensure the questionnaire is integrated into the EMR system to streamline the process.
  • Provide a comfortable and confidential environment for the family to fill out the questionnaire.
  • Use identified scores to facilitate a discussion with the family, providing appropriate guidance and support.

[37:46 - 45:34] Managing Wellness and Work-Life Balance

  • Importance of having a basic level of competence in mental health for everyone
  • Grant opportunities for physicians to receive training in managing ADHD, anxiety, and depression
  • The Pediatrician Next Door podcast as a platform to educate and entertain families and pediatricians
  • Personal values and rituals as a guide for managing well-being and making decisions

[45:35 - 50:59] Closing segment Takeaway

You can reach Dr. Wendy Hunter

Website: www.drwendyhunter.com

Facebook: Dr. Wendy Hunter | Facebook

Instagram the_pediatrician_next_door

Twitter:...

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Welcome to the Pediatric Meltdown podcast, where we delve into the challenges and triumphs of pediatric healthcare. Today, host Lia Gaggino has the pleasure of introducing her guest, (and self-proclaimed “superfan” of Pediatric Meltdown), Dr. Alisa Minkin, a trailblazing pediatrician and host of the JOWMA Podcast, a show dedicated to health education for the Orthodox Jewish community. In today’s episode, Dr. Minkin shares her inspiring journey as a pediatrician and her unwavering commitment to mental health awareness. Drawing from her experiences as a parent to a child with special needs, as well as her advocacy for mental health screenings, Dr. Minkin's story is one of passion, resilience, and making a difference in the lives of children and families. Despite the barriers of time and limited resources, she has embraced telehealth as a double-edged sword and implemented crucial mental health screenings in her practice. Her desire to hear more voices of lived experiences, particularly from autistic and neurodivergent individuals and family partners, reminds us of the importance of inclusion and diverse perspectives in approaching pediatric care. Her journey serves as an inspiration for healthcare professionals and parents alike. With her passion and determination, she is indeed a true mental health warrior. So, grab your headphones and tune in to this episode – you don't want to miss this thought-provoking episode.

The Spoons Theory: The spoon theory is a metaphor describing the amount of physical and/or mental energy that a person has available for daily activities and tasks, and how it can become limited. It was coined by writer and blogger Christine Miserandino in 2003 as a way to express how it felt to have lupus; explaining the viewpoint in a diner, she gave her friend a handful of spoons and described them as units of energy to be spent performing everyday actions, representing how chronic illness forced her to plan out days and actions in advance so as to not run out of energy.

The metaphor has since been used to describe a wide range of disabilities, mental health issues, forms of marginalization, and other factors that might place an extra and often unseen burden on people living with them. From Spoon theory - Wikipedia

[03:10 - 09:01] Barriers to meeting mental health needs

  • Limited time for pediatricians to address mental health concerns during appointments.
  • Lack of resources, especially for those who accept insurance or Medicaid.
  • Challenges in finding qualified therapists and mental health resources.
  • Disparities between Medicaid and private insurance coverage for mental health services.

[09:02 - 14:24] Training Programs and Resources

  • Case reviews and phone calls as part of the Reach program
  • Utilizing Project Teach, a child psychiatry access program
  • Listening to podcasts, including the Joma and Pediatric Meltdown podcasts
  • Learning from personal experiences and emotionally resonant stories

[14:25 - 22:34] Personal Reflections and Advocacy

  • Highlighting the importance of suicide prevention and her sister's experience with it.
  • Discussing the journey of implementing suicide prevention screening in her practice and allied supergroup.
  • Expressing gratitude for the support received from experts in the field.
  • Describing the introduction of combined ASQ Gad and PHQ screening tools in her practice.

[22:35 - 32:47] The Importance of Advocacy and Creativity in...

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Welcome back to Pediatric Meltdown. In this week’s episode, host, Dr. Lia Gaggino welcomes Dr. Lee Beers and Dr. Binny Chokshi, where they discuss the often-overlooked topic of military families and the unique challenges they face. As a military pediatrician, Dr. Beers shares her personal journey and experiences taking care of military-associated families. Dr. Chokshi, a civilian pediatrician who provides care to military families, also shares her role in researching the impact of military life on children's mental health and overall well-being. Together, they highlight the importance of understanding the demographics and specific stressors of military families, such as parental deployments, frequent moves, and potential injuries or PTSD. They also emphasize the strengths and resources available to military families, including the strong sense of community and access to specialized support services. The subject of military children and mental health can no longer hide in the shadows. These extraordinary young individuals sacrifice so much in service to our nation, so let us continue to advocate, educate, and empower our military families so that they receive the care, understanding, and support they truly deserve.

[00:33 -17:03] Opportunities for Pediatricians in the Military

  • Military scholarships available that cover medical school expenses and provide additional funds.
  • Unique clinical opportunities, such as working with military families in Guantanamo Bay.
  • Opportunities for leadership roles within the armed forces and military treatment facilities.
  • Ability to serve an important group of children and families while practicing medicine.
  • Access to resources and support specifically tailored to military families.

[17:04 - 23:16] Considerations for Caring for Military Children and Families

  • Asking specific questions to understand the stress and uncertainty of deployments
  • Recognizing the strength and support from military communities
  • Being creative in helping families navigate disruptions caused by deployments
  • Utilizing innovative programs like video calls for deployed service members and their children
  • Addressing the challenges of living in the moment due to uncertainties and stressors

[23:17 - 36:44] Impact on Mental Health of Children in Military Families

  • High prevalence of mental health struggles among military children
  • Factors impacting mental health moves, deployments, transitions, and caregiving for injured parents
  • Importance of recognizing and addressing the mental health needs of military children
  • Protective factors: positive childhood experiences, peer support, and a sense of community
  • Collaborative efforts to provide support for hidden helpers and families of injured service members

[36:45 - 46:50] The Role of Pediatricians

  • Pediatricians can advocate for military families, recognizing and addressing their unique challenges and life stressors.
  • Pediatricians can play a role in normalizing the act of seeking help and support for military kids and their families.
  • Pediatricians are in a unique position to support military families, utilizing their knowledge and expertise in pediatric care.
  • Serving as a military pediatrician offers opportunities for growth, leadership, and learning in the field of pediatrics.
  • Pediatricians can deepen their gratitude towards military families and appreciate the sacrifices they make for the nation.

[46:51 - 51:01] Closing...

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Welcome to this week's Pediatric Meltdown Podcast, where host Dr. Lia Gaggino invites guests Dr. Bruno Chumpatazi and Dr. Amanda Deacy to unravel the mysteries behind chronic symptoms in children. Together, they delve into the complexities of post infectious IBS, highlighting the multifaceted causes that contribute to these symptoms. From altered pain perception and processing to the potential role of inflammation, the experts leave no stone unturned. Discover how food sensitivities, the microbiome, and seasonal allergies come into play in shaping the experience of chronic symptoms. Join us as we explore the multidisciplinary treatment plans, focusing on non-pharmacological interventions like relaxation training and cognitive behavioral therapy. It's time to gain a better understanding and listen, learn, and advocate for the multidisciplinary support and resources that these children and their families desperately need. Together, we can make a profound impact on their journey towards wellness.

[09:24 -21:07] Impact and Contributing Causes

  • Disorders of gut-brain interactions (DGBI) affect 25% or more of school children worldwide.
  • Early life events, such as being born prematurely or having a nasogastric tube placed, can increase the risk of developing DGBI.
  • Sensitizing medical events, like inflammation or infection, can trigger or exacerbate DGBI symptoms.
  • Psychosocial factors, including depression, anxiety, family stress, and abuse, can also contribute to the development and severity of DGBI symptoms.

[21:08 - 34:35] Preliminary testing for evaluating abdominal pain

  • Acknowledge that the symptoms are real and not imagined
  • Avoid dichotomizing symptoms as either physical or psychological
  • Emphasize the biopsychosocial nature of the condition
  • Avoid giving families the impression that medication is a quick fix
  • Inform families that the treatment may take time and require attention and coping strategies

[34:36 - 48:43] Golden Rules in DGBI Treatment

  • Acknowledge that the symptoms are real and not imagined
  • Avoid dichotomizing symptoms as either physical or psychological
  • Emphasize the biopsychosocial nature of the condition
  • Avoid giving families the impression that medication is a quick fix
  • Inform families that the treatment may take time and require attention and coping strategies

[48:44 - 01:02:02] Non-pharmacological interventions for pediatric abdominal pain

  • Importance of attention and cognitive processing in pain management
  • Gradual physical rehabilitation to improve strength and stamina
  • Relaxation training as a mechanism to decrease overall nervous system activation
  • Various techniques under relaxation training, including hypnotherapy and biofeedback training
  • Educating adults (parents, teachers) on therapeutic approaches to influence the child's environment

[1:02:03 - 01:08:11] Closing segment Takeaway

You can reach Dr. Bruno Chumpatazi

Twitter: @‌Dr_BrunoC

You can reach Dr. Amanda Deacy

Twitter: @‌ADeacyPhD

Links to resources mentioned on the show

Hyams J et al. Functional Disorders: Children and Adolescents

Gastroenterol 2016; 150:1456-1468. PMID: 27144632

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As the only pediatrician in her Native American community, Dr. Empey’s insights and first-hand experiences offer a valuable perspective on the need for better representation and improved healthcare access. Dr. Gaggino and Dr. Empey urge all of the listeners, (especially all you early career physicians), to step up and take leadership roles at every level within the medical community. We cannot afford to ignore the health inequities faced by marginalized populations, including American Indian and Alaska Native children. Let us learn from the historical traumas that have shaped their communities and continue to impact their well-being. Through cultural competency, collaboration, and advocacy, we can prioritize their unique needs and ensure that their voices are heard. It is our call to action to dismantle systemic barriers and work towards healing and justice. The journey may be challenging, but the rewards of creating a more equitable and inclusive healthcare system for all are immeasurable. Together, we can pave the way for a brighter future, leaving no child behind.

[03:20-10:21] Challenges and Strengths of American Indian and Alaskan Native Children and Youth

  • Many pediatricians may not realize they have children from tribal communities in their practices
  • Consider the cultural, religious, and spiritual practices of these children and their families in providing care
  • Majority of American Indian and Alaskan Native population live off reservations, in urban centers
  • Urban population seeks care at children's hospitals due to limited IHS or tribal facilities
  • Language, cultural, and historical diversity among different tribes need to be acknowledged and respected

[10:22- 16:14] Historical Trauma and Health Inequities

  • Contextualizing health inequities within the historical traumas faced by American Indian and Alaskan Native communities
  • Impact of colonization, diseases, boarding schools, termination of tribes, and relocations on communities
  • Examples of personal and intergenerational traumas, such as the Trail of Tears and Indian boarding schools
  • Loss of culture, language, and family connectedness due to boarding school experiences
  • Effects of relocations on access to traditional foods, opportunities for employment, and increased poverty levels

[16:15 -21:25] Health Outcomes and Concerns for Kids

  • Mental health concerns, including an increased risk of suicide
  • Obesity and type 2 diabetes
  • Cardiovascular risk factors and hypertension
  • Lack of safe places for kids to play in some communities
  • Limited access to fresh fruits and vegetables due to food deserts

[21:26 - 27:17] Methods for Stress Reduction

  • Practicing mindfulness and meditation
  • Engaging in regular physical activity
  • Socializing and spending time with loved ones
  • Engaging in hobbies and recreational activities
  • Seeking professional help or therapy when needed

[27:18 - 31:44] Closing segment Takeaway

Links to resources mentioned on the show

  • AAP Caring For American Indian and Alaskan Native 2021 Policy Statement:

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Welcome to Pediatric Meltdown, the podcast dedicated to exploring the complexities and challenges of pediatric care. Today, host Dr. Lia Gaggino and guest speaker Dr. Marian Earls tackle the concepts of mental health competencies and integrated behavioral health. As pediatricians, it is crucial to have a multifaceted understanding of mental health and offer the necessary support to children in need. From debunking myths surrounding SSRIs to advocating for policy and payment support, Lia and Marian offer valuable insights into the integration of mental health into pediatric practice. By incorporating evidence-based therapies and working collaboratively with mental health specialists, pediatricians can effectively address mild to moderate mental health issues within their scope of practice. Pediatricians, with their long-standing relationships with families, have a unique opportunity to identify and address these issues early on. Together, we can break down the barriers and stigma surrounding mental health, ultimately improving outcomes and nurturing the emotional well-being of our future generation.

[03:18 -19:09] Overcoming Barriers and Promoting Mental Health

  • Helping pediatricians understand the tools they already have
  • Recognizing activities that promote mental health, such as reading with children
  • Understanding the role of psychiatrists in co-management
  • Discussing the panic and misconceptions regarding mental health assessment

[19:10 - 25:21] Collaboration and Advocacy for Improved Mental Health Services

  • Advocacy efforts by AAP at the national level to promote integrated mental health care
  • Need for engaged Chapters to build relationships with Medicaid programs and private payers
  • Recognition of the significant benefits of integrated care, including reduced stigma, improved access, and better outcomes
  • Ability to expand capacity and reserve referrals for children with more complex needs through effective management and collaboration with schools and community mental health services

[25:22 - 33:29] Overcoming Barriers and Promoting Mental Health

  • Helping pediatricians understand the tools they already have
  • Recognizing activities that promote mental health, such as reading with children
  • Understanding the role of psychiatrists in co-management
  • Discussing the panic and misconceptions regarding mental health assessment

[33:30 - 46:29] AAP Resources for Mental Health Support

  • Podcasts on psychopharm with experts discussing anxiety meds, SSRIs, and aggression
  • Understanding and managing medications for children on psychotropic drugs
  • Guidelines and resources for managing ADHD and depression
  • AAP's endorsement of Glad PC for identifying and managing depression in kids

[46:30 - 51:19] Closing segment Takeaway

Links to resources mentioned on the show

AAP Mental Health Initiatives: https://www.aap.org/en/patient-care/mental-health-initiatives/

AAP Mental Health Practice Readiness Inventory: https://downloads.aap.org/AAP/PDF/PracticeReadinessInventory.pdf?_ga=2.52822312.1802788953.1685034173-313239514.1676996324

Hunter and Goodie Integrated Behavioral Health in Primary Care:

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Youth mental health is a pressing issue that often goes untreated, but in this episode of Pediatric Meltdown, Dr. Lia Gaggino and Dr. Rich Dopp shed light on effective strategies for addressing this challenge. Dr. Dopp's expertise in treating adolescents with depressive disorders shines through as he discusses the use of SSRIs and the significance of understanding family history. The episode also highlights the importance of gathering information from multiple sources and utilizing various measures and questionnaires to assess depression in younger children. From recognizing the benefits of exercise in improving mood to discussing the importance of tailored treatment plans, they provide valuable insights for both healthcare professionals and caregivers. With practical advice and a personalized approach, this episode equips listeners with valuable insights to navigate the complexities of youth mental health.

[00:33 -14:52] The Rising Prevalence of Depression in Children and Adolescents

  • The increasing incidence of major depressive episodes among youth
  • The potential underestimation of depression rates in certain situations
  • The lack of access to treatment for the majority of affected youth
  • The impact of social media, sleep deprivation, traumatic experiences, and negative political climates on depression rates

[14:53 - 26:17] The Importance of Sleep for Mood

  • Sleep as a vital factor for mood regulation
  • Lack of sleep as a symptom of depression
  • Sleep disturbance and its impact on mental health
  • Strategies to support better sleep: removing electronic devices, reducing overhead lights, guided meditation, and breathing exercises

[26:18 - 43:30] Tailoring Therapy to Meet Individual Needs

  • Identifying goals is an important first step in tailoring therapy to meet individual needs
  • Social skills and problem solving exercises can lead to early gains in functioning
  • Therapy can be tailored to an individual's interests and hobbies
  • Changes in functioning can be easier to identify and foster than changes in feelings when treating depression

[43:31 - 56:11] Benefits and Effectiveness of SSRIs

  • Proven efficacy in treating depression and reducing symptoms
  • Effective in reducing anxiety symptoms in some individuals
  • Can help regulate sleep patterns and improve sleep quality
  • May enhance cognitive function and improve concentration

[56:12 - 01:02:25] Closing segment Takeaway

Links to resources mentioned on the show

AAP Guidelines for Adolescent Depression Glad PC 1 https://publications.aap.org/pediatrics/article/141/3/e20174081/37626/Guidelines-for-Adolescent-Depression-in-Primary?autologincheck=redirected

AAP Guidelines for Adolescent Depression Glad PC 2. https://publications.aap.org/pediatrics/article/120/5/e1313/71096/Guidelines-for-Adolescent-Depression-in-Primary

AACAP Facts for Families – Depression

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This episode of "Pediatric Meltdown" features an insightful conversation with Doctor Sandy Chung, the 2023 president of the American Academy of Pediatrics. Dr. Chung joins host Dr. Lia Gaggino to discuss the importance of investing in children's mental health. The AAP is a national organization that represents over 67,000 pediatricians and aims to promote the health and well-being of children. Dr. Sandy Chung's advocacy work through VMAP and AAP has been instrumental in shaping the discourse on children's mental health and providing access to mental health care. While policymakers need to understand the need for long-term investment in children's mental health, it is also the responsibility of every individual to prioritize mental health and create supportive environments for young people. Let us all work towards prioritizing the mental health of children and building a brighter future for coming generations.

[00:33 -18:39] Being the First Chinese American President of the AAP

  • Overcoming barriers and inspiring change
  • Importance of breaking stereotypes and categories
  • Encouraging individuals to pursue leadership roles
  • Finding the right group of like-minded professionals

[18:40 - 27:11] Making Mental Health Care Sustainable and Accessible

  • Implementing group therapy appointments, integrated behavioral health, brief interventions, and collaborative care to make mental health care more accessible and affordable
  • The AAP is actively working on making mental health care a top child health priority and advocating for sustainable funding and support
  • AAP aims to raise awareness about the value of pediatricians in early mental health intervention and promote the importance of prevention and resilience-building in children.
  • It is crucial for individuals, government, employers, and society as a whole to prioritize and support mental health care to ensure healthy and productive adult outcomes.

[27:12 - 35:13] Challenges in Addressing Mental Health in Healthcare

  • Lack of awareness and understanding of the importance of mental health in healthcare
  • The need for momentum and improvement in addressing mental health
  • The broader conversation of investing in children's well-being
  • Short-term perspective in healthcare financing and the need for a long-term investment approach

[35:14 - 41:19] Embracing Opportunities and Making a Difference in Pediatric Practice

  • Letting go of future worries: Embracing the uncertainty of life and career progression
  • Seizing opportunities: The power of taking chances and making a positive impact
  • Making a difference, big or small: Recognizing the potential to create change in everyday practice
  • Preventing future hardships: Harnessing the experiences of pediatric care to improve outcomes for children and families

[41:20 - 46:17] Closing Segment Takeaway

Links to resources mentioned on the show

National Network of Child Psychiatry Access Programs – find one near you!

www.nncpap.org/map

Other episodes you may like:

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112 Schizophrenia: Recognizing the Early Symptoms

96 AAP Blueprint for Youth Suicide Prevention: A Roadmap

91 Youth Mental Health...

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Unless you’ve been a victim of Healthcare Disparity and systemic racism, you may not be aware that such a thing exists, and that’s exactly why this episode of “Pediatric Meltdown” is especially important for you to hear. Host Dr. Lia Gaggino and her guest Dr. Terri Major-Kincade, discuss the structural barriers that exist in hospitals and Dr. Terri will give some practical advice on being empathetic and listening to patients' concerns. From Dr. Terri’s expertise in racial health disparities to Dr. Lia's wisdom in pediatric mental health, this episode represents a step towards understanding and addressing the root causes of these issues. It's clear that change is required to overcome the challenges in our healthcare system and provide equitable care for all. You’ll also hear about some creative ideas, everything from an Uber delivering breast milk to converting a convenience store into a Farmer’s Market. It’s solutions like these that tell us conversations around this issue must continue and more voices need to be heard to create the momentum required for change. We must recognize that health disparities are not only a moral issue but also an economic one that affects our entire society. By working together towards an overall change, we can create an equitable healthcare system that benefits everyone, regardless of their gender, race or socioeconomic status.

[00:33 -21:44] Disparities in Infant Mortality Rates

  • Infant mortality rates in certain zip codes in New York City for black infants were higher than some third world countries.
  • Black women with a college degree are still two times more likely to have an adverse birth outcome compared to white women with a GED in the United States
  • Poverty and lack of prenatal care are not the only factors contributing to these disparities
  • SES status (socioeconomic status) does not protect black women from experiencing adverse birth outcomes
  • The way in which the healthcare system intersects with black women is a contributing factor to disparate care.

[21:45 - 37:29] Impact of Stress on Pregnancy and Childbirth

  • Women who experience chronic stress have an increased likelihood of preterm birth
  • Chronic stress can lead to remodeling of the cervix and womb, causing challenges during pregnancy
  • Stress during pregnancy can also increase the risk of hypertension in children
  • Normalizing the act of asking for help and saying no can help break the cycle of stress
  • Chronic stress can also impact telomeres and shorten them, potentially leading to health issues

[37:30 - 50:26] Supporting a Grieving Family

  • Offer condolences and express your willingness to help
  • Listen actively and without judgment
  • Use the child's name and ask about their memory
  • Maintain eye contact. Let them know that you hear them, you see them
  • Respect the family's wishes and boundaries, and avoid offering unsolicited advice or opinions

[50:27 - 57:21] Vision for a Better Future

  • A future where conversations about race, color, and culture are unnecessary, but diversity is celebrated
  • Emphasizing cultural humility can help us see people's humanity rather than their circumstances
  • Allocating more resources to preventive health and normalizing mental health services can lead to significant improvements
  • Partnering with communities and addressing social determinants of health can help reduce health disparities
  • Recognizing our own biases and being open to learning and growth can lead to positive change for...

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The adverse effects of racism in healthcare have increasingly become a topic of discussion among medical professionals worldwide. In this episode of the Pediatric Meltdown, host, Dr. Lia Gaggino, is joined by Dr. Joseph Wright, Chief Health Equity Officer of the University of Maryland Medical System, to discuss the role of race consciousness in addressing systemic and structural inequities in healthcare delivery. Dr. Wright talks about how we can no longer ignore the impact of racism on child development, which can have long-term consequences for their health and well-being. It is the responsibility of pediatricians to advocate for a society that values diversity and promotes equity, and to continue learning about the science of resilience and epigenetic impacts of racism. We must push ourselves to confront and address systemic racism in our healthcare systems, and work towards a future where all children have equal opportunities for health and success. The path towards healing and transformation begins with acknowledging the truth of our past, and taking action to create a better future. If we commit ourselves to this work, together, we can create a brighter and healthier future for all children.

[00:33 -15:26] Racial Disparity and Inequities

  • Racial disparities and inequities are deeply embedded in society and history
  • Historical events like the murder of Emmett Till and church bombings highlight the violence against black people
  • The sacrifice of children in pivotal events in the civil rights era should not be forgotten
  • Tackling racial disparities and inequities requires collective effort and ongoing momentum

[15:27- 29:16] The Impact of Adversity on Child Development

  • Personal experiences can have a significant impact on a child's development and shape their worldview
  • Exposure to adverse experiences, such as racism and discrimination, can shape a child's worldview and impact their health outcomes
  • Stressors can sow the seeds for chronic diseases in children who experience adversity
  • Understanding the impact of exposure to racism and adverse experiences is crucial for child health professionals in promoting the well-being of children

[29:17-38:57] Factors affecting childhood development

  • A safe and secure community also plays a significant role in children's well-being
  • Small details such as self-care products that work for ethnic hair can also impact a child's perception of inclusivity and acceptance
  • Words, both big and small, can have powerful effects on a child's growth and development
  • Acknowledging and addressing racial disparities in healthcare can make a significant difference in child health outcomes

[38:58- 51:07] The significance of challenging systemic inequities in healthcare

  • The healthcare system benefits some groups while ignoring others, impacting the health of vulnerable children.
  • All children deserve to be healthy, and efforts should be made to ensure that those who have been left out are not forgotten.
  • It is necessary to challenge structural and systemic inequities to create a level playing field for all.
  • Addressing healthcare disparities requires a race-conscious approach that acknowledges the role of race and racism in differential experiences.

[51:08 - 55:46] Closing segment Takeaway

Links to resources mentioned on the show

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Despite ongoing efforts to combat the opioid crisis, there has been a steady increase in the number of individuals struggling with substance use disorder. This trend has left healthcare providers and parents searching for effective ways to address the problem. In this episode of Pediatric Meltdown, Dr. Lia Gaggino and Dr. Deepa Camenga delve into the impact of the opioid epidemic on children and teenagers. They also discuss strategies for screening, identifying, and treating substance use disorder in pediatric patients. One of the primary challenges faced by clinicians is maintaining confidentiality. It is crucial to ensure that teenagers feel heard and respected, as this is instrumental in building trust and facilitating necessary treatment. Simultaneously, parents play a vital role in initiating open conversations with their children about substance use and addiction. By proactively managing addiction at an early stage, teenagers can lead healthy and fulfilling lives, thereby avoiding the long-term consequences associated with addiction. If you know anyone who might be battling with this issue, please share this very important episode.

[00:33 -14:14] Opioid Use Disorders in the US

  • Approximately 2.7 million people in the US have an opioid use disorder
  • The numbers of teens and young adults with opioid use disorder are smaller but may be underestimated
  • The age of first use of opioids has risen from adolescence to just above 18 years old
  • The AAP recommends validated screeners for substance use such as the S2BI, B-STAD, and CRAS

[14:15 - 27:24] Strategies for Supporting Youth with Substance Use

  • Build a trusting relationship with the youth
  • Use open-ended questions to encourage conversation
  • Listen actively and reflectively to what the youth is saying
  • Avoid using judgmental language or tone

[27:25 - 38:59] Confidentiality in Adolescent Substance Use

  • Gray area in breaking confidentiality for substance use
  • Breaking confidentiality for fentanyl and heroin use is necessary
  • Clinical judgment needed for vaping and cannabis use
  • Be prepared for uncomfortable conversations with parents about breaking confidentiality

[39:00 - 48:06] Resources for Treating Substance Use in Teens

  • Child psychiatry access programs are expanding across the US
  • Family medicine providers can be valuable resources for treatment referrals
  • The Provider's Clinical Support System offers resources on medications for opioid use disorder
  • The AAP provides buprenorphine trainings and echoes for pediatric clinicians

[48:07 - 55:45] Closing segment Takeaway

You can reach Dr. Deepa Camenga

www.linkedin.com/in/Deepa-Camenga.

Links to resources mentioned on the show

--AAP News Article: Fentanyl a rising threat to child health: What pediatricians should know

https://publications.aap.org/aapnews/news/22634/Fentanyl-a-rising-threat-to-child-health-What

--Resources for Parents Partnership to End Addiction drugfree.org

--Provider...

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Mental health is a crucial aspect of our lives, yet it's often neglected and stigmatized. Dr. Lia Gaggino and her guest, Dr. Carol Chen, will discuss the delicate subject of self-harm and how it pertains to mental health in this episode of Pediatric Meltdown. They examine the numerous causes of young people's self-injury as well as the risk factors and comorbidities that go along with it. You'll learn about Dialectical Behavioral Therapy (DBT), a successful therapy, and how parents can help their kids who engage in self-harming behaviors. For parents, educators, and mental health professionals who want to address self-harm in a helpful and constructive way with advice on coping methods, particularly for adolescents struggling with self-injurious behaviors, this episode will provide significant insights and tools. as technology develops. However, it's crucial to be knowledgeable about mental health concerns and recognize the symptoms of distress in our loved ones and in ourselves. It is essential to establish a forum for open discussion and greater knowledge of the resources accessible. By addressing the underlying causes of self-harm, we can assist teenagers in developing healthier coping strategies and enhance their general wellbeing. So let's all work together to end the stigma associated with mental health problems, get those who need it some care, and encourage one another as we go through this healing process.

[00:33 -11:15] Blurring the Lines: The Challenge of Identifying Self-Injury Intentions

  • Self-injurious behavior is an umbrella term for actions that result in physical injury to oneself, including suicidal and non-suicidal behaviors
  • Non-suicidal self-injury specifically refers to behaviors where harm is intentionally caused to one's body for reasons not socially recognized or sanctioned, without the intention of ending one's life
  • Examples of non-suicidal self-injury include cutting, scratching, burning, hair pulling, and punching objects
  • It's important to differentiate between suicidal and non-suicidal behaviors for proper risk assessment and intervention, but the distinction can be blurry at times.

[11:16 -20:08] Understanding the Psychological Underpinnings of Self-Harm

  • Self-injurious behaviors have diverse reasons and psychological functions
  • Some teens may self-harm to rebel or seek attention, while others do it out of desperation or depression
  • Self-harm is often used as an unhealthy coping mechanism to deal with difficult emotions and to feel in control
  • Some use it to distract themselves or to feel something, as they may feel numb in their daily lives

[20:09 -28:50] Childhood Trauma and Self-Harm: Understanding the Link and its Implications for Treatment

  • Self-injury is associated with mental health disorders like anxiety, depression, eating disorders, substance use disorder, PTSD, and personality disorders
  • Childhood trauma, especially sexual abuse, is linked to an increase in cutting behavior
  • Borderline personality disorder includes self-harm as one of its nine criteria
  • Teenagers may exhibit borderline personality traits, including cutting, but are not diagnosed with personality disorders due to their developing personalities

[28:51-40:50] How Medications Can Help Heal Trauma and Unleash Inner Happiness

  • SSRIs can be used to treat anxiety and depression
  • Alpha agonists like Guanfacine or Clonidine can be helpful for impulsivity and trauma response
  • Naltrexone can be used for repeated self-injurious behavior
  • Abilify or Risperdal can be used for intellectual disability or ASD aggression

[40:51 - 47:00] Closing segment Takeaway

You can reach Dr. Carol Chen

Twitter:@carolchenmd1

Links to resources mentioned on the show

AACAP Self-injury in Adolescents Facts for Families: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Self-Injury-In-Adolescents-073.aspx

Online information for parents: When Children and Teens Self Harm. Healthychildren.org

https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/when-children-and-teens-self-harm.aspx

Management of Self-injurious Behaviors in Children with Neurodevelopmental Disorders - A Pharmacotherapy Overview: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555654/

AACAP – 13 Reasons Why

https://www.aacap.org/AACAP/Press/Press_Releases/2018/AACAP_Releases_13_Reasons_Why_Resources.aspx

Covid-19 and Self Harm

https://www.forbes.com/sites/tommybeer/2021/03/03/self-harm-claims-among-us-teenagers-increased-99-during-pandemic-study-finds/?sh=1fafff1f33e0

https://pubmed.ncbi.nlm.nih.gov/30274648/

Handouts and worksheets for intervention:

http://www.selfinjury.bctr.cornell.edu/perch/resources/distraction-techniques-pm-2.pdf

https://www.therapistaid.com/therapy-worksheet/dbt-distress-tolerance-skills

https://www.therapistaid.com/therapy-worksheet/urge-surfing-handout/dbt/none

https://www.therapistaid.com/therapy-worksheet/dbt-accepts/dbt/none

Other episodes you may like:

Episode #140

Eating Disorders: Avoidant/Restrictive Food Intake disorder (ARFID)

https://302.buzz/140EatingDisorders-ARFID

Key quotes for Twitter:

"All self-injurious behaviors, regardless whether they're suicidal or non suicidal, are to raise our worry level. They are all signs of distress."... Dr. Carol Chen

"Most commonly self harm is used almost as an unhealthy coping mechanism to deal with very difficult emotions and to release some sort of pain and tension and anxiety."... Dr. Carol Chen

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Psychological safety is crucial and cannot be undervalued in the continuing and challenging process of addressing physician burnout and prioritizing well-being. Dr. Gaggino's guest, Karen Horneffer-Ginter, PhD, discusses how organizations and institutions can start to acknowledge and deal with the systemic problems causing burnout by creating a space where clinicians can openly express concerns without fear of retaliation or condemnation. Individuals must prioritize their own self-care and wellness in addition to organizational and institutional reforms. Karen Horneffer-Ginter believes It's time to change the way healthcare is perceived and to value the humanity of people who care for others. Yes, burnout is a complex problem that calls for all hands-on deck. And Dr. Lia Gaggino and Karen Horneffer-Ginter will explore the concept of promoting a "safe-place culture" and the concept that clinicians can and should work towards creating an environment where everyone thrives and feels valued.

[00:33 -13:55] The Evolving Landscape of Wellness and Well-being in Healthcare

  • Recognizing the Neglected Importance of Mental Health in Medicine
  • Wellness vs. Well-Being: Exploring the Nuances and Evolving Definitions in Healthcare
  • Adapting Language for Genuine Conversations: Addressing Burnout, Moral Injury, and Beyond
  • Personalizing Wellness: Moving Beyond Individual Responsibility and Addressing Organizational Interventions

[13:56- 25:06] Challenges in Maintaining Boundaries and Well-being in Healthcare

  • Healthcare professionals find themselves sacrificing their own well-being, time, and personal needs to attend to the needs of others, going above and beyond their duties.
  • A distinction between work and personal life can be facilitated through rituals, similar to Mr. Rogers taking off his jacket and putting on his sweater.
  • healthcare providers MUST regularly check in with themselves, assess their own well-being, and acknowledge their vulnerabilities.
  • Healthcare professionals are often in a mindset of providing help rather than seeking it, which can hinder their own self-assessment and well-being.

[25:07 -39:20] Organizational Interventions and Advocacy for Well-being

  • Profit: The need to ensure financial sustainability and keep the lights on in the business of medicine.
  • Wellness: healthcare professionals taking care of their own well-being and finding a balance between personal and professional life.
  • Organizational interventions: Call centers, hospitalist services, and neonatal nurse practitioners could address workload and provide support.
  • Documentation and electronic health records: Dealing with the challenges and demands associated with electronic records and finding ways to improve efficiency and reduce administrative burdens.

[39:21- 49:53] The Importance of Self-Care and Support

  • Prioritizing personal needs and seeking professional help when necessary
  • Overcoming the stigma of seeking for professional help
  • Taking intentional breaks from the work-related responsibilities with apps, family time, alone time, etc.
  • Scheduling time for restorative activities and unplugging

[49:54 - 54:36] Closing segment Takeaway

You can reach Karen Horneffer-Ginter

Linked In: @Karen Horneffer-Ginter

Links to resources mentioned on the show

From Triple to Quadruple Aim:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226781/

Tait Shanafelt:

Physician Burnout: contributors, consequences and solutions https://onlinelibrary.wiley.com/doi/full/10.1111/joim.12752

Full Cup, Thirsty Spirit -

http://www.fullcupthirstyspirit.com

Stanley Brown Safety Plan:

Not designed for wellness planning but an interesting outline to consider when under duress:

https://suicidesafetyplan.com/forms/

Other episodes you may like:

Ep 135

Physician Wellness: Find Your One Thing.

https://302.buzz/135PhysicianWellness

Ep 116

Physician Wellness Coaching: Proven Benefit!

https://302.buzz/116PhysicianWellnessCoaching

Key quotes for Twitter:

"I think the sort of “well-being” term is an attempt to engage in a more nuanced conversation and have it be genuine and have it be something where we really are engaged at looking at authentic changes."... Karen Horneffer-Ginter, PhD on The Evolution of Wellness Terminology

"I always had interest in the mind body connection, sort of like the mind body medicine, mind body spirit medicine. And so I think medical education was sort of the obvious path to end up on because of the intersection of looking at mental, emotional health and physical health."... Karen Horneffer-Ginter, PhD

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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If you're a parent, you know that there's nothing quite as challenging as dealing with difficult childhood behaviors. Tantrums, potty training, and biting are just a few of the challenges that parents face on a daily basis. Today, Dr. Lia Gaggino talks with pediatrician Dr. Arthur Lavin and Therapist Susan Glaser who have not only authored several books on parenting But are the hosts of the highly acclaimed podcast Parent Talk that offers practical parenting tips and expert insights on everything from child development to managing conflicts with your kids. The explain how “Potty mastery” a significant milestone in a child's development is and should be approached as a partnership rather than training. With patience and understanding, parents can celebrate their child's achievements and encourage them to reach new milestones. So, whether you're a new parent or an experienced pro, this episode is for anyone looking to become a better parent.

[00:33 -15:50]Tips for Successful Parenting: Insights from the Parent Talk Podcast

  • Designed for parents of children of all ages
  • Provides practical strategies to manage conflicts with children
  • Offers insights into child development to help parents understand their behavior
  • Focus on “Mastery” vs “Training”

[15:51- 25:52] How to Navigate Potty Training: Tips from an Expert

  • Potty mastery can be a toddler task, ideally started around age two
  • Parents should set up the environment with potty seats and lots of underwear”
  • Start around age two when they have enough language and physical ability?
  • Pullups are not recommended, as they are essentially just diapers without tabs
  • Logical consequences reinforce potty training, such as having the child clean up their mess

[25:53- 39:43] Toddlers and Tantrums: Understanding the Big Bang of Consciousness

  • The big bang of consciousness occurs between 15-18 months of age when children begin to develop a sense of self-awareness.
  • Prior to this development, infants have no sense of self and react only to their immediate surroundings.
  • The sudden realization of self often leads to toddlers asserting their independence and saying "no" more frequently.
  • Tantrums can be a common response to frustration as toddlers learn to navigate their new sense of self and assert their desires
  • Parents should focus on providing a safe environment and positive reinforcement rather than punishing or shaming their child during a tantrum

[39:44 - 52:07] Strategies for Helping Children with Autism and Preschool Biting Behaviors

  • Occupational therapy and sensory-based strategies can help address behavior issues in preschoolers
  • Early intervention for children with autism spectrum disorders is crucial
  • Biting is a typical behavior among preschoolers, often triggered by inner turmoil rather than an intent to hurt others
  • Environment and class size can influence behaviors; lowering class size and having extra teachers can help address biting incidents
  • Understanding the root cause of constant biting can help address the behavior.

[52:08 - 57:35] Closing segment Takeaway

Links to resources mentioned on the show

Guests Susan Glaser and Dr. Arthur Lavin co-authored two books.;

Who’s the Boss: Moving Families from Conflict to Collaboration

Amazon.com: Who's the Boss? Moving Families from Conflict to Collaboration eBook : Glaser, Susan, Lavin, Arthur : Kindle Store

Baby and Toddler Sleep Solutions for Dummies.

Baby and Toddler Sleep Solutions For Dummies: Lavin MD, Arthur, Glaser MA, Susan: 9780470117941: Amazon.com: Books

Arthur and Susan are currently hosting a weekly podcast,

ParentTalk: Meeting the Challenges of Daily Parenting,

which can be found on all the major platforms.

https://podcasts.apple.com/us/podcast/ep-1-the-power-of-your-childs-no/id1641629355?i=100057727659

Other episodes you may like:

Ep 09 School Struggles ADHA or is it?

https://302.buzz/09SchoolStrugglesADHD

Ep 30 Who's the Boss: A Primer for Parents and Pediatric Providers

https://302.buzz/30WhosTheBoss

Key quotes for Twitter:

The Emergence of Self-Awareness: "The big bang in consciousness only occurs because there isn't consciousness in the sense of being aware that your situation can be different until about 15 to 18 months of age." ....Dr. Arthur Lavin

"The Power of Understanding Your Child's Perspective: 'Our message really is about helping parents understand where their child is coming from. I really think that that gives parents a very different frame of mind when they look at their child.'" ....Therapist Susan Glaser

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Baby and Toddler Sleep Solutions For Dummies

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When you think of HIV, do you breathe a sigh of relief thinking “well, at least we don’t have to deal with THAT anymore”? Has it completely fallen off your radar as a medical issue that is “under control”? Well, then it’s important that you listen to this episode. Dr. Gaggino talks with Dr. Julia Rosebush and Britt Hodgdon, LCSW. Together they dive into the topic of HIV and trauma recovery. They’ll share insights on how to support individuals living with HIV and overcome stigma, as well as discussing the concept of undetectable equals untransmittable and how it impacts communication and relationships. You’ll also hear about the role of trauma recovery and somatic therapy in destigmatizing HIV and promoting self-perception. This is a powerful conversation on how to thrive with HIV and befriend it.

[00:33 -18:52] Addressing HIV Stigma

  • HIV stigma still exists despite advances in treatment and prevention.
  • Stigmatizing attitudes can negatively affect the mental health and well-being of those living with HIV.
  • HIV stigma can lead to discrimination in healthcare and other areas of life.
  • Advocacy and education can help decrease HIV stigma and empower those living with the virus.
  • Language also plays a role in HIV stigma, and using non-stigmatizing terminology is important in reducing stigma.

[18:53- 33:22] HIV and Undetectable Viral Load

  • Undetectable viral load means untransmittable HIV to sexual partners
  • Years of research have solidified the undetectable equals untransmittable concept.
  • Youth should not be afraid of transmitting HIV if they achieve an undetectable viral load.
  • Normalizing conversations about HIV and reducing stigma surrounding the virus
  • Encouraging youth to prioritize their sexual health and seek appropriate medical care if needed.

[33:23 -46:07] Communicating about HIV Status: Language and Approaches for Young People

  • Importance of confidentiality and privacy when discussing HIV status
  • Strategies for building trust and rapport with young people when discussing HIV.
  • Highlighting the effectiveness of antiretroviral therapy for managing HIV
  • Encouraging young people to take ownership of their health and prioritize self-care.
  • The role of healthcare professionals in educating and supporting young people living with HIV

[46:08 - 54:38] Improving Conversations about Sexuality, Identity, and Gender with Young People

  • Professionals need to be fluent in “young-person-speak” to have effective conversations about sexuality, identity, and gender.
  • Assumed binaries should be avoided, and young people should be asked to name who they are and how they want to be referred to.
  • Centering young people in conversations about their bodies can be a relief for the medical field and benefit young people.
  • There is room for growth among professionals in this space.
  • Rethinking the way we talk to young people about sexuality, identity, and gender is ultimately necessary for caring for young people and families.

[54:39 - 1:00:03] Closing segment Takeaway

You can reach Dr. Julia Rosebush

LinkedIn: Julia Rosebush, DO, FAAP | LinkedIn

Hashtags: #hivprevention #hivawareness #gettingtozero #undetectableequalsuntransmittable

You can reach Brett Hodgdon

LinkedIn: britt hodgdon, lcsw

Links to resources mentioned on the show

CDC HIV Guidelines

https://www.cdc.gov/hiv/guidelines/index.html

CDC: HIV Information and Youth

https://www.cdc.gov/healthyyouth/youth_hiv/hiv-information-and-youth.htm

AAP Red Book:

https://publications.aap.org/redbook/book/347/chapter/5753080/Human-Immunodeficiency-Virus-Infection78?autologincheck=redirected

“The science is clear: with HIV, undetectable equals untransmittable”:

https://www.nih.gov/news-events/news-releases/science-clear-hiv-undetectable-equals-untransmittable

The Well Project – information for teens:

https://www.thewellproject.org/hiv-information/teens-and-hiv-transition-adulthood

Book- In My Own Country - A Doctor’s Story by Abraham Verghese

My Own Country: A Doctor's Story: Verghese, Abraham: 9780679752929: Amazon.com: Books

Other episodes you may like:

Episode #110

LGBTQ Youth Sexuality: Inclusive Parent-Child Conversations

https://302.buzz/110LGBTQYouth

Key quotes for Twitter:

"Caring professions are saying, I love you as you are. Show me your truth. But being a little more deliberate about it, I think that's where prevention lives." Britt Hodgdon

"You need to reach out to people who have expertise in the many different dimensions of the aspects of HIV disease to make sure that you are providing the best care for the patient." Dr. Julia Rosebush

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

My Own Country: A Doctor's Story

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Do you have a picky eater in the house? Then this is the episode you’ve been waiting for. Dr. Lia Gaggino’s guest this week is Dr. Natalie Prohaska where they’ll discuss avoidant, restrictive food intake disorder (ARFID), which was previously referred to as feeding disorder of children. They will break down the three different types of ARFID and discuss how they affect children's psychosocial and nutritional functioning. As the COVID-19 pandemic continues to affect our daily lives, mental health concerns such as eating disorders have seen a resurgence. Whether it's a fear of choking or contamination, this episode will provide valuable insight on how your clinician properly diagnoses and treats ARFID in order to improve the overall health and well-being for the child.

[00:33 -13:37] Understanding Avoidant Restrictive Food Intake Disorder (ARFID)

  • ARFID is not related to body image distress, but rather caused by sensory sensitivity, lack of interest in eating, or fear of inversive events
  • ARFID can affect nutrition, weight, and psychosocial functioning, and can be seen in both children and adults
  • ARFID is characterized by three types of symptoms: sensory sensitivity, lack of interest in eating, and fear of inversive events.
  • ARFID can progress from one category to another and may require specific treatment for feeding-related anxiety or OCD.

[13:38- 25:54] How to Manage Picky Eating in Children: Strategies and Tips

  • Breaking down food into smaller portions and gradually adding ingredients can help make it more manageable for picky eaters.
  • Children with oral aversions, such as those who were in the NICU and had tube feedings, may benefit from occupational therapy.
  • Encouraging children to describe the appearance, texture, smell, and taste of food in non-judgmental language can reduce their disgust response.
  • Using a five question approach, children can approach new foods more like a scientist and think objectively about what they are experiencing.

[25:55 -37:14] Overcoming Fear of Food in Kids: The Step-by-Step Approach

  • Aversive events such as choking on food can lead to a fear of eating, which can be treated similarly to OCD.
  • Treatment involves creating a hierarchy of manageable steps in challenging fears, starting with softer or liquid foods.
  • Parents play a crucial role in this treatment, as they need to provide education, empowerment, and motivation to their child.
  • Children with intellectual disabilities or autism may require a different feeding program tailored to their unique needs.

[37:15 - 44:41] Understanding ARFID: Diagnosis, Comorbidities, and Resources for Families

  • ARFID is a distinct illness from anorexia, though picky eating can sometimes lead to anorexia later on.
  • ARFID patients typically have a limited diet high in dairy and carbohydrates, while anorexia patients prefer produce and proteins.
  • Comorbidities with ARFID include anxiety, ADHD, autism, and medical issues like reflux or celiac disease
  • Families can find helpful information and support through resources like FEAST, AED, and the book "ARFID: A Guide for Parents and Caregivers.

[44:42 -51:00] Closing segment Takeaway

Links to resources mentioned on the show

AAP Pediatrics article:

Classification of Children and Adolescents with Avoidant/Restrictive Food Intake Disorder

Classification of Children and Adolescents With Avoidant/Restrictive Food Intake Disorder | Pediatrics | American Academy of Pediatrics (aap.org)

AAP Clinical Report

Identification and Management of Eating Disorders in Children and Adolescents https://publications.aap.org/pediatrics/article/147/1/e2020040279/33504/Identification-and-Management-of-Eating-Disorders

Online resources:

FEAST – Support for families affected by eating disorders https://www.feast-ed.org

EQUIP – Online eating disorder treatment https://equip.health

Book:

Avoidant Restrictive Food Intake Disorders: A Guide for Parents and Carers https://www.amazon.com/ARFID-Avoidant-Restrictive-Intake-Disorder/dp/0367086107

Other episodes you may like:

Episode #61

Eating Disorders: Prevention in Primary Care

https://302.buzz/61EatingDisordersPrevention

Episode #62

Eating disorders: Recovery Coaches Strengthen the Healing Team

https://302.buzz/62EatingDisordersRecovery

Episode #63

Eating disorders: Feeding Our Kids

https://302.buzz/63EatingDisordersFeeding

Key quotes for Twitter:

"These kids can't go out to dinner with their families or they can't go away to sleepover camp because of distress around what food is going to be there."...Dr. Natalie Prohaska

"For other people, they can just try new things... but for these kids, the fear is so big."...Dr. Natalie Prohaska

THANK YOU FOR YOUR SUPPORT!

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School-based healthcare centers (SBHC) are playing an important role in providing equitable access to healthcare for children who are not able to access a regular medical home. Today, host, Dr. Lia Giggino talks with Dr. Sara Bode about the benefits of a SBHC and the challenges they face in ensuring that every child has access to quality care. They discuss the challenges that school-aged children face in accessing healthcare, such as transportation issues, location, and competing priorities for parents. Dr. Bode emphasizes the importance of school health in providing a safety net for children and the need for collaboration between healthcare providers and educators to ensure that children receive quality healthcare and education. This episode highlights the benefits of a partnership between the health and education systems, demonstrating how working together can improve the overall health and well-being of students. If a school-based health center is something you want in your own community, you’ll hear information on exactly how you can make it happen.

[00:33 -15:08] The Benefits of Having an SBHC

  • They provide a safety net for kids who do not have access to a regular medical home due to various reasons such as transportation issues, location or access, and competing priorities for working parents
  • They can partner with primary care providers to provide comprehensive primary care to the underserved population of kids and connect them to a medical home for continued care
  • They offer opportunities for collaboration with specialty providers to provide better health outcomes for kids with chronic health conditions such as diabetes
  • They can help with wraparound care and observation to identify and address underlying health issues

[15:09- 22:07] How SBHCs Co-Manage Children's Health: Funding and Services

  • Students without an established medical home can receive care at the center
  • Partnership between school-based health centers and primary care providers can support medication management and follow-up care
  • School-based health providers have a unique understanding of social determinants of health for students
  • Funding for school-based health centers typically comes from traditional insurance sources such as Medicaid and private insurance

[22:08 -31:07] The Role of SBHCs in Addressing Mental Health Care Needs for Students

  • Lack of mental healthcare providers for students is a crisis in schools
  • School-based health centers can be a part of the solution to bridge the gap in services
  • Comprehensive primary care mental health services can be provided through school-based health centers
  • Telemedicine services, such as telepsychiatry, can be used to provide care and maintain appointment attendance
  • Advocacy and community pediatrics play a crucial role in transforming the systems of care provided to meet the needs of the community

[31:08 37:11] Opportunities for Pediatricians to Get Involved in School Health

  • The AAP Council on School Health provides resources for pediatricians to partner with schools, including working with school nurses and teachers.
  • The Council on Community Pediatrics offers opportunities for pediatricians to engage in advocacy and learn about community initiatives.
  • The Community Pediatric training initiative offers training opportunities for pediatricians interested in tackling issues like food insecurity in their communities.
  • It is important for pediatricians to keep their eyes and ears open, listen to patients' stories, and intentionally find ways to help families who may not be receiving care. Partnership between education and healthcare is crucial, especially in areas like mental health and suicide prevention.

[37:12 - 42:30] Closing segment Takeaway

You can reach Dr. Sara Bode

LinkedIn: sara bode | Search | LinkedIn

Twitter: @SaraBodeMD

Links to resources mentioned on the show

Advocacy:

  • Aap.org/cpti
  • This website offers and overview of the advocacy training opportunities for faculty and residents. It includes the advocacy training modules and the new Advocacy Portfolio, which is a supplement to a CV for faculty to use for promotion in advocacy.
  • Academic Careers in Advocacy Article:
  • Academic Careers in Advocacy: Aligning Institutional Values Through Use of an Advocacy Portfolio | Pediatrics | American Academy of Pediatrics (aap.org)

Key School Health Websites and Articles:

  • School Health (aap.org)
  • This resource has a collection of key articles as well as tools and learning opportunities in school health through the AAP.
  • Council on School Health (COSH) (aap.org)
  • Learn about how to get involved in school health through the Council on School Health at the AAP to help guide policy and practice.

Other episodes you may like:

Episode #106

Youth Suicide Prevention: Building Community Coalitions

https://302.buzz/106YouthSuicide Prevention

Episode #113

Advocate For Kids: #PutKids1st

https://302.buzz/113AdvocateForKids

Key quotes for Twitter:

"It's really an opportunity to have wraparound care for these kids with chronic health conditions to make sure that they're getting everything they need from education to medicine, to all of the pieces with parents at school to keep them healthy and in school."... Dr. Sara Bode

"Finding ways to bring care into schools so that we can really help improve that access has been an important part of what many of our providers in school health will do."... Dr. Sara Bode

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Aggression in children is a complex issue that can leave parents feeling helpless and desperate for a solution. Many turn to medication as a quick fix, but according to Dr. Lia Gaggino’s guest, Dr. Peter Jensen, multiple medications are not always the answer. It's important to assess the situation correctly and consider alternative approaches before turning to medication. In this episode, Doctors Gaggino and Jensen explore the various causes of aggression in children and provide tips on how to handle it effectively without resorting to excessive medication. Whether you're a parent, caregiver, or educator, the information provided in this episode can help you better understand aggression in children and how best to support them. Get your pad and pencils ready, you’ll be taking notes on this one.

[00:30 -27:46] Understanding the Different Types of Aggression in Children and How to Treat Them

  • The Importance of Assessing and Diagnosing before Prescribing Medication
  • Aggression in children can fall into different categories, such as chronically irritable and explosive or misinterpreting social cues
  • Diagnostic Skills Help in Identifying the Underlying Causes of Aggressive Behaviors in Children
  • Bipolar disorder and schizophrenia are unlikely causes of aggressive behavior in children

[27:47- 38:02] Understanding and Treating Aggressive Behaviors in Children

  • Treatment for ADHD should be maximized before turning to other medications
  • Resperidone and Aripiprazole have been approved by the FDA to treat aggression in children
  • Primary care providers need to get comfortable with atypical medications
  • Guidelines for treating maladaptive aggression in youth are available in the journal Pediatrics

[38:03 -48:14] Evaluating Medication for Children with Mental Health Disorders

  • Trauma should be considered when treating children with psychiatric medications.
  • Avoid the "pharmacotherapy of desperation," which involves adding multiple medications without clear rationale.
  • Deprescribing, or slowly decreasing medication use, can be helpful for children on multiple medications that may not be effective.
  • A thorough evaluation of the underlying disorder, using rating scales and input from multiple sources, is essential for choosing the right medication.

[48:15 - 57:06] Top Screening Tools for Child Mental Health

  • Vanderbilt Rating Scale is essential for monitoring ADHD in kids on stimulants
  • PHQ-9 is a quick and free depression scale that is recommended by the US Preventive Services Task Force and Academy of Pediatrics
  • SCARED is an effective tool for tracking and screening anxiety in children and can be given to parents or youth
  • PSC-17 is ideal for well-child visits as it has only 17 items and screens for inattention, ADHD, anxiety, and depression
  • Suicide specific tools like ASK Screening Questions and Columbia should be used alongside PHQ-9 for better screening of suicidal ideation and behavior; CRAFFT can be used to screen for substance use in teenagers.

[57:07 - 1:04:54] Closing segment Takeaway

You can reach Dr. Peter Jensen

Website: https://thereachinstitute.org/

LinkedIn: https://www.linkedin.com/company/the-reach-institute-resource-for-advancing-children-health/

Facebook: https://www.facebook.com/REACHInstitute/

Twitter: https://twitter.com/reach4kids

Links to resources mentioned on the show

www.thereachinstitute.org

TOSCA - https://www.jaacap.org/article/S0890-8567(14)00456-0/fulltext

T-May Study Part 1 https://publications.aap.org/pediatrics/article/129/6/e1562/32167/Treatment-of-Maladaptive-Aggression-in-Youth-CERT?autologincheck=redirected

T-May Study Part 2. https://publications.aap.org/pediatrics/article/129/6/e1577/32128/Treatment-of-Maladaptive-Aggression-in-Youth-CERT

Glad-PC Part 1: https://publications.aap.org/pediatrics/article/141/3/e20174081/37626/Guidelines-for-Adolescent-Depression-in-Primary

Glad-PC Part 2: https://publications.aap.org/pediatrics/article/141/3/e20174082/37654/Guidelines-for-Adolescent-Depression-in-Primary

PHQ-9 and ASQ screen for depression and suicidality: https://www.nimh.nih.gov/sites/default/files/documents/PHQ-A_with_depression_questions_and_ASQ_PDF.pdf

Vanderbilt: https://www.nichq.org/resource/nichq-vanderbilt-assessment-scales

SCARED (parent version): https://www.aacap.org/App_Themes/AACAP/docs/member_resources/toolbox_for_clinical_practice_and_outcomes/symptoms/ScaredParent.pdf

SCARED (child version): https://www.aacap.org/App_Themes/AACAP/docs/member_resources/toolbox_for_clinical_practice_and_outcomes/symptoms/ScaredChild.pdf

CRAFFT: https://crafft.org/wp-content/uploads/2020/09/CRAFFT_2.1N-HONC_Self-administered_2020-09-30.pdf

PSC-17 (parent). https://thereachinstitute.org/wp-content/uploads/2021/06/psc_17_parent.pdf

PSC-17 (youth): https://thereachinstitute.org/wp-content/uploads/2021/06/psc_17_youth.pdf

Other episodes in the series you may like:

Episode #136

Youth Violence Prevention: Threat Assessment and Management

https://302.buzz/136Youth Violence Prevention

Episode #137

Understanding Aggressive Behaviors: Who, What, Why, When and Where

https://302.buzz/137Understanding Aggressive Behaviors

Key quotes for Twitter:

"The most important skill for a primary care provider is to get comfortable with assessment and diagnosis."...Dr. Peter Jensen

"Highly unlikely for aggression to be bipolar disorder or schizophrenia."... Dr. Peter Jensen

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Childhood can be a challenging time for many young individuals. As they try to navigate the world around them, they often display aggressive behaviors in different situations. But not all aggression is harmful, as it can be a normal part of development. Understanding what constitutes normal childhood aggression and identifying its triggers is essential for parents and clinicians alike to help children thrive. In this 2nd of a 3-part series on childhood aggression, Dr. Lia Gaggino talks with Dr. Elizabeth Wallis from the REACH Institute. They discuss the nature of childhood aggression, how parents and clinicians can identify its triggers, and how trauma can affect children's brains. By recognizing the signs of concerning behavior early on, parents and clinicians can intervene appropriately to help young individuals grow into healthy adults. Get ready for a thought-provoking conversation.

[00:33 -14:54] Understanding Normal Aggression in Children and Identifying When to Worry

  • Normal aggression is a part of development in children and can be seen in frustration, emotion dysregulation and communication difficulties.
  • Consider the scenario around aggressive behavior, including who, what, when, where, and why, can give insights into the causes of aggression.
  • Trauma and neglect can greatly affect a child's brain and make them more reactive to situations.
  • Trauma, neglect, and abuse can change children's brains and lead to hyperarousal and increased reactivity to situations

[14:55- 29:01] How to Address Aggressive Behavior in Children: Tips for Parents and Pediatricians

  • Teaching prosocial skills and positive reinforcement
  • Teach positive social skills and give positive reinforcement for good behavior
  • Implementing natural consequences for damaging behavior, such as having the child save up allowance to pay for damage
  • Discuss gun safety with families and ask about access to firearms in the home in a thoughtful manner.

[29:02 -37:23] Partnering with Schools and Mental Health for Resilience-Building in Children

  • The impact we can have on a child's life as mental health professionals
  • Approaching schools and mental health professionals with humility, compassion, and empathy
  • Being an advocate for the child when working with schools and mental health professionals
  • The need for communication and collaboration between mental health professionals, schools, and parents for the child's success

[37:24- 45:27] The Impact of Reach Program on Pediatricians

  • Reach Program helps pediatricians to realize that psycho pharm is a small part of things and communication skills matter a lot more.
  • The program reinforces the importance of motivational interviewing and negotiation skills.
  • The answer to all problems is not a pill; development, learning difficulties, environment, and trauma are also key factors.
  • Fresh perspectives from child psychiatrists can be helpful for complex cases, and resources like the Child Psychiatry Access Program are available for pediatricians.

[45:28 -51:24] Closing segment Takeaway

You can reach Dr. Elizabeth Wallis

Social Media:

REACH Website: https://thereachinstitute.org/

REACH LinkedIn: https://www.linkedin.com/company/the-reach-institute-resource-for-advancing-children-health/

REACH Facebook: https://www.facebook.com/REACHInstitute/

REACH Twitter: https://twitter.com/reach4kids

Links to resources mentioned on the show

REACH Website:

https://thereachinstitute.org/

Novel on foster care and opiate use disorders - Barbara Kingsolver “Demon Copperhead” https://www.amazon.com/s?k=demon+copperheads&hvadid=642474846899&hvdev=c&hvlocphy=9017275&hvnetw=g&hvqmt=e&hvrand=13080877742977967640&hvtargid=kwd-1933879423848&hydadcr=22536_13531205&tag=googhydr-20&ref=pd_sl_vd7ivhroy_e

ADHD Book of Lists:

https://www.amazon.com/ADHD-Book-Lists-Practical-Attention-dp-1118937759/dp/1118937759/ref=dp_ob_title_bk

Ross Greene “The Explosive Child”:

https://www.amazon.com/Explosive-Child-Sixth-Understanding-Chronically-ebook/dp/B08NP52GTW/ref=sr_1_1?hvadid=377840592844&hvdev=c&hvlocphy=9017275&hvnetw=g&hvqmt=e&hvrand=727528003361919285&hvtargid=kwd-805239585098&hydadcr=12913_9733997&keywords=dr+ross+greene+the+explosive+child&qid=1680273129&sr=8-1

CHADD: https://chadd.org

Understanding 504 Plans: https://www.understood.org/en/articles/what-is-a-504-plan#What’s_in_a_504_plan

Other episodes you may like:

Episode #136

Youth Violence Prevention: Threat Assessment and Management (Part1)

https://302.buzz/136YouthViolencePrevention

Key quotes for Twitter:

"It [the reach course] really transformed my practice." Dr. Elizabeth Wallis

“What can help? Teach prosocial behaviors by our own modeling! Build positive skills using natural consequences and restitution. Empower kids to make better choices and to master frustration”. Dr. Lia Gaggino

“When thinking about aggression, consider the context – the 5 W’s. What happened? Who was involved? Why did this happen? When did the behaviors occur? Where did this happen? Was it Provoked? Get the whole story”… Dr. Lia Gaggino

“It is easy to assume the worst when there are concerns about aggression. Consider the developmental stage. This is what we are so good at”.… Dr. Lia Gaggino

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Explosive Child

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This is the first of three episodes on aggression in youth and violence prevention.

Dr. Gaggino’s guest is Cindy Marble, who retired from the US Secret Service after 27 years, including two tours in the protective intelligence division. Cindy now trains individuals across various sectors on behavioral threat assessment and prevention, including K-12 schools, campuses, and private industry. In this podcast, she emphasizes the team approach to threat assessment, drawing on the insights of mental health providers, physicians, and local law enforcement. Cindy highlights that there is no single profile of a potential aggressor, and that prevention requires an understanding of the individual's behavior and circumstances. She underscores the role of physicians and mental health providers in identifying potential threats, as well as considering factors such as home environment and law enforcement history. Cindy emphasizes that understanding the "why" behind a person's behavior is critical to preventing violent acts

  • Many thanks to the AAP and the MIAAP for making these 3 episodes possible by funding guest honorariums and podcast editing costs. In full disclosure, I have not received any funding from either entity for this series.

First, some facts:

  • According to the Washington Post, there have been 376 school shootings since Columbine (1999)
  • 348,000 students have experienced gun violence since Columbine shooting

[00:33 -12:57] Understanding the Pathway to Violence: A Multidisciplinary Approach

  • Threat assessment is a community process that requires a multidisciplinary team.
  • There is no specific profile of someone who carries out violent attacks.
  • It's essential to focus on a person's behavior rather than their traits.
  • Taking a multidisciplinary approach can help identify a pathway to violence and prevent violent incidents.
  • Threat assessment is a community process involving partnerships with healthcare providers, mental health professionals, and local law enforcement.

[12:58 -28:22 Key Indicators and Intervention Strategies

  • Warning signs may include a change in behavior, loss of interest or connections, and inappropriate interest in past mass violence attacks.
  • Capability, access to weapons, and mental and physical ability are all considered in the threat assessment process.
  • Assessing a person's capability to carry out an act of violence, along with their mental and emotional state, is crucial in determining the level of risk.
  • Interventions should focus on connecting the individual to support systems and responsible adults to prevent isolation and marginalization.
  • Punishment or disciplinary action may not be the most effective solution and may exacerbate behavioral issues. Instead, focusing on intervention and support can lead to positive outcomes.

[28:23 - 40:40] The Importance of a Collective Approach in Threat Assessment

  • Physicians cannot be expected to single-handedly assess and manage a threat
  • Building relationships with schools and law enforcement can lead to a more effective community-based threat assessment process
  • Understanding HIPAA and FERPA laws can provide comfort in sharing information for the safety of an individual
  • Threat assessment is a collective effort that shares liability and considers different perspectives to create a management plan
  • Best practice in threat assessment involves a systematic process of gathering information, documenting decisions, and creating a management plan together as a team

[40:41 - 49:20] Creating Safe Communities: The Importance of Threat Assessment Training

  • Belonging to a community can give a sense of purpose and bigger belonging, which can prevent joining unhealthy radical groups
  • It is important for individuals in schools, hospitals, and other sectors to receive threat assessment training to recognize warning signs and intervene in potential threats.
  • Creating threat assessment teams and forming a community circle of safety can help prevent targeted violence.
  • It is important for individuals in schools, hospitals, and other sectors to receive threat assessment training to recognize warning signs and intervene in potential threats.
  • Creating threat assessment teams and forming a community circle of safety can help prevent targeted violence.

[49:21 - 56:19] Closing segment Takeaway

You can reach Cindy Marble

Website: https://www.ontic.co

Twitter:https://twitter.com/ontic_co

Linkedin:Ontic: Overview | LinkedIn

Links to resources mentioned on the show

HIPAA and FERPA privacy waiver statements:

https://www.hhs.gov/sites/default/files/hipaa-privacy-rule-and-sharing-info-related-to-mental-health.pdf

https://studentprivacy.ed.gov/faq/when-it-permissible-utilize-ferpa’s-health-or-safety-emergency-exception-disclosures

The Final Report and Findings of the Safe School Initiative

https://www2.ed.gov/admins/lead/safety/preventingattacksreport.pdf

Threat Assessment in Schools: A Guide to Managing Threatening Situations and to Creating Safe School Climates (2004)

Available at: https://www2.ed.gov/admins/lead/safety/threatassessmentguide.pdf

Guide for Developing High-Quality School Emergency Plans (2013)

Available at: https://rems.ed.gov/docs/School_Guide_508C.pdf

Making Prevention a Reality: Identifying, Assessing & Managing the Threat of Targeted Attacks (2017)

Available at: www.fbi.gov/file-repository/making-prevention-a-reality.pdf

Protecting America’s Schools. A U.S. Secret Service Analysis of Targeted School

Violence (2019).

Available at: https://www.secretservice.gov/sites/default/files/2020-04/Protecting_Americas_Schools.pdf

Averting Targeted School Violence: A U.S. Secret Service Analysis of Plots Against Schools (2021).

Available at: https://www.secretservice.gov/sites/default/files/reports/2021-03/USSS%20Averting%20Targeted%20School%2

Other episodes you may like:

Ep #42 Deciphering Psychological Assessment Reports: What Your Need to Know

https://302.buzz/42AssessmentReports

Ep #32 DisruptiveBehaviors: Insights and Strategies from a Child Psychiatrist

https://302.buzz/42AssessmentReports

Key quotes for Twitter:

“Threat assessment is the process of gathering information – “dots”. The PCP, schools, therapists, and law enforcement all have dots to add to the picture. The key is communication” … Dr. Lia Gaggino on creating assessment teams and forming a community circle.

“These are NOT random acts, but instead result from intensive planning – research, preparation, acquiring means and finally implementation, the act. The acts are targeted to a person, place or institution and are laden with meaning to the perpetrator”. Dr. Lia Gaggino on acts of violence in schools and workplace

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Join your host, Dr. Lia Gaggino, on this episode of Pediatric Meltdown as she chats with Dr. Danny Mallen, a pediatric gastroenterologist and medical educator at Cincinnati Children's Hospital Center. Dr. Mallen talks about his interest in nutrition, the puzzle that is the gut, and his passion for helping children with celiac disease. He also discusses his article on finding your “One Thing” and how mentors and opportunities play a role in one's career. Burnout is real. We look to physicians to take care of us, but let’s make sure that your doctor is getting everything they need for their own wellness. Dr. Mallen’s insights on the importance of finding joy in your work will ring true for every profession and he continues his efforts to improve medical education for general pediatricians and fellows. Don't miss this fascinating conversation about the challenges and rewards of physician’s wellness!

[00:33 -12:42] Daniel's Journey to Pediatrics and Interest in Wellness

  • During his training, he found himself happiest and smiling more when working with children, ultimately leading him to specialize in pediatric gastroenterology.
  • Daniel is passionate about medical education and mentoring trainees, recognizing the importance of wellness in the medical profession.
  • Through his own experiences in training and becoming a parent, Daniel recognized the need for addressing physician burnout and is involved in research on the topic.
  • His interest in wellness came about through his own experiences with stress and recognizing the importance of self-care in the medical field

[12:43 - 24:32] Addressing Burnout in Medical Professionals: Insights from a Pediatrician

  • The culture of overworking and sleep deprivation has been prevalent in the medical field for a long time, with long shifts and being on call for extended periods being seen as a "badge of honor."
  • Institutional changes such as shorter shifts and better work-life balance policies are being implemented. However, progress is slow, and more needs to be done to sustain a healthy work environment for medical professionals.
  • Burnout is a real issue that can impact the quality of care medical professionals provide and their well-being. It is important for medical professionals to recognize the signs of burnout and take steps to address it, seeking taking time off to recharge, and finding hobbies or activities outside of work can all contribute to a healthier work life balance.
  • Personal experiences with burnout and overwhelm are common among pediatricians, and recovery often involves taking time off, seeking support from colleagues and loved ones, and practicing self-care.

[24:33 -40:17] Strategies for a Work-Life Balance in Academic Medicine: The Eisenhower’s Box Method

  • Importance and urgency are the key factors to consider while managing tasks
  • Urgent tasks with low importance can be delegated or automated
  • Restorative activities, even if they are not productive, can help reduce burnout
  • Tasks that are not important and not urgent can be avoided to reduce unnecessary stress.

[40:18 - 51:46] Creating a Supportive Environment for Healthcare Professionals: Strategies and Best Practices

  • Providing anonymous peer-to-peer support can make a significant difference in mental health for healthcare workers.
  • Critical Incident Stress Management (CISM) teams can be instrumental in helping individuals process traumatic events and feel less isolated in their experiences.
  • It's important for healthcare professionals to envision the life they want and seek it without assuming compromise and suffering are necessary steps to achieving success.
  • Mentors, supervisors, and leaders want healthcare workers to succeed and prioritize their happiness, and seeking their support and guidance can be invaluable.

[51:47 - 56:50] Closing segment Takeaways include:

  • Burn out felt like being in the swamp and trudging through. Not burn out feels like walking on the edge.
  • Likely all of us have struggled with feelings of “not good enough” and the imposter syndrome. Sharing those feelings is therapeutic – “I am not alone”
  • A culture shift from “I have to endure” to “I love my job”
  • Envision the life you want without having to suffer to get there
  • Consider the Eisenhower Box when thinking about tasks: important, urgent, not important, not urgent. If it is important and urgent, do it. If it is important but not urgent, schedule it. If it is not important but urgent, delegate it. If it is not important and not urgent, don’t do it!

You can reach Dr. Daniel Mallen

Twitter: @dannymallon24

Links to resources mentioned on the show

Pediatric Resident Burnout-Resilience Consortium Study pedsresresilience.com

Insight Timer

Insight Timer - #1 Free Meditation App for Sleep, Relax & More

-Landrigan CP, Rahman SA, Sullivan JP, Vittinghoff E, Barger LK, Sanderson AL, Wright KP Jr, O'Brien CS, Qadri S, St Hilaire MA, Halbower AC, Segar JL, McGuire JK, Vitiello MV, de la Iglesia HO, Poynter SE, Yu PL, Zee PC, Lockley SW, Stone KL, Czeisler CA; ROSTERS Study Group. Effect on Patient Safety of a Resident Physician Schedule without 24-Hour Shifts. N Engl J Med. 2020 Jun 25;382(26):2514-2523. doi: 10.1056/NEJMoa1900669. PMID: 32579812; PMCID: PMC7405505.

-West, CP, Dyrbye, LN, Shanafelt, TD. (Mayo Clinic, Rochester, MN; and Stanford University Medical Center, Stanford, CA, USA). Physician burnout: contributors, consequences and solutions (Review). J Intern Med 2018; 283: 516– 529.

-Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, Menaker R, Rummans TA, Dyrbye LN. Career fit and burnout among academic faculty. Arch Intern Med. 2009 May 25;169(10):990-5. doi: 10.1001/archinternmed.2009.70. PMID: 19468093.

-Kemper KJ, Schwartz A, Wilson PM, Mahan JD, Schubert CJ, Staples BB, McClafferty H, Serwint JR, Batra M; PEDIATRIC RESIDENT BURNOUT-RESILIENCE STUDY CONSORTIUM. Burnout in Pediatric Residents: Three Years of National Survey Data. Pediatrics. 2020 Jan;145(1):e20191030. doi: 10.1542/peds.2019-1030. Epub 2019 Dec 16. PMID: 31843859

another episode you may like:

Episode #116

Physician Wellness Coaching: Proven Benefit

https://302.buzz/116PhysicianWellnessCoaching

Key quotes for Twitter:

"Pediatrics has been one of the places where people are generating data and looking into this [Wellness] and really sounding the alarm."..Dr. Daniel Mallen

"The culture is shifting ever so slowly, especially with parental leave.".. Dr. Daniel Mallen

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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As an educator and administrator, Meadow Nuyen acknowledges the challenges faced due to the pandemic, such as staffing shortages and virtual learning for early childhood education. Meadow talks about the importance of empowering parents and recognizing them as the first educators during a child's developmental years. She believes that parents should feel comfortable advocating for their child's needs and speaking up if they have any concerns. She stresses the importance of recognizing the family unit, (regardless of traditional family structures), and valuing their knowledge about their child's needs and development. Meadow’s passion for early childhood education and empowering parents shines through in this episode. She stresses the importance of providing high-quality pre-K experiences, monitoring children's milestones, and working together to support a child's development. You’ll walk away from this episode anxious to implement the “Parent-Teacher-Clinician” superpower that all kids deserve.

[00:33 -10:09] The Importance of Early Childhood Education

  • Parents should speak up if they have concerns and advocate for their child's needs.
  • The human brain develops most before age five, making early education a critical time for youngsters.
  • Youngest learners need the support and encouragement of role models from all walks of life.
  • Parents, educators and clinicians can share information to best support the child's development.
  • Children who experience separation anxiety during the transition into preschool require special attention.

[10:10- 22:22] Trauma-Informed Teaching and Supporting Families

  • Adverse Childhood Experiences (ACEs) study and understanding the impact of trauma on children's development.
  • Cultivating empathy and compassion for children and families who have experienced trauma.
  • Shifting perspective to ask "What happened to?" instead of "Why are you doing this?"
  • Listening to families and letting them talk to feel heard and validated.
  • Normalizing conversations about trauma and its possible effects to open communication and healing.

[22:23 -30:15] Combating Food Insecurity in Schools

  • Providing free meals for all enrolled students
  • Reducing stigma around receiving free meals
  • Addressing the issue of food insecurity in all communities, regardless of wealth
  • Acknowledging the impact of food insecurity on learning and health
  • Encouraging healthy eating habits and access to nutritious foods

[30:16 - 42:59] Assessment and Evaluation in Schools

  • The NWEA assessment is a standardized test that is administered nationwide.
  • The assessment is conducted three times a year in some districts and twice a year in others.
  • A 504 plan is a legal document that provides additional support to students with learning difficulties upon parental request.
  • An IEP is a more intensive individualized education plan given to children who have been evaluated and tested by a school district's psychologist.
  • The IEP team includes the special ed director, teacher, special education staff, principal, and family to create goals and interventions to support the child's needs.

[43:00 - 52:04] Some of the Takeaways include:

  • Children are all learners. The educator’s job is to identify struggles and to build skills and mastery.
  • Educators' best strategy for learning is to empower parents. They are the first teachers. They know their child best.
  • All adults can use the trauma-informed lens to support kids. “Something happened” vs. focusing on the behaviors. Not to set the expectation bar lower but to bring empathy to the table. The behavior serves a purpose in the child’s world and for the parent’s as well.
  • Schools are always keeping eyes and ears on a child – mastery, struggles – and have strategies they use to support kids. Multi tiered system support follows a teacher’s assessment and is fluid.
  • Tier 1 – this child can learn whole group lessons
  • Tier 2 – this child needs small group lessons in addition to whole group lessons
  • Tier 3 – this child needs more intensive instruction and 1:1 learning

https://302.buzz/PM-WhatAreYourThoughts

You can reach Meadow Nuyen

Linkedin: Meadow Nuyen | LinkedIn

Links to resources mentioned on the show

Home | Build Up Michigan this includes a list of milestones for children age 3 to 5

Preprimary Evaluation Team (PET) / Overview this includes information on how to access an assessment for birth to 6 through the pre primary evaluation team at KRESA (if families feel the student is developmentally behind).‌

Multi-Tiered System of Supports (MTSS) info on MTSS (multi tiered systems of support) - it's really about educating the whole child!‌

Michigan's Top 10 Strategic Education Plan Michigan Department of Education's Strategic Plan (#1 is Expand early childhood learning opportunities) That's Me!

Adverse Childhood Experiences (ACEs) (cdc.gov) Adverse Childhood Experiences (ACE):

Another episode you may like:

Episode #111

Moral Dilemmas: Health is A Human Right: Why Are We Falling Behind?

https://302.buzz/111HealthIsaHumanRight

Key quotes for Twitter:

"One of the challenges in education is the lack of qualified staff. We need more people passionate about working with kids."... Meadow Nuyen

"As educators, we need to be empathetic and understanding of the behaviors our students and families may display. They may be a byproduct of abuse or neglect."... Meadow Nuyen

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Childhood trauma can have a lasting impact on mental health and well-being, but addressing it in therapy requires a careful and compassionate approach. In this episode, child psychologist, Dr. Conni Lutes, shares her unique strategies on working with young children who may be experiencing behavior issues or challenges related to autism. Your host, Dr. Lia Gaggino and Conni discuss the importance of using language and creative outlets, such as art and play therapy, to help kids express themselves and make progress. By taking these steps, practitioners can help children feel heard and supported. By creating a safe and comfortable environment and meeting children where they are, therapists can help children process their trauma and move towards healing.

[00:33 -15:56] Strategies for Working with Children in Therapy

  • Create a colorful and comfortable therapy environment with bean bag chairs, pillows, and other calming tools.
  • Encourage artistic expression and play to help children feel more comfortable and have a voice when they feel silenced.
  • Focus on the child's strengths first to build trust and establish a foundation for future therapy sessions.
  • Approach trauma and behavioral issues by first getting to know the child as a whole, not just focusing on the problematic behaviors or experiences.
  • Start sessions by focusing on the child's strengths, rather than immediately addressing any traumatic experiences or behavior issues.

[15:57- 30:41] Strategies for Supporting Children with Autism and Anxiety

  • Continually assess children to understand their behavior and the underlying factors that contribute to it.
  • The powerful role of art therapy in helping children with limited language skills
  • Using social stories and role-playing as effective strategies to help autistic children learn how to join and feel understood
  • The importance of understanding developmental stages and expectations in managing anxiety and worry in elementary-aged children
  • Introducing the concept of a "smart part" of the brain and "red alert" to teach children how to gain control over their feelings and move from a state of anxiety to a more rational, problem-solving state.

[30:42 -42:23] Promoting Collaboration between Doctors, Therapists, and Schools

  • Recognize the importance of all the adults in a child's life, including pediatric clinicians, schools, and therapists.
  • Emphasize a strength-based approach to working with children, focusing on their unique abilities and passions.
  • Encourage shared control between parents and children, giving children choices and opportunities to feel empowered.
  • Use strategies such as the five senses exercise to help children shift from reacting to thinking.
  • Facilitate cross-disciplinary communication and collaboration to ensure that everyone has a complete picture of the child's strengths and challenges.

[42:24 -51:46] Creating a Multidisciplinary Team: Tips and Strategies

  • The importance of multidisciplinary teams, involving OT, PT, and speech.
  • Humility is essential for physicians to recognize they are not aware of everything.
  • Teachers must understand that the child can behave differently in different settings.
  • Collaboration between therapists, clinicians, teachers, and parents is necessary.
  • Accepting the child's strengths alongside their weaknesses is fundamental.

[51:47 - 56:44] Closing segment Takeaway

Links to resources mentioned on the show

Jay Shetty: Home - Jay Shetty

Jim Fay Love and Logic: Love and Logic Institute, Inc

Stanley Greenspan: The Greenspan Floortime Approach

Ken Ginburg’s Book: Congrats—You're Having a Teen!: Strengthen Your Family and Raise a Good Person eBook

Other episodes you may like:

Dr. Colleen Cullinan’s four part Series on Executive Function

**Episode #88

ADHD: Strategies for Boosting Executive Function Pt I

https://302.buzz/88ADHD-Boosting Executive Function

**Episode #109

ADHD: Executive Functions Pt II

https://302.buzz/109ADHDpt2

**Episode #119

ADHD: Executive Functions Pt III

https://302.buzz/119ADHD-Pt3

**Episode #120

ADHD: Executive Functions Pt IV

https://302.buzz/120-ADHDpt4

Dr. Mark Sloane

**Episode 29

Goldilocks, Tigger & Eeyore: Regulation and Childhood Behaviors

https://302.buzz/29GoldilocksTiggerEeyore

Key quotes for Twitter:

"Kids often get misdiagnosed and pigeonholed as bad kids when in fact that's just been misinterpreted." … Dr. Conni Lutes

"I brought up the word confused a lot in my office with autistic children because I don't think they were given a lot of opportunities to talk about their confusion." … Dr. Conni Lutes

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Congrats―You're Having a Teen!: Strengthen Your Family and Raise a Good Person

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https://302.buzz/PM-WhatAreYourThoughts

Dr. Brooks Keeshin, a triple-board trained child psychiatrist with a focus on trauma, shares his journey into child psychiatry, and discusses the idea of it being a subspecialty of pediatrics. The conversation leads to a discussion on the role of pediatricians in prescribing psychotropic medication and the importance of identifying and recognizing mental health concerns in children. Dr. Keeshin highlights the pitfalls of thinking about mental health as a catch-all, and reminds pediatricians to consider individual diagnoses to guide treatment options. He also points out that psychotherapeutic interventions are usually at the top of the list, and that medication is only one consideration. Get your pencils out…. You’ll want to take notes…

[00:33 -13:56] The Importance of Identifying Mental Health Concerns

  • Identifying mental health concerns should begin with listening to the family's concerns and the child's or adolescent's voice.
  • Using measurements such as universal screening or targeted screeners can help inform the differential diagnosis.
  • It is important to move away from the thinking that mental health is a catch-all, and instead focus on individual diagnoses that will guide treatment recommendations.
  • Early identification and treatment of mental health concerns can improve outcomes and prevent future problems.
  • Having a process to rule out other contributing factors to distress, such as adjustment disorders, can lead to more accurate diagnoses and effective treatment.

[13:57 - 26:01] Choosing Treatment Options for Pediatric Anxiety

  • The importance of getting a full picture of the child's symptoms, including using screeners such as SCARED
  • Considering evidence-based interventions for pediatric anxiety, such as anxiety-focused CBT or SSRIs
  • Combination therapy with psychotherapeutic intervention and SSRIs may offer the best chance of complete remission
  • SSRIs such as Fluoxetine, Sertraline, and Citalopram have the greatest evidence base and experience in youth
  • Assessing the level of impairment and degree of symptoms in making a decision about medication vs. psychotherapeutic intervention

[26:02 -38:10] Addressing Anxiety Symptoms in Traumatized Kids

  • Stepped approach involves addressing other contributing factors before using SSRIs
  • Ensure physical safety of environment before trauma-focused therapy
  • Address sleep first as chronic insomnia can drive anxiety symptoms
  • Maximize other interventions like social determinants of health and trauma therapy before giving SSRIs
  • Aggressively titrate SSRIs to effective doses for robust response

[28:11 - 51:33] Improving Access to Expert Child Psychiatric Care

  • Improving access to comprehensive psychiatric evaluations by child psychiatrists is essential for identifying children with severe psychiatric needs.
  • The limited number of child psychiatrists means better triage is needed to ensure the most severely impacted children receive the necessary care.
  • Educating child psychiatrists about the comfort levels and limitations of ongoing psychiatric treatment in primary care can be helpful in improving collaboration.
  • Consider outpatient programs or day treatment programs for kids after inpatient treatment to help them prepare for a return to their normal life.
  • Consider partnering with primary care if it would be more appropriate for the child in the long term.

[51:34 - 59:59] Closing segment Takeaway

Links to resources mentioned on the show

UTAH PIPS

https://utahpips.org/

CLINICAL REPORT: Children Exposed to Maltreatment: Assessment and the Role of Psychotropic Medication

https://publications.aap.org/pediatrics/article/145/2/e20193751/68268/Children-Exposed-to-Maltreatment-Assessment-and?autologincheck=redirected

The National Child Traumatic Stress Network

nctsn.org

AAP Trauma-Informed Care https://publications.aap.org/pediatrics/article/148/2/e2021052580/179745/Trauma-Informed-Care

CAMS Child and Adolescent Anxiety Multimodal Study

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818613/

GLAD PC 1 https://publications.aap.org/pediatrics/article/141/3/e20174081/37626/Guidelines-for-Adolescent-Depression-in-Primary?autologincheck=redirected

GLAD PC https://publications.aap.org/pediatrics/article/141/3/e20174082/37654/Guidelines-for-Adolescent-Depression-in-Primary

GAD 7

https://adaa.org/sites/default/files/GAD-7_Anxiety-updated_0.pdf

SCARED

https://www.ohsu.edu/sites/default/files/2019-06/SCARED-form-Parent-and-Child-version.pdf

PHQ 9-A https://www.aacap.org/App_Themes/AACAP/docs/member_resources/toolbox_for_clinical_practice_and_outcomes/symptoms/GLAD-PC_PHQ-9.pdf

Other episodes you may like:

Ep 95- A child Psychiatrist's Perspective for PCP's: Leave the "Fix It" Mindset at the Exam Door

https://302.buzz/95ChildPsychiatrist

Ep 93- Trauma and Resilience: Affiliate!

https://302.buzz/93TraumaResilience

Ep 90- Why Kid's Mental Health Means So Much to Me: Moving Mountains

https://302.buzz/90WhyKidsMental Health

Ep 89- Youth Mental Health Crisis: An Opportunity for Innovation

https://302.buzz/89YouthMentalHealthCrisis

Key quotes for Twitter:

"Child psychiatry could have been a pediatric subspecialty rather than the way it's structured today." … Dr. Brooks Keeshin

"I really think of myself as a pediatrician who just went and got additional training experience." … Dr. Brooks Keeshin

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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https://302.buzz/PM-WhatAreYourThoughts

The American Academy of Pediatrics Section on Pediatric Trainees is an active group that offers a variety of leadership roles for medical students, residents, and fellows. Dr. Madeleine Norris shares her journey from child neurology to pediatric mental health and her involvement in the AAP. Your host, Dr. Lia Gaggino, a leader in the AAP, explains how trainees can submit abstracts to the SOPT Abstract Competition and become a member of the Section on Pediatric Trainees or the Section on Early Career Physicians. Madeleine also discusses her role as a Deputy Editor for the Feature in the journal Pediatrics. If you are or know someone who is a trainee, medical student or resident, make sure that you share this episode with them. They’ll thank you for it.

[00:33 - 6:11] Introduction to Madeleine’s Pediatric Journey

  • Madelyn is a PGY two resident in a categorical pediatrics tract at NYU.
  • Her initial interest in child neurology before switching to pediatric mental health.
  • Her future goal of becoming a triple boarded child psychiatrist.

[6:12-8:43] Her role with the AAP’s Section on Pediatric Trainees

  • Importance of getting involved in trainee leadership.
  • Opportunities for medical students and residents to join the section.
  • Various leadership roles available within the section
  • Encouragement for trainees to apply even if they don't feel fully qualified.

[8:44 -13:35] What her duties are as the Deputy Editor for the Pediatrics Journal Feature

  • Coaches and mentor's trainees in the developmental editing process
  • Focuses on education and encouraging trainees to write and share their perspectives.
  • Offers feedback and support to authors even if their piece is not accepted.
  • Three-year term for the Deputy Editor position

[12:36 -23:23] Details for Submitting Narrative Work for the Pediatrics Journal Feature

  • Essay competition offered in relation to the Races Against ACEs campaign.
  • Submissions open on March 3rd and close on April 14th.
  • Criteria for submission, word count and author number, can be found in show notes
  • All trainees are eligible to apply.

[23:24 - 27:08] Closing segment Takeaway.

You can reach Dr. Madeleine Norris.

Twitter: @Maddie__MD

Instagram: @maddie_.norris

Links to resources mentioned on the show

ACES Too High website: https://acestoohigh.com/

1998 ACES Study: https://pubmed.ncbi.nlm.nih.gov/9635069/

AAP Peds Trainees (On Twitter): @AAPSOPT Use #RacesAgainstACEs and #PedsPerks.

Submission Info for the 2023 Essay Competition: “Races Against ACEs” https://docs.google.com/document/d/1T6vCN3e8Ib1SGb8L_Ab-Q1pEXSJXO9qZT_1aO50-lKQ/edit?usp=sharing

Submission portal: https://submit-pediatrics.aappublications.org/

Pediatrics Manuscript Processing System submit-pediatrics.aappublications.org

Author Instructions | Pediatrics | American Academy of Pediatrics American Academy of Pediatrics (aap.org)

Other episodes you may like:

Episode #93

Trauma and Resilience: Affiliate!

https://302.buzz/93TraumaResilience

Episode #56

Toxic Stress: Safe, Stable Nurturing Relationships are the Antidote.

https://302.buzz/56ToxicStress

Key quotes for Twitter:

“This year's SOP advocacy campaign is focused on Races Against ACEs. Join us in understanding, evaluating, and responding to the impact of adverse childhood experiences on pediatric health outcomes.”....Dr. Madeleine Norris

"The Section on Pediatric Trainees in the AAP is an active and dynamic group that offers opportunities for trainees to get involved in leadership, advocacy, and more. Find out how you can become a member".. Dr. Madeleine Norris

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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https://302.buzz/PM-WhatAreYourThoughts

The medical world is accomplishing great things; for example - Rapid Whole Genome Sequencing. A cutting-edge concept that has cut diagnoses of rare diseases from weeks and months to days and hours. It’s called Project Baby Deer and it’s focused on implementing evidence-based precision medicine and pediatrics to facilitate rapid whole genome sequencing for sick inpatients, neonates and children across the state. The project was born out of a collaboration between Dr. Caleb Bupp, Dr. Andrea Scheurer and Dr. Joseph Fakhoury. Your host, Dr. Lia Gaggino talks with these 3 clinicians about this groundbreaking initiative that is helping to provide better care for children across the state. If you know someone who is in medical school, you’ll need to share this episode with them.

[00:33 -28:07] Intros / What is Rapid Whole Genome Sequencing?

  • Michigan’s “Baby Deer” project was designed after California’s “Baby Bear” project.
  • The genetic code is made up of billions of adenine (A), cytosine (C), guanine (G) and thymine (T)
  • Variations in the code is what makes us unique.
  • In the past, sequencing was expensive and slow, but technology has made it faster and cheaper.
  • Entire genetic code can be sequenced in hours with accurate results.

[28:08- 35:40] Benefits of Genetic Testing for Children

  • Genetic testing can provide important information about a child’s risk of developing a particular health condition in the future.
  • Genetic testing is faster and cheaper than ever before.
  • Genetic testing can help reduce the cost of care by providing more accurate diagnoses and treatments.
  • It can also help identify inherited traits and conditions that could affect a child’s health.
  • Knowing the cause of a medical issue helps make better decisions on how to treat it

[35:41 -46:04] The Benefits of Collaboration

  • Bronson and DeVos hospitals collaborated to develop a comprehensive consent process, as well as a system for sharing and analyzing the data.
  • The two hospitals have also developed a system for follow-up care, ensuring that any positive results are followed up on and that any negative results are discussed with the family.
  • The collaboration between Bronson and DeVos has made rapid WGS accessible to more families and has helped to improve the quality of care for those families.
  • Although the cost is a main barrier to expansion, the collaboration between the two hospitals will provide rapid WGS to patients in need.

[46:05 - 1:02:49] What is Rare Disease Day?

  • Rare Disease Day is the last day of February, the rarest day of the year.
  • It is a day to raise awareness and hope for the 300 million people worldwide who live with a rare disease.
  • It is a day to highlight the need for research, support, and advocacy for these diseases.
  • It has been happening every year since 2008.

[1:02:50 - 1:08:48] Closing segment Takeaway.

You can reach Dr. Joseph Fakhoury

Facebook:Joe Fakhoury | Facebook

Instagram: @jfakhoury.515

LinkedIn:Joseph Fakhoury | LinkedIn

You can reach Dr. Andrea Scheurer

Facebook:Andrea Scheurer Monaghan | Facebook

Instagram: @amsmonaghan

LinkedIn: andrea scheurer-monaghan

Twitter: @ascheurermd / Twitter

You can reach Dr. Caleb Bupp

LinkedIn:caleb bupp | Search | LinkedIn

@raredeseaseday

raredeseaseday

Links to resources mentioned on the show.

Project Baby Deer: https://www.mha.org/issues-advocacy/project-baby-deer/

Breaking Barriers to Rapid Whole Genome Sequencing in Pediatrics: Michigan's Project Baby Deer https://doi.org/10.3390/children10010106

Rapid Genome Sequencing: Consent for New Technologies in the Neonatal Intensive Care Context:

https://publications.aap.org/pediatrics/article/150/6/e2022058222/190125/Rapid-Genome-Sequencing-Consent-for-New

Other episodes you may like:

Episode #126

Body Grief and Ableism: Lived Experience

httfps://302.buzz/126BodyGrie

Key quotes for Twitter:

"The name Project Baby Deer was really modeled after a California project entitled Project Baby Bear" - Dr. Andrea Scheurer

"We now have the ability to use genetic testing and to use genetic testing that comes back fast to make diagnoses" - Dr. Caleb Bupp

“She (Dr. Scheurer) reached out to me and a couple other subspecialists just to sort of gauge our interest. And I dove right in…” - Dr. Joseph Fakhoury

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Patient Confidentiality is a complex subject and more times than not, the answer to the questions will begin with “Well, it depends….” Dr. Elizabeth Alderman, a pediatrician, shares her journey into pediatrics and how she has handled this issue in her own practice in the state of New York. Both Dr Gaggino and Dr. Alderman talk about the frustrations that healthcare providers face when they must decide on the best course of action to take, particularly when there are concerns about the safety and wellbeing of the adolescent patient. Listen in as they discuss navigating these complexities requiring a delicate balance between respecting a patient's confidentiality, ensuring their safety, and complying with legal and ethical obligations.

[00:33 -15:50] Opening Segment / Adolescents and the 21st Century Cures Act

  • The 21st Century Cures Act has provided adolescents more access to confidential healthcare
  • It has made it easier for adolescents to receive mental health services without parental consent
  • It has expanded access to contraception and sexual health services without parental consent
  • It has provided more protection for adolescents with chronic illnesses to be able to access care without parental consent.
  • It has also strengthened HIPAA protections for adolescents.

[15:51- 31:08] How can healthcare providers ensure confidentiality for adolescents?

  • Have a routine part of the visit that discusses confidentiality and set expectations between the healthcare provider and the patient.
  • Have a conversation with the parents or guardians about leaving the room if needed during sensitive conversations.
  • Read the After Visit Summary before giving it to the patient to ensure that no sensitive information is included that should not be seen by parents or guardians.
  • Work with the EHR vendor to set up rules around the patient portal that honor state law privacy exceptions.
  • Encourage patients to ensure that their own email is linked to the patient portal instead of a parent or guardian’s email.

[31:09 -42:16] Empowering parents in conversations with their teens

  • Recommending parents bring up topics like sex and drugs with their teens
  • Assessing whether parent involvement is appropriate in each situation
  • Discussing the limits of confidentiality
  • Role-playing conversations with parents

[42:17 - 50:37] How to Ensure Adolescents Receive Confidential Medical Care

  • Make sure to know what state laws you are working under related to birth control, STI testing, mental health and prescribing medication for mental health disorders.
  • Look for links and resources related to state laws and reproductive rights.
  • Look for handouts related to adolescent confidentiality from the Society for Adolescent Health, AAP or your state’s AAP chapter.
  • Always be mindful of how your words will be interpreted by a patient.

[50:38 - 59:26] Closing segment Takeaways

Don’t forget to sign up for Dr. Gaggino’s February 24th Beta Training

for Professionals who want to re-think the mental health services they offer

Up Your Game - Improving Kid's Mental Health Care

Links to resources mentioned on the show

State by State Variability in Adolescent Privacy Laws: https://publications.aap.org/pediatrics/article/149/6/e2021053458/187003/State-by-State-Variability-in-Adolescent-Privacy?autologincheck=redirected

Book: “Congrats, You’re Having a Teen” by Kenneth Ginsberg https://302.buzz/CongratsTeen

21st Century CURES ACT 21st Century Cures Act | FDA

Other episodes you may like:

Episode #103

“Talking To Teens: A Reframe with Dr. Ken Gensberg”

https://302.buzz/103 TalkingToTeens

Key quotes for Twitter:

“Every day is interesting. I work with wonderful teenagers, young adults and their families, colleagues who are committed to our patients and to advocacy”… Dr. Elizabeth Alderman

“Or even emotional harm can be interpreted in certain ways. These are things to consider in taking care of adolescents and preserving confidentiality around the 21st Century Cures Act”… Dr. Elizabeth Alderman

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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The challenges of mental health in children are complex, to say the least. One of this podcast’s favorite guests, Dr. Mark Sloane is a long-time pediatrician with decades of experience in this field, returns to talk about the challenges of persuading primary care physicians to pursue additional education, the effects of trauma on children, and the demand for more training in medical school and residency. There’s also a discussion on the impact of screening on mental health and the use of SSRIs in children.

[00:33 -15:31] Opening Segment /Importance of Mental Health Treatment

  • We’re introduced to Dr. Mark Sloane, and we hear about how his journey into pediatrics.
  • Primary care doctors need more mental health training.
  • Pediatrics have evolved over the last 20-30 years and needs to be accepted.
  • The Authority Health Project is providing training to residents to integrate trauma-informed care into their practice.

[15:32- 29:12] Traumatic Stress and Mental Health

  • Serotonin genetics significantly increases the risk of PTSD with traumatic exposure.
  • Prenatal stress, especially from domestic violence, can increase the risk of anxiety disorders.
  • Epigenetic factors can be used to assess a newborn's risk for anxiety and other mental health issues.
  • Mental health medications are often seen as a last resort for treating traumatized children.
  • Trauma therapy is essential for treating underlying mental health issues in traumatized children.

[29:13 -49:31] Building Relationships and Connection: The Magic of the Room

  • The Power of Relationships- The importance of building relationships as the cornerstone to emotional wellbeing.
  • Going Beyond Compliance- Facilitating environments where kids feel safe and supported rather than simply compliant.
  • Adopting a Team Approach- Understanding the need for team effort and how it can help foster parents and staff to create successful outcomes.
  • The CTAC Model Evolves- Examining how the CTAC model has evolved over time to include physicals, fetal alcohol syndrome screens, and more.

[49:32 -58:45] Advice for the New Medical Professional

  • Focus on connection with patients
  • Meet the needs of the community
  • Listen to veteran doctors / Get a mentor
  • Build incentives for trauma screen completion

[58:46 - 1:05:22] Closing segment Takeaway

Don’t forget to sign up for Dr. Gaggino’s February 24th Beta Training

for Professionals who want to re-think the mental health services they offer

Up Your Game - Improving Kid's Mental Health Care

Links to resources mentioned on the show.

Bruce Perry

https://adoptioncouncil.org/publications/meeting-children-where-they-are-the-neurosequential-model-of-therapeutics/

Book: What Happened to You?

https://302.buzz/WhatHappenedToYou

Andrew Garner – Thinking Developmentally https://publications.aap.org/aapbooks/book/509/Thinking-Developmentally-Nurturing-Wellness-in?autologincheck=redirected

Trust-Based-Intervention – Karen Purvis

https://child.tcu.edu/#sthash.Y8d2nwaJ.dpbs

Steve Southwick - https://danielafranz.com/southwick-on-resilience/

https://www.ptsd.va.gov/publications/rq_docs/V25N4.pdf

Courses:

REACH Institute: https://thereachinstitute.org

Massachusetts General Pediatric Psychopharmacology: https://mghcme.org/courses/child-adolescent-psychopharmacology-2023/

Heather Forkey – Trauma and Resilience

https://podcasts.apple.com/us/podcast/pediatric-meltdown/id1529656785?i=1000566491972

Andrew Garner -

https://podcasts.apple.com/us/podcast/pediatric-meltdown/id1529656785?i=1000536975449

Other episodes you may like:

Episode #29

Goldilocks, Tigger & Eeyore: Regulation & Childhood Behaviors

https://302.buzz/29GoldilocksTigger

Episode #03

Pediatric Hero: Building Safe Spaces for Kid's Emotions with Dr. mark Sloane

https://302.buzz/3PediatricHero

Key quotes for Twitter:

“Doctors have told me, hey, the first time I wrote for an antidepressant, the kid got manic. And I thought, never again am I gonna do this. This is not what I should be doing.” - Dr. Mark Sloane

"How can we get them more training without overwhelming them? That's my tendency is when I get an interested person, I kind of wanna just drown them with everything I have'' - Dr. Mark Sloane

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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This is a very special episode where I (the Pediatric Meltdown producer) get to interview your host, Dr. Lia Gaggino. There are lots of great things happening in 2023 and we thought this would be a great way to tell you about all of it as well as getting to know your host a little bit better. We’ll talk about what made her fall in love with Pediatrics as well as her decision to step down from the practice. There is a sneak peak of some episodes coming up, an overview of the “Up Your Game” event she is planning at the end of February (the link to join is below). And we do a rapid-fire random question and answer game that gives you a little more info on the doctor… Do you like the same dessert????

[00:33 -05:39] Let’s start at the Beginning.

  • She went from “hippie” to intern.
  • She did her rotation in pediatrics and loved it.
  • And why she stepped down from practicing.

[05:40-11:07] Her involvement with the American Academy of Pediatrics

  • She’s served in several capacities on the AAP including president, vice president, and board member.
  • Lia talks about the AAP and their outreach to other countries.
  • The AAP policies that came about due to the pandemic

[11:08 –18:49] Lia Talk about the Podcast

  • We share our favorite episodes.
  • What kind of subjects we can look forward to hearing in 2023
  • Lia is “very picky” when it comes to choosing the guests for the show.

[18:50 - 28:33] Let’s hear about the new Newsletter and Event

  • The newsletter will go out twice a month and will highlight past and future guests, polls, articles of interest, etc.
  • The “Up Your Game” Event (02/28/23), is for clinicians to understand how they can help kids with mental concerns.
  • A quick game of “word association”

Sign up for Dr. Gaggino’s February 24th Beta Training

for Professionals who want to re-think the mental health services they offer

Up Your Game - Improving Kid's Mental Health Care

You can reach Dr. Lia Gaggino

Website & Newsletter: https://medicalbhs.com/

Facebook:Dr. Lia Gaggino | Facebook

Instagram: @pediatricmeltdown

Twitter: @gaggino

Linkedin: Lia Gaggino, MD, FAAP | LinkedIn

Links to resources mentioned on the show

American Academy of Pediatrics

Home (aap.org)

Other episodes you may like:

Episode #01

Words Matter-Talking about Weight & BMI

https://302.buzz/01Words Matter

Episode #02

Caring for Children in Foster and Kinship Care: Keeping a Trauma-Informed focus

https://302.buzz/02CaringForFosterChildren

Episode #26

The 3 B's - Brain, Body, Behavior: Managing Anxiety

https://302.buzz/26The3Bs

Episode #71

Depression: Naming the Monster

https://302.buzz/71DepressionNamingThe Monster

Episode #114

Palliative and Hospice Care: A conversation on Grief and Joy

https://302.buzz/PM114Palliative-HospiceCare

Key quotes for Twitter:

“I'm pretty picky about who I bring onto the show, so I vet them pretty well. I wanna make sure that they are experts” … Dr. Lia Gaggino

"The American Academy of Pediatrics was a leader and continues to be on all things Covid 19 related, pertaining to children"... Dr. Lia Gaggino

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Ehlers-Danlos Syndrome…. Ever hear of it? Well, they say that it’s the most common illness that you’ve never heard of. Jayne Mattingly makes a return appearance and gives Dr. Gaggino an update on her health and life since she was last on the podcast. She will talk about how her condition has progressed and gives an honest account of what life is currently like for her. It’s emotional, it’s raw, and it’s real.

[00:33 -13:39] What is Ehlers-Danlos syndrome (EDS)?

  • It is the most common illness that you've never heard of.
  • There are 14 different types of EDS, the most common being hypermobile EDS.
  • It is a genetic condition and is becoming increasingly more common.
  • People with EDS may need to use mobility aids and make changes to their living space or lifestyle to accommodate their condition.

[13:40- 24:23] What Impact Has EDS Had on Jayne's Life?

  • She’s now a wheelchair user and has had to move into an accessible home.
  • She’s had 14 brain and spine procedures and surgeries.
  • She’s had to switch her focus from recovery coaching to training and educating professionals to become eating disorder recovery coaches.
  • Jayne created a nonprofit called the AND Initiative which gifts mobility aids and provides resources, education, and advocacy for those with disabilities and chronic illnesses.

[24:24 -32:10] What Are Some of the Difficulties Associated with EDS?

  • The world is not as accessible as one might think when one becomes disabled.
  • Grief is experienced with the small things, such as getting dressed in the morning or using a shower chair.
  • Navigating a world that doesn't understand can be isolating.
  • Loss of independence or having to rely on others for help.

[32:11- 39:09] What Are Some Ways to Support Those with EDS?

  • Educate yourself about EDS and learn about its symptoms and treatments.
  • Listen and ask questions about how you can help them manage their EDS.
  • Offer assistance but when the answer is “no thank you” .... Believe them.

[39:10 - 46:59] Closing segment Takeaway.

*Don’t forget to sign up for Dr. Gaggino’s February 24th Beta Training

for Professionals who want to re-think the mental health services they offer

Up Your Game - Improving Kid's Mental Health Care

Where to get in touch with Jayne

Instagram: @jaynemattingly

Twitter: @jayneimattingly

Linkedin: jayne mattingly | Search | LinkedIn

Links to resources mentioned on the show

Health Equity for Children and Youth with Special Health Care Needs: A Vision for the Future. https://publications.aap.org/pediatrics/article/149/Supplement%207/e2021056150H/188217/Access-to-Services-for-Children-and-Youth-With?autologincheck=redirected

The AND Initiative: www.theandinitiative.com

Book: Disjointed – Ehlers Danlos Syndrome

Other Pediatric Meltdown episodes you may like:

Episode #62

Eating Disorders: Recovery Coaches Strengthen the Healing Team

https://302.buzz/62RecoveryCoaches

Episode #63

Eating Disorders: Feeding Our Kids

https://302.buzz/63FeedingOurKids

Key quotes for Twitter:

“I have really very little independence...the small things are where the grief comes in”...Jayne Mattingly

“The world is really actually not as accessible as you think until you become disabled".. .Jayne Mattingly

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Dr. Lia Gaggino asks pediatric neurologist Dr. Sarah Dixon some interesting questions about a phenomenon called “TikTok Tics”. Ever hear of it?? Yeah…. Me either. But it is, indeed, a real thing. We’ve all seen TV shows or movies where someone with Tourette’s spews out a string of curse words and many people think that is the definitive symptom of the disorder. It is more complicated than that. Dr. Dixon talks about the different types of tic disorders and offers up some good news for kids and their parents who are struggling with the challenges of tics that most tics will fade away.

[00:33 -19:24] Understanding Tik Tok Tics

  • They are commonly seen in older adolescents developing tics for the first time.
  • These movements have previously been referred to as "functional tics."
  • They fall under the larger umbrella diagnosis of "functional neurologic disorder" (FND)
  • FND is a subconscious habit-driven or learned behavior that causes distress or diminishes quality of life.

[19:25- 24:03] Understanding Functional Neurologic Disorder (FND)

  • FND is not associated with structural, chemical, or electrical neurologic disorders.
  • It represents an abnormally learned motor plan.
  • FND often affects children who are skilled at quickly learning motor or academic tasks.
  • Treatment includes cognitive behavioral therapy and multidisciplinary approaches.

[24:04 -27:47] Understanding the Different Types of Tic Disorders

  • Provisional Tic Disorder: characterized by one or more motor or vocal tics for less than a year.
  • Chronic Motor or Vocal Tic Disorder: characterized by one or more motor or vocal tics for more than a year.
  • Tourette Syndrome: characterized by two or more motor tics and at least one vocal tic for at least a year.
  • Tic disorders are thought to be a spectrum of conditions rather than unique disorders.

[27:48-37:59] When to Refer to a Neurologist for Tic Disorders

  • When the patient is bothered by the tics
  • When there is a suspicion of a comorbidity
  • When the examination findings are abnormal
  • When the tics have been present for more than a year or are increasing in frequency or complexity.

[38:00 - 46:10] Closing segment Takeaway

*Don’t forget to sign up for Dr. Gaggino’s February 24th Beta Training

for Professionals who want to re-think the mental health services they offer

Up Your Game - Improving Kid's Mental Health Care

Links to resources mentioned on the show

Tourette Association of American website -

https://tourette.org

TicHelper - Online, self-guided therapy program for tics:

https://www.tichelper.com

TikTok Tic papers:

TikTok Tics: A Pandemic Within a Pandemic:

https://movementdisorders.onlinelibrary.wiley.com/doi/full/10.1002/mdc3.13316

The Phenomenology of Tics and Tic-Like Behavior in TiKTok:

https://pubmed.ncbi.nlm.nih.gov/35303587

Other Pediatric Meltdown episodes you may like:

Episode #97

Helping Kids Thrive; A Parent’s Story

https://302.buzz/97HelpingKidsThrive

Episode #93

Children with Disabilities; Don’t forget their Emotional Well-Being

https://302.buzz/92Disabilities&EmotionalWellbeing

Key quotes for Twitter:

“There are systems in the brain to encourage movement, and there are systems that inhibit extra movements from happening. And the latter is where we think the pathology lies for tics” ....Dr. Sarah Dixon

"The majority of people, (like 70%), will outgrow their tics by late adolescence or early adulthood"... Dr. Sarah Dixon

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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When you hear Dr. Joey Skelton speak about his patients, it’s clear how deep his commitment runs. He looks beyond the numbers as he believes that each patient deserves to be treated like an individual being. Today's discussion is on childhood obesity. But don’t make the mistake of rolling your eyes and thinking “oh, yeah… it’s a problem” .... This is a different kind of discussion with a different kind of doctor. You’ll hear some things in this episode that you’ve never heard before. Dr. Gaggino asks some difficult questions and Dr. Skelton teaches us about another way to look at kids and obesity.

[00:33 -19:54] Opening Segment

  • Dr. Skelton quit his gastroenterologist practice to focus on obesity research and education.
  • He believes that understanding the entire family is important in addressing obesity and wants to dive deeper into research in this area.
  • His program is set up so that families can start when they are ready, and it takes into consideration that they may have a lot of other stressors in their lives.
  • Number one referral he makes is to a counselor for issues around anxiety or depression, and number two referral is to a mental health resource for parents who may be struggling with similar issues.
  • Our bodies are naturally inclined to gain weight as a means of preparing for potential famines or wars.

[19:55 - 35:37] A New Way of Looking at Obesity.

  • Recognizing the complexity of factors that can impact behavior change, such as access to food, work schedules, and lack of cooking skills.
  • Addressing obesity can be difficult when a parent is already overwhelmed with other stresses in their life.
  • Restricting or limiting portion sizes and encouraging certain foods can lead to negative outcomes, such as increased weight gain and conflicts over food.
  • BMI is a screening tool and should not be used as a definitive diagnostic tool for obesity.
  • Keeping the focus on the person, and behaviors related to preventing diabetes rather than just focusing on weight loss can be more effective.

[35:38 -46:07] HAES (Health at Every Size) fights against Preconceived Notions

  • Listening to podcasts and reading stories from writers in the movement can be emotional and eye-opening.
  • Writers such as Virgie Tovar and Aubrey Gordon share their personal experiences of how their weight affected their interactions with friends, the healthcare industry, and society as a whole.
  • It's important for healthcare providers to approach patients with a weight-neutral mindset, focusing on overall health rather than weight.
  • Creating a safe and non-judgmental environment for patients is crucial in weight-inclusive care.
  • Advocate for recognizing that people can be in larger bodies and still be healthy.

[46:08 - 53:37] Dr. Skelton’s recommendations

  • Screening labs should begin around age 10, taking into account risk factors such as family history and physical findings.
  • Look for opportunities to address issues of weight and health in a size-acceptance spirit.
  • A mindset shift is required to recognize that health behaviors are often influenced by social drivers and the environment.
  • The need for education, support, and understanding for patients, rather than using tests to scare families.

[53:38 - 59:24] Closing segment Takeaway.

Don’t forget to sign up for Dr. Gaggino’s February 24th Beta Training

for Professionals who want to re-think the mental health services they offer

Up Your Game - Improving Kid's Mental Health Care

You can reach Dr. Skelton

Twitter:@DrJoeySkelton

Linkedin:Joseph Skelton | LinkedIn

Links to resources mentioned on the show

HAES Movement

The Health at Every Size® (HAES®) Principles - ASDAH

Podcast: Maintenance Phase Website

https://www.maintenancephase.com/

Virgie Tovar Website

https://www.virgietovar.com/

Podcast: Rebel Eaters Club

https://podcasts.apple.com/us/podcast/rebel-eaters-club/id1495401238

Aubrey Gordon

https://www.yourfatfriend.com/

Huffington Post Article: Everything You Know About Obesity is Wrong

https://highline.huffingtonpost.com/articles/en/everything-you-know-about-obesity-is-wrong/

Other episodes you may like:

Episode #63

Eating Disorders: Feeding our Kids

https://302.buzz/63FeedingOurKids

Episode #62

Eating Disorders: Recovery Coaches Strengthen the Healing Team

https://302.buzz/62RecoveryCoaches

Episode #61

Eating Disorders: Prevention in Primary Care

https://302.buzz/61Prevention

Key quotes for Twitter:

"As healthcare providers, we need to get away from self-directed dieting."…. Dr. Joey Skelton

"There are things that we can do differently and there is research that has shown that we can change some of these behaviors through behavior modification programs."…. Dr. Joey Skelton

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Child abuse has long been a troubling and widespread issue, and sadly, it seems to be getting worse. Munchausen by Proxy (MBP), often known as somatic illnesses or medical child abuse, is one particularly nefarious kind of child maltreatment. Children's health and safety may be seriously impacted by this type of child abuse. Clinicians must be aware of the symptoms and warning signs of MBP in order to safeguard children against this condition. Dr. Nasuh Malas returns to the show to talk about this issue and give practical advice for clinicians.

[00:33 -11:27] Any New Findings Regarding Somatic Disorders and Munchausen By Proxy?

  • Somatic disorders, such as somatic symptom disorder, are characterized by physical symptoms that cannot be explained by a medical condition, and are often caused by stress or depression.
  • Studies have found that individuals with somatic disorders are more likely to engage in Munchausen by proxy behaviors than those without the disorder.
  • These findings have important implications for the diagnosis and treatment of both disorders, as well as for preventative measures against child abuse.
  • Early detection of somatic disorders in parents or caregivers is crucial in order to identify potential risk factors for Munchausen by proxy.
  • Mental health professionals should be aware of the link between somatic disorders and Munchausen by proxy when assessing patients for these conditions.

[11:28- 25:17] What the Psychiatrist can offer?

  • Psychiatric assessments are used to identify and diagnose the underlying psychological and emotional issues that may be driving the patient's symptoms.
  • Psychiatrists can also provide psychotherapy, which can help the patient better understand and cope with their symptoms, as well as explore the underlying causes of the disorder.
  • Psychiatrists may also recommend lifestyle changes or other forms of therapy to help the patient better manage their symptoms.
  • Collaborative care is often recommended for treatment of somatic disorders, as a team of healthcare professionals can provide comprehensive care for the patient.
  • Psychiatry is a crucial part of the treatment for somatic disorders, such as Munchausen by Proxy (MBP), as it offers a comprehensive approach to the diagnosis and management of psychiatric disorders.

[25:18 -34:57] Red Flags to Watch Out For

  • Red flags for Munchausen by Proxy include: disregarding medical advice, iatrogenic injury to the child, isolating the child from normal routine, fading or lying about symptoms, and meeting psychological needs through the child's illness
  • Children with somatic symptom and related disorders may develop an identity of being physically ill, which can be reinforced by their caregiver
  • Caregivers may selectively accept certain aspects of a child's evaluation and treatment and disregard evidence that does not fit their belief about the child's condition
  • It is important for healthcare professionals to be aware of these issues and engage with families in a way that addresses their concerns and promotes the well-being of the child
  • The continuum between somatic disorders and Munchausen by Proxy can be difficult to navigate, but it is essential to consider both physical and psychological factors in the evaluation and treatment of the child.

[34:58 - 43:32] Recommendations from Dr. Malas

  • Have handouts available for patients and families to learn more about somatic symptom disorders
  • Consider working with therapists and schools to provide coping strategies and functional plans for returning to school
  • Familiarize yourself with the clinical pathways and scripting provided by organizations such as the American Academy of Child Adolescent Psychiatry for managing and communicating about these conditions
  • Assess and address any additional barriers the patient may be facing, such as bullying or family dynamics
  • Recognize your limitations and refer to specialized care when necessary

[43:33 - 49:53] Closing segment Takeaway

Links to resources on the subject

Kelty Family Handbook:

https://keltymentalhealth.ca/sites/default/files/resources/Somatization%20Family%20Handbook%202019.pdf

Dr. Malas’ Review on the topic:

https://pubmed.ncbi.nlm.nih.gov/28188588/

The AACAP Clinical Pathway:

https://pubmed.ncbi.nlm.nih.gov/30782623/

The AACAP Facts for Families:

https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Physical_Symptoms_of_Emotional_Distress-Somatic_Symptoms_and_Related_Disorders-124.aspx

Psychiatry Times Article on Somatic Symptom Disorder:

https://www.psychiatrictimes.com/view/best-practices-treating-youth-somatic-symptom-related-disorders

Other episodes you may like:

Episode #23 (Dr. Malas’s prior episode)

Psychiatry Support in the Inpatient Pediatric Setting: Consult Liaison Services on Apple Podcasts

https://302.buzz/23PsychiatrySupport

Episode #73

Need a Child Psychiatrist’s help? Phone a Friend

https://302.buzz/73NeedachildPsychiatrist

Key quotes for Twitter:

“Youth are presenting to emergency settings with high levels of suicidal thoughts, self-injurious behavior, eating disorders, and aggression."....Dr. Nasuh Malas

"Keeping good documentation, being very neutral with neutral language, and being objective is really important”... Dr. Nasuh Malas

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of these show notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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As Dr. Gaggino looks back on her episodes over the past year, she gives out kudos to some of the standout guests of 2022. She also has some reminders of past episodes that you may have missed or may even be worth another listen, (just scroll down to get those links) and there’s a sneak peek at some of the exciting things to come in 2023. If you haven’t already, make sure to tap on that follow button and to ensure that you’ll never miss an episode, get that automatic download every Wednesday morning. Dr. Gaggino has been working hard to get some fantastic shows lined up for you. 2023 going to be an AMAZING YEAR…

[00:33 -2:11] Children's Mental Health and Depression

  • Children are struggling with mental health issues, and it is our responsibility as adults to support them
  • Building strong relationships and creating a sense of belonging can be healing for children and families
  • It is important to educate ourselves and seek out help from professionals when needed

[2:12- 3:04] Medications for Mental Health in Children

  • Dr. Jeffrey Strawn’s episode #44 discusses the use of SSRIs for children's mental health
  • It is important to feel comfortable with a few medications and seek guidance from a child psychiatrist if needed
  • The National Network of Child Psychiatry Access Programs (NNCPAP) can provide resources and support

[3:05 -3:26] Assessing Social Determinants of Health

  • Dr. Kofi Essel's episode #74 discusses the impact of food insecurity on children's mental health
  • Asking about food insecurity and advocating for resources can be a simple yet effective intervention
  • Other social determinants, such as housing and access to healthcare, can also impact children's mental health

[3:27-4:48] Psychoeducation for Children's Mental Health and Supporting our own wellbeing

  • Dr. Colleen Cullinan's episodes (such as episode 26 on anxiety and episode #71 on depression) provide valuable information on psychoeducation for children
  • Dr. Cullinan's four-part series on executive function and ADHD (episodes #88, #109, #119, and #120) is also helpful for understanding and supporting children with these conditions
  • Dr. Kemia Seraff's episode #108 and Dr. Miko Rose's episode #69 offer ideas for maintaining our own well-being as pediatric clinicians
  • It is important to take care of ourselves so that we can better support the children and families we work with

[4:49 - 10:57] Connecting with Others in the Field

  • The American Academy of Pediatrics (AAP) and state AAP chapters provide opportunities for connection and support with other pediatric clinicians
  • The AAP's policy statements, clinical and technical reports, and continuing education offerings are valuable resources for staying up to date on best practices in pediatric care
  • Joining a local or national pediatric group can be a great way to connect with others and find support in the field.

Links to resources mentioned on the show

Dr. Lia Gaggino’s Website https://www.medicalbhs.com/

NNCPAP.org : NNCPAP National Network of Child Psychiatry Access Programs

Colleen Cullinan’s Greatest Hits

Pt1: ADHD- Strategies for Boosting Executive Function https://302.buzz/88ADHD-Boosting Executive Function

Pt2: ADHD Symptoms- Executive Functions https://302.buzz/109ADHDpt2

Pt3: ADHD- Executive Function https://302.buzz/119ADHD-Pt3

Pt4: ADHD-Executive Function https://302.buzz/120-ADHDpt4

Ep71 Depression: Naming the Monster https://302.buzz/71DepressionMonster

Ep 26 The 3Bs: Brain, Body, Behavior: Managing Anxiety https://302.buzz/26-3BsBrainBodyBehavior

Additional Episodes Mentioned

Ep #44 Anxiety Disorders in Children: Treatment Pearls https://302.buzz/44-AnxietyDisorders

Ep #69 Mindfulness in Medicine: the Joy Initiative https://302.buzz/69-Mindfulness

Ep #74 Food Insecurity: No Child Should Go Hungry https://302.buzz/74-FoodInsecurity

Ep #108 Physician Moral Injury: Healing the Healer https://302.buzz/108-PhysicianMoral

Key quotes for Twitter:

“Kids are really struggling and it’s our job to be there for them” ....Dr. Lia Gaggino

"Many of the skills to do this work are really about relationship building. I call it “The Magic in the Room”. It is being with others and creating a sense of belonging that is healing for our patients and families… Dr. Lia Gaggino

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Norrine Russell is the creator of a cutting-edge coaching approach for challenging children, such as those who are 2E, have ADHD, Autism, or Anxiety, as well as those who have learning disabilities. Since 2009, Connected Coaching has demonstrated success with hundreds of students. Dr. Russell is an expert in child development, learning styles, special needs, and effective parenting practices. She has twenty years of experience developing positive youth development and parenting education programs. She combines her expertise to give parents and students the full support and resources they require to develop and prosper. Listen in on the conversation between Dr. Lia Gaggino and Norrine Russell, PhD. This new concept could be groundbreaking.

[00:33 -13:41] Personal Journey from Academic Job to Youth Development

  • Her son’s diagnosis of ADHD and the Tampa Bay ADHD Parent support group
  • The success of Russell Coaching as the largest student coaching practice in the country
  • The coaching Process
  • Significance of multimodal treatment
  • Gathering coping mechanisms used in Therapy

[13:42- 29:35] Access of Quality Psychiatric Care

  • How coaching works differently than traditional psychiatry
  • Current insurance model is not tailored to diagnoses or treatments like coaching
  • How the symptom tracker helps in coaching
  • Difficulties pediatricians face in providing medical care
  • Possible partnership between psychologists and pediatricians

[29:36 -45:59] What the AAP says about ADHD

  • Understanding 504s and IEPs
  • Finding local and national resources
  • The impact of COVID19
  • Filling in the gaps of the education system
  • Improved parent/student relationship when students have a coach

[46:00- 55:57] Preparing for college could be a mental health transition

  • Looking ahead on what is needed for college life
  • The change of schedules, daily routines, and moving out of the home to independent living plays a part
  • Emotional Autonomy and the desire to do things on their own terms
  • Tips on how parents can effectively advocate for their child’s ADHD
  • A much more hopeful outlook on the next decade for those with ADHD

[55:58 - 1:16:00] Closing segment Takeaway

You can reach Dr. Norrine Russell

Facebook: https://www.facebook.com/drnorrinerussel

Instagram:@russellcoachingllc

Linkedin: Norrine Russell | LinkedIn

Pinterest: https://www.pinterest.com/russellcoaching/

Links to resources mentioned on the show

Website: https://russellcoaching.com

Book: Asking the Right Questions about ADHD Before, During, and After Your Child's Diagnosis

AAP Clinical Practice Guideline The Diagnosis, Evaluation and Treatment of children and adolescents with Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: https://publications.aap.org/pediatrics/article/144/4/e20192528/81590/Clinical-Practice-Guideline-for-the-Diagnosis

CHADD - https://chadd.org

ADDitude Magazine: https://www.additudemag.com

Other episodes you may like:

**Episode #88

ADHD: Strategies for Boosting Executive Function Pt I

https://302.buzz/88ADHD-Boosting Executive Function

**Episode #109

ADHD: Executive Functions Pt II

https://302.buzz/109ADHDpt2

**Episode #119

ADHD: Executive Functions Pt III

https://302.buzz/119ADHD-Pt3

**Episode #26

The 3 Bs: Brain, Body, Behavior - Managing Anxiety

https://302.buzz/26ManagingAnxiety

**Episode #71

Depression: Naming the Monster

https://302.buzz/71Depression

Key quotes for Twitter:

“What I will say is if your student has been experiencing anxiety or depression because they really don't feel capable at school, I think things like depression, anxiety can be secondary really to ADHD and to some of the learning differences…” Dr. Norrine Russell, PhD

"Coaching works really well on the virtual platform because in essence, it's like a meeting. You've got to check in about goals, you have skill building to do, you have information to process. I think that it is really very well suited to the virtual platform"... Norrine Russell, PhD

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Dr. Cullinan is back to finish up this 4-part series on ADHD. There is an enormous amount of practical information and parenting tips in these 4 episodes. If you haven’t yet, be sure to pull up parts 1, 2 and 3. Here is some data from ADDA (American Deficit Disorder Association

WHAT IS ADHD?

Attention deficit hyperactivity disorder (ADHD) is a Neurodevelopmental disorder. It is one of the most common disorders of this kind diagnosed in children. ADHD often carries over into adulthood.

ADHD is a highly genetic, brain-based syndrome that has to do with the regulation of a particular set of brain functions and related behaviors.

These brain operations are collectively referred to as “executive functioning skills” and include important functions such as attention, concentration, memory, motivation and effort, learning from mistakes, impulsivity, hyperactivity, organization, and social skills. There are various contributing factors that play a role in these challenges including chemical and structural differences in the brain as well as genetics.

[00:33 -10:10] Finding an Effective Consequences

  • Logical Consequences Connected to Behavior
  • Explaining why an emotional lecture is ineffective
  • Kids and Manipulation
  • The complexity and sophistication of manipulation

[10:11-16:55] The role of parents in developmental milestones

  • Effectiveness of “Emotion Coaching” on Child Development
  • Necessary techniques/ practices for emotion coaching & emotion labeling
  • Definition of TLC (Task Limit Consequences)
  • Developmentally Matched Way to Communicate with Child

[16:56 - 30:40] Benefits of Reward Systems for Families

  • Improved Behavior & Increased Self-Discipline
  • Enhanced Motivation & Productivity Levels
  • Strengthened Parent/Child Relationship
  • Implementing the Raffle ticket strategy

[30:41-41:50] Leveraging strengths instead of consequence-based discipline strategies

  • Offering Choice and Freedom in Learning Processes
  • Acknowledging We Are a Team Working Toward Same Goals
  • Building People Up to Improve Executive Functioning Skills
  • Activities such as puzzles, art projects, reading can motivate kids to want to work on executive functioning skills

[41:51 - 46:53] Closing segment Takeaways

You can reach Dr. Colleen C. Cullinan

Twitter: @ColleenCullinan

Links to resources mentioned on the show

Dr. Ross Green Dr. Ross Greene (drrossgreene.com)

Other episodes you may like:

**Episode #88

ADHD: Strategies for Boosting Executive Function Pt I

https://302.buzz/88ADHD-Boosting Executive Function

**Episode #109

ADHD: Executive Functions Pt II

https://302.buzz/109ADHDpt2

**Episode #119

ADHD: Executive Functions Pt III

https://302.buzz/119ADHD-Pt3

**Episode #26

The 3 Bs: Brain, Body, Behavior - Managing Anxiety

https://302.buzz/26ManagingAnxiety

**Episode #71

Depression: Naming the Monster

https://302.buzz/71Depression

Key quotes for Twitter:

“It's offering choice and freedom, and it's doing stuff you're already doing but in just a more strategic way that gets kids excited. That's where behavior change happens. That's where motivation happens.”....Dr. Colleen Cullinan talking on behavior modification of ADHD Children

"Vengeance is not a behavior change strategy".. Dr. Colleen Cullinan talking on behavior modification of ADHD Children

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Dr. Colleen Cullinan is back for part III, diving deeper into Executive Function. This series not only takes a look at the condition from the child’s point of view, but also the parents. Dr. Gaggino asks the questions that many have thought but few have asked. If you’re a parent of a child with ADHD, this is especially for you. Dr. Cullinan knows you. She hears you. And she gives a voice to those that have been on the sidelines. Pro Tip: listen to this with a pen and paper nearby. You’ll want to refer back to your notes often on this one.

[00:33 -12:42] Opening Segment

  • We’re introduced to Dr. Colleen Cullinan and continue with part 3 (of a 4 part) series
  • Picking up where we left off in episode 109 on “Executive Function”
  • How adults and children differ in terms of Executive Function
  • The definition of “Working Memory”
  • Driving a car in terms of Executive Functions
  • Data on ADHD and car accidents

[12:46- 19:54] Hindsight, Foresight and ADHD

  • Hindsight: working memory and time
  • Foresight: Anticipating potential outcomes in the future
  • Running through scenarios and consequences
  • Internal dialogue as a tool to insights and behavior

[19:55 -23:57] How to Find What’s Motivating For Kids

  • Communicating with the ADHD kid on their level, both developmentally and morally
  • Motivations are centered around “winning” or “losing”
  • Understanding right versus wrong
  • How to deal with temper tantrums in this stage

[23:58-46:13] Understanding the Stages of Developmental Empathy in Kids

  • Stage One – Lack of Empathy or Egocentrism
  • Stage Two – Beginning Stages of Understanding Others’ Perspectives
  • Stage Three – Moral Reasoning & Perspective Taking (capable of true empathy
  • Understanding that kids are capable of true empathy, they just need time and experience with it

[46:14 - 51:33] Closing segment Takeaways

You can reach Dr. Colleen C. Cullinan

Twitter: @ColleenCullinan

Links to resources mentioned on the show

Other episodes in the series:

Episode #88

ADHD: Strategies for Boosting Executive Function Pt I

https://302.buzz/88ADHD-Boosting Executive Function

Episode #109

ADHD: Executive Functions Pt II

https://302.buzz/109ADHDpt2

Key quotes for Twitter:

“Kids who meet criteria for ADHD tend to be about 2-3 years delayed compared to their same age peers. And I think this is particularly true with working memory and working memory is really a tricky executive function”.. Colleen Cullinan

“There is a lot of data that suggests that folks who meet criteria for ADHD are in more car accidents and have more moving violations and tickets… colleen Cullinan

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Dr. Lia Gaggino talks to Dr. Herschel Lessin on how physicians can juggle their ADHD patients, parents, practice.

Here are some facts on ADHD (Attention deficit hyperactivity disorder):

-There's more than one type of ADHD

-ADHD is genetic.

-There is no cure for ADHD, but medication and therapy can control symptoms

-ADHD often persists into adulthood

-People with ADHD may be protected by the Americans with Disabilities Act

“ADHD is a chronic condition of the brain that makes it difficult for children to control their behavior.

According to national data, AKHD affects about 9.4% of U.S. children ages 2-17 including 2.4% of children ages 2-5 and 4%-12% of school-aged children…” American Academy of Pediatrics ADHD | All AAP | AAP

[00:33 -8:20] Opening Segment

  • Dr. Gaggino introduces us to Dr. Herschel Lessin
  • What drives Dr. Lessin’s passion to be a pediatrician?
  • How his personal experience inspired him to learn more about ADHD
  • If managed properly, ADHD has to potential of being a “Superpower”

[8:21- 16:21] Current Pharmaceutical Development for ADHD Treatment

  • Issues with current drug availability
  • Potential solutions moving forward
  • Problem Regarding Pediatricians Comfort with Treating ADHD
  • Barriers to Treating ADHD

[16:22 -32:47] The economics behind drug pricing and formulary change

  • How this affects health care providers and patients
  • Challenges posed by mid-year formulary changes
  • Disruption to patient treatment plans
  • Difficulty in switching between medications
  • National Shortages of Short Acting Medication

[32:48 -59:32] Making a List from the ADHD Toolkit

  • Learning How to Code for all Service
  • Documenting Your Thinking
  • How to Set Up a Practice for ADHD Kid
  • The importance of documentation and avoiding being audited

[59:33 - 1:07:23] Closing segment Takeaway

Links to resources mentioned on the show

AAP

ADHD toolkit -

https://302.buzz/AAP-ADHDToolKit

ADHD Clinical Practice Guideline -

https://302.buzz/ClinicalPracticeGuideline

AAP publication “Congrats You’re Having a Teen!”

https://shop.aap.org/congrats-youre-having-a-teen-paperback/

REACH Institute -

https://thereachinstitute.org/Ma

Massachusetts General Child and Adolescent Psychopharmacology 2023 course -

https://302.buzz/mgcaPsycPharma

AACAP - ADHD Facts for Families -

https://302.buzz/AACAP-ADHD

NEI Global - neigglobal.com

Stephen Stahl’s Prescriber’s Guide -

https://302.buzz/PrescribersGuide

Find the state map for your child psychiatry access program

NNCPAP National Network of Child Psychiatry Access Programs

Another episode you may like:

Episode #68

Trouble At School

https://302.buzz/TroubleAtSchool

Episode #88

Strategies For Boosting Executive Function

https://302.buzz/88ADHD-Boosting Executive Function

Episode 104

Youth Mental Health;

https://302.buzz/104YouthMentalHealth

Key quotes for Twitter:

“If you wanna do this successfully in the office, you are not the only cog in this wheel”:... Dr. Herschel Lessin on not only the physician needs training in treating ADHD, but the front office needs training on meeting ADHD patients needs.

“No one will treat children unless you pay exorbitant amounts out of pocket and next to no one will do that. And so I thought to myself, am I gonna let these people drown or am I gonna try to help them”.. Dr. Herschel Lessin on dealing with the Insurance companies

THANK YOU FOR YOUR SUPPORT!

Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.

If you’d like to connect with me, you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Dr. Susan Walley was born to work with kids. She was hooked from the beginning. Recognizing that repertory issues are the #1 cause of hospitalization and realizing that parents don’t realize the impact on their own kids, gave her the inspiration to dive into the work of tobacco/nicotine/vaping addiction. Dr. Lia Gaggino asks the questions that you’ve been wondering about. But first, let’s look at some stats:

Results from the Annual National Youth Tobacco Survey (22 findings)

Almost 1 Million Youths use 2 or more tobacco products

E-Cigarettes are the most commonly used tobacco products

About 1 Million youths use any combustible tobacco products

  • 11.3% (3.08 million) middle & high school students reported current use (past 30 days) of any tobacco product
  • Approximately 3.7% (1.00 million) of all students reported currently smoking any combustible tobacco product
  • 3.5% (960,000) reported current use of multiple (≥2) tobacco products

[00:32 -14:38] Opening Segment

  • Dr. Gaggino introduces us to Dr. Susan Chu Walley
  • Dr. Walley was born to take care of kids
  • Just how dangerous is second-hand smoke?
  • Vaping is a Youth epidemic
  • The tobacco companies are taking advantage of a loop hole in the law in order to market to kids

[14:39 - 27:07] The Teen brain is more sensitive to nicotine

  • Tobacco/Nicotine can cause irreversible brain cell damage and long term behavioral damage.
  • Usually, the gateway to future drug use
  • Data is still developing regarding vaping because it’s only been around for a fairly short time
  • There are currently around 15,000 vape flavorings

[27:08 -50:54] Messaging: What Works?

  • It’s difficult for clinicians to give their recommendations without sounding judgmental
  • Motivational interviewing and offering help in quitting is shown to be accepted
  • The money is being spent in advertising vs education of the dangers of tobacco/nicotine/E-cigarettes

[50:55 - 58:11] Closing segment Takeaway

You can reach Dr. Susan Walley

Linkedin: Susan Walley, MD, MHCM, NCTTP, FAAP | LinkedIn

Resources:

Other episodes you may like:

Episode #20 Talking to Teens about Sex, Drugs & Rock n Roll

https://302.buzz/E20-Teen

Episode #5 Substance Use Disorders and Childhood Exposures

https://302.buzz/E05-SubstanceUseDisorders

Mentioned in the Episode

EVALI stands for E-cigarette or Vaping use-Associated Lung Injury

ACT stands for Ask / Council / Treat

Resources:

  1. MMWR Tobacco Product Use in US Middle and High School Students 11.11.2022.

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Who will heal the healers? Managing physician burnout is a tall order. And yet when both Dr. Tyra Fainstad and Dr. Adrienne Mann found themselves going through difficult life-chapters, they saw a need in the system that had not been addressed. Their program, Better Together, is for the medical community that may feel isolated or may feel like there’s no outlet. Even though there are definite differences between a Coach and a Physician, when listening to the doctors speak about their program, it seems so logical that the two would work hand in hand with one another. If you’re dealing with burnout or know someone who is, you’ll want to take a listen.

[00:30 -23:04] Opening Segment

  • Dr. Gaggino introduces us to Dr.Tyra Fainstad and Dr. Adrienne Mann
  • We learn about their journey into medicine and being a life coach.
  • They found that burnout was their common thread.
  • The difference between Coaching and Therapy

[23:05 - 30:54] How a “Cute Little Study” grew into the “Better Together” program?

  • Web based program with 3 ways of participation; (Zoom, write in on the website and weekly modules)
  • When they first started, 100 people signed up and that told them how much it was needed.
  • Although many didn’t do the work, they actually listened and benefited from the recorded Zooms

[30:55 -56:28] The 3 “Better Together” factors

  • Emotional Exhaustion, Depersonalization, Personal Ethikasy (Accomplishment)
  • Burnout is 2-10 times higher in women vs men
  • Should a program like this be required for interns?

[56:29 59:35] What would you tell your “Intern-self”

  • If you knew then what you know now… would you have even been ready to hear it?
  • Are you grateful for your anxiety?
  • “There’s No Right Way”

[59:36 - 1:04:08] Closing segment Takeaway

You can reach Dr. Tyra Fainstad

Facebook: Tyra Fainstad | Facebook

Instagram: @tyraindenver

Twitter: @TyraFainstadMD

You can reach Dr. Adrienne Mann

Instagram: @amw1983

Twitter: @AMannimalMD

Resources:

Better Together website

www.bettertogetherphysiciancoaching.com

Life Coach School

https://www.lifecoachschool.com

Book mentioned:

“Lessons in Chemistry” by Betty Garmus

Amazon.com : lessons in chemistry

Other episodes you may like:

Episode #108 Physician Moral Injury; Healing the Healer

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Eating the right foods, getting enough rest, participating in some activity... We’ve all heard that so many times, we can’t even count. However, when Dr. Lenz says it… he backs it up with evidence. Listen in while Dr. Michael Lenz makes the connection of what’s really going on in a patient that is suffering from chronic pain. It all sounds so logical when Dr. Lenz talks about the Food-Mind-Body connection. Dr. Gaggino and Dr. Lenz talk about how the brain processes pain and offer some answers that you may not have thought about. If you suffer from chronic pain, fibromyalgia, etc., you’ll want to listen with a pen and pad nearby.

[00:33 -16:29] Opening Segment

  • We hear about Dr. Lenz journey into the medical profession
  • How his love of sports relates to his chronic pain practice
  • When all those around them are in disbelief, just validating a patient's pain is half the battle
  • Are “Growing Pains” real??? Maybe it’s something else… Dr. Lenz digs deeper to find the actual answer

[16:30- 29:20] The Pain Continuum

  • How the brain processes pain
  • Some physicians are not connecting the symptoms; don’t ask the right questions
  • 40% of children that have Crohn's disease also have IBS
  • The importance of Food-Mind-Body relationship

[29:21 -39:32] Connecting the dots

  • Offering validation, hope, and trust….however, maybe medication is not your first “go-to”
  • The hypervigilant brain
  • Dr. Lenz’s evidence based approach
  • People who are on the Central Pain Spectrum need regularity more than originally thought

[39:33 -27:05] But what about Medication?

  • Opioids may make chronic pain worse
  • Having patients keep track with a Diary, record the schedule and history,
  • You can have an impact early on in a patient’s life so they don’t end up “just like grandma”

[57:06 - 1:02:26] Closing segment Takeaway

Links to resources mentioned on the show

The Podcast: Conquering Your Fibromyalgia

Apple: Conquering Your Fibromyalgia Podcast on Apple Podcasts

Spotify: https://cutt.ly/ConqueringFibromyalgia

Dr. Lenz's Book

https://cutt.ly/ConqueringYourFibromyalgia

Key quotes for Twitter:

“I got kicked off of Facebook. I said boy, a lot of people here. It seems like they're talking about this like it's a stage four metastatic cancer and we're just doing palliative care. Like nobody's ever going to get better. And I said, my patients get better” ...Dr. Michael Lenz

"Right now, there is no specialist that's really the expert. There may be people in a GI dept and one of them has an interest in this area, but they are not psychiatrists. There might be a psychiatrist who's interested in things, but they're not the neurologist and vice versa".. Dr. Michael Lenz

THANK YOU FOR YOUR SUPPORT!

Pediatric...

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You should know that we’re talking about very hard things today. However, death is part of life, and (just like adults), children are not excluded. But logic doesn’t ease the blow when a child passes. Keith was only 6 months old. He left behind 2 loving parents who have now dedicated their lives to creating special programs, support groups and educating medical professionals on best practices when faced with a family going through this kind of a life altering chapter. Dr. Gaggino talks with Rachel and Aaron Lewis about their journey with their son Keith. They’re also joined by Dr. Lisa Humphrey, Director of the Division of Hospice and Palliative Medicine at Nationwide Children’s Hospital. Together, they’ll tell you about the effect that Keith’s life and death have had on the practice of children in palliative and end of life care. Oh, by the way……Grab your tissues, this will be a tough one.

[00:33 -20:16] Opening Segment

  • We’re introduced to Dr. Lisa Humphrey and we hear about how her passion for palliative care was born
  • We meet Rachel and Aaron Lewis who talk about their son Keith’s journey
  • The myths about palliative care
  • The difference between Palliative Care and Hospice
  • Being Decisionally Agnostic is a key factor in Palliative Care

[20:17- 35:48] Hope for the Best, Prepare for the Worst

  • The importance of respecting the decisions of the family
  • There is active communication between team members to “keep themselves in check”
  • Is it okay to talk about death with the parents and how do we do that in a helpful way?
  • Reading the room is a valuable skill set

[35:49 -48:43] Preconceived Notion

  • Important to have the families in the room (if they want to be there)
  • Parents actually watching the team work to save their child with dignity, intellect and intent can be helpful for the bereavement process
  • The magic of the first breath and the last breath

[48:44 1:05:05] Get out of your comfort zone

  • Biggest fear is that the child’s name will be forgotten
  • Encourage the family sitting out in the waiting room to be a part of the care
  • For team members: show your validation of the child by showing up, being there saying the child's name, push your humanity forth.

[1:06:06 - 1:11:25] Closing segment Takeaway

You can reach Dr. Lisa Humphrey

You can reach Rachel Lewis

Facebook:Rachel Houser Lewis | Facebook

Instagram:@rachel_lewis21.12

You can reach Aaron Lewis

Facebook: Aaron Lewis | Facebook

Links to resources mentioned on the show

You can learn more about Keith’s story at

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https://cutt.ly/WhatAreYourThoughts (https://cutt.ly/WhatAreYourThoughts) Advocacy can take many forms, from speaking out publicly to organizing groups to writing letters to elected officials. Whatever the form, advocacy is an important way to bring attention to issues and make change. And although anyone can be an advocate, there’s definitely an art to being an “Effective Advocate”. Today, Dr. Gaggino talks with Dr. Pam Shaw who has perfected the art of advocacy. Among the many hats that Dr. Pam Shaw wears, (i.e., Professor of Pediatrics, Assistant Dean for Clinical Sciences, Associate Vice Chancellor for Student Services, President of the Kansas Chapter of the AAP– just to name a few), her passion to make things better for all children has no boundaries.  Listen in to not only Dr. Shaw’s personal journey, but also about her work in Washington, D.C. on behalf of all children everywhere.    [00:33 -12:46] Opening Segment Dr. Gaggino introduces us to Dr. Pam Shaw What drives Dr. Shaw’s passion to be an AAP Advocate on the national level?   What does an AAP Advocate actually do? For children's issues, you need lots of organizations working together

[12:47- 25:03]  Bipartisan Concerns   Good opportunity to start with AAP Politics are affecting the doctor/patient relationship Learning opportunities are created when local chapters share successes as well failures with each other In order to make an impact, VOTE!!

[25:04 -41:20]  Emphasis On Pediatrician’s Needs Safety Training Vaccine Funding Mental Health parity Payment for Services Coding review

[41:21 -45:13] How Can Pediatricians Up Their Game? Join your local chapter of AAP Sign up to be a key contact for AAP VOTE! (And encourage family and friends to vote as well)

[45:14 - 50:40]  Closing segment Takeaway

You can reach Dr. Pam ShawFacebook: https://www.facebook.com/pam.shaw.108/about (Pam Shaw | Facebook) Instagram:  https://www.instagram.com/pkshaw/ (@pkshaw) Twitter: https://twitter.com/Pkshaw1 (@Pkshaw1) Links to resources mentioned on the show   HRSA (Health Resources and Services Administration) https://www.hrsa.gov/grants/apply-for-a-grant (Apply for a Grant | HRSA)   COSGA (Committee for State Government Affairs) https://www.aap.org/en/community/aap-committees/committee-on-state-government-affairs/ (Committee on State Government Affairs (COSGA) (aap.org))   American Association of Pediatrics https://www.aap.org/ (https://www.aap.org/) “67​,000 pediatricians committed to the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults”   Get a non-partisan Vote-ER badge and sign-up families to vote -  https://vot-er.org/ana/ (https://vot-er.org/ana/)

Get your FREE QR badge https://vot-er.org/badge/ (https://vot-er.org/badge/)   AAP Advocacy email  stgov@aap.org aap.org/stateadvocacy

Federal Advocacy email  kids1st@aap.org aap.org/en/advocacy

AAP Media Relations email  aap.org/en/news-room/general-media-mailboxaap.org/en/news-room

Other episodes you may like: Episode #66  School Shootings: The Aftermath and Prevention  https://cutt.ly/SchoolShootings (https://cutt.ly/SchoolShootings)

Key quotes for Twitter: “ I can take care of their health, but if they’re actually going to thrive, I have to advocate for them to be involved in programs that I know work...Pam Shaw "In the DNA of a pediatrician….. Is advocacy"..  Pam Shaw

THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot). If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown...

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https://cutt.ly/WhatAreYourThoughts (https://cutt.ly/WhatAreYourThoughts) No one expected it. How could you? I mean, he was doing so well. Taking the meds, socially engaged. Everything seemed fine….. But one day in February something went wrong. Dr. Colleen Kraft makes a second appearance on the podcast, but this time, she walks us through her very personal journey of how schizophrenia has affected her family as well as her, as a mother. It’s difficult to hear, but it’s something that will stay with you for a very long time. Dr. Elise Falluco, one of the foremost leading pediatric psychiatrists, helps shed light on this mental illness that 24 million people deal with every day. Our host, Dr. Lia Gaggino gets the hard truth to some hard questions.  Listen in as 3 of the most accomplished medical professionals in the United States discuss this often-stigmatized mental illness, schizophrenia.    Schizophrenia: Noun  PSYCHIATRY a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.

(in general use) a mentality or approach characterized by inconsistent or contradictory elements. "Gibraltar's schizophrenia continues to be fed by colonial pride"

[00:30 -15:37] Opening Segment The back story on Dr. Falluco and Dr Kraft and what led them to wanting to work with children Dr. Falluco talks about (her son), Tim’s schizophrenia diagnosis  33% diagnosed schizophrenics are treatment resistant   If 33% of cancer patients were treatment resistant, we would be demanding new and better treatment

[15:38 - 24:46] What are the early signs to look out for? No longer cares about appearance, gets tired, sleep disrupted, apathy, stops bathing, etc. Psychosis sometimes masquerades as depression  The difference between the child who has an “imaginary friend” and a child that is not developmentally typical  Most common scenario: parents bring their child to the doctor because the child was found talking to themselves.

[24:47 - 34:16]  How to Ask the hard questions The question that will determine “True Psychosis” vs “Psychotic Like Experiences” Why headphones might be a red flag? How to get past the stigma 

[34:17 - 59:13]  What causes Schizophrenia?   Medications and treatments currently being researched How much do genetics factor into diagnosing schizophrenia   Making the distinction between bipolar and psychosis We need to change the language that is associated with schizophrenia (i.e. “Psychotic Killer”, Schizophrenic Criminal”)

[59:14 - 1:08:56]  Closing segment Takeaway

You can reach Dr. Colleen Kraft Instagram: https://www.instagram.com/docmom3460/ (@docmom3460) Linkedin: https://www.linkedin.com/in/colleen-kraft-7a30708/ (Colleen Kraft | LinkedIn)

You can reach Dr. Elise Falluco Linkedin: https://www.linkedin.com/in/elise-fallucco-9b402485/ (Elise Fallucco | LinkedIn)

Resources: Other episodes you may like: Episode #13  Psychiatric consultation https://cutt.ly/PsychiatricConsultation

Resources Mentioned in the Episode Song lyrics mentioned by Dr. Kraft “Song For Sandy” by Alela Diane https://www.youtube.com/watch?v=nsnXT8fGhrs (Song for Sandy - YouTube)

Song lyrics mentioned by Dr. Kraft “Mona Lisas & Mad Hatters” by Elton John https://cutt.ly/MonaLisasMadHatters (https://cutt.ly/MonaLisasMadHatters)

Dr. David Kessler’s website https://grief.com/ (Grief.com - Help For Grief Because LOVE Never Dies) Podcast:  Healing https://cutt.ly/HealingWithDavidKessler (https://cutt.ly/HealingWithDavidKessler)

Tender Hearts Community https://www.davidkesslertraining.com/tenderhearts.com...

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https://cutt.ly/WhatAreYourThoughts (https://cutt.ly/WhatAreYourThoughts) Why is the U.S. falling behind in healthcare and what can we do to change the narrative?  In this episode, Dr. Gaggino talks to the author of “Who Shall We Let Die”, Dr. Koye Oyerinde. As a Public Health/Global Health Expert, Dr. Oyerinde has had a major role in strengthening health systems for the delivery of Reproductive, Maternal, Newborn, Child and Adolescent Health services in low and middle-income countries. Listen in as Dr. Gaggino and Dr. Oyerinde have a frank discussion about the current state of healthcare in the U.S. According to the World Health Statistics 2022: "The Billion target will not be reached by 2023, and progress is less than 1/4 of that required to reach the Sustainable Development Goals by 2030"

[00:33 -10:42] Opening Segment Dr. Gaggino introduces us to Dr. Koye Oyerinde It was inevitable that Dr. Oyerinde would become a doctor since he spent so much time in hospitals when he was a child. What is a “Go Fund Me Health System”?

[10:43- 25:29]  Human Rights Abuse   Top Executive compensations are in competition with our healthcare.. Too many programs without coordination between any of them  Do the American Indians, the UK and Canada have a healthcare system that the US should duplicate?  The mindset of today’s healthcare stems from a long held tradition

[25:30 -30:53] Global Health section of the AAP AAP is able to influence other countries by sending US based experts to initiate better practices The US can be proud of the work we do well, but we need to be humble about the work we don’t do well.  If members of the AAP are interested in Global Health, there are opportunities to join the Global Health section 

[30:54 - 36:20]  Closing segment Takeaway

You can reach Dr. Koye Oyerinde Website:  http://www.drkoyeoyerinde.com/ (www.drkoyeoyerinde.com) Twitter: @DrKoyeOyerinde Linkedin: https://www.linkedin.com/in/koyeoyerinde?lipi=urn%3Ali%3Apage%3Ad_flagship3_profile_view_base_contact_details%3BibQQYms%2BRAej0Jr2pseFOg%3D%3D (linkedin.com/in/koyeoyerinde)   Dr. Oyerinde’s Book “Who Shall We Let Die” Amazon: https://cutt.ly/WhoShallWeLetDie (https://cutt.ly/WhoShallWeLetDie)   Discounted copies are also available upon request at http://www.drkoyeoyerinde.com/ (www.drkoyeoyerinde.com) (contact tab)     American Association of Pediatrics https://www.aap.org/ (https://www.aap.org/) “67​,000 pediatricians committed to the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults”

For current Data and Stats Check out the World Health Organization https://www.who.int/ (World Health Organization (WHO))   Other episodes you may like: Episode #46  Moral Dilemmas: Where Medicine and Ethics Meet  https://cutt.ly/46MoralDilemmas (https://cutt.ly/46MoralDilemmas)

Key quotes for Twitter: “Top Executive compensations are in competition with our healthcare... Koye Oyerinde "Healthcare is a human right"..  Koye Oyerinde

THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot). If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown (Instagram), and https://twitter.com/gagginol?lang=en (Twitter), or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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https://galas.fm/podcast/4167def2-fdf6-4746-931f-04a437df8efc Dr. Dennis Flores’ first study looked into the circumstances that contributed to the recent HIV infection of young gay men in Atlanta. This was done with an awareness of the personal and contextual factors that increase sexual and gender diverse individuals' vulnerability for HIV/STI infection and poor care-related outcomes. His subsequent HIV/STI prevention work, which includes community education in both urban and rural areas, serving as the national spokesperson for HIV testing campaigns, and workforce development with about 1400 nurses across three continents, has been inspired by that study. Serving in numerous leadership positions for the Association of Nurses in AIDS Care is only one example of the man's career-long dedication to nursing leadership and HIV/AIDS care. Dr Gaggino and Dr. Flores talk about his work over the years in the community and the Social Stigma of LGBTQ+ and its Effects.  Heteronormative: * adjective             denoting or relating to a world view that promotes heterosexuality as the normal or preferred sexual orientation.             "This is believed to stem from heteronormative and patriarchal setups of traditional heterosexual relationships"

Cisgender * adjective              denoting or relating to a person whose sense of personal identity and gender corresponds with their birth sex.               "If you were born a male and you identify yourself as a male, you are considered cisgender."    [00:30 -12:36] Opening Segment Dr. Gaggino introduces us to Dennis Flores, PhD, ACRN Dennis’ passion is facilitating conversations between the LGBTQ+ child and the parent The US has a different way of looking at sexuality vs the rest of the world. Removing stigma around sexuality is the first step Don’t let fear of the myth that just talking about sex with your child will make them want to have sex

[12:37 - 24:58]  Is Gatekeeping an American trait?   Insecurity is magnified even more when they don’t see representation in the media. A parent that provides a supportive , accepting and inclusive context is the most that you can do Media is finally coming around regarding depictions of LGBTQ+ in commercials, movies, TV shows Dennis’ talk about his in depth research on LGBTQ+ youth and the relationship they have with their parents Establish open lines of communication during those elementary years.

[24:59 -32:26] Resources that clinicians can offer parents Construct these conversations over a period of several years; personal space, permission, consent, etc. Clinicians can facilitate these conversations Be open to perhaps the parent isn’t ALWAYS the expert

[32:27 -44:53]  Normalize the LGBTQ+ conversations  A TV show can initiate “difficult” conversations. Watching shows together lightens the mood and makes it so much easier to talk  Capitalize on teachable moments Advice for clinicians: language / visual cues to establish a welcoming atmosphere (a “safe place”)

44:54 - 49:22]  Closing segment Takeaway

You can reach Dalmacio Dennis Flores, PhD, ACRN Webpage: https://www.nursing.upenn.edu/live/profiles/15515-dalmacio-dennis-flores (https://www.nursing.upenn.edu/live/profiles/15515-dalmacio-dennis-flores) Facebook:  https://www.facebook.com/dalmacio.floresiii/friends (Dalmacio Dennis Flores III | Facebook) Twitter:  @dfloresrn

Pronouns: he, him, his

Resources: Other episodes you may like: Episode #15  https://cutt.ly/15-CaringForTransgenderYouth (https://cutt.ly/15-CaringForTransgenderYouth)

Books...

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https://galas.fm/episode/c9cdb65d-ccc5-516e-b2c1-86554d5e112b The eight key executive functions are Impulse control, Emotional Control, Flexible Thinking, Working Memory, Self-Monitoring, Planning and Prioritizing, Task Initiation, and Organization. Early identification and intervention is important for helping individuals with ADHD to reach their full potential. Dr. Colleen Cullinan is back for part 2 in Dr. Gaggino’s series on ADHD. They pick up where they left off on Episode #88 (the link to the episode is below). You’ll hear a deeper dive into the strategies and specific techniques of caring for the ADHD child.  According to a 2016 CDC report, about 3 in 4 US children with current ADHD receive treatment. Let’s take a closer look at some of the other stats on that report.   62% were taking ADHD medication Ages 2–5: 18% Ages 6–11:  69% Ages 12–17: 62% 47% received behavior treatment Ages 2–5: 60% Ages 6–11:  51% Ages 12–17: 42%

Altogether, 77% were receiving treatment. Of these children: About 30% were treated with medication alone. About 15% received behavior treatment alone. About 32% children with ADHD received both medication treatment and behavior treatment.

About 23% children with ADHD were receiving neither medication treatment nor behavior treatment.

[00:30 - 08:17] Opening Segment Dr. Gaggino introduces us to Dr. Colleen Cullinan Dr. Gaggino and Dr. Cullinan pick up where they left off from Ep 88

[8:18 - 10:37]  The diagnosis should be a “strength based model”   The Hyper focus of an ADHD child will activate that chemical excitement in their brain. “Attention Deficit” is a misnomer What is the true definition of ADHD?

[10:38 - 24:00] How do we adjust to meet where kids are? Redirect the attention that they DO have  Tolerating the experience of “Chemical Boredom”? The ADHD child can strengthen their weaknesses in a planful, stepwise, gradual way The executive function of INTERNAL SPEECH

[24:01 -54:26]  The Golden Ratio for ADHD This is not to be used as a reward 14 positive interactions to neutralize 1 negative interaction It only takes 5 minutes a day The parent’s job is to listen, reflect and praise

[54:27 - 1:01:48]  Closing segment Takeaways

You can reach Dr. Colleen C. Cullinan Email:  colleen.cullinan@nemours.org Twitter:  https://twitter.com/colleencullinan?lang=en (@ColleenCullinan)

Resources: Episode #88 https://cutt.ly/ADHD-Ep88 (https://cutt.ly/ADHD-Ep88)

Parent Child Interaction Therapy (PCIT) http://www.pcit.org/ (pcit.org)

Book Mentioned in the Episode https://cutt.ly/RaisingAnEmotionallyIntelligentChild (https://cutt.ly/RaisingAnEmotionallyIntelligentChild)

Key quotes for Twitter: “When we think about a 7 y/o, who, when it comes to internal speeches, actually looks more like a 5 or 4 y/o, we really do need to think about how we can start to teach this skill of pause, reflect, look around, use your internal dialogue”... Dr. Colleen C Cullinan

“Actually, kids with ADHD might have superior attentional skills. they might be able to hyper focus on the things that are interesting to them or that activate that sort of chemical excitement in their brain”... Dr. Colleen C Cullinan   THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot). If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown (Instagram), and https://twitter.com/gagginol?lang=en (Twitter), or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to...

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TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.    When Dr. Kemia Sarraf's 13-year-old son was diagnosed with leukemia in 2014, her world — at least for the next three years — came to a full stop. And as he regained his health—which, by the way, he's great now—it led her down a path that would ultimately become her life's work. In this episode, she discusses with Dr. Gaggino, the trauma she experienced that inspired her to develop a special trauma-responsive coaching paradigm that is especially well-suited for frontline workers who are exposed to chronic toxic stress and who are therefore directly affected by the numerous ways that vicarious and secondary trauma "show up" in everyday life. Dr. K established Lodestar in 2016 with a focus on coaching techniques that are trauma-responsive for medical colleagues who are suffering from severe burnout, vicarious trauma, and moral injury.     [00:30 - 11:15] Opening Segment Dr. Gaggino introduces us to Dr. Kemia Sarraf How her son’s illness started her on the path of helping other medical professionals The discovery of the common thread: Trauma among medical professionals

[11:16 - 16:00]  Being mindful about building a “Trauma Informed” practice  People who are in intense pain and want to be coached toward something The client holds the outcome The concept: we all carry wounds Unbearable “Stuckitude”

[16:01 - 38:28] The impact of chronic, toxic stress Both Dr. K and Dr. Gaggino talk about what they experienced during the early days of the pandemic  How children of different ages handle stress  An underutilized tool: curiosity  The shift from “how do we take care of our patience” to “how do we take care of ourselves” “We are hemorrhaging colleagues”

[38:30 -41:44] The factors that move us toward Trauma The unrelenting nature of trauma itself Lack of rest and recreation Real or perceived loss of control Lack of resources (emotionally as well as physically) Loneliness (disconnection) The toxic story of “I’m the only one”

[41:45 -52:45] So…. What’s the way out? Actively connect with others There’s power in naming and sharing The asking is therapeutic  Self-Compassion It’s ok to ask… “are you having thoughts of hurting yourself”

[52:46 - 58:15]  Closing segment and Takeaways   For More episodes on Suicide Awareness Listen as Dr. Gaggino interviews her own sister (Ep105) https://cutt.ly/show105 (https://cutt.ly/show105)   Website  https://www.lodestarpc.com (https://www.lodestarpc.com)   social media links Facebook:  https://www.facebook.com/KemiaS (Kemia Sarraf | Facebook) Twitter:  https://twitter.com/DrKemia (@DrKemia) Linkedin: https://www.linkedin.com/in/drkemia/ (Dr. Kemia Sarraf M.D.,)

http://www.lodestarpc.com (www.lodestarpc.com) Bessel VanDer Kolk – The Body Keeps the Score

Lodestar trainings:   https://www.lodestarpc.com/book-online (Trauma-Mitigation Master Classes) for 2023 have just opened.   https://www.instituteforphysicianwellness.com/pre-summit-training-day-2022/?fbclid=IwAR0MYAtYjeXvSy5QJXIgZSGHyobRwwToRMR31_klAbIQPQUPm3S31Ye0imQ (Trauma-Responsive Physician Leadership Workshop)  in San Antonio on Sunday November 6th 

Resources: Physician’s Crisis line 888-491-0141

988lifeline.org 1-800-273-TALK or 8255 Crisis text HOME to 741741 American Foundation for Suicide Prevention http://www.afsp.org (www.Afsp.org) for Out of the Darkness walks and national locations in your community

BeThe1

Other episodes mentioned “Hope and Resilience: My Sister’s Story”  https://cutt.ly/show105 (https://cutt.ly/show105)

Key quotes for Twitter: “Your brokenness does not diminish your...

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TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.    A national project called Zero Suicide aims to address the issue of suicide in the medical and mental health systems. The effort is founded on the idea that suicide can be stopped and that systems of medical and mental health care can do more to do so. Seven elements make up the entire Zero Suicide prevention strategy: LEAD, TRAIN, IDENTIFY, ENGAGE, TREAT, TRANSITION and IMPROVE. These elements insure a practical comprehensive approach to suicide care. In this episode, Dr. Gaggino interviews Dr. Julie Goldstein Grumet. Dr. Grumet is a clinical psychologist and public health expert. Dr. Grumet is the director of the Zero Suicide Institute at EDC, Inc. and she developed the Zero Suicide Toolkit to assist health and behavioral care leaders and leadership teams in implementing the seven elements (mentioned above) of the initiative.   Her goal has been to develop the framework, tools, and work schedules required for the Zero Suicide effort to be implemented effectively.     [00:30 - 06:29] Opening Segment Dr. Gaggino introduces us to Dr. Julie Goldstein Grumet Dr. Grumet tells us about her background and how she came into the field Julie recognized that the healthcare system had been left out of the first national strategy for Suicide Prevention.

[6:30 - 9:41] How Dr. Grumet came to develop the Toolkit  First launched in 2014 Taking the guesswork out of implementing the recommendations    An organized, concise blueprint that outlines the seven elements

[09:42 - 22:07] What makes this program so different?  Evidence based Fidelity  The Core Clinical Components: Screen, Risk Assessment followed up with a safety plan The seven elements: LEAD, TRAIN, IDENTIFY, ENGAGE, TREAT, TRANSITION and IMPROVE The clinical data and being completely “evidence based” is what makes this program work as well as it does. How Zero Suicide is about a culture shift These components bundled with the seven elements will not only keep the patient safe but will also keep the staff safe as well.

[22:08 -48:39] Get comfortable having that conversation  Removing lethal means There are online courses you should take (see link below)  “I GOT THIS” ....

[48:40 - 54:26] Closing segment - Takeaways Thank you to Julie for her time today and to the entire ZS team at EDC for offering guidance and support for system change and ZS implementation. Zero Suicide is an aspirational goal and a methodology for suicide prevention.  In 2012, The Action Alliance included ZS as part of the National Strategy to transform healthcare systems.  ZS is a bundle of strategies that include both clinical components and implementation components.  Strap on your seat belt, this is your roadmap to better care. LEAD, TRAIN, IDENTIFY, ENGAGE, TREAT, TRANSITION, IMPROVE.  You can start at any spot though would HIGHLY recommend LEAD then TRAIN!!!   Many of you are already doing IDENTIFY with PHQ screening as we were.  With the new BF guidelines to add suicide screening this is a perfect opportunity to use TRAIN to implement ASQ or CSSR-S screening. Clinical components include screening, risk assessment, safety planning, lethal means safety, care transitions, hand-offs and caring contacts.   Implementation components include training a “competent, caring and confident staff (us too!), continuous quality improvement/data collection, and fidelity to the model. ZS is a culture shift – the system/hospital/practice bears the responsibility to care for patients using evidence-based strategies that work.  These are not home-grown tools - all of the tools/methods are backed by research.  Consider the medical model -asthma, we know

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TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or referrence of other mental health disorders that may act as triggers.   In the United States, suicide is the second leading cause of death for children and adolescents between the ages of 10 and 24. Suicide rates have been increasing in recent years, with the rate for girls aged 15-19 doubling between 2007 and 2015. While boys are more likely to die by suicide, girls are more likely to attempt it. There are many factors that contribute to pediatric suicide, including mental health disorders, bullying, social media, and family stressors. Teenage girls are particularly at risk for depression, which is the most common mental health disorder among adolescents. Depression can be a precursor to suicide and lead to self-harming behaviors, such as cutting.  Here are some hard core facts: There are more suicide deaths than motor vehical accidents There are more suicide deaths than homicides 

In this episode, Dr. Gaggino speaks with Sarah Mead and Erica Espinoza, from Gryphon Place (the local crisis center in Kalamazoo Michigan). They give us their unique perspective on working with people in crisis.    [00:30 - 10:16] Opening Segment Dr. Gaggino introduces us to Sarah and Erica Erica tells us what it takes to be a crisis volunteer There’s been over 20 million calls since the hotline started in 2005. Erica tells us the different ways to de-escalate a situation

[10:17 - 12:54]   988 is not a new program…. They just gave us an easier way to get to the hotline  Myth: 988 goes directly to the police… Fact: 988 is actually made to reduce the amount of emergency involvement 988 is there to de escalate the situation and not involve the police   There was a 45% increase in volume the week that 988 was implemented compared to the week before (that’s a 66% increase from the same week last year)

[12:55 - 15:10] SomeThings To Look Out For Risk Factors: Depression or substance use disorder, traumatic brain injury, chronic pain, any serious health conditions Risk Factors:  bullying, unemployment, any sudden drastic change in a person's life. (i.e. divorce, a death of a loved one, a suicide), a history of childhood trauma or a family history of suicide  Warning signs: They might talk openly about killing themselves, or use language like I'm feeling hopeless. I feel overwhelmed. I just don't know what to do. I don't see another way out. Nobody can understand the situation that I'm in and they may talk about the unbearable pain that they feel. Warning signs: increased use in alcohol or drugs, if they're buying a gun or stockpiling pills, if they start saying goodbye or giving away priceless possessions. 

[15:11 -29:30] Asking someone if they’re having thoughts of suicide will not encourage them to kill themselves Why we should not use the phrase,  “Committed Suicide” Why we should not refer to it as a “failed” or “unsuccessful attempt”, One of the goals of SPAN is to educate the gun retailers on how to pick up on the warning signs of someone who may have thoughts of suicide.

[29:31 - 34:04]  Closing segment Takeaways

Resources: Gryphon.org and for Kalamazoo SPAN goals Gryphon.org/SPAN scroll to Goals and Objectives 988lifeline.org 1-800-273-TALK or 8255 Crisis text HOME to 741741 American Foundation for Suicide Prevention http://www.afsp.org (www.Afsp.org) for Out of the Darkness walks and national locations in your community

BeThe1

Trainings:  QPR http://www.qprinstitute.com (www.qprinstitute.com) SafeTalk and ASISST http://www.livingworks.net (www.Livingworks.net)   The Trevor Project support for LGBTQ+ youth in crisis to call 1-866-488-7386 or go online to chat http://www.thetrevorproject.org (www.thetrevorproject.org) AAP Youth Suicide Prevention Blueprint:...

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Suicide Prevention  Hope and Resilience:  My Sister’s Story  TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers.   In this very personal episode of Pediatric Meltdown, Dr Gaggino talks with her sister, Alyssa, who attempted to take her own life 19 years ago. As with many who attempt suicide, there were many factors that may have contributed. Risk factors include a history of trauma, mental health disorders, relationship difficulties that can all add up until the individual is overwhelmed and feels hopeless. Dr. Gaggino and her sister talk about the dark times, but also talk about Alyssa’s recovery and incredible resilience. But first, some facts and figures  Suicide is defined as death caused by self-directed injurious behavior with intent to die as a result of the behavior. A suicide attempt is a non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior. A suicide attempt might not result in injury. Suicidal ideation refers to thinking about, considering, or planning suicide Suicide was the second leading cause of death among individuals between the ages of 10-14 and 25-34 , the third leading cause of death among individuals between the ages of 15-24, and the fourth leading cause of death among individuals between the ages of 35 and 44. There were nearly two times as many suicides (45,979) in the United States as there were homicides (24,576)

[00:-5:26] Opening Segment Lia introduces us to Alyssia Together, they talk about the trauma they went through growing up How trauma manifests itself.

[5:27-15:22] How Alyssa started her journey “into the system” Finding the right regiment The one clinician that made the difference  After bottoming out, how Allyssa recovered 

[15:07-26:03] Closing Segment The “Rewired version” of Alyssa Signs to look out for Alyssa brings us up to date on her life

[26:04-30:15] Dr. Gaggino’s Takeaways 9 takeaways to think about Closing Goodbyes

Tweetable Quotes: “I got to a point where….. I just couldn’t try anymore…"  - Alyssa Gaggino, LMSW  (on her suicide attempt)  “I think people worry sometimes that they’re going to make someone suicidal by asking the question There’s lots of evidence that that isn’t the case….”  Dr. Lia Gaggino   Resources mentioned in the episode: -Child Psychiatry Access Network Program locator map:  http://www.nncpap.org/ (www.Nncpap.org)  -Suicide warning signs and risk factors:  https://afsp.org/risk-factors-protective-factors-and-warning-signs (https://afsp.org/risk-factors-protective-factors-and-warning-signs)   Numbers to reach out to for help 1-800-273-TALK (8255) National Suicide Prevention Lifeline Talk: 988  Suicide & Crisis Lifeline Crisis Text: Dial 741-741 and Text the word “HOME”

For Veterans (wasn’t mentioned, but still good to know) Talk: 988 then press 1   (Veterans Crisis) Text: Dial 838-255 (For Veterans)

MC3 (Michigan Medicine) Email:  MC3-admin@med.umich.edu Tele: 844-828-9304  

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Welcome to Pediatric Meltdown! In Today’s episode, our guest is Travis Atkinson.  Travis has worked in the crisis intervention field for over 20 years and describes how our mental health system of care was created with a medical model that does not meet the needs of our patients. Our offices and emergency departments are facing enormous numbers of kids who are struggling, and it is up to us to create a patient-centered system that works based on choice, agency, and freedom. Many models work: mobile crisis response and stabilization teams, peer support and recovery coaches, and integrated behavioral health in outpatient clinics. When treating mental health historically we have been wrong so many times. We must do better now. Travis closes with advice for change - lead with a servant's heart and consider the serenity prayer - grant me the serenity to accept the things I cannot change; the courage to change the things that can be changed, and the wisdom to know the difference.

[00:30 - 09:02] Opening Segment Travis Atkinson is a skilled clinician and musician who has worked in behavioral health services for 20 years. He is the president of the Crisis Residential Association and former Crisis Services Committee chair for the American Association of Suicidology. He received his BA from the University of Michigan and his master's degree from National Lewis University. Travis lives in Grand Rapids, Michigan with his wife and three daughters.

[09:02 - 17:04] Community Responds to Behavioral Health Emergencies with Dedicated Mental Health Crisis Lines and Mobile Crisis Teams There are dedicated mental health crisis lines available that can help divert people from psychiatric hospitals or emergency departments. Mobile crisis teams are a type of intervention that can be used to meet people in the community who are experiencing a mental health crisis. These teams are available in most communities and can provide support for up to 90 days.

[17:04 - 25:25] TD Solutions: How to save $5,000 a day by using mobile crisis teams The community mental health services are often responsible for the operation of mobile crisis teams. One type of team that we haven't talked about yet is the co-sponsor model, in which a clinician and a police officer or law enforcement work together. Reaching out to your community mental health center or your local law enforcement to find out if these teams are available and who they are available for is important. People with mental illness are more likely to be a victim of crime than they are to be a perpetrator of the crime.

[25:26 - 33:14] Mental health services should be available to everyone There is a need for psychiatric hospitals to provide high-quality treatment that meets the goals of the individual, not just keeping them safe. The goal of psychiatric hospitals should be to help patients develop meaningful life skills that will carry on beyond their stay. There is a trend toward treating patients as individuals and leveling the hierarchy between doctors and other professionals.

[33:14 - 41:22] Intervening Found Strategies to Help You Intervening found that other strategies helped, but that the barriers to providing crisis services persist. One barrier is licensure, which makes it difficult to provide physical interventions and limits who can be taken in. Another barrier is the administrative burden, which makes it difficult to keep the service running. Funds would be better spent on more youth crisis residential beds, crisis continuum, and psychiatric urgent care centers.

[41:22 - 49:22] How to Meet the Needs of Families with Mental Illness If a pediatric colleague encounters a family with the possibility of a lot of chaos, they should try to find ways to meet the needs of that family, such as accepting and committing to therapy. Clinicians should also be aware that youth have less control over their environment than adults, which can...

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Welcome to Pediatric Meltdown! In Today’s episode, our guest is https://parentandteen.com/author/ginsburgemail-chop-edu/ (Ken Ginsburg, MD, MSEd). Dr. Ginsburg re-frames adolescence - not peril and drama, but instead, a time marked by exploration, curiosity, and joy. Parents often believe that they won't matter anymore, but in reality, they matter more than ever. While teens are embarking on their journey to independence, the adults in their lives, us too, serve as guides and teachers. We are the emotional containers for big feelings and "lend our calm". Teens are "super learners" and the world is their oyster if we paint the journey with hope and excitement. Pediatric clinicians offer a safe space to share all the ups and downs. For teens and parents, knowing that we have their back is golden!   Dr. Ginsburg is the Founder & Program Director, of the Center for Parent and Teen Communication He is a physician, adolescent medicine specialist, and Professor of Pediatrics at Children’s Hospital of Philadelphia. He is committed to preparing adults to be the kind of people that adolescents deserve in their lives. He supports local, regional, and national organizations in developing programs and policies that strengthen families and see young people through a strength-based lens. He speaks to parent, professional, and youth audiences nationally and internationally and is the author of 5 award-winning parenting books as well as a toolkit for youth-serving professionals. CPTC is rooted in his strength-based philosophy and resilience-building model. [00:30 - 08:59] Pediatric Meltdown: Dr. Ken Ginsburg on the Importance of Adolescence Dr. Ken Ginsburg is the founder and program director of the center for parent and teen communication. He is a physician adolescent medicine specialist and professor of pediatrics at the children's hospital of Philadelphia. He supports local, regional, and national organizations in developing programs and policies that strengthen families and see young people through a strength-based lens. He speaks to parent-professional and youth audiences nationally and internationally, and is the author of five award-winning parenting books as well as a toolkit for youth-serving professionals. CPTC is rooted in his strength-based philosophy and resilience-building model.

[08:59 - 17:37] How to Raise a Resilient Child At some point, parents need to learn how to do things independently, and adolescence is a crucial time for this. Parenting during this time can be difficult because parents are anxious and want to protect their children from harm. To help parents navigate this stage successfully, they need to remember that their children are growing and developing and that mistakes are part of the process. Parents should also share their strengths with their children and help them develop coping mechanisms for when stress is unavoidable.

[17:37 - 26:38] The Truth About Adolescences Adolescents are emotional and rational beings, with brilliant emotional brains. The emotional brain takes over during adolescence, and this can be challenging for adults to manage. Adolescents need our guidance and support to think, plan, and reason. Communication with adolescents is different than when children are younger and requires a calm, respectful, and understanding approach. Adolescents are not inherently risky and need our guidance to explore their boundaries safely.

[26:39 - 35:06] How to create golden opportunities at the limit of what they know To create golden opportunities at the limits of what they know, so that their brains, which want more and more knowledge, get it there and they don't have to go beyond those points. Make school incredibly enriching. You make home enriching, you make it so that when the kids are at their limits, their brains go as happy brains. If you don't give them those golden opportunities and don't set boundaries, then they will push too far and go into risk...

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School Avoidance, social anxiety, and phobias are all common in childhood affecting 5% to 12% of kids. This is a lot of patients showing up in pediatric practices. The gold standard for treatment is exposure therapy, but that model has its limitations. How do you get a kid on an airplane multiple times to help with fear of flying? A new virtual reality (VR) therapy model is an exciting option. Trained psychologists use VR goggles and with sophisticated software create a patient avatar and experiences where patients can gradually face their fears. Research shows in small studies that the experience feels real and that fears diminish. Larger RCT are needed to push this therapy into the mainstream. Dr. Abbie Vanderwege shares her successes with this therapy and walks us through the patient experience. This is an exciting option for children and adolescents who are struggling. Dr. Vanderwege with a major in Psychology from Kalamazoo College in 2004, quickly transitioned into the master's degree program in Counseling Psychology at Western Michigan University, which she completed in 2006. While working toward that degree, she developed an interest in holistic health and pursued a graduate certificate in Holistic Health Care, which she also received in 2006. Dr. Vanderwege then accepted a position as a family therapist for the Family Reunification Program at Bethany Christian Services. Feeling at home in Kalamazoo, she entered the APA-accredited Ph.D. program at Western Michigan University in Counseling Psychology in 2007 and completed a full-time APA-accredited predoctoral internship at the Battle Creek VA Medical Center where she pursued rotations in outpatient and residential PTSD, outpatient mental health, inpatient mental health, and substance abuse treatment. After completing her Ph.D. in 2011, she joined Child & Family Psychological Services 2011, and then directed the Portage office from 2014 to 2020. In 2020 she joined Teletherapy Group where Dr. Vanderwege sees children and adult clients virtually and face-to-face. Dr. Vanderwege has completed advanced training in psychological evaluation, anxiety and PTSD therapies, and mindfulness

[00:30 - 08:58] Pediatric Meltdown: Dr. Abbie Vanderwege Talks About Social Anxiety, School Refusal Dr. Abbie Vanderwege is a pediatric psychologist who has a Ph.D. in counseling psychology from Western Michigan University. She has worked as a family therapist for the family reunification program at Bethany Christian services and entered the APA accredited Ph.D. program in counseling psychology at Western Michigan University in 2007. After completing her Ph.D., she joined child and family psychological services and then directed the Portage office until 2020. In 2020, she joined a teletherapy group where Dr. Vander Wigg sees children and adult clients virtually and face to face.

[08:59 - 17:05] Nurture vs Nature?, School Avoidance: How to help kids Specific phobias occur in about 5% of children and can be grouped into a few different areas such as animals, medical procedures, loud noises, storms, and clowns. Some changes that may indicate a child is experiencing anxiety include dropping out of school, not wanting to practice driving, sleeping less than the recommended amount, and having little free time. If parents notice any changes in their child's behavior that seem out of the ordinary or interfere with their ability to function normally, they should consult a therapist.

[17:05 - 26:01] Exposure Therapy Can Help Reduce Anxiety   The foundation for many effective therapies for anxiety exposure therapy works by systematically introducing and maintaining contact with the feared experience until the experience no longer produces the fear response. For a typical Exposure therapy, an approach would be, developing a hierarchy of feared situations An example of such is when you’re afraid of driving, we would start with driving in the car...

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Welcome back to Pediatric Meltdown today we are joined by Dr. Colleen Kraft. Dr. Colleen, the past president of the AAP 2018 and offers an overview of the impact the pandemic has had on child development including safety and security, nutrition, physical health, educational opportunities, and responsive caregiving. These are the pillars that make up the WHO Nurturing Care Framework. Dr. Kraft takes us beyond assessing the damage and instead focuses on the strengths that still stand. She makes the analogy of a house on fire. The house is burnt to the ground, but the foundations remain. Let's build from that. Rooms were damaged, but the house still stands nearly whole. Let's repair and rebuild. The home was filled with smoke, but the fire was extinguished. Let's clean away the soot and repaint. This analogy reminds us of the power of hope and action. As clinicians, we can help families see the possibilities and we can connect them to resources. We can also advocate for an educational reframe that supports college and academics and vocational paths. We need a society that embraces all skills and opportunities. In closing, Dr. Kraft reminds us that we are the child experts and that our voices matter.   Colleen A. Kraft, MD, MBA, FAAP is the Senior Medical Director for Clinical Adoption at Cognoa, a digital medical device company designing products to address the unmet developmental and behavioral health needs of children. Dr. Kraft served as the 2018 President of the American Academy of Pediatrics. Her background includes work in primary care pediatrics, pediatric education, and health care financing. Dr. Kraft received her undergraduate degree at Virginia Tech and her M.D. from Virginia Commonwealth University, and her MBA from the University of Cincinnati. She completed her residency in Pediatrics at Virginia Commonwealth University.        [00:29 - 08:47] Pediatrician Colleen Craft Shares Her Vision for the Future of Pediatrics Dr. Colleen Kraft is a pediatrician and the senior medical director for clinical adoption at Cognoa. She has been a pediatrician for 34 years and served as the 2018 president of the American academy of pediatrics. Her journey into pediatrics drew her to work with families and children, promoting their optimal physical, developmental, and psychosocial health. She is also an advocate for pediatricians and all the work that we can do on behalf of kids.

[08:47 - 16:51] Virtual Reality Therapy for Phobias The world health organization promotes the nurturing care framework, which focuses on five pillars of early childhood development: adequate nutrition, safety and security, opportunities for early learning, and healthy relationships. During the pandemic, safety and security for children were disrupted by the death of adults and the displacement of secure bonds with parents. Housing insecurity was a major problem during the pandemic.

[16:51 - 24:36] Children Suffered from Cognitive and Motor Developmental Deficits during the Pandemic There is a disruption in various aspects of children's lives during the pandemic, including their safety, health, and early learning opportunities. the importance of responsive and caring adults in providing nurturing care for young children, and notes that this was particularly disrupted during the pandemic. The negative effects that virtual learning can have on children, and notes that this is particularly true for those with disabilities or who are struggling with attention span.

[24:36 - 36:28] Resilience is Built on Relationships Pediatricians need to start with the basics and focus on relationships with kids to help them rebuild their resilience. Schools can play a role in helping kids rebuild their resilience by assessing their strengths and promoting vocational skills based on what kids want to do. Adults need to remember that they are valuable and that their skillset does not just include...

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Welcome back to Pediatric Meltdown Today we are on our 100th Episode, once again we have Dr. Robert Saul, Dr. Saul is a pediatrician and medical geneticist, and has been guiding parents and their children’s physical, and behavioral, and mental care for over 40 years. He is a Professor of Pediatrics (Emeritus). Dr. Bob Saul developed the Parental Awareness Threshold, a simple framework that guides parents and guardians to actively parent with self-awareness, empathy, and compassion. Parents who use this framework create a healthy environment where children learn to build safe, stable, and nurturing relationships as well as exhibit love and respect for others in their community.   In the medical world of high-tech imaging and laboratory testing, the true practice of taking a comprehensive medical history and the laying on of hands gets forgotten or brushed aside relegating physicians and advanced practitioners to the role of technicians. We must never underestimate the skills of listening and the power of shared humanity. After four decades of pediatric practice, Dr. Robert Saul shares his wisdom and his insights about practicing the art of medicine.     [02:00 - 10:29] The Art of Medicine: Dr. Saul on the Relationship between Science and Art   Dr. Saul is a pediatrician and medical geneticist who has been guiding parents and their children's physical behavioral and mental healthcare for over 40 years. He is a professor at the Medical University of South Carolina and has authored four books. Dr. Saul is also a very prolific writer and has blogged about leaving the Columbine world and how to be the best parent you can be.

[10:30 - 18:22] How to Connect with Patients   Medical things that need to be done may not be able to be done because of socioeconomic status or what is happening in a person's life at the time. The art of medicine is to ask routine medical questions and then let the patient know how much they matter to the physician. It takes years of training and experience to become a good physician. It is important to remember the patients' names and what is important to them, in order to connect with them.

[18:22 - 26:08] Doctor Shares What brings Him, Joy, When He thinks About His Career   The importance of a physical exam and how it can be used to diagnose medical conditions. Talks about the importance of establishing trust with patients and how this can be done through listening and providing reassurance. The joys that come with practicing medicine say that it is especially rewarding to see the positive responses from patients years after their encounter.

[26:09 - 33:42] Lessons from a Career in Medicine   Seeing patients and helping families down the line. Remembering him as their doctor before. He finds being in his clinic for several decades in practice rewarding What Dr. Saul learned the most is what the families go through and learning to be with them and reassure them.

[33:43 - 42:46] Closing Segment Connect with Dr. Robert Saul, See links below. Final Words

Thank you to Dr. Saul for his return to this podcast. Use your professional pedestal or pulpit to be the voice of children It is easy to think our job is to tell others how to live better, but our job is really to listen first and then offer advice, guidance, insights experience hope, and empathy. Do not underestimate the power of the literal touch of the sacredness of the laying on of hands. If you are not humbled or hourly as Dr. Saul said, because he is an overachiever you may not be paying attention. Pediatrics is advocacy use your voice, use it loudly, and use it proudly. 5 pieces of advice from Dr. Saul

Trust parent intuition. Leave biases and assumptions at the door and start anew when you enter the exam room. listen, intently look at the patient and family, step away from the computer when you can, and ask forgiveness when you

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Year 2 of the podcast is coming to a close and just sharing a few thoughts about yours truly and inviting you to join the mailing list for upcoming opportunities... stay tuned! The imposter syndrome is a thing, and yep, I experience all those self-doubts and thoughts "who am I to..." fill in the blank. So, here's a little pep talk for you and for me too! [00:01 - 01:46] Stepping Away from Clinical Care in 2022 Who am I if I’m no longer seeing kids Am I still a pediatrician? After 33 years as a practicing pediatrician, not including the time spent in residency, it’s a huge shift. Yes, I am, and It’s called reinvention. I consider this a new chapter and a new adventure. Having no idea how to do a podcast, I jumped in and had some help and encouragement And Pediatric Meltdown was born. This gives me an opportunity to meet and talk to amazing pediatricians, therapists, Parents and educators and even some grown-up patients.

[00:01 - 01:46] Many of us suffer from imposter syndrome. Asking yourself a question such as “Am I smart enough? Do I have the right stuff?.” Pep Talk for you and for me You are smart enough Your work And you are helpful You speak from experience You have given up enough and it's okay to take a break, and change course

[00:01 - 01:46] Closing Segment My goal in year 3 is to build listenership I believe that the information from our guests is valuable and can bring help to everyone. Kindly share our podcast and help me reach the goal: See links below.

THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot).   If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown (Instagram), and https://twitter.com/gagginol?lang=en (Twitter), or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being. 

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Dr. Stacy Beller Stryer walks us through all the reasons why we all need to put down our phones, tablets and computers and get outside! Being in nature provides a myriad of benefits for our emotional and physical well-being with reductions in stress, improved attention and lowered blood pressure and cortisol. It's a free and safe remedy that can be prescribed online right in your practice! Using Nature Prescribed, clinicians, patients and families, create a prescription for a nature experience that includes dose, frequency and instructions with a built in text reminder!     Key Highlights:   [00:30 - 08:38] Pediatric Meltdown: How Nature Can Help Pediatrician and associate medical director for nature prescribed, Stacy Beller Stryer, joins the show to discuss the benefits of nature for children and how to prescribe nature prescriptions to improve their health. Stacy emphasizes the importance of nature for social development, mental health, and physical health, and notes that it is important for children of all ages. Studies have found that children who spend more time outside have better mental health outcomes, including decreased anxiety and depression. Stacey encourages adults to spend more time outside to benefit their mental health as well.

[08:39 - 16:24] How to Prescribe Nature to Improve Mental Health The benefits of nature include physical and mental health improvements. Forest bathing is a form of therapy from Japan that focuses on green space and taking in the environment. There are studies that show people who are prescribed nature are less stressed and have better immune systems. Providers can prescribe nature by filling out a prescription on Nature Prescribed's website. The prescription is sent to the patient's cell phone or computer, and they can decide how often to receive reminders.

[16:24 - 24:11] Prescribing Prescription Drugs to Kids There are many ways to prescribe nature for mental health, including writing a prescription and having a doctor enter it into the electronic medical record (EMR). There are many resources available online, including posters and swag, to help people get started. One way to make nature more accessible for people is to work with local parks or green spaces.

[24:11 - 32:16] Teachers Encouraged to Take Kids Outside for Therapy Teachers should take kids to therapy or sessions, bring them outside, and do the session outside to improve outcomes. There are now more and more therapists who are doing their sessions outside or walking and talking. Nature has many benefits, including decreased anxiety and depression, increased physical activity, and better academic outcomes.

Closing segment Final Words

Thank you to Dr. Stacy Beller Stryer  Nature matters  It is sad that Kids on average get 6 to 8 minutes of outdoor time per day but its changeable Numerous studies finds that the closer you are to nature the better the outcome and the better your sense of wellbeing Forest bathing is a form of Japanese therapy. It reduces heart rate, blood pressure and cortisol Immersion in nature. Using all five senses allows you to revel in wonderment and amazement. So how do you get your patients outside? Head to natureprescribe.org and click on prescribe from there. Healthcare providers, teachers and therapists can use the site to up your game.  Start with an email to Stacy or Richard  Dr. Stacy Bella Stryer's final advice, which I think is lovely. Take a break, take more time. Go Outside

Key quotes: “Take a break, take more time. Go Outside” - Dr. Stacy Bella Stryer

Connect With Dr. Stacy Beller Stryer Email:stacy@parkrxamerica.org

Resources Mentioned:   Book: Richard Louv “Last Child in the Woods”   https://parkrxamerica.org/providers/human-benefits-of-nature.php (https://parkrxamerica.org/providers/human-benefits-of-nature.ph)p  ...

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Welcome to another episode of Pediatric Meltdown. Parenting children requires patience, hope, limitless love, and joy, however, it is the hardest job ever. As pediatric clinicians, we partner with parents to ride the sometimes bumpy ride of parenthood. We all want happy, successful children, but for many children, the journey is difficult and for children with mental health concerns, finding help is often difficult. Parent Natasha Robinson is a fierce advocate for her son Isaiah. From an early age, Natasha knew that her son needed help and resources. She began an exhausting journey of finding the right autism diagnosis and the services and programs to meet his needs. Sometimes we, the pediatricians, psychiatrists, teachers, and therapists helped immensely, and sometimes we got it wrong and got in the way. She persisted and continues to be a voice for him, and now, having sought additional training is a strong parent advocate for all children who need more.

Key Highlights: [00:30 - 09:29] Opening Segment

Natasha Robinson is a 35-year-old single mother from Kalamazoo who spends her days hanging with her 11-year-old son. She currently runs her own communications business and works part-time as a secretary. Her favorite job, however, is being a mom to Isaiah. Natasha has worked as a news reporter, substitute teacher, community health worker, and social worker in Michigan and North Carolina. She has a BA in journalism from Wayne state university and an MS In psychology from the University of Phoenix. 

[09:30 - 18:51] Having A 7-year-old son with ADHD and Dysregulated Emotional State.

Natasha shares her struggles of parenting an autistic son, specifically the challenges of managing his ADHD and emotional dysregulation. She describes a journey to find medications and therapies that work best for her son. This process has been difficult and ongoing, with many side effects. Her main concern has been the potential for harmful side effects from medication, which can be difficult to research and navigate.

[18:52 - 27:29] Navigating Through The Pandemic

Isaiah has a lot of challenges due to his disabilities, Despite this, he is also very funny and loves to make people laugh. Due to the pandemic, Isaiah's school year was disrupted and he was unable to access many services he was used to. This was very difficult for him. Since the pandemic, Isaiah has been able to resume some of his old activities, but his mood can vary greatly and he can be difficult to deal with when he is in a bad mood.

[27:29 - 36:06] The Advocacy for Change

Natasha has dedicated her life to advocating for her son with autism and would like to do more in the future to help other families with similar situations. One of the ways she plans to do this is by creating a focus group of parents who have children with various disabilities. She believes that having parent voices in places where decisions are made will help improve the quality of care for children with autism." Closing segment Final Words

Huge Thanks to Natasha for honest and raw conversations about parenting who struggles to meet social expectations Children with autism disorder need resources like nurses, family, and projects to find an early intervention  We should continue to get better at recognizing children who are on the autism spectrum Be ready to re-assess and beware of overshadowing diagnoses that distract you from really taking a comprehensive, hard look at the child, standing in front of you. Check-in with parents and caregivers. They may be exhausted and could use your concern and care. Get creative and innovative and continually reassess your services. Partner with other clinicians and departments when there's a lot of cross-usage of services. our families are gracious patient and forgiving, and Lord knows, How Natasha has given clinicians so much grace Ask about the joy. Where does the child Excel and thrive...

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In February of 2021, the AAP, NIMH, and the AFSP convened, along with over 100 clinicians, a workgroup with a shared goal and dream of compiling a roadmap for youth suicide prevention, and in March of 2022, the AAP Blueprint for Youth Suicide was released. This comprehensive body of work provides clinical pathways, initiatives for community partner collaborations, resources, and advocacy materials. Additionally, there is an extensive section on the epidemiology of youth suicide informed by a health equity lens. The panelists share the story of the creation of the Blueprint along with practical information on the navigation of the site.   Today we are joined by Dr. Lisa Horowitz, Dr. Christine Moutier, and Dr. May Lau   Dr. Lisa Horowitz is a Staff Scientist / Pediatric Psychologist in the National Institute of Mental Health Intramural Research Program at the National Institutes of Health. The major focus of Dr. Horowitz’s research has been the detection of suicide risk in the medical setting. She is the lead PI on six NIMH suicide prevention protocols that involve validating and implementing the Ask Suicide-Screening Questions (ASQ) in the ED, inpatient medical/surgical, and outpatient primary care settings. Dr. Horowitz is collaborating with hospitals, outpatient pediatric clinics, and school settings around the country, assisting with the implementation of suicide risk screening and management of patients who screen positive using the ASQ Toolkit and Youth Suicide Risk Screening Clinical Pathways   Dr. Christine Yu Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention, knows the impact of suicide firsthand. After losing colleagues to suicide, she dedicated herself to fighting this leading cause of death. Dr. Moutier has served as UCSD professor of psychiatry, dean in the medical school, medical director of the VA Psychiatric Unit, and has been clinically active with diverse patient populations, such as veterans, Asian refugee populations, as well as physicians and academic leaders with mental health conditions. She has presented at the White House, testified before the U.S. Congress, and has appeared as an expert in The New York Times, The Washington Post, Time magazine, The Economist, The Atlantic, the BBC, and CNN.   May Lau, MD, MPH, is an Associate Professor in the Department of Pediatrics at the University of Texas Southwestern Medical Center and the medical director of the Adolescent and Young Adult Program at Children’s Medical Center Dallas, where she provides care for adolescent females and males, including sexual and gender minority youth. Dr. Lau co-chairs the American Academy of Pediatrics (AAP) Texas Pediatric Society (TPS) Committee on Adolescent and Sports Medicine, has been elected to the AAP Section on Adolescent Health Executive Committee and is a fellow of the Society of Adolescent Health and Medicine. She educates fellows, residents, and medical students on the specialized care of adolescents. Her research focuses on a variety of areas including adolescent mental health and gender-affirming care. Dr. Lau has spoken at national meetings on a variety of adolescent medicine topics including mental and sexual and reproductive health.          Key Highlights:    

[00:00 - 18:43] Pediatricians Tackle Suicide Prevention The project, which was called the \"Blueprint for Youth Suicide Prevention,\" was spearheaded by the American Foundation for Suicide Prevention and the National Institute of Mental Health and was completed in March 2019. The summit, which was held in February of 2019, brought together a diverse group of pediatricians to discuss ways to prevent suicide in youth. The final product of the summit was a blueprint for suicide prevention that has been implemented by many different organizations.

[18:43 - 27:10] Pediatricians can use this blueprint to screen for suicide in their practice...

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health and behaviors and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino, Today we are joined by Dr. Sarah Mohiuddin.

Dr.  Mohiuddin is the Director of the Multidisciplinary Autism Program at the University of Michigan. She also is the fellowship training director of the Child Psychiatry Fellowship Program at Michigan Medicine and co-director of behavioral science sequence at the University of Michigan Medical School.  She is passionate about educating medical students, residents, fellows and other physicians about childhood mental health and care of individuals with ASD and developmental disabilities across the lifespan.

In a surprising, at least to me, conversation, child psychiatrist Dr. Mohiuddin shares a new mental healthcare perspective for PCP's - abandon the "fix it" mindset and instead consider a chronic illness model that focuses on partnership with the patient and family to identify their most important concerns. Her insights suggest that using our longitudinal relationship with families, we can make enormous impact. For those of us who are overwhelmed by the notion of mental health care is primary care, Dr. Mohiuddin suggests reframing our negative self-talk and setting positive intentions for the day - "You've Got This!" comes to mind for me. Deep breath, you know more than you think you do!            Key Highlights:   [00:30 - 09:04] Dr. Sarah Mohiuddin on How to Address Overwhelming Mental Health Needs in Pediatric Patients Welcoming back,  Dr. Sarah Mohiuddin is a child psychiatrist and director of the multidisciplinary autism program at the University of Michigan. She also is the fellowship training director of the child psychiatry fellowship program at Michigan Medicine and co-director of behavioral science sequence at the University of Michigan Medical School. She is passionate about educating medical students, residents, fellows, and other physicians about childhood mental health and care of individuals with autism spectrum disorders and developmental disabilities across the lifespan. During the course of becoming a physician, she believes that breaking down patients and building them up is important, but can lose pieces

[09:05 - 25:56] How to Address the System of What's Going On at School, but Not Everything Has to Be Achieved in a Visit Pediatric clinicians need to reframe their job as a partnership with patients and families, rather than “Fixing” things Mental health is similar to medical issues in that there are acute exacerbations and chronic stressors that cannot always be fixed\ It is important for pediatric clinicians to listen to patients and understand their values in order to help them make change Mental Health Conditions: It's Not Just About Fixing Them

[25:57 - 34:24] How to Collaborate with a Pediatrician to Improve Patient Care When meeting with patients, it is important to be clear about expectations and to level them for the patient. It is also important to be patient with patients and not expect them to fix everything right away. Patients can learn a lot from their physician colleagues, especially when it comes to general intervention strategies.

[34:25 - 42:58] Primary Care Physicians Struggle To Find Meaning In Their Work Taking advantage of Primary Care.  focusing on positive self-talk rather than the negative. CBT for physicians Acknowledging the our work is hard. Closing segment Final Words

All of us who care for children are overwhelmed by their emotional distress. Let the patient and family lead. Let them identify Partner with the family to seek change over time and help create a working game plan using your expertise Pediatricians have the advantage of longitudinal relationships with families and kids...

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health and behaviors and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. Summer is here and it's time to take a breath, enjoy the sunshine and take a little downtime. Heading to Bali, yes Bali!, with my sister and daughter for a tropical adventure - My Bali Breather. Hope you will make time for yourself too!   Key Highlights:   [00:30 - 02:30] Taking a Mental Health Break:  Taking a mental health break and going to Bali some thoughts on the world and how it feels right now War in Ukriane Covid is still here. Shootings But despite of all of these, In the words of Dr. Heather Forkey “We can Affiliate with others”

[02:30 - 02:30] Sharing Some Things That Brings Me Joy Resources Mentioned:  I love listening to podcast  https://podcasts.apple.com/ph/podcast/hidden-brain/id1028908750 (Hidden Brain by Shankar Vedantan) https://gretchenrubin.com/podcasts/ (Happier with Gretchen Rubin and her sister Liz)  I’m a worrior and getting lost in reading a book, makes me forget about my worries. https://www.amazon.com/This-How-Always-Laurie-Frankel/dp/1250088550 (Such a lovely book: This is How it Always Is by Laura Frankel) A Movie that I would recommend! https://www.imdb.com/title/tt0805564/ (Hands down best movie ever: Lars and The Real Girl - you have to watch this one!!)

[03:04 - 05:28] Summer Escape: Find some escape in things that aren't deep It’s okay to do nothing. Take your time and relax. Eat something that are delicious food like  Watermelon Juicy peaches Ice cream! Closing segment Final Words

Key quotes: “I think that we have to really look at the world as being open to possibilities and that good pervades, all of the awful stuff.” Dr - Lia Gaggino

THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot).   If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown (Instagram), and https://twitter.com/gagginol?lang=en (Twitter), or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being. 

This Is How It Always Is: A Novel

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health and behaviors and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, we are joined by Dr. Heather C. Forkeyl, MD Heather C. Forkey, MD, is a Professor of Pediatrics at the University of Massachusetts Chan Medical School, and Division Director for the Child Protection Program and Foster Children Evaluation Service (FaCES) of the UMass Memorial Children’s Medical Center. She also serves as the Medical Director of Lifeline4Kids at the University of Massachusetts Medical School. She received her undergraduate degree from Cornell University and medical degree from the State University of New York at Buffalo School of Medicine and Biomedical Sciences. She completed her pediatric residency and chief residency at the Children’s Hospital of Philadelphia. In addition to her clinical work, Dr. Forkey has been the recipient of local and federal grants to address issues of children in foster care and to translate promising practices to address the physical and mental health needs of children who have been traumatized. She has published and presented nationally and internationally on the topics and serves in leadership roles for the National Child Traumatic Stress Network and the American Academy of Pediatrics on issues related to foster care and child trauma. She recently co-authored the book Childhood Trauma and Resilience: A Practical Guide, now available from AAP Press.      We commonly think of the human response to trauma, stress, and threat as "fight, flight or freeze", but there is one more, "affiliate". We are designed to be with others and resilience lies in our ability to find safe, stable, and nurturing relationships. Our past is not our future and surrounding ourselves with those who truly care for us is the key to thriving.   Key Highlights:   [00:01 - 18:47] Affiliate Response: Recognition of Young Adults from Foster Care having Similar Outcomes Yet Genetically Unrelated.   Various aspects how toxic stress impact kids Kids that experience trauma has impacts on immune system, neural pathways and that are rapidly endocrine system especially epigenetic areas.  Ex. why traumatized kids might have constipation.  Fight-Flight and Freeze has a limited Benefits Affliation: How one can be able to ask for help managing stress   How humans has evolved to have an ability recognizing what is safe and not safe  Pulling people to manage stress together. Affiliate response  Safe, stape and nurturing.  Tiger Chameleon: Determining trauma through patterns. Dr. Baylin coming up with animal analogies responding exposure to trauma Tigers are kids associated with developmental delay that feels constantly threatened. Chameleons are kids that can look like manipulators but infact they are just good at using clues and can manage situations.

[18:48 - 43:47] How Behaviors should not be placed out of the blue.  Cognitive triangle: Thought leads to feeling that leads to a behavior Changing negative message can help kids change their cognitive triangle processing into a positive one. Interactions from caregivers, is shaping your map and the map of your world. How parents and kids has the opportunity to rewrite the map  Three R’s: Reassure, Routine, Regulate Stress kids has a difficulty of Learning the skills of play  Letting the child lead by using Praise Paraphrase pointed out and not use the cues for families who stressed Stay Curious, Asking open-ended questions Doing it with respect and empathy It’s natural for peditricians in recognizing affiliate response Trauma Coaches are employed to train foster parents to understand trauma Accompanying the kid’s growth and making them understand the process especially to those who have serious diagnosis.

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health and behaviors and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, we are joined by Katherine Steingass, MD. Dr. Steingass is a Developmental-Behavioral Pediatrician at Nationwide Children's Hospital and an assistant professor of Pediatrics at the Ohio State University College of Medicine. She is a member of the complex health care team and the medical director for the Spinal Bifida Program, as well as the Program Director for the Developmental-Behavioral Pediatrics Fellowship; her primary clinical interests include evaluation and care of children with developmental delays and disabilities, including cerebral palsy, myelomeningocele genetic conditions, autism and the sequelae of prematurity.   She is a co-chair for the early childhood Special interest group in the Society for Developmental-Behavioral Pediatrics and is involved in the AAPS Council on Children with Disabilities. Dr. Steingass received her medical degree from the Medical College of Ohio at Toledo and completed her Residency at Nationwide Children's Hospital, followed by a Fellowship in Developmental-Behavioral Pediatrics at Rainbow Babies and Children's Hospital in Cleveland, Ohio. Join us today as we talk about Children with Disabilities:  Don't Forget Their Emotional Well-being! Key Highlights: [00:01 - 22:13] Kids with Disabilities Often Miss Out on Mental Health Screening There is a significant body of literature suggesting that children with disabilities experience higher rates of mental health symptoms, including ADHD, anxiety, and depression. Developmental screening is essential for identifying kids who may be at risk for these conditions. Qualitative questioning can provide valuable information about a child's overall well-being It is essential to balance the need to assess a child's medical conditions with the need to determine their behavioral health.        Should we be rethinking our perspective on medications for kids with autism? Behavioral interventions should be tailored to the child’s individual needs with autism.  Physical symptoms and medical causes should be investigated to determine the cause of aggression in children with autism. Constipation is a common culprit in the development of aggressive behaviors in children with autism. There are identifiable triggers for a head banging, and it can be helpful to look at the behavior in terms of its function. It is vital to consider the child's symptoms and history and their environment.       It is common for children with autism to have comorbid mental health disorders. Medication options for aggression can vary depending on the child's symptoms.

[22:14 - 37:41] We Have to be Mindful of the Families, the Parents, and Siblings When Approaching Care for Kids with Chronic Medical Conditions There is a lot of investigative work that needs to be done before starting a medication like this, as it has potential side effects.         One way to help families during this difficult time is to normalize the experience and ask open-ended questions about their well-being. When talking with families of kids with chronic medical conditions, it is crucial to also focus on their function and quality of life.       Developmental-Behavioral Pediatrics: Tips for Clinicians The importance of adapting to the environment to promote mental health for children with disabilities. The role of a Developmental-Behavioral pediatrician in this process emphasizes the importance of detective work to identify and address underlying issues.  Clinicians should ask parents and children about their goals and plans for the future and their current experiences and feelings.

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, we are joined by Dr. Jon Price and Dr. Jenna Vallejo. Jon Price, MD FAAP, is a Dublin, OH general pediatrician who has been in primary care and pediatric urgent care. He is co-chair of the Ohio Pediatric Council, a dialog group linking pediatricians and insurance plans looking for win/win solutions to improve health care access and coverage for children and attain the financial means for pediatric practices to provide excellent care. He is a member of AAP committees dedicated to child health financing policies and advocacy with public and private health insurance payers. (COCHF,PAAC) Jenna is the Chief Operating Officer of Potomac Pediatrics in Rockville, MD. She is a healthcare executive that utilizes innovative ideas to revolutionize the patient experience. For the past few years, she has focused on building an integrative mental health model in primary care pediatrics that is accessible & affordable for patients and financially viable for the practice. Jenna is passionate about striving to offer more expansive pediatric services that can be tailored to the patient to optimize patient outcomes while reducing overall medical expenses for families and the healthcare system.  Jenna previously served in the United States Navy as a Hospital Corpsman, as well as worked in family practice and urgent care nursing roles.  Her clinical experience combined with her healthcare leadership expertise allows her to approach challenges from the patient experience viewpoint and the practices need to achieve financial success.  Join us today as we talk about the importance of insurance credentialing and how physicians should be paid for the extra work that we do.

Key Highlights: [00:01 - 15:41] The Struggles of Child Poverty in America Eligibility of Medicaid and Chip for children in the United States. The states have agreed to not disenroll any patients until the government declares that the public health emergency from Covid19 is over. · Jon talks about how employers can provide health insurance for their employees They discuss how Medicaid and Chip differ, how the program works, and how it might change in the future. There is a lot of confusion about how to code for mental health services, and payers are looking at those who are using more upper-level codes Pediatricians need to get creative to cover mental health costs

[15:41- 32:14] Mental Health Staff Urge Insurance Companies to Do Better How insurance companies could be doing better in terms of reimbursing mental health professionals, and stresses the importance of insurance credentialing      How care plans for children with mental health issues can be complicated to manage After a child leaves the doctor's office, they are still often linked to the child's care and may be called upon to assist in the future.     How to get paid for your phone calls and portal messages. Physicians are trying to figure out how to navigate the system and get paid for their work. There is a lot of complexity involved in getting paid for these activities. pediatric healthcare is valuable, and it is important to be recognized for what we do.   Pediatric healthcare professionals need to be prepared to fight for our profession if we want to be recognized and paid fairly.

[32:15 – 1:03:24] Docs Beware: Pre-Audit Denials Can Mean Low Payment    Being paid quickly can be difficult to achieve, and documentation is key to avoiding timely filing issues There are a lot of manpower hours required to get paid, and it can be difficult to keep up with the demand. It is important for doctors to have a billing team in place that understands the insurance process...

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"You have been assigned this mountain so you can show others how it can be moved" Mel Robbins. In this podcast, Dr. Lia Gaggino discusses her experience with children's mental health and emotional wellbeing. She shares the reason why she has been so interested in this field, and that childhood experiences can shape who you become as an adult. She also discusses the importance of seeking help and how therapy can be a gift. Dr. Lia explains why there should be no shame in seeking medication if it is necessary to help improve a child's mental health. Pay close attention since she will be sharing interesting ways to cultivate self-help. Listen and enjoy! Key Highlights: [00:01 - 03:34] Opening Segment Why Lia became interested in the children's mental health field The importance of children's mental health and emotional wellbeing The benefits of therapy and medication for those who need it. [03:35 - 09:23] Why Kid's Mental Health Means So Much to Me How medication can be a game changer for those with mental health issues Ways to connect with others and cultivate self-help Lia recommends books, podcasts, movies and music Seven things Bessel van der Kolk shares in https://www.amazon.com/-/es/Bessel-van-Kolk-M-D/dp/0143127748/ref=sr_1_1?adgrpid=125942079495&gclid=CjwKCAjw4ayUBhA4EiwATWyBrk07eH1wr8nlAKkkP2BA71-iZ9fx_huI3fyq4JLRoSDGzZW2tEbrXRoCPi8QAvD_BwE&hvadid=537528894618&hvdev=c&hvlocphy=1003659&hvnetw=g&hvqmt=b&hvrand=6438506407853482206&hvtargid=kwd-359119618262&hydadcr=28915_14482663&keywords=body+keeps+a+score&qid=1653322052&sr=8-1 (The Body Keeps The Score) [09:24 - 13:06] Closing Segment How to best take care of yourself Resources Mentioned: Podcast: https://gretchenrubin.com/podcasts/ (Happier by Gretchen Rubin), https://brenebrown.com/podcast-show/unlocking-us/ (Unlocking Us by Brene Brown) Books:https://www.amazon.com/Theophilus-North-Novel-Thornton-Wilder/dp/0060088923 ( Theophilus North by Thornton Wilder), https://www.amazon.com/-/es/Vanessa-Diffenbaugh/dp/0345525558/ref=sr_1_1?__mk_es_US=%C3%85M%C3%85%C5%BD%C3%95%C3%91&keywords=The+language+of+flowers+by+vanessa+diffuser+enbaugh&qid=1653322358&s=books&sr=1-1 (The Language of Flowers by Vanessa Diffenbaugh). Anything by Alice Hoffman and Brene Brown. Film:https://www.imdb.com/title/tt0805564/ ( Lars and The Real Girl )- WATCH THIS ONE Music: https://open.spotify.com/album/1bt6q2SruMsBtcerNVtpZB (Fleetwood Mac Rumors), Moonlight Sonata, pop music, Maroon 5, Pachabel's Canon Key Quotes: "Childhood shapes you and you rise above or you struggle." - Lia Gaggino "Mental illness does not limit you, but it is important to seek help." - Lia Gaggino "We're really good at meeting other people's expectations, but not always our own." - Lia Gaggino THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot. If you’d like to connect with me, you can find me on LinkedIn, Facebook, Instagram, and Twitter or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
The Language of Flowers: A Novel

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Even though the situation that we are facing with the youth mental health crisis right now is daunting, there is such an opportunity for creativity and innovation and with the kind of clinicians that we interview today, there is such an opportunity to really write a new plan. Dr. Lois Lee and Dr. Ben Biermann discuss how primary care settings are seeing an increase in children coming in with suicidal thoughts or attempts. They emphasize the importance of partnerships between providers and discuss ways to advocate for funding for expanded mental health care. They also talk about early intervention services, community-based mental health programs, and school-based mental health services. Dr. Lois Lee’s work focuses on pediatric emergency medicine, health disparities, injuries, and health policy. This is grounded in her clinical work as a pediatric emergency medicine physician at Boston Children’s Hospital and Associate Professor of Pediatrics and Emergency Medicine at Harvard Medical School. At Boston Children’s Hospital, she is the Associate Program Director for Public Policy at the new Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion. Dr. Biermann is a child and adolescent psychiatrist on faculty at the University of Michigan Medical School.  His clinical work focuses mainly on hospital-based care:  psychiatric emergency services, psychiatric inpatient, consultation/liaison, and ECT treatments. Dr. Biermann’s clinical and scholarly focus has been on adolescents with mood disorders and disruptive behaviors, treatment-resistant depression, and youth in crisis.  He also has an interest in substance use disorders and dual diagnosis.  Key Highlights:  [00:01 - 08:41] Open Segment Dr. Lois and Dr. Ben share their background and work The increase in the boarding of mental health patients Mental health crises are not a COVID induced problem [08:41 - 18:22]  Risk Assessments And Safety Planning With The Child First Pediatrician's perspective on the current state of emergency rooms and children who are seeking care How child psychiatry can be helpful to know if a  child should be admitted or not to the hospital Social work helps to ensure that mental health is a part of the patient's care [18:23 - 28:24] How We Can Better Serve Our Kids Why emergency room doctors should assess a child's risk for suicide Doctors should consider if kids need to be medically cleared before admitting them How to provide more equitable care for all children [28:25 - 38:02] Ensure Patients Receive The Best Possible Care The potential of telehealth in psychiatry The importance of investing in psychiatry workforce development There is a need for more mental health professionals due to the increasing population Engaging patients in a standardized way can help connect them to treatment  [38:03 - 51:50] Mental Health Is A National Crisis Why the integrated behavioral health care can be helpful  More collaboration and coordination are needed to address the youth mental health crisis What can help improve access to care and funding for mental health initiatives [51:51 - 1:00:24] Final Takeaways Our kids are not doing well emotionally Access to mental health care is in short supply Suicide remains the second leading cause of death in youth The emergency rooms are overrun with kids waiting, boarding for help The pandemic magnified the mental health crisis For underserved minoritized and poor youth, the access to services is even more challenging When a kid hits the emergency department with mental health concerns, what happens next depends on where the ED is located If they are medically cleared, an assessment of risk, and intent access to mean follow if there's been suicidal ideation When psychiatry support is available, ED intervention is more likely to happen Ultimately, the question is a disposition Empower and educate primary care, pediatricians and clinicians

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ADHD is a label, it's a name of a category of behaviors that we want to look at and potentially see how can we change the environment to make a kid the most successful as possible. In today’s episode, our guest is Colleen Cullinan, Ph.D., a pediatric psychologist at Nemours/Alfred I. DuPont Hospital for Children in Wilmington Delaware. She specializes in integrated primary care within the Division of Behavioral Health. Dr. Cullinan completed her Ph.D. in Clinical Psychology at Western Michigan University in 2015. Dr. Cullinan supervises psychology externs and interns, and she directs medical education efforts for Nemours’ residency training programs. Her presentation and publication records center around integrated care, family-based interventions, and experiential cultural humility training.  If you want to gain a deeper understanding of the strategies for boosting executive function, this episode is for you! Key Highlights:  [00:01 - 11:13] Open Segment An overview of ADHA management Having conversations with families about the types of ADHA The executive functioning in kids and adults Why setting families expectations is a critical part of ADHD management [11:14 - 22:42]  The Journey of Starting to Manage A Chronic Neuro-Biological Condition Dr. Colleen’s outlook on children having trouble at school Why the Vanderbilt can be helpful You need the time to do a good job to gather information [22:43 - 33:47] Kids with ADHD Need a Lot of Practice What happens when the medication therapies are not working How executive function coaching looks like Why internal speech is important and complex Kids need more training in nonverbal cues [33:48 - 45:49] Executive Functions That Are Underdeveloped Incentive systems do work, but sometimes we are trying to incentivize the wrong thing Talk about hindsight, foresight, and insight How the sense of time is perceived by kids vs adults [45:50 - 57:07] Working Memory vs Multitasking The executive function of working memory Dr. Colleen's insights about multitasking being a fantasy Always think about the kid and their family [57:08 - 1:11:44] Final Takeaways Start with conceptualizing the diagnosis when talking to parents Take a good history, a really good history Throw away the label and really look at the executive function Start with psycho-education for families and patients Lay out the deficits of ADHD For kids with ADHD, the impact of those executive functional skills deficits may set them back two to three years Lay out building the parent's skills of expectation, setting realistic goals Let's talk about some of the specific deficits Internal speech Hindsight, foresight, and insight Cents of time Working memory  Explain to families that ADHD is highly genetic and that there are often ADHD families Future teaching and predicting setting expectations and what that can look like Set the tone with the families Lay out that intervention and management will be an experiment

Resources Mentioned: https://www.amazon.com/Driven-Distraction-Recognizing-Attention-Childhood/dp/0684801280 (Driven To Distraction - Ned Hallowell) https://www.amazon.com/-/es/Ross-W-Greene/dp/0060931027/ref=sr_1_1?__mk_es_US=%C3%85M%C3%85%C5%BD%C3%95%C3%91&crid=37EJWPAT09J3Z&keywords=The+Explosive+Child+by+Ross+Greene&qid=1652203040&s=books&sprefix=the+explosive+child+by+ross+greene%2B%2Cstripbooks-intl-ship%2C849&sr=1-1 (The Explosive Child - Ross Greene) https://www.amazon.com/-/es/Peg-Dawson/dp/1593854455/ref=sr_1_1?__mk_es_US=%C3%85M%C3%85%C5%BD%C3%95%C3%91&crid=1IEJLHZRUPOOM&keywords=smart+but+scattered+by+Peg+Dawson+and&qid=1652203176&s=books&sprefix=smart+but+scattered+by+peg+dawson+and+richard+guard%2Cstripbooks-intl-ship%2C407&sr=1-1 (Smart But Scattered - Peg Dawson and Richard Guard)...

Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood
Smart but Scattered: The Revolutionary "Executive Skills" Approach to Helping Kids Reach Their Potential
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Apraxia is a disorder that affects language development. It is most commonly seen in children between two and seven years old, but it can also occur at any point during development. In this episode, Dr. Sheryl Rosin, Ph.D. discloses the symptoms of apraxia speech and the importance of visiting a specialist for an evaluation if you believe that your child may have it. During the evaluation, your child's receptive and expressive language skills will be assessed to determine if there is a problem with that area of development. If there is a problem, therapies may be recommended to help your child improve their speech. Let’s dig into the childhood apraxia! Dr. Sheryl Rosin is a speech-language pathologist, professor, and certified autism specialist with 25 years of experience in the field. She has presented around the world and has been published in research journals on best practices in assessment and intervention for individuals with ASD. She is the owner and director of Palm Beach Speech-Language Specialists in south Florida and the Founder and Consulting Director of The St. Kitts Spectrum Services Centre in St. Kitts, the first autism clinic in the Caribbean. Dr. Rosin was the recipient of the 2017 Louis M. DiCarlo Award for Clinical Achievement from the American Speech-Language-Hearing Association. Key Highlights:  [00:01 - 09:27] Open Segment An overview of apraxia speech The difference between apraxia in adults and children A referral to a professional for further evaluation is always beneficial in determining if apraxia is present [09:28 - 22:46]  Referring A Child  For An Assessment Have an honest and open conversation with parents when referring the child for an assessment Things pediatricians might see when referring a child for an assessment of a speech or language disorder Different ways apraxia can be diagnosed  [22:47 - 32:53] Therapy Involves Building Up Vocabulary and Fluency Speech therapy for children with apraxia and dislocates It is more typical for individuals to have typical disfluency than stuttering Why singing can be a great way for disfluent individuals to improve their communication skills [32:54 - 44:17] It's Always Okay to Check Out A Child's Development  The difference between stuttering and apraxia When pediatricians should refer children for speech and language evaluation Pediatricians shouldn’t wait too long to refer a child for evaluation to offer hope to parents The importance of following up on any concerns or suspicions that may arise after a good visit [44:18 - 50:53] Final Takeaways When children are not meeting developmental milestones for receptive or expressive language, check it out. Childhood apraxia is a speech disorder of motor coordination and planning Apraxia may look like groping or searching to get sound out Because this is a motor coordination and planning disorder, there may be associated fine motor and gross motor delays as well The differential includes brain trauma and injury Refer for an evaluation when you're concerned, there is no time to waste It helps the speech therapist for us to set the state of what some of these possibilities might be The evaluation with the therapist, especially with these young kids is to play really smart play Therapy for apraxia looks like learning a sport and building motor memory Moving on to stuttering and stutter like Stuttering can be a lifelong disorder Trust your expertise to know what feels like a typical development When in doubt, check it out 

Resources Mentioned: https://www.apraxia-kids.org/ (Apraxia Kids) https://www.asha.org/public/speech/disorders/stuttering/ (ASHA American Speech-Language-Hearing Association)

Connect with Dr. Sheryl Rosin through https://www.instagram.com/speechandot_in_palm_beach/ (Instagram), https://www.linkedin.com/in/sheryl-rosin-phd-ccc-slp/ (LinkedIn), and https://www.youtube.com/channel/UCZuupyHBNVXjhFc3twNvf1Q (Youtube).  Key

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Domestic violence is a pattern of abusive behavior in which one partner repeatedly uses physical force or threats of violence against the other partner. It can take many forms, including physical, sexual, emotional, and economic abuse. Domestic violence affects everyone, no matter what age or size, and it is an important topic we should cover, however, it might be triggering for some people. If you're worried that someone you know may be experiencing domestic violence, it's important to talk to them about it.  In today’s episode, our guest Dr. Claudia B. Fenderson, EdD shares with us relevant information about the resources available to help victims get out of abusive relationships and discloses why professionals like pediatricians can play an important role in identifying and providing resources to children and families affected by domestic violence.  Dr. Claudia B. Fenderson has served as the Director/Chair of the Doctor of Physical Therapy Program at Marist College until her retirement this past year. She has a BS in Physical Therapy from Columbia University; an MS in Physical Therapy from Long Island University and an EdD in Child and Youth Studies from Nova Southeastern University. Her career spans more than 45 years and the majority of her experience has been in the areas of education and neurologic rehabilitation, primarily in infants and preschoolers with developmental delays and disabilities.  Key Highlights:  [00:01 - 09:31] Open Segment  How Dr. Claudia got interested in domestic violence Violence can be classified into four types: physical, sexual, psychological, and economic Domestic violence can involve any type of abuse, from physical to emotional to financial, and can happen to anyone [09:32 - 20:07] Have Conversations About Healthy Relationships with All of Your Patients There are warning signs that should be observed in order to identify domestic violence It is important for professionals to ask about domestic violence when they are concerned for a child's wellbeing How to identify a controlling relationship, and offer resources to teens who are in a difficult relationship [20:08 - 33:28] Provide Resources and Support to Victims During Covid was difficult to identify people who were experiencing domestic violence Health care professionals should be aware of risks and be prepared to help victims in difficult situations Domestic violence is a problem that affects both men and women, but it is especially an issue for women Healthcare providers should be aware of the signs and symptoms of domestic violence [33:29 - 41:45] Help Patients Feel Less Alone  By asking questions, clinicians can help prevent harm to patients and children Offering resources and help to adult victims of domestic violence is essential Adults need to know that they are not alone and that they can come to talk to us if they need help [41:46 - 44:38] Final Takeaways All professionals who care for kids have an opportunity to ask about domestic violence and safety Domestic violence and intimate partner violence is all about control We often consider physical abuse, but we need to think about emotional abuse Domestic violence is common with estimates that one-third of men and women have been in a domestic violence situation and that 15% of children may have witnessed domestic violence Domestic violence is a public health concern Teens who have witnessed domestic violence may believe that violence is an acceptable way to deal with conflict Ask universally about domestic violence and intimate partner violence The covid pandemic increased the incidence of child abuse and neglect, and domestic violence  Other risk factors for domestic violence may include immigrant status How do we help? When domestic violence is disclosed, reassure the victim that no one deserves to be abused Assess the safety Know the resources in your community Let the victim know they are not alone and that...

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We know that change is hard and it takes a lot of hard work, but we want to remind you that it's okay to take small steps in the right direction. If you're feeling stuck or frustrated with your current path, remember that it's okay to be patient and to start small! In this episode, Dr. Jutte shares his journey as a pediatrician, and why he has focused on community-based interventions to address social determinants of health. He also discusses the importance of poverty and how it impacts health disparities in our population. Pay close attention since we have a deep conversation on how pediatricians can raise awareness and connect with their patients to make a difference. His mission is to increase thoughtful investments into low-income communities in order to revitalize them and support the well-being and health of these neighborhoods.  We need your help. We need your voice. We need you to get involved. Let’s dig into Neighborhood Transformation: Changing the Zipcode Impact! Douglas Jutte, MD, MPH is Executive Director of the Build Healthy Places Network, a national organization with the mission to transform the way organizations work together across the health, community development, and finance sectors to more effectively reduce poverty, advance racial equity, and improve health in neighborhoods across the United States. Key Highlights:  [00:01 - 10:52] Open Segment Dr. Jutte shares his background and work experience The reason why pediatrics is one of his favorite specialties How Dr. Jutte went from a primary care pediatrician to the executive director of Build Healthy Places Network How pediatricians can work with other professionals to improve the health of their patients [10:53 - 19:41] The Importance of Community Engagement The importance of revitalizing low-income communities Why having community engagement is key to addressing health disparities What the social determinants of health are and why they need to be interconnected to improve individual health The key components of thriving communities [19:42 - 28:33] The Community Development Sector How the Obama administration helped revitalize neighborhoods that may be experiencing gentrification There is a lot of money available for various purposes, but it is not legislated or part of the regular budget [28:34 - 38:44] Pediatricians and Healthcare Providers Are Essential Players How for-profit affordable housing developers use federal affordable housing tax credits to make projects more affordable for low-income families Methods community development centers use to help low-income residents The role of Community Development Corporations (CDCs) in affordable housing Why the government can’t just give money to non-profits directly [38:45 - 48:48] We Underestimate The Power of our Doctor Title Pediatricians need to be aware of and engaged with the issues surrounding community development Pediatricians have a lot of power to advocate for their community and can help develop policies that support health Why work as a pediatrician has the potential to have long-term impacts on children's health [48:49 - 58:32] Final Takeaways The path to your passion is not linear Zipcode has more implications on health outcomes for children than genetic code Lifting out of poverty is not just about lifting an individual or their family, but about lifting the neighborhood When looking at heat maps for poverty and obesity, there is a perfect overlap with poor neighborhoods The mission of Build Healthy Places Network is to transform the way organizations work together across the health The components of a thriving and vibrant community There are funds to the tune of 300 billion earmarked for affordable housing  Community development corporations and financial institutions move funds in complicated ways both non-profit and for-profit organizations This is a good return on investment  Pediatricians play a role in what seems overwhelming...

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Trigger warning: suicide Dr. Lois Lee’s work focuses on pediatric emergency medicine, health disparities, injuries, and health policy. This is grounded in her clinical work as a pediatric emergency medicine physician at Boston Children’s Hospital and Associate Professor of Pediatrics and Emergency Medicine at Harvard Medical School. At Boston Children’s Hospital, she is the Associate Program Director for Public Policy at the new Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion. Eric Fleegler, MD MPH is a pediatric emergency physician and health services researcher at Boston Children’s Hospital and Assistant Professor of Pediatrics and Emergency Medicine at Harvard Medical School. He was a political science major at Brown University, received his MD from the University of Pennsylvania School of Medicine and his MPH from the Harvard School of Public Health. His clinical work includes attending to the emergency department as well as director of the sedation service at Boston Children’s.   [00:01] Opening Segment Eric and Lois share their to the pediatrics space Why they are focused on injury prevention?

[08:25] A Pediatrician’s Role in Firearm Injury Prevention How enormous is the firearm injury problem in the United States? Eric shares some important stats The importance of limiting gun access to kids The role of pediatricians and other healthcare professionals in preventing firearm injuries Lois explains

[18:01] Safe Storage of Firearms Lois talks about an interesting study about gun access among kids How pediatricians should talk to families about storing firearms in the home Listen to Eric and Lois Where firearms can be stored if there is a child with a mental health issue in the home

[28:24] The Right Approach to Talk About Firearms With Families Conversations about firearms are different from other common patient conversations Here’s why Storytelling is a great approach to forwarding advocacies on firearm injury prevention Legislations and regulations around the country are varied regarding firearm injury  prevention Eric tells us how this is affecting children’s safety from firearms

[39:24] Institutional Changes to Prevent Firearm Injuries and Death Connecting with government officials about firearm injury prevention Gun manufacturers cannot be sued for any injury or death Here’s what we can do Institutional changes are key to firearm injury prevention Lois explains

[48:10] How to Start Your Advocacy on Firearm Injury Prevention The severity of firearm-related deaths according to Lois Lois and Eric have messages for their younger selves Listen to their messages too! The role of the local chapters of the American Academy of Pediatrics

[55:54] Final Takeaways Conversations about firearm injury prevention are painful and frustrating Stats to consider in relation to firearm-related injuries and deaths Children of color are at a higher risk of injuries and death from firearms Suicide and firearm-related injuries and death Access to firearms among children in the home The parents keeping their children safe and the children’s curiosity about firearms The role of pediatricians in preventing injuries and death from firearms Mental health and access to firearms among children Alternatives to keep the children safe aside from having guns Where to store firearms Being non-judgmental in talking with families about firearms It is legal to ask for information about firearms in the United States Talking with children regarding firearm storage Risk of having a firearm in the home among older kids or teenagers Gun laws make a difference Pediatricians should reach out to legislators  Firearms are leading causes of death and should be considered a serious matter If the family or patient has a gun, ask with respect and don’t make hasty assumptions Be brave in keeping the children safe from firearms

Key Quotes: “Everything in...

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Dr. Sanjeev Arora is the founder and executive director of Project ECHO. He is also a distinguished professor of medicine with tenure at the University of New Mexico’s Health Sciences Center.  Previously, he served as executive vice chair and acting chair of the Department of Internal Medicine and president of the medical staff. He also served on the UNM Health Sciences Center board for five years. Dr. Arora has also served as president of the University Physicians Association. Born in Nangal, India, Dr. Arora was raised in a household of physicians which gave him a strong sense of responsibility to give back to his community from an early age. In 1980, he moved to New York and, later, Boston to study medicine and become a gastroenterologist. In 2003, he founded Project ECHO to ensure more people had access to best-practice care for hepatitis C. Today, the ECHO model is being used in nearly every country to solve the world’s greatest challenges in health care, education, and journalism, and more.   [00:01] Opening Segment Dr. Sanjeev Arora shares his journey that started in his home country of India He talks about the origins of Project ECHO

[07:36] The Four Key Principles of Project ECHO The four key principles of the ECHO model What does Sanjeev mean by “democratizing knowledge?” Child psychiatry is one of the most underserved spaces in healthcare How can this be solved?

[17:57] How to Scale the ECHO Model  Sanjeev talks about what should be the foundation of offering service He shares some strategies to scale Project ECHO to other diseases This is the way that Sanjeev and his team measure the outcomes of the ECHO model

[27:53] The Future of Project ECHO Sanjeev gives his outlook for the future of the ECHO model He shares an inspiring thought on the reality about happiness Disease prevention and healthcare education are only two of their priorities Here’s why they’re promoting these advocacies

[36:50] Final takeaways A simple idea can move mountains What it takes to take healthcare to the next level The four key components of the ECHO model Project ECHO has been participated by millions around the world The strategy used by the Project ECHO Learning by doing The benefits of the ECHO model Love and compassion as embodied in the ECHO model The American Academy of Pediatrics serves as a learning hub for the ECHO model The only way people can be happy

Key Quotes: “If an expert, a specialist in a university, just shares their knowledge with primary care doctors [and] in rural areas, good things will happen.” - Dr. Sanjeev Arora “The only way a human being can be really happy is by living a life of service.” - Dr. Sanjeev Arora Email Sanjeev at Sanjeev.Arora@salud.unm.edu and visit https://hsc.unm.edu/echo/ to know more about Project ECHO.

THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot).  

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown (Instagram), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being. 

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Kevin Mills is the co-founder of Streamlined Podcasts, a full-scale podcast production agency that helps podcasters edit and produce their podcasts consistently for an affordable price. With industry-leading turn times, technologies and teams, you'll have trouble finding a better value anywhere else. Before Streamlined Podcasts, Kevin's entrepreneurial journey began in direct-to-consumer sales. He's worked with companies ranging from door-to-door vacuum sales to mortgage lending, and he now spends his time and efforts helping podcasters focus on what they do best producing content. He is passionate about making it as easy as possible for content creators to get their message to their audience.   [00:01] Opening Segment Here’s my story on how I started the Pediatric Meltdown Podcast Why podcasting is a great avenue to get your message across

[08:24] How to Find The Target Audience For Your Podcast Podcasting is a decentralized platform unlike traditional media Kevin explains Here’s an exercise to determine the target audience of your podcast You don’t have to be an expert to start a podcast Listen to Kevin

[18:07] Opportunities that Podcasting Offers This product has everything you need to start a podcast! Link below Podcasting offers personal and business opportunities Learn more Visit streamlinedpodcasts.com for more information!

[28:11] Final Takeaways Podcasting is fun! A podcast is a decentralized platform Podcasting allows you to create a passion product Podcasting can build your business Start podcasting by determining who you want to serve Podcast episodes can be solo or with guests The services that Streamlined Podcasts offers What’s included in the base rate of PodBoxx? FREE PodBoxx for our listeners! Link below

Key Quotes: “Figure out who is the audience that your podcast serves, and then everything that you do in your podcast…should be engineered to serve that audience. ” - Kevin Mills “I was able to create content that helped other people without me having to be the expert…so if you think there's no way [you] could have a podcast because [you’re] not an expert, don't let that be your excuse.” - Kevin Mills

Email kevin@streamlinedpodcasts.com to reach out to Kevin or check out streamlinedpodcasts.com to know more about his work. Set up your podcast through the PodBoxx! Win a free PodBoxx by signing up https://streamlinedpodcasts.com/podboxx-giveaway/ (here).

Resources Mentioned: https://mightyparenting.com/podcast/?msclkid=9a335760b37111ecacd25d20e820ec66 (Mighty Parenting Podcast) https://gretchenrubin.com/the-happiness-project?msclkid=4f031f8cb37211ec8ef6fef65d98a3f6 (The Happiness Project - Gretchen Rubin) https://brenebrown.com/podcasts/ (Brené Brown - podcast episodes) https://msrachelhollis.com/ (Rachel Hollis) https://podcasts.apple.com/us/podcast/pediatrics-on-call/id1519830825?msclkid=3ce29f40b37311ecad9adf71103a0976 (Pediatrics on Call) https://podcasts.apple.com/in/podcast/raising-good-parents/id1450208347?msclkid=528683aeb37311ecb214f20c3c893e95 (Raising Good Parents) https://podcasts.apple.com/us/podcast/docs2dads-podcast/id1598314025?msclkid=7a0bea25b37311ecab9f4f61ccb8b2a6 (Docs2Dads Podcast)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being. 

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Dr. Lisa Lowery is a native of Grand Rapids and a graduate of Ottawa Hills High School.  She attended Michigan State University receiving her Bachelor of Science Degree in Microbiology, with Honors. Her research during her fellowship concentrated on sexually transmitted diseases and reproductive health.  While at the Johns Hopkins, she obtained a Master of Public Health in the Department of Population and Family Health Sciences with a Certificate of Concentration in Maternal and Child Health. Currently, Dr. Lowery is an Adolescent Medicine specialist at Helen DeVos Children’s Hospital-Spectrum Health Medical Group.   She has been on faculty since July 2004.  Dr. Lowery also serves as Adolescent Medicine Section Chief and an Associate Program Director for the Combined Internal Medicine/Pediatrics Residency Program Michigan State University/Grand Rapids Campus.  She is the president of West Michigan Medical Society/National Medical Association and serves on the Grand Rapids Urban League Board of Directors and the Michigan Eating Disorders Alliance Board.  In the summer of 2018, started serving on the Cherry Health Foundation Board and the Kent County Community Health Advisory Committee.   [00:01] Opening Segment What’s been happening in Dr. Lisa Lowery’s career? She gives an update Lisa talks about their monthly series on diversity, equity, and inclusion

[07:01] Breaking Down Structural Racism The next generation of physicians should have these qualities Listen to Lisa The impacts of the pandemic to the healthcare sector according to Lisa Lisa talks about structural racism and why it matters in the healthcare sector

[17:48] Dealing With Oppression and Discrimination Oppression and discrimination look different among teenagers Lisa explains The importance of making appointment-setting easy for teenage patients What does being an “emotional container” mean?

[27:58] Being Vulnerable With Patients Lisa shares a humbling moment she experienced as a medical practitioner It is all right for physicians to be vulnerable with their patients Lisa tells us why The right way to communicate with a patient according to Lisa

[37:24] Learning About Bystander Interventions Lisa reveals a secret about how she talks with her patients The benefits of conducting Bystander Intervention Workshops Recognizing privilege that people of color don’t have

[47:57] Making a Difference in the Healthcare Sector How physicians can lend their voices to promote diversity, equity, and inclusion Lisa’s reminder for physicians who want to make a difference in their workspaces Here’s Lisa’s message for her younger self that you don’t want to miss

[56:29] Closing Segment   Final takeaways Everyone has racial biases Start with recognizing your own biases The uncomfortable feeling of being curious Addressing teenagers who are people of color and LGBTQIA+ The importance of empathy Safety among children of our BIPOC brothers and sisters Questions that physicians should ask their young patients Why allyship is important When to intervene as a bystander Small changes can lead to radical shifts Fixing racism is not a minority’s responsibility Let’s all be lifelong learners

Key Quotes: “...medicine is still a great career. It's a great calling. We get to interact in people's lives and hopefully, make a difference.” - Dr. Lisa Lowery “Be humble. Be brave. Start somewhere…change doesn't always come easy.” - Dr. Lisa Lowery Resources mentioned: Book Review: https://www.npr.org/2019/08/15/751070344/theres-no-such-thing-as-not-racist-in-ibram-x-kendis-how-to-be-an-anitracist (How to be an Anti-Racist) https://www.amazon.com/Dumb-Things-Well-Intended-People-Say/dp/1600374913/ref=sr_1_1?crid=1BXRJRVIF57OK&keywords=35+dumb+things+well-intended+people+say&qid=1648573601&sprefix=%2Caps%2C526&sr=8-1 (35 Dumb Things Well-Intended People Say)...

Inclusive Conversations: Fostering Equity, Empathy, and Belonging across Differences
Nice Racism: How Progressive White People Perpetuate Racial Harm

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Dr. Sheryl Ryan is Professor of Pediatrics, Chief of the Division of Adolescent Medicine, and Director of Outpatient Adolescent Clinical Services at the Penn State Health Hershey Medical Center. She is a pediatrician who is board certified in both Adolescent Medicine and Addiction Medicine.  Currently, she is focusing her research on the education of both school personnel and pediatricians in rural areas of Pennsylvania around screening and intervention for youth using alcohol and other substances – through a federally funded Project ECHO grant. She is also currently funded through an NIH HRSA grant to train addiction medicine fellows at Penn State, and increase the capacity of primary care and behavioral health care providers to treat individuals with substance use disorders.  As a board-certified specialist in adolescent medicine, Dr Ryan also continues to be clinically very active in providing both outpatient and inpatient care to adolescents and young adults with complex medical and mental health issues.    [00:01] Opening Segment Why Dr. Sheryl Ryan became interested in pursuing a career in pediatrics How did Sheryl realize that she could apply her pediatric skills to substance use?

[06:09] Current Data About Substance Use Among Kids Substance use among kids has declined over the past years Sheryl shares some data The importance of asking the right questions to determine substance use Screening tools that Sheryl suggests for at-risk kids and adolescents

[16:43] The Impact of Legalizing Marijuana Use She shares her thoughts about making marijuana use legal The relation of substance use on an adolescent’s brain development The long-term effects of substance use among kids that doctors found out

[26:47] Influence of Parents on Their Kids Sheryl talks about the Cannabis use disorder Parents using substances or drinking alcohol have major influences on their kids Sheryl explains Don’t miss our interesting conversation about vaping

[36:50] Possible Interventions and Patient’s Consent The role of pediatricians in dealing with substance use among kids Listen to Sheryl’s insights The different interventions that pediatricians can utilize to address substance use Asking for consent from the patient regarding possible interventions is a must Here’s why

[46:02] Legislative Measures to Deal With Substance Use How to navigate this tricky situation of telling parents about their kids’ substance use The legislative measures being put into place to deal with substance use among kids Sheryl has an important message for her resident self, which you should not miss!

[56:30] Closing Segment   Final takeaways Huge appreciation for Sheryl for joining us today Substance use has dropped since the 1990s Early use of substances may lead to a higher risk of substance use disorder and addiction The short-term effects of legalizing marijuana use There’s still so much to learn about the effects of substance use among kids and teens Cases of accidental ingestion of THC are increasing Safety measures available to patients Effects of cannabinoids on an adolescent’s brain development Possible long-term effects of substance use among kids What cute cannabinoid intoxication among teens may look like  The results of the Adolescent Brain Cognitive Development Study  Cannabinoid addiction is a threat that should be taken seriously Why advocate for safety measures against substance use Role of parents in substance use among their kids The right questions to ask kids The Effectiveness of the Screening, Brief Intervention, and Referral to Treatment  Suggested screening tools to use What does Brief Intervention look like? Telling parents about their kids’ substance use Looking for available resources in your states Kids deserve to know the risks of substance use Resources provided by the American Academy of Pediatrics  Never...

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Trigger warning: This episode includes discussions about suicide and depression Dr. Joanna Quigley is a Clinical Associate Professor of Psychiatry at the University of Michigan. She has also been on faculty at the University of Pittsburgh and trained in Pediatrics, General Psychiatry, and Child and Adolescent Psychiatry at the University of Kentucky. She engages in a number of collaborative efforts to support mental health care in the primary care setting, the care of children with chronic illness and mental health care needs, as well as for adolescents struggling with substance use.  Dr. Quigley serves as a consulting child psychiatrist for the Michigan Child Collaborative Care (MC3) program at the University of Michigan providing outreach support to primary care pediatric, family medicine, and obstetric providers across the state of Michigan.  Dr. Quigley was the lead author on the 2019 AAP Policy Statement “Alcohol Use by Youth.”   [00:01] Opening Segment How serious is the problem of alcohol use among kids? Dr. Joanna Quigley shares her insights What pediatricians and patients should know about the CRAFFT questionnaire

[06:29] Screening Tools for Kids  How to screen kids the right way for alcohol use according to Joanna Joanna gives some tips to start a conversation with kids properly Why families should watch out for binge drinking

[16:55] Alcohol Use and Related Issues How mental health and substance abuse relates to alcohol use among kids Pediatricians should also consider their pre-conceived biases when screening kids: Here’s why These sectors have a high risk for alcohol use and substance use disorders: Listen to our discussion

[26:40] Family-Based Approaches on Alcohol Use Is there a connection between alcohol use and ADHD and autism spectrum disorders? The downsides of some resources in relation to substance and alcohol use abuse The importance of family-based approaches in treating alcohol use among kids

[36:28] The Right Way to Talk With Kids About Alcohol Use How to help the parents in talking with their kids about alcohol use The latest data about the parents’ perception of underage drinking The advantages of routine screening according to Joanna

[41:21] Closing Segment   Final takeaways Acknowledgment of Joanna’s work for kids and pediatricians Alcohol use being a common issue among kids The evidence-based tool that pediatricians can use Administering questionnaires both written and verbal Substance Use Disorder transcends race, ethnicity, religion, gender, socioeconomic status, and sexual identity, among others Our definition of binge drinking An alternative way to talk about alcohol use with kids Relation of comorbidities to drinking Mental health and substance use disorder Kids with a high risk of alcohol use How treatment of alcohol use should be Joanna’s message for parents to prevent substance abuse among their kids Available resources below What should be the end goal for kids

Key Quotes: “When we're seeing patients and thinking about who should we be ‘worried’ about…it's not just teenage boys…binge drinking is a problem for girls as well.” - Dr. Joanna Quigley “Family-based work is often essential when we're addressing substance use disorders in adolescents…that is a big component of the care. ” - Dr. Joanna Quigley

Resources mentioned: https://publications.aap.org/pediatrics/article/144/1/e20191356/37084/Alcohol-Use-by-Youth~ (Alcohol Use by Youth) https://nida.nih.gov/ast/s2bi/#/ (The Screening to Brief Intervention) http://www.niaaa.nih.gov/YouthGuide (Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide) http://teens.drugabuse.gov (National Institute on Drug Abuse) https://crafft.org/wp-content/uploads/2019/02/CRAFFT-2.0_Clinician-Interview.pdf (The CRAFFT Interview (version 2.0)) https://www.samhsa.gov/ (Substance Abuse and Mental Health Services Administration) Pediatric...

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Dr. V. Fan Tait is a pediatric neurologist with years of experience in child health and wellness, family-centered care in medical homes, children with special needs, health care delivery, and advocacy for children, families, and pediatricians. She earned a BS from the University of Alabama, her MD from the University of Kentucky Medical Center, and completed her pediatric residency and pediatric neurology fellowship at the University of Utah Medical Center.  For more than 10 years, Dr. Tait directed the Department of Child Health and Wellness which included many of the strategic priorities of the academy: early brain and child development; the Institute of Healthy Childhood Weight; Bright Futures and the National Center on Early Childhood Health and Wellness, which addressed health in Head Start and Child Care. In addition, she led the Disaster Preparedness Advisory Council (DPAC) from its inception and continues to be actively involved in the national climate change initiatives.   [00:01] Opening Segment Dr. Fan Tait tells us the story behind her career as a pediatric neurologist She talks about the advocacy that she only realized when she became a pediatrician

[05:46] Becoming a Member of the American Academy of Pediatrics Here’s how Fan became a chapter president of the American Academy of Pediatrics What she loves the most about working with her fellow pediatricians in the Academy The main reason medical homes are a big issue for Fan Fan leaves a message for her fellow pediatricians

[15:57] Coping with the Effects of the COVID-19 Pandemic The effects of the COVID-19 pandemic on patients’ mental health Listen to Fan’s thoughts Fan shares some resources about how to address mental health issues Pediatricians should accept the fact that they can’t fix everything Here’s what they should focus on instead The importance of education according to Fan

[30:39] Pediatricians Taking Care of Themselves Why pediatricians should also take care of their health and wellness Listen to our interesting exchange about “moral injuries” Here’s our conversation about vaccines and vaccination programs What’s the difference between self-sacrifice vs. self-preservation?

[45:17] Dealing with Negative Self-Thoughts How pediatricians can deal with their negative self-thoughts Fan gives us a sneak peek about the 2022 Healthcare Workforce Rescue Package Link below Fan sends a message for her resident self Listen to her message!

[54:33] Closing Segment   Final takeaways Acknowledgment for Dr. Fan’s contributions to the American Academy of Pediatrics How to start an advocacy campaign for kids The effects of the COVID-19 pandemic on our mental health Resources about the COVID-19 pandemic accessible to you Access to care services remains an issue What pediatricians can offer to families right now Screening for social determinants of health, depression, suicidal ideation, food insecurity, and housing Don’t fix everything alone Remember why we pediatricians are making sacrifices What is a “moral injury?” Dealing with burnout The metaphor of the oxygen mask The 2022 Healthcare Workforce Rescue Package The economic impacts of COVID-19 on patients and pediatricians Be honest about what you can and cannot do. You are enough, always

Key Quotes: “You don't have to be proud in the negative sense of pride, but you do have to have confidence in yourself, that you can do it, and you should do it.” - Dr. Fan Tait “f physicians are well themselves, then I believe the care that they give is better.” - Dr. Fan Tait

Resources mentioned: https://nihcm.org/publications/physician-burnout-suicide-the-hidden-health-care-crisis?utm_source=NIHCM+Foundation&utm_campaign=05fc2b6289-080921_VBC_Webinar_Invite_non_registrants&utm_medium=email&utm_term=0_6f88de9846-05fc2b6289-167785432 (Physician Burnout & Moral Injury: The Hidden Health Care Crisis)...

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It is challenging to manage kids with suicidal ideation and parents who rely on for you help with limited resources. In this episode, I share with you the best practices, resources, and tips that could help you manage your practice and avoid that stress so you could focus on giving your patients the best experience! [00:30 - 14:30] Get Your Resources Ready! The best online resources you could turn to How to determine if you are ready Checklist to ensure you have an efficient process workflow  Sharing best practices: Meet with bodies that have a play on a child’s emotional health Managing the patient from home versus in an emergency room Why having a social worker in your practice is critical

Key Quotes: So don't underestimate the power of your voice.” - Lia Gaggino Resources mentioned: CALM: Counseling on Access to Lethal Means https://www.nimh.nih.gov/research/research-conducted-at-nimh/asq-toolkit-materials (Ask Suicide-Screening Questions (ASQ) Toolkit) Pediatric Meltdown Episode 38: https://podcasts.apple.com/us/podcast/suicide-prevention-in-primary-care-save-a-life/id1529656785?i=1000523149132 ( Suicide Prevention in Primary Care: Save a Life!)

THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot).  

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown (Instagram), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being. 

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Dr. Scott Grant is an academic primary care pediatrician and hospitalist working in Southeast Michigan. He completed his medical school in El Paso, TX, and was a pediatric resident and chief resident at Phoenix Children’s Hospital in Arizona. His primary clinical interest is in behavioral health, especially the interaction of childhood adversity and trauma with developmental and behavioral outcomes. He recently took on a role as a District CATCH Facilitator with the AAP, which helps pediatricians engage with their communities more directly through grant-supported community partnerships.   [00:01] Opening Segment Dr. Scott Grant shares the story behind his pursuit of pediatrics as a career Here’s the part of pediatrics that Scott enjoys the most

[04:18] Tolerable vs. Toxic Stress: What’s the Difference? Scott learned about this TED Talk that changed how he looked at pediatrics Link below The difference between tolerable and toxic stress Scott explains Scott talks about the importance of safe, stable, and nurturing relationships with patients Scott shares the signs of a meaningful conversation with patients

[15:50] Relationship-building Tips For Pediatricians Pediatricians need to make families feel that they’re humans too Scott tells us why How to build trust and relationships with families Scott shares his experience working with fathers

[25:18] Emotional Regulation: What Is It? Scott tells us how he decided to produce the Docs2Dads Podcast Link below What we should know about emotional regulation How to replace bad habits among kids Disciplinary actions are now changing

[35:43] Work-Life Integration is the Way to Go Scott prefers work-life integration over work-life balance He tells why He wants to normalize saying good things to your spouses and children What are its benefits? Scott sends a message for his resident self Listen to his message!

[42:23] Closing Segment   Final takeaways Awareness of adverse childhood experiences Nadine Burke Harris on TED Talk Toxic stress is unbuffered stress Adverse events can become tolerable if they are buffered by safe, stable, nurturing relationships How to connect with patients and their families How to regulate emotions Why listen to the Docs2Dads Podcast The role of dads in a patient’s life Why silence and pauses are important too within patient conversations Serving as emotional containers Work-life integration

Key Quotes: “Sometimes, before families need a physician, they need just a human being that understands that they're having the worst day of their life.” - Dr. Scott Grant “You can't replace bad habits with no habits. You have to replace bad habits with good habits.” - Dr. Scott Grant Resources mentioned: Journal Article: https://publications.aap.org/pediatrics/article/148/2/e2021052582/179805/Preventing-Childhood-Toxic-Stress-Partnering-With (Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health) Video: https://www.youtube.com/watch?v=95ovIJ3dsNk (How childhood trauma affects health across a lifetime | Nadine Burke Harris) Pediatric Meltdown Episode 56: https://podcasts.apple.com/us/podcast/toxic-stress-safe-stable-nurturing-relationships-are/id1529656785?i=1000536975449 (Toxic Stress: Safe, Stable, Nurturing Relationships are the Antidote)

Email sgrant3@dmc.org to connect with Scott or follow him on Instagram @docs2dadspod. Check out https://www.dmc.org/ (https://www.dmc.org/) to know more about his work.   Listen to Scott on https://podcasts.apple.com/podcast/id1598314025?mt=2&app=podcast&ls=1 (Docs2Dads Podcast)!

THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot).  

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn),...

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Dr. Phil Boucher is a direct care pediatrician in Lincoln, Nebraska, and father of 6.  He is also the host of two amazing podcasts. In Raising Good Parents Podcast, he focuses on helping parents enjoy parenthood more while in Pediatrics 2.0 Podcast, Dr. Boucher and his guests discuss the latest trends in pediatric practices from clinical updates to research advancements to revolutions in care delivery.  He paid a visit to Pediatric Meltdown to talk about his journey to pediatrics, his reasons for going solo, and the need for pediatricians to use their voices to inform the general public and our legislators in shaping our healthcare system for the better.   [00:01] Opening Segment Dr. Phil Boucher talks about the story behind his pursuit of pediatrics The fun about the science of pediatrics that we both enjoy

[05:08] Launching a Direct Primary Care Practice The challenges that Phil needed to face early on in his pediatrics career His motivations for opening a solo pediatric direct primary care practice The difference between direct primary care from traditional practice The benefits of launching a solo practice according to Phil

[15:24] Creating Content for Both Parents and Patients The more difficult challenge brought about by the COVID-19 pandemic What’s more difficult than physical and financial challenges? Phil gives us an important reminder about our use of social media The lessons that listeners can learn from his 2 podcats

[25:12] A Pediatrician’s Role in Shaping the Healthcare System How pediatricians can use their expertise in sharing relevant information to the public The role that pediatricians can play in informing legislators about health-related issues Phil’s message for his younger self that you should hear too!

[35:51] Closing Segment   Final takeaways Be brave and find what works for you Why Phil pursued solo practice Why create a podcast What pediatricians can learn from Phil’s podcast, Pediatrics 2.0 Expert advice for parents that they can hear from Raising Good Parents Podcast The opportunity to build relationships with parents and patients Promoting our advocacies through social media Connecting with legislators to advance our advocacies Finding fellow advocates in your local community Why we should embrace change

Key Quotes: “Direct [primary care] really means a direct relationship with patients and the physician rather than having the insurance middleman that kind of dictates care.” - Dr. Phil Boucher “If you can provide good information, you are able to capture attention and change hearts and minds because of your relatability, your authenticity, and your credibility as a physician.” - Dr. Phil Boucher Resources mentioned: Phil’s podcasts: https://library.drphilboucher.com/podcast (Raising Good Parents Podcast) https://podcasts.apple.com/us/podcast/pediatrics-2-0/id1465176586 (Pediatrics 2.0) Pediatrics 2.0 previous episode: https://podcasts.apple.com/us/podcast/interview-with-dr-paul-offit/id1465176586?i=1000547227082 (Interview with Dr. Paul Offit)

Email pboucher@drphilboucher.com to connect with Phil or check out https://library.drphilboucher.com/drphilboucher (https://library.drphilboucher.com/drphilboucher) to know more about his work. 

THANK YOU FOR YOUR SUPPORT! Pediatric Meltdown was listed as https://blog.feedspot.com/pediatric_podcasts/ (a Top 20 Pediatric Podcast on FeedSpot).  

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown (Instagram), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great...

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Dr. Jane Meschan Foy has spent more than 35 years in pediatric primary care, public health, administration, and medical teaching. Her special interests include mental health services in pediatric primary care and school settings; access to health care for under-served populations; primary care of children with special health care needs; and residency training in mental health, community pediatrics, and advocacy. Dr. Foy’s publications on mental health include 2 AAP textbooks (2018)—Mental Health Care of Children and Adolescents: A Guide for Primary Care Clinicians and Promoting Mental Health in Children and Adolescents: Primary Care Practice and Advocacy; the AAP Policy Statement “Mental Health Competencies for Pediatric Practice” and Technical Report, “Achieving the Mental Health Competencies” (both Pediatrics, 2019).   She recently edited a new publication to support clinicians at the front lines, Managing Mental Health Concerns in Pediatrics: A Clinical Support Chart. She currently serves as an associate editor of the AAP Textbook of Pediatric Care and as Associate Editor, Mental Health for Pediatric Care Online (PCO).        [00:01] Opening Segment I introduce Dr. Jane Foy Her journey from pediatrics to mental health

[05:34] Multidiscipinary Model in Pediatric Mental Health An alarming observation from Jane about her patients’ childhood experiences Jane talks about the importance of tapping other disciplines in helping patients The reasons for building linkages with schools and communities Protocols in dealing with difficult behaviors among kids in school

[15:46] Mental Health Competencies Why it’s important to lay out mental health competencies The cultural change that is happening in the mental health space Jane shares the story about their advocacy on their Medicaid system The barriers they’ve broken with this advocacy Their mechanisms to ensure funds for mental health are being used appropriately

[30:27] Mental Health Monitoring Among Patients Psychopharmacology education among healthcare providers’ Building trust between the therapist and the family The “cheer up” model A critical piece of anxiety treatment according to Jane How to set up office systems that to monitor patients

[45:53] Resolving Health Problems as a Community Jane’s advice for her resident self that you should also hear The power of resolving obstacles with a community, and not alone The truth about suicide prevention

[47:39] Closing Segment   Final takeaways Jane’s vision on integrated behavioral health and collaborative mental health care Creating team models as key to our work Children who are not getting mental health care Cultural change in mental health work among pediatricians Our “pediatric advantage” Barriers to providing mental health care Systemic change is now ready to happen Approaching mental health issues as emergencies Brief interventions that pediatricians can offer How to use the “cheer up” model What you need to know about psychopharmacology Look for champions in your social circles right now You are not along. You’ve got this

Key Quotes: “Listen to your instincts and also listen to your patients and follow them.” - Dr. Jane Foy “When you do encounter obstacles in getting accomplished what you want to accomplish, look to others. Just don't suffer alone.” - Dr. Jane Foy

Resources mentioned: https://pubmed.ncbi.nlm.nih.gov/31636143/ (Mental Health Competencies for Pediatric Practice) https://pubmed.ncbi.nlm.nih.gov/31636144/ (Achieving the Pediatric Mental Health Competencies) https://pubmed.ncbi.nlm.nih.gov/15629972/ (A process for developing community consensus regarding the diagnosis and management of attention-deficit/hyperactivity disorder) https://pubmed.ncbi.nlm.nih.gov/12456924/ (Working to improve mental health services: the North Carolina advocacy effort)...

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Dr. Kofi Essel is a board-certified community pediatrician at Children’s National Hospital (CNH) in Washington, D.C. He serves as Assistant Professor of Pediatrics, the Director of the George Washington University School of Medicine and Health Sciences Culinary Medicine Program, the Director of the GWU Community/Urban Health Scholarly Concentration, and the Director of the GWU Clinical Public Health Summit on Obesity.   Dr. Essel has dedicated his career to advocacy/research around healthcare training, health disparities, and community engagement, with expertise and national recognition in the areas of addressing obesity and food insecurity in families.  [00:01] Opening Segment Let’s get to know Dr. Kofi Essel He talks about his journey that brought him to pediatrics

[04:40] The Reality About Food Insecurity What pediatricians should understand about food insecurity Kofi shares the latest statistics How it relates to racism in the country COVID-19 is not an equalizer, but a magnifier of existing social issues Kofi explains The first step to resolve food insecurity Kofi breaks down what food sovereignty is

[17:53] Role of Poverty and Privilege in Food Insecurity The “humanistic ability” that people should be able to possess Why this is culturally relevant Does working hard solve food insecurity among people living in poverty? Listen to our exchange How poverty is expensive and privilege is blinding The connection between food insecurity and treatment approaches

[27:24] Screening Food Insecurity What the Hunger Vital Sign is and how to use it Privacy issues to consider when screening for food insecurity Shame and guilt are major concerns How to deal with food anxiety

[43:27] Holistic Approach to Resolve Food Insecurity Here’s a quick guide from Kofi for pediatricians Find an anti-hunger champion A team is still needed even if there’s a champion or advocate We talk about the evolution of pediatrics through the years The importance of holistic approach in giving treatments to patients

[53:57] An Important Message for Healthcare Providers A great resource for healthcare providers to resolve food insecurity Link below Kofi’s message to his younger self that you need to hear too Giving yourself a chance to do something you want to do

[01:00:02] Closing Segment   Final takeaways Hungry kids in wealthy countries The problems magnified by the COVID-19 pandemic Food sovereignty Step-by-step goal-setting of food-insecure homes Poverty as the root cause of hunger “Work hard to succeed” is actually a myth Structural racism The pandemic is not the great equalizer The likelihood of a person or family going hungry Obesity paradox Putting the best foot forward Food insecurity and food anxiety The two-question hunger vital signs The importance of asking questions Talking with a parent alone away from the child My personal realizations while talking with Kofi Looking for an anti-hunger champion Use your voice to advance advocacies No child should be hungry, ever

Key Quotes: “The ability to choose one's food is a humanistic ability and ability we should be able to provide to people.” - Dr. Kofi Essel “I am where I need to be. I'm learning what I need to learn. I have the right mentors in place. I have all the capacity I need, and it's going to be okay. It's gonna be okay.” - Dr. Kofi Essel

Resources mentioned: Book: https://link.springer.com/book/10.1007/978-3-319-76048-3?token=HOLIDAY21&utm_campaign=3_fjp8312_springerlink_shopping_katte_HOLIDAY21&gclid=Cj0KCQiAt8WOBhDbARIsANQLp96wxtIlL3BzVHTKkcpQLZ2YPRSYwJ9pZAyMcjqv2mFkIKhiM8L03NEaAoHeEALw_wcB (Identifying and Addressing Childhood Food Insecurity in Healthcare and Community Settings) AAP Policy Statement: https://publications.aap.org/pediatrics/article/136/5/e1431/33896/Promoting-Food-Security-for-All-Children (Promoting Food Security for All Children) AAP Food Research...

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Dr. John Straus is the Founding Director of the Massachusetts Child Psychiatry Access Program (MCPAP) and a 2020 Mom’s Inaugural winner of the Maternal Mental Health Hero Award. Dr. Straus is the mind and heart behind MCPAP, which has inspired and been the model for Maternal Mental Health doctor-to-doctor consultation programs across the U.S.  Dr. Sheila Marcus, meanwhile, is a Clinical Professor at the University of Michigan, Section Chief for Child and Adolescent Psychiatry and Co-Director of the Infant and Early Childhood Clinic (IECC). Her areas of interest include intergenerational transmission of illness, maternal child attachment and early risk factors for childhood psychiatric illness including presentation of autism in toddlers.   [00:01] Opening Segment Let’s get to know Dr. John Straus and his role in the MCPAP Meet Dr. Sheila Marcus, a clinical professor at the University of Michigan 

[04:58] The Birth of the Massachusetts Child Psychiatry Access Program John’s role in making the Child Psychiatry Access Program possible Sheila’s motivation for joining and contributing to the Program John talks about the pediatricians’ engagement so far within the Program

[15:10] Accessible Child Psychiatrist Support The system in place to get help from a child psychiatrist What they mean by “rightsizing mental health” The limitations of psychiatry that psychiatrists should realize

[20:16] Sustainable Child Psychiatry Program A major concern on the primary care side according to Sheila The driving factors for states to adopt and sustain the child psychiatry program The role of health insurance The growth of the infant mental health lens Treating a mother’s pre- and post-partum illnesses

[30:00] Mental Health Screening in Prenatal Care We talk about the lack of mental health screening in prenatal care The assignments of obstetricians in prenatal care We have an interesting exchange about the specialty of pediatricians 

[35:01] The National Network of Child Psychiatry Access Programs The importance of offering substance use services What to consider in administering medications to kids The role of the National Network of Child Psychiatry Access Programs

[40:34] Distribution of Psychotherapeutic Resources There are no intrinsic mental health issues How patients and providers can capitalize on the Michigan program The next big step now is distributing psychotherapeutic resources Their message to their younger selves you’d want to hear too!

[47:28] Closing Segment   Final takeaways The growth of a national child psychiatry program The risk of mental health issues among kids Mental health screening in prenatal care The variety of child psychiatry programs per state You’re not incompetent. Sometimes, cases are just hard to address The life-altering benefit of the MC3 Diagnostic clarification is key The impact of trauma on patients Sending behavioral health consultants across Michigan Available resources and programs in your state The “Next Gen Training” The importance of time among pediatricians States with no child psychiatry access program yet Go to nncpap.org to know where your state program is Do what you love and enjoy the journey. 

Key Quotes: “The problem is not an intrinsic mental health issue. It's environmental, whether it's trauma or some other social determinants of health.” - Dr. John Straus “If you're treating a mom for postpartum illness, or prepartum illness, you got to think about the baby and the attachment issues and how to make sure that the dyad is healthy.” - Dr. Sheila Marcus Resources mentioned: http://www.mcpap.org (Massachusetts Child Psychiatry Access Program) http://www.nncpap.org (National Network of Child Psychiatry Access Programs)

Email smmarcus@med.umich.edu to connect with Sheila or check out http://www.med.umich.edu (www.med.umich.edu) to know more about her work. Reach out to John by

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Happy 2022! In this episode, we will discuss first what should be our priorities to help ourselves draw how we want this year to look like. We will also talk about the power of family and community not only to our personal growth but also to our individual health and why we should regularly make time for our loved ones. Lastly, we will be laying down all the important topics that are going to cover this 2022, topics that we feel should be talked about more in and out of the medical space. [00:01] Here’s to a Fruitful 2022 For Everyone! My biggest challenge in the previous year Why resilience is key to overcoming the pandemic Take a leap and here’s why Follow your passion

[02:20] The 7 Priorities for the Self This Year How to build safe, nurturing, and stable relationships The 7 things we should prioritize for ourselves Why we should make time for our loved ones When to call a friend

[12:09] What to Look Forward to In 2022 The underrated benefits of sleeping regardless of age group The important topics we will be talking about this year The guests that we will be bringing back this year

[17:54] Closing Segment   Do you have topics in mind that you want me to discuss? Links below Final announcements

Key Quotes: “I hope that there are those of you out there that want to take leadership roles and know that you deserve and belong there. Your voice is important because of what you do. You are an expert in your field. .” - Dr. Lia Gaggino “Don't be afraid to take a leap. Sometimes it works. Sometimes it doesn't. But you have to try and follow your passion..” - Dr. Lia Gaggino

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), http://instagram.com/pediatricmeltdown (Instagram), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@medicalbhs.com or gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being. 

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Trigger warning: depression, suicide Dr. Colleen Cullinan is a pediatric psychologist at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware. She specializes in integrated primary care within the Division of Behavioral Health. Dr. Cullinan completed her PhD in Clinical Psychology at Western Michigan University in 2015. Dr. Cullinan supervises psychology externs and interns, and she directs medical education efforts for Nemours’ residency training programs. Her presentation and publication records center around integrated care, family-based interventions, and experiential cultural humility training.    [00:01] Dr. Colleen Cullinan Shares Her Thoughts About Depression Colleen’s thoughts about the effects of the pandemic on people’s mental health What to do if depression hinders a person to live normal life Why Colleen is veering away from symptom-based approach of depression

[08:15] What Matters Most to Kids Are Their Everyday Experiences What matters most to kids that pediatricians should prioritize Colleen breaks down the different therapies available currently Here’s why problems are not always fixable according to Colleen

[18:32] How to Apply Acceptance and Commitment Therapy Colleen gives us a background about Acceptance and Commitment Therapy She gives us a lesson that we can learn from watching a horror movie What is its connection to approaching depression? She talks about diffusion and why people should know more about it

[28:10] The Power of the Brain in Helping a Child Going Through Depression We talk about Motivational Interviewing The right questions to ask to kids according to Colleen A popular intervention under Acceptance and Commitment Therapy How to train the brain to generate something that helps the kids

[43:31] Challenge the Frame, Not the Content We have an interesting exchange about “creative hopelessness” The role of values in Acceptance and Commitment Therapy A great definition of goals that pediatricians should keep in mind The messages that people receive everyday matter in therapies Challenging the frame, not the content Colleen explains further the Acceptance and Commitment Therapy

[58:43] Why People Should Not Be Serious Always Colleen gives a few take home messages for pediatricians Why people should not take everything so seriously She talks about the transformative impact that pediatrics brought to her

[01:06:14] Closing Segment   Connect with Dr. Colleen Cullinan on Twitter @colleencullinan and @Nemours Final takeaways: Recognizing the “negative” emotions that we feel Effects of impairment to the body Cognitive behavioral therapy Acceptance and Commitment Therapy An important lesson from playing a beach ball Naming the “thing” Avoidance at the heart of suffering  Some crossovers with mindfulness Curiosity and the suffering Why language matters Experiences and language What the patient values Connection and belonging Safe, stable, nurturing relationships Appreciation for Colleen!

Key Quotes: “Avoidance is really at the heart of all mental [suffering] in my opinion.” - Dr. Colleen Cullinan “There's a lot of data that shows that when people are more invested in the conversation, they're more likely to do the thing that you say.” - Dr. Colleen Cullinan Resources Mentioned: Books https://amzn.to/3JYLOmc (The Thriving Adolescent) https://amzn.to/3FciOnn (Stop Avoiding Stuff) https://amzn.to/3nbGoKE (The Mindful Self-Compassion Workbook) Websites http://www.thrivingadolescent.com (Thriving Adolescent) https://contextualscience.org/ (Association for Contextual Behavioral Science) https://www.praxiscet.com/act-training/ (Praxis - ACT Training) Pediatric Meltdown previous episodes https://apple.co/3JQLRjX (Caring for Children in Foster and Kinship Care: Keeping a Trauma-Informed focus with Moira Szilagyi) https://apple.co/3qb7aos (The Art of Conscious Parenting with Dr. Robert

The Thriving Adolescent: Using Acceptance and Commitment Therapy and Positive Psychology to Help Teens Manage Emotions, Achieve Goals, and Build Connection
Stop Avoiding Stuff: 25 Microskills to Face Your Fears and Do It Anyway
The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thrive

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Pediatricians get up every day thinking about how to meet the needs of children. And very often we forget about our own health. In this episode of Pediatric Meltdown, Dr. Lia and Dr. Michelle Fiscus discusses physician burnout, what it means to face identity challenges as a physician, and overcoming these challenges.  Dr. Michelle Fiscus is a board-certified pediatrician who practiced general pediatrics in Franklin, TN for 17 years before joining the Tennessee Department of Health in 2016. She most recently served as medical director of the Tennessee Vaccine-Preventable Diseases and Immunization Program until she was terminated from that position for sharing a memo regarding a 34-year-old case law that allows certain minors to consent for their own medical care. Dr. Fiscus was thrust into the national spotlight after she released a statement shedding light on the choice of those in leadership in Tennessee state government to place their political agendas over the best interest of the people they serve. She has used this platform to support the work of public health and reinforce the importance of vaccines and other public health measures in ending the COVID-19 pandemic. Dr. Fiscus is an associate clinical professor in the Department of Pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt. She is a past president of the Tennessee Chapter of the American Academy of Pediatrics and now serves on the Board of Directors of the American Academy of Pediatrics as District IV Chair.   [00:01] Dr. MIchelle Fiscus Shares Her Story With Us Why she went into pediatrics  Suffering from significant burnout that led her to Public Health Going into the Vaccine-Preventable Diseases and Immunization Program

[11:52] Covid-19, the Vaccine Rollout, and Controversy  Dr. Fiscus’ role in COVID mitigation and responses Tennessee's hesitation in promoting COVID-19 vaccines Controversy and pushback regarding vaccination in Tennessee Dr. Fiscus choosing to acknowledge the expiration of her executive service

[21:06] The Interference of Politics and Public Health The overstepping of political opinion into COVID-19 management  Dr. Fiscus’ exposure to National and International news  How it’s been for Dr. Fiscus and the difficulty and challenges of this exposure The toll on mental health when facing criticism and pushback 

[32:54] Being a Disruptor in Pediatrics What’s next for Dr. Fiscus?   Pediatricians taking the darkest punches and overcoming challenges  If you could go back to when you were in residency what would you tell yourself? 

[42:57] Closing Segment   Connect with Dr. Michelle Fiscus on twitter @drfixus Final takeaways: Pursue your passion  Burn out looks like exhaustion  and unhappiness Being a pediatrician can look like many things  The right thing keeps me going; I can move the needle, I am a problem solver, I will hold others accountable in the face of misinformation

Key Quotes: “If you know that there's something that you would just love, then figure out how to go get it. You have to make yourself a little bit vulnerable to get there. But don't be afraid to pursue the thing that you think is going to make you happiest.” - Dr. Michelle Fiscus “I honestly couldn't stomach the interference of politics in public health. Just the unwillingness to understand that the decisions that are being made affect real lives and are causing real deaths and real suffering, and real orphans and real impact to our healthcare system.” - Dr. Michelle Fiscus

“As you get up every day and think about how to meet the needs of kids, remember to give yourself a moment of grace. “ - Dr. Lia Gaggino 

Connect with Dr. Fiscus on twitter @drfixus

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/...

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Dr. Miko Rose is the creator and Program Director of the “Joy Initiative,” a project she started at the Michigan State University College of Human Medicine and College of Osteopathic Medicine schools. In 2013, she was awarded the SAMHSA American Psychiatric Association Minority Leadership Fellowship Grant, from which she built the foundation to develop emotional resilience, happiness, and mindfulness training tailored to meet the unique needs of medical providers.  She now offers one of the first formal classes on happiness and joy in medical schools in the nation--which she has been teaching as a for-credit class in two medical schools for the past seven years. This curriculum has since expanded to provide training for peak performance for team coaches, trainers and student athletes.   [00:01] Dr. Miko Rose Shares Her Story With Us Miko talks about her journey into the psychiatric field We talk about trauma and how they affect patients

[06:40] What People Don’t Ask About Depression  How at-risk populations inform the approach of the healthcare system Why healthcare providers should let parents lead the discussions What people don’t ask about depression that we should know

[16:58] The Birth of the Joy Initiative  Healthcare providers have struggles of their own too Listen to Miko’s story The happiness and wellbeing programs that Miko started The Joy Initiative and learning about the science of happiness

[28:54] The Power of Mindfulness Meditation What can healthcare providers do with the Joy Initiative? The four tiers that any wellness program should have The different techniques to try to get one’s self to relax We did an exercise that you can do with us right now!

[40:00] Why Mind Vacation is a Must Mindfulness meditation also has a positive effect on the physical body Connect with Miko with the links below! The “mind vacation” that everyone should take everyday

[47:01] Closing Segment   Final takeaways: Mental health conditions and trauma Healthcare providers have their own struggles too The power of empathy The body of research about mindfulness continues to grow Seeking our own healing to be a healer The Joy Initiative and its mission  The four tiers of the Joy Initiative One-minute vacations How to start a mindfulness journey

Key Quotes: “I knew that ultimately nobody needs to be alone just because we're expected to be superheroes.” - Dr. Miko Rose “We don't need something outside of ourselves to be with ourselves.” - Dr. Miko Rose Email mikorose@gmail.com to connect with Miko. Check out https://joyinitiative.com/ (https://joyinitiative.com/) to know more about her work.  Resources Mentioned: https://www.facebook.com/groups/555558531865677 (Joy Initiative-COSGP-SOMA Community)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being. 

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Dr. Alison Schonwald is a Developmental Behavioral Pediatrician and co-founder of Touchstone Neurodevelopmental Center. After her undergraduate education at Yale University and medical school at the University of Pennsylvania, Dr. Schonwald completed pediatric residency and Developmental Behavioral pediatrics fellowship at Boston Children's Hospital, where she served as faculty from 2001-2019.  Dr. Schonwald’s clinical interests include early diagnosis of autism and developmental delays, psychopharmacology for children with a variety of developmental disorders, cultural competence in families of children with developmental disorders, and transition to adult care. She is the author of two books, “Pocket Idiot’s Guide to Potty Training Problems,” and “ADHD in Adolescents: A Comprehensive Guide.” She currently serves on the American Board of Pediatrics Subboard for Developmental Behavioral Pediatrics and the MA Board of Early Education and Care, while maintaining a busy clinical practice and continuing to teach primary care pediatricians.   [00:01] Dr. Alison Schonwald Shares Her Story With Us Alison talks about her pediatric career in the developmental behavior field How to approach a parent who’s thinking their child has ADHD

[07:26] How to Identify Developmental Delays in a Child The importance of knowing the history of the child Alison talks about how she determines potential developmental delays How language can help pediatricians point out potential issues in a child Alison reveals her tips to ask about possible traumatic experiences Parents should bring these pieces of information in the consultation

[17:35] Thoughts About Existing Screening Tests Here’s why pediatricians should not be afraid to diagnose patients How small and rural communities can help kids with ADHD We talk about prescription medicines like stimulants and non-stimulants Alison shares her thoughts about current screenings tests She gives a few recommended resources that can access now

[27:22] The True Role of a Pediatrician in a Child’s Life Alison shares some tips for pediatricians to improve their craft Here’s an inspiring story about a patient who had made a friend When the journey with the child patient really starts according to Alison The true role of the pediatricians in taking care of a child

[37:40] Being a Healthcare Provider is More Than Just Diagnosis The relationship among children, their families, and communities Don’t miss these inspiring message from Alison to her younger self Why you should listen to this TED Talk by Abraham Verghese

[41:38] Closing Segment   Final takeaways: The first step is always listening to the story Assuring families that they get the help they need Developmental trajectories and ADHD What to observe in a child  What to look for in teenagers The possibility of trauma Collateral information is key Teacher feedbacks are important too Being upfront to parents about your diagnosis The role of stimulants in screening tests Other possible factors that affect a child aside from ADHD Available resources for parents and families Diagnosis is not the start of the journey Sorting through the many differential diagnoses

Key Quotes: “The journey starts when you first recognize there is something different about your child.” - Dr. Alison Schonwald “Being a doctor isn't about making a diagnosis and providing a treatment…it's about participating in a process of wellness so that we're actually doing something...” - Alison Schonwald

Email alisonschon69@gmail.com to connect with Alison or follow her on http://twitter.com/AlisonSchon (Twitter). Check out https://www.touchstonema.com/ (https://www.touchstonema.com/) to know more about her work.  WATCH OUT for the announcements about the Mental Health Conference to be organized by the American Academy of Pediatrics! 

Resources Mentioned: Touchstone Neurodevelopmental Center...

Zuckerman Parker Handbook of Developmental and Behavioral Pediatrics for Primary Care
Starving the Anxiety Gremlin: A Cognitive Behavioural Therapy Workbook on Anxiety Management for Young People (Gremlin and Thief CBT Workbooks)
Coping Cat Workbook, Second Edition (Child Therapy Workbooks Series)
The Pocket Idiot's Guide to Potty Training Problems
ADHD in Adolescents: A Comprehensive Guide
My Own Country: A Doctor's Story
Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications

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Dr. Paul Dworkin is the Executive Vice President for Community Child Health at Connecticut Children's Medical Center and professor of pediatrics at the University of Connecticut School of Medicine.   For 15 years, he previously served as physician-in-chief at Connecticut Children’s and chair of Pediatrics at UCONN.  Dr. Dworkin’s interests are at the interface among child development, child health services, and child health policy. Dr. Dworkin’s honors include teaching awards, visiting professorships, and named lectureships.  He was the editor of the Journal of Developmental and Behavioral Pediatrics from 1997-2002 and was a member of the first entering class of the Academy of Distinguished Educators at the UCONN School of Medicine. Dr. Dworkin has served on the boards of numerous community-based organizations and recently completed his tenure as chair of the board of the Urban League of Greater Hartford. [00:01] Dr. Paul Dworkin Shares His Story With Us Paul talks about his journey into the pediatrics space What’s his belief about the science of development and behavior?

[05:19] Biology of Adversity Questions to ponder on about child health services The driving factors that can make or break a pediatrician Paul talks about the “biology of adversity” The basic premises of delivering child health services How to encourage a family-led agenda in a child health context

[15:13] The Decade of the Brain The extremely important red flags to watch out for according to Paul The power of surveillance and screening in detecting problems in the child Assumptions about children that you should hear right now Paul reveals the story behind their pilot study on children’s health What’s the study about?

[26:47] Proactive Approach in Child Health Interventions  All relevant sectors should be consulted in crafting child health interventions Here’s why 2 problems that healthcare providers encounter everyday Why being proactive in checking up on children is a must

[36:23] Reach Out and Read   We have an interesting exchange about the Reach Out and Read program Specific calculations to drive support to healthcare investments Paul gives us a sneak peek on how they replicated the Reach Out and Read strategy How to scale the existing systems and processes we have right now

[48:25] Politics and Healthcare How to make sure that investments in healthcare will generate positive outcomes The case for prioritizing child health services transformation Data is important but should be relevant and appropriate Listen to our exchange Is there a correlation between political colors and child health services?

[01:01:07] Paul’s Advice for Resident Pediatricians Lack of coordination among the supposed coordinators create a bottleneck What kind of bottleneck and how to resolve it? Here’s Paul’s message for healthcare providers today Don’t miss his advice for his resident self!

[01:12:05] Closing Segment   Final takeaways: Actionable steps for child health reform Big ideas to consider such as child health promotion instead of prevention Decade of Brain Impacts of poverty and racism to children Problems that providers encounter daily Cross-sectoral efforts are the ways to go “Help Me Grow,” a bold strategy that has been implemented for children 4 steps of the “Help Me Grow” model Reach Out and Read Program Should we expect a return on investment in our healthcare projects? Stop paying attention to the wrong metrics Anticipatory guidelines and support Big changes feel overwhelming...at first

Key Quotes: “I always say that the science of development and behavior were key to enhancing the impact of child health services and particularly for general pediatrics.” - Dr. Paul H. Dworkin “I think I would have encouraged myself, in addition to pursuing some fellowship training, to also think about expanding my knowledge in other related areas.” - Dr. Paul H....

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Trigger warning: suicide, gun violence Dr. Zakia Alavi is a Diplomat of American Board of Psychiatry and Neurology in general psychiatry and child & adolescent psychiatry. Dr. Alavi is an Associate Professor in the Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University. For the Department of Pediatrics, Dr. Alavi is involved with developing and training pediatric residents and general pediatricians about children’s mental health through a State of Michigan and HRSA funded grant.  Currently, Dr. Alavi provides psychiatric services to children through the Community Mental Health clinic in Jackson Michigan. Dr. Alavi is the chief medical officer for Midstate Health Network, and NorthCare Network which are  Medicaid Managed Behavior health Plans for  21 counties in lower Michigan and Michigan’s Upper Peninsula, respectively.   [00:01] Dr. Zakia Alavi and I Talk about the Recent School Shootings  Why school shootings are still happening How we should protect our kids from gun-related violence

[06:32] How to Discuss School Shootings With Kids When to bring up discussions about gun violence Looking at school shootings as awful tragedies Who should also be considered as victims? The appropriate things to say to early elementary children Why adults should regulate their own emotions What to say to children aged 9-10 years old The topics that should be included in dinner conversations

[17:23] Resolving Gun Violence in Schools Strategies from Zakia to discuss firearms as a public health hazard The age group that is the easiest and most difficult to support according to Zakia Gun violence is a public health problem and should not be a debate The unique opportunity for healthcare providers to resolve gun violence Warning signs to watch out for in relation to homicide risk The dangers of the language that we use

[30:06] Take a Deep Breath Then Take Action The right questions to ask to parents or families  The resources that families can access right now Zakia’s message for patients and pediatricians alike

[38:33] Closing Segment   Final takeaways: Appreciation to Zakia for raising awareness about gun violence in this episode We are still prioritizing guns over children Our job as adults in protecting children The right words to say to kids and families What to consider in talking with the youngest children What to say to elementary school kids The easiest and hardest age group to work with How to talk to parents about guns in the household Don’t glorify guns How guns are stored at homes Talk about intense emotions and the use of words and threats. When should a parent worry about their child being either a risk to themselves or to others? Talking with families about gun violence is inevitable Why reach out to child psychiatrists The time for change is NOW

Key Quotes: “If your child is asking questions, then you've done a great job creating a safe holding environment at home.” - Dr. Zakia Alavi “Take a deep breath and talk to each other, talk to your families. Give families, your children a big hug.” - Dr. Zakia Alavi Email alavizak@msu.edu to connect with Zakia or check out https://raind.msu.edu/ (https://raind.msu.edu/) to learn more about her work.

Resources Mentioned: https://www.healthychildren.org/English/safety-prevention/at-home/Pages/Handguns-in-the-Home.aspx (Guns in the Home) https://www.nncpap.org/map (Child Psychiatry Access Programs in the United States ) National Childhood Traumatic Stress Network https://www.nctsn.org/resources/for-teens-coping-after-mass-violence (For Teens: Coping After Mass Violence) https://www.nctsn.org/resources/wildfires-tips-parents-media-coverage (Tips for Parents on Media Coverage) https://www.nctsn.org/resources/parent-guidelines-helping-youth-after-recent-shooting (Parent Guidelines for Helping Youth after the Recent Shooting)...

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Dr. Whitney Casares is a private practice pediatrician, American Academy of Pediatrics author, and a mom to 2 young girls in Portland, Oregon.  She says that her kids are her best teachers, but that she also went to school for forever. After completing her undergraduate degree in journalism, she completed her medical school training at the University of Vermont and pediatric residency training at Stanford University. She also holds a Masters of Public Health in Maternal and Child Health from the University of California, Berkeley.  Whitney said that after her daughters were born, she got lost in their needs and let hers fall to the wayside. When she went back to work postpartum, life got even more complicated as she layered on more responsibilities and added more to-dos. She had to dive deep to redefine what it means to be a successful mom.  By flipping the switch and investing in her own social and emotional health, she stopped just surviving motherhood and started thriving.   [00:01] Dr. Whitney Casares Shares Her Story With Us Whitney talks about her story as a privately practicing pediatrician Here’s why she started blogging and podcasting

[07:11] Achieving Work-Life Balance Whitney gives us a sneak peek into the life of a pediatrician mom The pressure of being a working mom--regardless if you’re a patient or not If pediatricians are always stressed, this is what will happen Is work-life balance really possible?

[17:48] Dealing with Trauma and Stress Here are some practical tips from Whitney to de-stress How to deal with trauma as a pediatrician? What listeners can learn from Whitney’s podcast The priorities that working pediatrician moms should always have Whitney’s life framework

[31:45] The Special Part of Working in the Pediatric Sector Holiday hacks from Whitney that you should not miss! Whitney has a message for her resident self  The special part of being a pediatrician according to Whitney

[39:27] Closing Segment   Final takeaways: The reality of being a working mom The harder we work, the less we have to give What people should realize about work-life balance You just can't be present if you don't feel good Practical steps for working moms to improve their lives Resources you can access in Whitney’s website Whitney’s life framework that you can follow too 2 holiday hacks you can try Why pediatricians should take care of themselves Things to reflect upon this holiday season

Key Quotes: “We can control how we show up for our own lives.” - Dr. Whitney Casares “You are enough.” - Dr. Whitney Casares Email info@modernmommydoc.com to connect with Whitney. Check out https://modernmommydoc.com (Modern Mommy Doc) or her http://fb.com/modernmommydoc (Facebook), http://twitter.com/modernmommydoc (Twitter), and https://www.instagram.com/modernmommydoc/ (Instagram) pages to know more about her work.  Listen to https://modernmommydoc.com/podcast (The Modern Mommy Doc Podcast) to learn tips and strategies to be successful as a working mom!  Resources Mentioned: Book: https://www.amazon.com/Working-Mom-Blueprint-Parenting-Yourself/dp/1610024869/ref=sr_1_1?keywords=The+Working+Mom+Blueprint%3A+Winning+at+Parenting+Without+Losing+Yourself%21&qid=1637771130&sr=8-1 (The Working Mom Blueprint) Podcast: https://gretchenrubin.com/podcasts (Happier with Gretchen Rubin)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Working Mom Blueprint: Winning at Parenting Without Losing Yourself

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Wendy is a writer, poet, and educator, is a former university vice president, professor, policy advisor, and attorney. She is also the founder and curator of the tiny poetry project – narrative medicine for the soul. She uses narrative medicine and medical humanities as a way of healing, understanding, teaching, and connecting to others regarding issues of illness and health.  In this episode, she shares her experience and the lessons that she learned when they found out her baby had a life-threatening congenital heart condition. A few lessons she talked about today include why pediatricians should introduce themselves properly, how immortality can be a normal topic between parents, and what patients should feel when they’re in the hospital.  [00:01] Wendy Hind, Ph.D. Hind Shares Her Story With Us Wendy talks about how they found an irregularity in her baby How she and her husband came up with the decision to keep their baby 

[05:52] It’s Okay If You Don’t Know All The Answers  What being in a healthy marriage can do to a family  Wendy shares her experience of having to go to hospitals often Wendy’s message for pediatricians who don’t know all the answers 

[15:15] What Patients Need to Feel in a Hospital Setting  The importance of mentors in a pediatrician’s life  Why patients need to feel they are heard The things that frustrate parents in a hospital setting 

[20:12] The Power of a Simple Introduction  The pediatrician as the ringleader and conductor  Wendy explains  Why pediatricians should introduce themselves properly to patients Talking about mortality between parents 

[30:00] What You Should Know About Narrative Medicine  Wendy breaks down narrative medicine and why you should learn it too The power of hearing another person’s story and humanity  Don’t miss this poem reading from Wendy!  Read more from her in the links below

[40:51] Closing Segment   Final takeaways: Always keep humanity and basic kindness in mind  It’s okay for pediatricians to not know everything  The power of listening  Pediatricians should introduce themselves properly Read the chart before you see the patient Parents and patients know more about their own situation than you do Parents and patients worry about outcomes and mortality Deliver the important news yourself  Talk to the other specialists involved Narrative Medicine allows patients and parents to tell their stories A powerful poem from Wendy you need to read now  Find out more about Wendy’s work on the links below 

Key Quotes: “Never underestimate the power of a simple introduction and who you are and why you’ve come in the room.” - Wendy Hind, Ph.D. “Poetry has been my mode of telling my story.” - Wendy Hind, Ph.D. Email w_hind@hotmail.com or tinypoetryproject@gmail.com to connect with Wendy. Check out https://www.tinypoetryproject.com/ (Tiny Poetry Project) or its http://fb.com/tinypoetryproject/ (Facebook), https://twitter.com/tinypoetryproj1 (Twitter), and https://www.instagram.com/tinypoetryproject/ (Instagram) pages to know more about her work.  Resources Mentioned: https://brenebrown.com/podcast/introducing-unlocking-us/#close-popup (Introducing: Unlocking Us): Brené Brown’s podcast https://www.oprah.com/ (Oprah) Book https://amzn.to/3CvqLnl (What Happened to You?) https://amzn.to/3lESlbW (Cutting for Stone) https://amzn.to/3AjA5Jh (My Own Country)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share...

What Happened to You?: Conversations on Trauma, Resilience, and Healing
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Cutting for Stone: A novel

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Emilee Young, RDN, LD is a Registered Dietitian dedicated to helping those in recovery. She has worked in both an intensive outpatient and a partial hospitalization setting where she has been able to support clients in recovery.  Emilee practices based on the philosophy that “all foods fit” and wants to help clients create a sustainable and joyful experience with food and movement. She specializes in binge eating disorder recovery and enjoys working with clients to establish peace with food. Emilee is a fat-positive and anti-diet dietitian working from a Health At Every Size © and Intuitive Eating model. [00:01] Emilee Young Shares Her Story With Us I introduce and welcome Emilee Young, RDN, LD Emilee tells us the story on why she’s focused on eating disorders

[05:15] Weight is Not Health What dieticians would advise to pediatricians Listen to Emilee’s advice! Here’s the truth about body mass index that you should know Weight is not health Emilee mentions some factors to consider when defining health She breaks down her specialization in terms of food movement in the body

[15:44] Division of Responsibility Emilee talks about “division of responsibility” in a nutshell What is food bargaining and why is it not advisable? No one is immune to the diet culture Here’s what to do with it

[25:44] When to Refer a Patient About Eating Disorders Our patients are the experts of their own body Healthcare providers should always listen When pediatricians should refer patients to other healthcare providers Why patients should be allowed to eat their preferred food How often should this be allowed? How to deal with patients with food restrictions

[35:33] How to Build Safe Spaces for Kids Having a team of experts is a good support system for the child Pediatricians should choose their words very carefully Kids are sponges What pediatricians should understand about safe spaces Healthcare providers should pay attention to these points of reflection GIving autonomy to patients Reflecting about patient-centered care

[42:37] Closing Segment   Final takeaways: When pediatricians should refer their patients for eating disorders Attitudes about weight, diet, culture and fat shaming among pediatricians The right way to talk about the growth trajectory of a child “Health at every size” and intuitive eating A child’s food preferences change over time Body mass index may be flawed Factors to consider when looking into a child’s health Division of responsibility for parents Setting up rewards food is not advisable Listen to the patient and validate their feelings Interventions for patients with anorexia The antidote to diet culture Choosing our words wisely 

Key Quotes: “I think a part of that division of responsibility is making sure that your child has its preferred foods.” - Emilee Young, RDN, LD “I think one of the biggest things that I've learned as a dietitian is being a good listener.” - Emilee Young, RDN, LD Email emilee@couragetonourish.com to reach out to Emilee or follow her on http://instagram.com/nutrition_em (Instagram). Check out https://couragetonourish.com/ (Courage to Nourish) to know more about her work. Resources Mentioned: Pediatric Meltdown previous episodes Ep. 62: https://apple.co/3na3MZn (Eating Disorders: Recovery Coaches Strengthen the Healing Team) Ep. 61: https://podcasts.apple.com/us/podcast/eating-disorders-prevention-in-primary-care/id1529656785?i=1000540607780 (Eating Disorders: Prevention in Primary Care) Ep. 1: https://apple.co/3kvFxmU (Words Matter- Talking about Weight and BMI) Books https://amzn.to/3o9BY8o (Health At Every Size) https://amzn.to/39E4EOE (Intuitive Eating) https://www.ellynsatterinstitute.org/product/feeding-with-love-good-sense-6-13-years/ (Feeding with Love and Good Sense series By Ellyn Satter)

If you’d like to connect with me, you can find me on...

Intuitive Eating: A Revolutionary Anti-Diet Approach
Health at Every Size: The Surprising Truth About Your Weight

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Jayne Mattingly is a masters-level eating disorder recovery coach and the owner and Chief Executive Officer of the Global Virtual Coaching Group Practice, Recovery Love and Care. Jayne identifies as fully recovered from a lifelong eating disorder and also lives with a chronic illness and is disabled, which has inspired her to help others within their own healing journeys.  Jayne’s coaching style is a collaborative approach where she perseveres with and advocates for each and every one of her client’s. She has a passion for helping those within their recovery, especially when it comes to body image conception, chronic illness, living with disability and body betrayal and helping others find self-compassion and body kindness.  Jayne’s overall mission is to help those within their eating disorder recovery find success within the hostile recovery environment in which we live!  [00:01] Jayne Mattingly Shares Her Story With Us I introduce and welcome Jayne Mattingly Why she pursued a career as an eating disorder specialist

[05:32] Eating Disorder Recovery Coaching What do Jayne’s clients look like? Not all of them have anorexia How can eating disorders specialists work with physicians? Jayne shares her experience Eating disorders should be resolved with as much support as possible She tells us how

[15:47] Misconceptions About Recovery Coaches Children might misinterpret eating disorders  Here’s how to avoid misinterpretation Jayne gives us a sneak peek at their body of knowledge What recovery coaches are not according to Jayne

[25:16] Health At Every Size What to know about intuitive eating and “health at every size” The relation of weight and trauma according to Jayne The connection between recovery and weight that you don’t want to miss

[35:25] The Reality About Diet Culture Listen to our interesting exchange about diet culture Don’t miss Jayne’s message to healthcare professionals How to break our preconceived notions about body sizes

[45:02] Closing Segment   Final takeaways: Common misconceptions about eating disorders Team-based care for individuals offers a safety net A health coach provides support with goal setting, not diagnosis Reframing weight in the context of the 8 pillars of health Health At Every Size: What does this mean? Connection of trauma and weight The effects of cognitive trauma Our words matter when we're talking about the children's BMI, and using language like obese How to not succumb to diet culture

Key Quotes: “With eating disorders, you could not have too much support.” - Jayne Mattingly “Listen to your patients and your clients because there's usually so much more going on than just the weight piece.” - Jayne Mattingly

Email recoveryloveandcare@gmail.com to reach out to Jayne or follow her on http://instagram.com/recoveryloveandcare (Instagram). Check out https://recoveryloveandcare.com/ (Recovery Love and Care) to know more about her work.

Resources Mentioned: Book https://amzn.to/3o9BY8o (Health At Every Size) https://amzn.to/39E4EOE (Intuitive Eating) https://amzn.to/3CJz3r6 (8 Keys to Recovery from an Eating Disorder) https://amzn.to/2Y4dO4x (The Body Keeps the Score)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Intuitive Eating: A Revolutionary Anti-Diet Approach
Health at Every Size: The Surprising Truth About Your Weight
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
8 Keys to Recovery from an Eating Disorder: Effective Strategies from Therapeutic Practice and Personal Experience (8 Keys to Mental Health)

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Dr. Michaela Voss graduated medical school from University of Kansas Medical Center – Kansas City, KS, in 2010. She completed her pediatric internship and residency in 2013 at Children’s Hospital of Wisconsin – Milwaukee, WI. Afterwards, she pursued advanced training in the field of adolescent medicine, graduating from fellowship in 2016 at Seattle Children’s Hospital – Seattle, WA.  During this time, Dr. Voss was a Leadership and Education in Adolescent Health (LEAH) Fellow and participated in research under a T32 grant. Currently, Dr. Voss is Medical Director of The Eating Disorder Center at Children’s Mercy – Kansas City, MO. In addition to her clinical and administration duties, she enjoys educating medical professionals and the general community about adolescent health and eating disorders. She participates in multiple research and quality improvement projects to expand evidence based medical knowledge of eating disorders.    [00:01] Dr. Michaela Voss Shares Her Story With Us I introduce and welcome Dr. Michaela Voss  Michaela shares why focuses on eating disorders

[04:45] Terms About Eating Disorders Here are the terms that we need to be familiar with according to Michaela anorexia nervosa Bulimia nervosa Binge eating disorders Avoidant/restrictive food intake disorder Orthorexia nervosa Atypical anorexia nervosa Being healthy “to the extreme” is also not healthy Anorexia does not discriminate

[09:44] How to Prevent Eating Disorders  The role of the primary care pediatrician in preventing eating disorders Here are a few resources that pediatricians can access now Michaela shares some interesting insights about Body Mass Index Health should be prioritized over weight

[19:15] Health at Every Size Michaela talks about the concept of “health at every size” (HAES) Children know how to eat intuitively Michaela explains What pediatricians should tell kids and adolescents about their bodies Here’s an analogy about dogs that you should hear right now

[29:39] Plating at an Early Age What if we never weigh a child? Listen to our exchange here Guidelines and checklists that pediatricians can use  Why kids should start plating their food at 3-4 years old The things that primary care pediatricians should unlearn

[39:17] Eating Disorders and Mental Health The reason primary care providers should advocate for more research The right words to say and when to say them Connections between eating disorders and mental health Focusing on things that the patient can control themselves

[49:05] Learning From Other Disciplines Listen to Michaela’s message for her resident self The additional experience that might save a life Resources about HAES that you can access now

[52:59] Closing Segment   Final takeaways: Categories of eating disorders Primary care providers and their role in preventing eating disorders The importance of awareness about eating disorders among primary care providers Rethinking body mass index Weight guidelines that providers can use Genetics and growth trends  Health parameters to considers, not just weight The dangers of focusing on weight only The concept of “health at every size” Advice we can share to families and patients Resources that can be useful to providers

Key Quotes: “Even healthiness in the extreme is not healthy. Moderation is important.” - Dr. Michaela Voss  “You can't make a change if you don't know that change needs to be made.” - Dr. Michaela Voss 

Email mvoss@cmh.edu to reach out to Michaela or check out https://www.childrensmercy.org/ (https://www.childrensmercy.org/) to know more about her work.

Resources Mentioned: AAP Policy Statement: https://pediatrics.aappublications.org/content/147/1/e2020040279 (Identification and Management of Eating Disorders in Children and Adolescents) https://www.nationaleatingdisorders.org/ (National Eating Disorders...

Sick Enough
Eating Disorders: A Guide to Medical Care and Complications

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Our guests for today are brothers, Brandt and Evan Ingber. Brandt is a 23-year-old who works full-time and lives with his brother. Brandt enjoys Pokemon Go, Anime, lightsaber dueling and volunteering with Special Olympics fundraisers and at animal shelters. Meanwhile, Evan is a 25-year old who also works full-time and enjoys outdoor activities, boating, fishing, camping, yardwork, working with his hands and lightsaber dueling. Evan also volunteers in his spare time as a snowboard coach and at fundraisers for Special Olympics.   ACTIVITY CODE 91839 CME INSTRUCTIONS: Completion of these steps are required to earn CME credit.  TO OBTAIN CME CREDIT: SELF-ATTEST WITHIN 4 WEEKS. GO TO: https://cmetracker.net/MSU/Publisher?page=pubOpen#/EventID/91837/ (case sensitive)  Click on the Sign In option on the left menu.  You will be required to create a profile if you have not used the system before.  Enter the activity code provided on this sheet.  Complete the online evaluation, attest to your time in attendance, and follow the screen instructions to print your certificate. Make sure your computer is set to allow pop-ups from the site or the certificate will not show.

If you have any issues obtaining your certificate, please contact the CME Office at spring18@msu.edu or by calling 517-884-8871   CME Activity Information Sheet can be found https://drive.google.com/file/d/1MujSb2KW2kWGg4age1OtwX-VY_HSgBEW/view?usp=sharing (here).   [00:01] Brandt and Evan Ingber Share Their Story Welcome to the first CME series in Pediatric Meltdown! What to expect in the 3rd episode of this series How to get credits for CME I introduce and welcome our guests, Brandt and Evan Ingber

[04:23] The Importance of Trust Brandt talks about how he learned he has autism Conversations are hard for people like Brandt He tells us why Parents should be supportive of their children Brandt shares his experience with his mother Brandt tells a story on how trust can be a big issue Brandt’s message for doctors about people with autism Is it hard to be in a romantic relationship?

[14:41] Going Through Depression Brandt talks about his experience in reading emotions What’s next for Brandt?  Evan shares his interesting thoughts about autism Evan tells us the importance of practicing social skills among people with autism He tells the story on how he got involved in social activities Evan shares his experience with depression When did he ask for help?

[25:04] The Right Kind of Care for People with Autism Evan shares his experience getting help with his depression How can doctors improve the way they help people with autism Here’s Evan’s message for doctors that you don’t want to miss The story behind Evan’s tattoos What healthcare providers should realize about Autism Spectrum Disorders How autism affects a person

[35:15] The Power of Sharing Your Story What’s next for Evan? Evan puts into perspective his life as a person with autism His bravery for sharing his story with someone How to earn CME credits

[40:52] Closing Segment   Final takeaways: Doctors should realize autism is a spectrum disorder Don’t break promises The understanding of Brandt and Evan about autism Communication is hard for people with autism What’s connected with autism and what’s not Goal-setting among people with autism The importance of social skills and participating in social activities How Brandt and Evan enjoy their daily jobs Mental health struggles of people with autism How doctors can improve their way of handling people with autism Not letting autism get in the way to live your life Expressing gratitude as a healthcare provider for being part of their journey

Key Quotes: “Do or do not. If you keep saying that you try, it means that you don’t actually believe in yourself.” - Brandt Ingber “If I didn't go through what I did, I wouldn't be who I am today.” -...

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Dr. Joshua Prudent is a 3rd year pediatric resident at Nationwide Children's Hospital in Columbus, Ohio, and the District Resident Representative to the American Academy of Pediatrics for District 5 (Ohio, Michigan, Indiana, Ontario). He did medical school at the Johns Hopkins School of Medicine in Maryland, and initially came from the San Francisco Bay Area of California. Following residency, Josh plans to spend some time working in an urgent care setting before pursuing fellowship in pediatric hematology/oncology. His advocacy interests include immigrant/refugee rights, vaccine advocacy, youth mental/behavioral health, childhood injury prevention and secure pediatric research funding.   [00:01] Dr. Joshua Prudent Shares His Story With Us Welcome to the bonus episode of Pediatric Meltdown! Here’s why this episode is special I introduce and welcome Dr. Joshua Prudent

[02:09] Advocacy on Safe Storage of Firearms  Joshua gives us a sneak peek about the Trainees for Child Injury Prevention (T4CIP) He talks about their advocacy on #saferstorage of firearms Is there a 100% safe option? How to give advice people who own firearms Joshua shares the mission of the Day of Action on safer storage of firearms

[12:51] Participating in the Day of Action How to participate in the Day of Action through our social media accounts The kinds of images that we can use for the Day of Action Attend T4CIP’s webinar on speaking up for child health What people should realize about firearm injuries on children The difference between young children and old children

[22:55] Closing Segment   Final takeaways: 4.6 million children live in a home with a firearm, and every two hours and 48 minutes a child dies as a result of a firearm injury.  The conversations are hard and the emotions run high. But we must be able to talk about keeping kids safe. While the safest home for a child is one without a gun, safer storage is the next best thing. Removing a firearm from the home needs to be a heart to heart conversation

Key Quotes: “One of the big goals of this year's campaign is to try to get more families, more community organizations involved in the Day of Action.” - Dr. Joshua Prudent “Firearm safety has always been a big topic of interest for advocates, especially in the realm of childhood injury.” - Dr. Joshua Prudent Email johua.prudent@nationwidechildrens.org to reach out to Joshua or check out https://www.nationwidechildrens.org/ (https://www.nationwidechildrens.org/) to know more about his work. REGISTER to this webinar by the T4CIP on Wednesday, Oct. 27, 2021 at 12-1 p.m. ET: https://bit.ly/T4CIPwebinar (Why Ask?: Speaking Up for Child Health) USE the hashtag  #SaferStorage to continue the conversation on Twitter at 2-3pm EST. SHARE your thoughts and messages all day in all your social media platforms #SaferStorage Join the conversation on Twitter @CIRPatNCH

Resources Mentioned: https://www.nationwidechildrens.org/research/areas-of-research/center-for-injury-research-and-policy/education-and-training/t4cip (Trainees for Child Injury Prevention) https://www.nationwidechildrens.org/research/areas-of-research/center-for-injury-research-and-policy (Center for Injury Research and Policy)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Dr. Stephanie M. Peterson is an Associate Dean of the College of Arts and Sciences at Western Michigan University (WMU). She earned her doctorate in Special Education at The University of Iowa in 1994. She served two 3-year terms on the Board of Directors for the Behavior Analyst Certification Board and was appointed by the Governor of Michigan to the Michigan Board of Behavior Analysts, Michigan’s licensing board for behavior analysts. She served as Board President for 2 years.   Dr. Sheryl Rosin is a speech-language pathologist, professor, and certified autism specialist with 25 years of experience in the field. She has presented around the world and has been published in research journals on best practices in assessment and intervention for individuals with ASD. She is the owner and director of Palm Beach Speech-Language Specialists in south Florida and the Founder and Consulting Director of The St. Kitts Spectrum Services Centre in St. Kitts, the first autism clinic in the Caribbean. Dr. Rick Solomon is a developmental and behavioral pediatrician with over 25 years’ experience diagnosing and providing intervention for children with ASD.  Dr. Solomon is a nationally recognized expert in the field of autism science and intervention. He is in private practice at The Ann Arbor Center for Developmental and Behavioral Pediatrics in Ann Arbor Michigan and is the founder of The PLAY Project, an evidence-based, parent-implemented autism intensive early intervention model that uses a developmental, relationship based, and playful approach.   Kirsten Brown is a licensed Occupational therapist with over 25 years’ experience working with children and families.  She is the owner of First Achievements, PLLC in Hebron Kentucky and provides home-based early intervention and office-based OT services. She has presented workshops for early intervention providers, therapists, and parents on the topic of addressing the social-emotional, sensory, and behavior challenges in early intervention.  Kirsten co-authored the PLAY Project Tele-PLAY manual with Dr. Rick Solomon.  ACTIVITY CODE 91838   CME INSTRUCTIONS: Completion of these steps are required to earn CME credit.  TO OBTAIN CME CREDIT: SELF-ATTEST WITHIN 4 WEEKS. GO TO: https://cmetracker.net/MSU/Publisher?page=pubOpen#/EventID/91837/ (https://cmetracker.net/MSU/Publisher?page=pubOpen#/EventID/91837/) (case sensitive) 1. Click on the Sign In option on the left menu  2. Enter your email and password to log into the system. You will be required to create a profile if you have not used the system before.  3. Enter the activity code provided on this sheet.  4. Complete the online evaluation, attest to your time in attendance, and follow the screen instructions to print your certificate. Make sure your computer is set to allow pop-ups from the site or the certificate will not show.  If you have any issues obtaining your certificate, please contact the CME Office at spring18@msu.edu or by calling 517-884-8871.   CME Activity Information Sheet can be found https://drive.google.com/file/d/1iydYxAsUXi_GOH25TWLNbWCi6oTtfQqZ/view (here).   [00:01] Early Intervention and Referrals Welcome to the first CME series in Pediatric Meltdown! What to expect in this series I introduce and welcome our guests

[06:48] Raising The Question of Autism Sheryl talks about her experience diagnosing autism She shares her day-to-day The possible red flags of autism according to Sheryl  Rick tells us the right way to raise a possible issue of autism What are some screening questions that pediatricians can ask? The importance of transparency and why silence doesn’t help

[18:21] The Right Time for Early Intervention Programs Kirsten shares her experience diagnosing autism as an occupational therapist When to refer the child to early intervention programs Stephanie breaks down Applied Behavior Analysis...

Uniquely Human: A Different Way of Seeing Autism

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Dr. Susan Hyman is a Board Certified Developmental Behavioral Pediatrician. She is chief of the division of Developmental Behavioral Pediatrics at the University of Rochester, which includes outpatient specialty services dedicated to diagnosis and ongoing medical consultation and behavioral care for children and youth with autism and other developmental disabilities for a large region of Central and Western NY.  The division provides inter-professional education for pediatric, nursing and other trainees and has a service that engages in community consultation.  She is the Co-Principal Investigator of the Rochester Site of the Autism Cares Network sponsored by Autism Speaks. Her research interests include medical care and behavioral interventions for children and youth with autism spectrum disorders, diet and nutrition in children with autism, among other areas.  She has been very active in the American Academy of Pediatrics with a focus on supporting the primary care pediatrician in the identification and care of youth with autism and other developmental disorders in the medical home. Dr. Hyman served 14 years as chair of the Autism Subcommittee and 6 years on the Executive Committee of the Council on Children with Disabilities.  To further these goals, she and her team have been actively involved in ECHO Autism for practices in the Central and Western NY region.   CME INSTRUCTIONS: Completion of these steps are required to earn CME credit.  TO OBTAIN CME CREDIT: SELF-ATTEST WITHIN 4 WEEKS. GO TO: https://cmetracker.net/MSU/Publisher?page=pubOpen#/EventID/91837/ (https://cmetracker.net/MSU/Publisher?page=pubOpen#/EventID/91837/) (case sensitive) 1. Click on the Sign In option on the left menu  2. Enter your email and password to log into the system. You will be required to create a profile if you have not used the system before.  3. Enter the activity code provided on this sheet.  4. Complete the online evaluation, attest to your time in attendance, and follow the screen instructions to print your certificate. Make sure your computer is set to allow pop-ups from the site or the certificate will not show.  If you have any issues obtaining your certificate, please contact the CME Office at spring18@msu.edu or by calling 517-884-8871 CME Activity Information Sheet can be found https://drive.google.com/file/d/1MUWMiu9FJgTPZ12ZtjxBqTkRMytJ06TJ/view?usp=sharing (here). [00:01] Dr. Susan Hyman Shares Her Story With Us Welcome to the first CME series in Pediatric Meltdown! What to expect in this series I introduce and welcome Dr. Susan Hyman Susan shares why she pursue a career as a pediatrician

[07:12] The Clinical Report on Autism Susan gives emphasis about the need of patients to receive holistic care She raises some questions that pediatricians have to address for children with autism  We exchange ideas about this big myth about people with autism The overall goal of their Clinical Report on Autism according to Susan Physicians should convey to patients they have enough time We discuss the first part of the Clinical Report The privilege of being a primary care provider The screening measures recommended 

[20:13] Why Early Interventions Are Important Susan discusses the importance of early interventions Is there a difference between children who received early interventions and those who didn’t? Susan shares an interesting information The recommendations of Bright Futures We talk about the 64-trillion-dollar question What is it and what can be the answer? The critical screening tools for pediatricians according to Susan Susan talks about the ethics of screening you should not miss! The age groups that are high-risk to Autism Spectrum Disorders

[33:43] The Major Cause of Death Among Children With Autism A frustration of pediatricians about insurance companies that should be addressed How pediatricians can avoid cognitive...

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Dr. Sarah Stelzner is an academic pediatrician and the focus of her career has been developing programs in Community Pediatrics and promoting team-based care in the medical home model.   She is currently the lead faculty in the Our Kids Our Community Advanced Training which was established in 2017 to improve health outcomes of children and youth served by Eskenazi Medical Group (EMG) and now other Pediatric Urban Teaching Clinicians through partnership with their medical groups.   Dr. Stelzner is the Physician Lead for the Addressing Social Health and Early Childhood Wellness (ASHEW) program for the Indiana Chapter of the American Academy of Pediatrics.  She cares for patients and families and teaches medical students and residents in the International Marketplace neighborhood in a Federally Qualified Health Center (Eskenazi W. 38th st).   Finally, she served as co-president of the Indiana Chapter of the American Academy of Pediatrics and is currently INAAP Legislative Chairperson.   [00:01] Dr. Sarah Stelzner Shares Her Story With Us I introduce and welcome Dr. Sarah Stelzner The mentors who’ve helped Sarah in her career

[05:03] Early Childhood Wellness Sarah talks about the project, “Addressing Social Health and Early Childhood Wellness” (ASHEW) Mitigating the harmful impacts of toxic stress and nurturing human relationships How promising is the ASHEW Initiative and what is its potential to contribute in relational health?

[16:38] Survey of Well-being of Young Children What you should know about the Survey of Well-being of Young Children (SWYC) The features of SWYC that families and patients need to know Does SWYC have any limitations? What to do when positive screens appear Sarah talks about the Help Me Grow National Center

[26:44] Mobilizing Family Leaders  What families should know about Aunt Bertha How we can integrate community health worker models in our approach The power of mobilizing family leaders Sarah gives us a few tips to improve the language we used with patients

[36:14] Building Relationships and Identifying Strengths of Family and Community How pediatricians can join these advocacy groups Don’t miss Sarah’s message for her resident self Pediatricians need healing too Sarah explains There have been promising improvements in the relational health space Listen to our exchange

[42:27] Closing Segment   Final takeaways: Relational health as a strengths-based model Sarah’s body of work and its connection with the 2021 AAP Policy Statement on Relational Health Learning collaborative models Engaging family at the beginning of a treatment Screening tools available right now How to sustain our work Explore resources in your state The EBCD resources Mobilizing family and community leaders Closed loop referrals How to ensure that the support provided is what the patient wants The ASHEW Initiative Keep looking or finding and rejoicing in the magic moments that we have with children and families

Key Quotes: “...if we can help kids have those positive childhood events, it mitigates what they might be experiencing in terms of social drivers that have negative impacts.” - Dr. Sarah Stelzner “Step back from trying to fix things and focus on building relationships and understanding the family and community strengths.” - Dr. Sarah Stelzner Email sstelzner@iu.edu to reach out to Sarah or check out https://www.iu.edu/index.html (https://www.iu.edu/index.html) to know more about her work. Resources Mentioned:  Addressing Social Health and Early Childhood Wellness (https://www.wiaap.org/ashew/ (ASHEW)) AAP Policy Statements https://bit.ly/3i5fT7l (Preventing Childhood Toxic Stress) https://pediatrics.aappublications.org/content/148/2/e2021052579 (Trauma-Informed Care in Child Health Systems) https://medicalhomeinfo.aap.org/about/Documents/EBCD_Well_Child_Grid.pdf (The First 1,000 Days: Bright Futures...

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Andrew Garner, MD, PhD, FAAP, is a Clinical Professor of Pediatrics at Case Western Reserve University (CWRU) School of Medicine and a Primary Care Pediatrician with University Hospitals Medical Practices in Cleveland, Ohio. Dr. Garner is a product of the Medical Scientist Training (MD, PhD) Program at CWRU and the Pediatric Residency Training Program at the Children’s Hospital of Philadelphia.  Dr. Garner is the co-author of the American Academy of Pediatrics’ (AAP) original (2012) and recently revised (2021) Policy Statements on Childhood Toxic Stress. He has also co-authored an AAP-published book entitled “Thinking Developmentally.” Dr. Garner is a past-president of the Ohio Chapter of the AAP, and he has served on several AAP Leadership Workgroups, including Early Brain and Child Development, Epigenetics, and Poverty.  Dr. Garner is passionate about promoting the safe, stable and nurturing relationships that buffer toxic stress and build the rudiments of resilience [00:01] Dr. Andrew Garner Shares His Story With Us I introduce and welcome Dr. Andrew Garner Why pursue pediatrics?  Andy shares his reasons

[06:00] Safe, Stable, and Nurturing Relationships Andy talks about the effects of adverse experiences to children He shares some interesting insights about biological changes due to toxic stress Adversity is not destiny and here’s why The role of relational health in resolving toxic stress and adverse children experiences Why relationships should only be built, but nurtured as well Andy explains

[17:40] Public Health Approach and Positive Experiences Is there a connection between adversity and positive experiences? The role of pediatricians in promoting positive experiences among children  How to apply public health approach in addressing adverse experiences Don’t miss our exchange about the “universal prevention” How pediatricians think in a multi-generational manner

[29:01] Strong Emotions Are Superpowers Pediatricians can also support the parents, and here’s how Our only lever for change Andy breaks down the concept of bio-behavioral synchrony What the society can improve on in terms of handling and showing emotions He talks about how children can channel strong emotions into worthwhile endeavors

[39:35] Transform Pain, Not Transmit It How people really deal with stress Pain not transformed is transmitted to others Listen to our exchange about anti-vaccine movements How can healthcare providers simplify the benefits of vaccines

[48:20] Closing Segment   Don’t miss Andy’s message for his resident self Final takeaways: AAP’s policy statements on toxic stress and trauma The relation between adverse childhood experiences and behavioral outcomes Adversity is not destiny Safe, stable, and nurturing relationships buffer and create positive experiences Building partnerships and systems to lift kids up The role of public health approach in promoting positive experiences among kids What to understand about relational health The social circles around the children Building solid therapeutic relationships with parents and patients How pediatricians can build their own resilience

Key Quotes: “All kids need positive experiences to thrive.” - Dr. Andrew Garner “What we all strive for as human beings is to be in sync with others.” - Dr. Andrew Garner Email andrew.garner@uhhospitals.org to reach out to Andy or follow him on http://twitter.com/DocAndGar (Twitter). Check out https://www.uhhospitals.org/ to know more about his work.

Resources Mentioned: https://bit.ly/3i5fT7l (AAP Policy Statement: Preventing Childhood Toxic Stress) https://pediatrics.aappublications.org/content/148/2/e2021052579 (AAP Policy Statement: Trauma-Informed Care in Child Health Systems) https://pediatrics.aappublications.org/content/148/2/e2021052580 (AAP Policy Statement: Trauma Informed Care Clinical Report) Book:...

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I am honored to invite Dr. Hovig Artinian back to the podcast to talk about sleep. In this episode Dr. Artinian discusses obstructive sleep apnea and we delve a little deeper into the effects of sleep on behavior. Dr. Artinian helps us create a differential diagnosis around the symptom of snoring and offers practical tips to help us determine when a sleep study may be indicated. We spend time discussing strategies for improving sleep and sometimes the answers are pretty straightforward - exercise and nutrition. Sit back, relax and listen , but don’t fall asleep! [00:01] Dr. Hovig Artinian Shares His Story With Us I introduce and welcome Dr. Hovig Artinian Why Hovig loves to study sleep 6 Sleep Domains

[04:45] Obstructive Sleep Apnea 101 Hovig talks about the obstructive sleep apnea What it is and isn’t What to look for in a child if you find out they’re snoring When to ask for a sleep study according to Hovig How sleep can affect the behaviors of children

[14:50] How Sleep Impacts Children’s Behaviors The red flags that parents should watch out for  The relationship between down syndrome and sleep Hovig gives an interesting knowledge about growth hormones The effects of the surrounding environment to a child’s sleep

[25:13] Preventing Sleep Disorders There’s no such thing as too much love Prevention strategies against sleep disorders The connection between sleep and trauma Don’t miss Hovig’s parting message for us! 

[36:20] Closing Segment   Final takeaways: What we should know about the 6 sleep domains Does your child snore? The BEARS Questionnaire might help Dig a little bit deeper into the snoring of your child Be uneasy of the child is always uneasy Poor sleep among children can look like ADHD, depression, mood disruptions, and irritability The environment has an effect on a child’s sleep Sleep study as the gold standard to determine obstructive sleep apnea The uses of CPAP masks Other conditions where sleep disorders should be considered Preventing sleep disorders

Key Quotes: “Certainly, having sleep problems can cause behavioral problems. It can worsen inattention, it can worsen hyperactivity, or irritability.” - Dr. Hovig Artinian “If they snore do more!” - Dr. Hovig Artinian Email hovig.artinian@helendevoschildrens.org to reach out to Dr. Artinian and check out https://bit.ly/37yDxnq (Helen DeVos Children’s Hospital) to know more about his space. Resources Mentioned: Pediatric Meltdown Ep. 25: https://apple.co/3tUsHBT (Kids and Sleep Why Getting Enough ZZZ's Matters) https://www.ohsu.edu/sites/default/files/2019-06/BEARS%20Questionnaire.pdf (BEARS Questionnaire) https://mc3.depressioncenter.org/ (Michigan Child Collaborative Care)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Trigger warning: suicide Dr. Zakia Alavi returns to the podcast to talk about physician burnout and suicide. This is a difficult conversation and for some this episode may be difficult and you may not be in a place to listen. If you are struggling please reach out to the National Suicide Prevention line 800-273-8255, the Crisis Text Line - text "HOME" to 741741 or the new Physician Support Line staffed by our psychiatrist peers - 888-409-0141. We will be exploring the barriers physicians and other healthcare clinicians face when struggling with mental health concerns. The mental health stigma is real and many, even those in very dark spaces, may not seek help because of fear of repercussions, job loss and shame. While we may wear the superhero cape (stethoscope) and aspire to be superheroes, we are not super human only human. Many of us trained in an era of trial by humiliation and intimidation and learned that vulnerability of any kind was not an option. Today we share warning signs that you may be reaching your burnout threshold, crisis resources and a message of hope that we are here for each other. [00:01] Dr. Zakia Alavi Shares Her Story With Us I introduce and welcome Dr. Zakia Alavi  Zakia shares her thoughts about physician suicide  Suicide is more complicated than most people think

[07:13] Recognizing One’s Struggles  Healthcare professionals can also be “not okay” too Why our competitiveness as humans can do us more harm than good We often feel guilty for not accomplishing all our tasks during the day How to stop this feeling

[17:06] Warning Signs Among Physicians Zakia talks about the biopsychosocial model What is it and why should we know about it? Check yourself and your colleagues too! Here’s how The airport sign that can be applicable for physicians  We have an interesting exchange about physicians being difficult patients

[27:04] How Physicians Can Ask for Help Here are some practical tips for physicians to take a break Who can physicians call when they need help? The number one thing we think about when we hear “trauma” We talk about this certain stigma about physicians  Why medical students should be taught how to say “no” The difference between suicide occurrences between male and female physicians

[39:53] Opportunities for Physicians to Help  Start speaking up to the healthcare leaders to make a positive change Don’t miss the opportunity to help when you feel you or others need help Contact details to take note of in case you need help

[44:02] Closing Segment   Final takeaways: Warnings signs we should look out for Impact of burnout on physicians Self-care ingredients When should you ask for help? Suicide Prevention Hotlines

Key Quotes: “A physician lost to suicide impacts so many people, so many more people than probably other professions.” - Dr. Zakia Alavi “If you see something, say something...to yourself, to others.” - Dr. Zakia Alavi Email alavizak@msu.edu to get in touch with Dr. Alavi and visit https://raind.msu.edu/ (https://raind.msu.edu/) to learn more about her work. Physician Support Line 1-888-409-0141 staffed by psychiatrists for physicians, fellows, residents and medical students 8 am- 1 am 7 days/week National Suicide Prevention Lifeline - 1-800-273-8255 Crisis staff available 24/7 365 days/year Crisis Text "HOME" to 741741  Crisis staff available 24/7 365 days/year

Resources Mentioned: Pediatric Meltdown Ep. 36: https://apple.co/38UWj8R ("We Burnout, We Break, We Die" Author Christopher Veal Speaks Out About Medical Student Mental Health and Suicide) https://bit.ly/3BWulFW (We Burn Out, We Break, We Die: Medical Schools Must Change Their Culture to Preserve Medical Student Mental Health) https://bit.ly/3nmEeZD (Larner Stories Project) https://self-compassion.org/ (Self-Compassion by Dr. Kristin Neff) Book https://amzn.to/3no91W4 (Stop Physician Burnout)...

Stop Physician Burnout: What to Do When Working Harder Isn't Working
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

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The simple act of asking LGBTQ youth, “how do you want to identify yourself? '' is already a big step towards making the world a better place for them. Another point of discussion that should be raised regarding this matter is mental health, specifically on how we can transform the culture of stigmatizing and victimizing these young people to one that simply recognizes them as humans, regardless of their Sexual orientation or gender identity.. The right questions to ask LGBTQ youth, alongside other related topics on their mental health, are what we discussed with Dr. Erin Klein and Dr. Karen Bernstein today.  Dr. Klein is a third-year pediatrics resident at Northwestern University - Ann & Robert H. Lurie Children’s Hospital of Chicago while Dr. Bernstein is an Adolescent Medicine clinician and educator with special interests in adolescent reproductive health, adolescent weight management (including obesity and eating disorders), and adolescent primary care for underserved youth. [00:01] Dr. Erin Klein and Dr. Karen Bernstein Share Their Story With Us Erin and Karen talk about where their paths have crossed  Don’t miss our discussion about “coming out” among the LGBTQ youth

[07:32] The Right Questions to Ask  How “Queer” has been reclaimed by the youth of today Language is crucial  Ask kids these questions if you want to know more about their sexual orientation We discuss making the youth’s identity “official” in electronic medical records (EMRs) Why confidentiality is a crucial factor for LGBTQ youth

[17:24] Making Mental Health Services Accessible We have an interesting discussion about mental health among LGBTQ youth Are mental health services accessible for the LGBTQ youth? Advocacies don’t always need to be big projects  Here’s what Karen thinks 

[27:28] How to Rally People to Join Our Advocacies Do you want to learn more about mental health among LGBTQ youth? Karen shares some resources you can check out now The initiatives of the American Academy of Pediatrics on LGBTQ issues Writing for publications is another powerful step to rally people and call on legislators

[37:57] What Erin and Karen Will Say To Their Younger Selves Erin tells the young version of her that things will always get better  Don’t miss Karen’s message for her resident self 

[42:24] Closing Segment   Final takeaways: Words do matter Don't make assumptions when you go into a room. Be open and listen Questions to ask and how to phrase them Many EMRs now capture sexual orientation and gender identity or SOGIE data to allow preferred pronouns and names. The mental health of our teens is critical. The current problem is stigmatizing and victimizing LGBTQ youth  Resources you can access now  Links below Consider hospital committee policies and EMR options. Reaching out to school boards can be powerful. On the state and national level, learn about state legislation and speak up for LGBTQ youth Write op-eds blogs and post on social media If you're an AAP member, consider joining the section on LGBTQ health and wellness Practice with love

Key Quotes: “It’s not being LGBT that causes these mental health problems. It’s living in a household or attending school or being in a community or society that doesn’t affirm your identity that’s more of a risk factor.” - Dr. Erin Klein “I think that Gen Z has taught us a lot on how to approach everyone with love and not put people in binary categories.” -  Dr. Karen Bernstein Email erin.e.klein@gmail.com to connect with Erin then kbernste@uic.edu to reach out to Karen. Check out https://www.luriechildrens.org/ (Ann & Robert H. Lurie Children's Hospital of Chicago) to know more about Erin’s work and then https://chicago.medicine.uic.edu/ (The University of Illinois College of Medicine) to learn more about Karen. Resources Mentioned: https://brenebrown.com/ (Brené Brown)...

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Welcome to the 1-year anniversary of Pediatric Meltdown! It’s been a year since I started this podcast, but I am only getting more addicted to it. This podcast has allowed me to do something that I really enjoy and made me realize that I love talking with people. Specifically, I love having conversations where we can just be in our genuine selves.  Join me today as I look back on the past 52 weeks and reflect on the countless conversations and moments I shared with my guests. As we start another year, may we find hope and courage to face all challenges and celebrate our wins with the people we love dearly.  [00:01] It’s Been a Year! First of all: Thank you for joining me on this ride My realizations during the COVID-19 pandemic 

[02:10] My Realizations in Doing This Podcast I really thought the public has lost trust in doctors and in science as a whole Here’s what I learned Medicine, as a practice and as an art, is magical, and here’s why Hate can be contagious, and this is the antidote My message to all the parents out there Are you a therapist? You need to hear this My open letter to my pediatrics colleagues 

[09:58] Closing Segment   Final words and reminders

Key Quotes: “Find time to take care of yourselves, and if you’re struggling, it’s okay to not be okay.” - Dr. Lia Gaggino “The antidote to [hate] is steadfast courage and commitment to doing the right thing for the right reasons.” - Dr. Lia Gaggino “Know that those of us in this helping profession do this for love, not money.” - Dr. Lia Gaggino

Resources Mentioned: https://www.aappublications.org/ (American Academy of Pediatrics) 

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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We continue our discussions about birthing experiences, and this time, we’re going to talk about the experience of the Latinx community in our healthcare system. Kristina Ledlow and Dr. Karen Garcia join us to talk about ways to improve the services being provided for the community, especially for Latinx mothers. We can only broaden cultural competence by listening to others experiences and by stepping out of our own perspectives. Pediatric clinicians serve not only our newborns and infants but also support our moms and families. Thinking about how we embrace all of our families through their eyes only improves the care we give. [00:01] Kristina Ledlow and Dr. Karen Garcia Share Their Story With Us Kristina and Karen talk about the kind of work they are involved in  They give interesting details about birthing ourselves 

[06:40] Latinx Mothers and Their Healthcare Experiences  The experience of Latinx mothers in the healthcare system  Kristina shares their approach in taking care of mothers during the prenatal stage Karen gives a piece of advice that first-time mothers should hear  Ask from a place of curiosity and live with empathy 

[16:46] Better Service for the Latinx Community We have an interesting exchange medical insurance  How can providers improve how they serve the patients? Kristina and Karen explain  Even if providers mean well, they might still deal trauma to the patients Karen recalls her experience as an immigrant assimilating in the United States

[26:25] Knowing Other People’s Culture  How to communicate with your patients the right way Kristina and Karen share some tips and resources The books you can read and authors you can follow right now The beauty of discovering other people’s cultures

[36:14] No Explanations Needed    Kristina has a message for her younger self that you should not miss Karen sends a message for her resident self you’d want to hear  “No” is a complete sentence, and you don’t need to always explain yourself 

[42:35] Closing Segment   Final takeaways: It is hard to recognize that much of our medical system is white-centric. Culturally, Latinx families see physicians as powerful and are differential There are many barriers to accessing care The sentence, “Tell me about who is living in your household.” The patriarchy in Latinx families Don't make assumptions or rush to judgment and other messages for providers Be aware of your own biases Reading books by Latinx authors can be a start to your awareness and curiosity

Key Quotes: “I think that if we are validating to our patients, if we validate their stories, and we come from a place of curiosity and empathy, that's a really good starting point..” - Kristina Ledlow “It’s okay not to know. It’s okay not to be sure what [the patients’] cultural beliefs and backgrounds are so come from a place of curiosity and ask them so you can better support them.” - Dr. Karen Garcia Email ledlokr@bronsonhg.org to connect with Kristina then garciak@bronsonhg.org to reach out to Karen. Check out https://www.bronsonhealth.com/ (Bronson Hospital) to know more about their work. Resources Mentioned: Pediatric Meltdown previous episode: https://apple.co/3yc1MCe (Radical Change: Birthing Experience in the BIPOC Community) Books to read https://amzn.to/3y5R00j (The House on Mango Street) https://amzn.to/3B4mQN4 (Like Water for Chocolate) Recommended authors https://allpoetry.com/Pablo-Neruda (Pablo Neruda) https://bit.ly/3j6MEC3 (Gabriel García Márquez) https://www.isabelallende.com/ (Isabel Allende) Other resources mentioned https://brenebrown.com/ (Brené Brown) https://bit.ly/3z7NHa9 (Acculturation and Depressive Symptoms Among Pregnant and Postpartum Latinas) https://bit.ly/3z8eKlZ (Perinatal Depression Treatment Preferences Among Latina Mothers) https://bit.ly/3sGcSOW (Prenatal depression in Latinas in the U.S....

Like Water for Chocolate: A Novel in Monthly Installments with Recipes, Romances, and Home Remedies
The House on Mango Street

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Erica Guthaus has been supporting families in their childbearing years since 2008 and has been part of the professional birth community since 2014. A highly skilled communicator, educator, and encourager, she specializes in transformative growth, empowerment, and wisdom keeping.  As the Conjuror of Birth Reclamation at Rootead, Erica is bringing her skill set to life by supporting Red Birth Green birth workers and families in claiming compassionate, inclusive, and respectful care for the entire family dynamic during childbearing years. Born and raised in Kalamazoo, she currently lives in Lansing with her husband, 4 kids, and 6 rescue pets. [00:01] Erica Guthaus Shares Her Story With Us Erica shares her journey in becoming a “doula” She breaks down what a doula is and why you should have one

[07:05] People Over Policy  Erica talks about their mission of restoring humanity Do not treat people as numbers and statistics  Why her tagline in life is “People Over Policy” The simple and easy step to decolonize spaces  Why curiosity is uncomfortable according to Erica 

[17:25] A Young Black Woman’s Experience in the Healthcare System  The experience of a young Black woman in a healthcare setting Erica offers a unique perspective  Why delivering information the right way is crucial in interacting with patients  Erica shares interesting insights about the healthcare system A frightening position and place for a pregnant or first-time mother 

[28:43] Pursuing Racial Reconciliation and Diversity  What you should realize about racism according to Erica  Why engaging with people is like peeling off an onion  Erica gives her thoughts about engaging the youth in their initiatives   She talks about our progress in racial reconciliation and diversity 

[39:09] Generating Sincere Patient-Provider Conversations   The very first question that providers need to ask to their patients  How to generate sincere conversations with patients  No is a complete sentence that providers should accept from patients  Believe the patients even if you can’t understand them yet  The most fulfilling part of working in the healthcare sector 

[54:45] Closing Segment   Final takeaways: A doula provides non-clinical, social-emotional support for pregnant mothers  Thinking about the people that the healthcare system really serves  People over policy Why asking questions is important to change the system Why people assume and judge others first before understanding them better Real experience starts on the phone Many women of color still don’t feel like they’re being taken care of  What Erica would do if she can change the system Many of the things we can do to change the experience of BIPOC patients are free. Not seeing color is racist. Period No is a complete sentence that should be accepted  Incremental change is happening; be part of the change now We need to believe the patients, to see them, and to not dismiss them

Key Quotes: “All of the things that actually would have the most change are free.” - Erica Guthaus “It should not take a high-profile situation for the situation to be believed.” - Erica Guthaus Email erica.g@rootead.org to connect with Erica or check out https://www.rootead.org/ (Rootead Enrichment Center) to learn diverse, inclusive, anti-racist, and trauma-informed programs for mothers.  Check out her https://www.ericaguthaus.com/ (personal website) to know more about her work.  Learn more about the https://redbirthgreen.com/ (Red Birth Green) and their doula community

Resources Mentioned: https://brenebrown.com/ (Brené Brown)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and...

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We all picture the joyous new mother. Happy, put together and radiant. The reality is often very different. Many moms are relieved that their baby. A mother’s mental health has a direct impact on her baby and we as pediatric clinicians are in a perfect position to support her. Dr. Rena Menke, a clinical psychologist with 15 years of experience working with pregnant and postpartum mothers, walks us through a model of care that promotes parenting skills and supports infant mental health. Dr. Menke describes how we can help parents by finding “beautiful moments” between a caregiver and their baby. [00:01] Dr. Rena Menke Shares Her Story With Us How Dr. Menke shares her journey to the infant mental health field What to expect in infant mental health according to Dr. Menke

[04:13] 3 Moments Between a Mother and Her Baby Why pediatricians need to consider mental health in treating patients Dr. Menke connects a mother’s mental health to that of her child  The reality about motherhood you need to realize  She talks about her program, “Early Relational Health” Is it exclusive for mothers? When is it best implemented? The 3 types of moments to watch out for between a mother and her baby

[14:20] Creating Beautiful Moments How to advise mothers in overcoming challenging moments with their babies Dr. Menke shares how to practice empathy with parents  What pediatricians can learn from the infant mental health field  Check out some resources on early relational health! Links below  Building a “partnership” with parents to create beautiful moments 

[24:28] Building Meaningful and Healthy Relationships  We talk about the things that pediatricians do best  What confidence brings to parents in terms of taking care of their children Simple exercise parents can do when talking about their kids  How meaningful and healthy relationships are built 

[32:31] Closing Segment   Final takeaways: Infant mental health was pioneered by Selma Fraiberg, author of “The Magic Years” Perinatal mood and anxiety disorder prevalence is about 40%. Early relational health is an intervention developed by pediatrician, David Willis A primary care physician or provider may identify an infant-parent dyad that may need some support. Identifying the 3 key moments between the mother and her baby  We may need to take a breath and pause as we help guide through interactions that we are concerned about There's formal online training for interested clinicians to learn more about upstream prevention intervention Rena’s contact details below Child psychiatry access programs are available across the country. Links below For information on how to develop integrated behavioral health in your practice, please reach out to me in the show note links

Key Quotes: “I think what's wonderful is we now know that there are so many different resources for moms and babies… ” - Dr. Rena Menke  “When parents are feeling confident and able to care for their children, then they have more ability to choose what they're doing.” - Dr. Rena Menke  Email renam@med.umich.edu to connect with Dr. Menke or check out http://med.umich.edu/ (http://med.umich.edu/) to know more about her work.  Resources Mentioned: Pediatric Meltdown previous episodes https://apple.co/3AaFUsr (Perinatal Mood and Anxiety Disorders: Treatment Risks and Benefits) https://apple.co/3xrondB (Psychiatric Consultation: The Doctor is In!) https://apple.co/3ytl7j9 (The Art of Conscious Parenting with Dr. Robert Saul) https://mc3.depressioncenter.org/ (Michigan Child Collaborative Care) https://cssp.org/our-work/project/advancing-early-relational-health/ (Center for the Study of Social Policy: Early Relational Health Screen) https://first3yearstx.org/early-relational-health-webinar-series/ (First 3 Years, Early Relational Health Webinar Series)...

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(Trigger warning: suicide) My guest today is Dr. Samantha Shaw, a psychiatrist specializing in women’s health, with an emphasis on perinatal health. She drops by the podcast today to talk about women’s experiences and safe treatment options. Dr. Shaw shares information about helpful resources and virtual support groups and encourages clinicians to screen, identify and refer early. [00:01] Dr. Samantha Shaw Shares Her Story With Us How Dr. Shaw became a psychiatrist specializing in women's and perinatal health We talk about obstetricians and using the Edinburgh Postnatal Depression Scale

[04:36] A Baby’s Mental and Emotional Well-Being When to prescribe Selective serotonin reuptake inhibitors (SSRIs) to women Are they safe during pregnancy? The impact of a mother’s feeling and emotions to her baby We have an interesting exchange about postpartum depression and anxiety What could’ve been their evolutionary causes? Don’t leave depression and anxiety during pregnancy untreated  Dr. Shaw tells us why  30% of babies goes through this kind of experience

[14:24] Mental Health of Mothers Dr Shaw breaks down what is called the Poor Neonatal Adaptation Syndrome She gives important pieces of information about breastfeeding Don’t let the name “antidepressant” fool you Dr. Shaw explains Dr. Shaw shares her experience on mothers with more complex mental health situations Controlling ADHD among women  How to find someone like Dr. Shaw Common questions you should ask to Dr. Shaw 

[24:01] Responsibility of Pediatricians Don’t believe sensationalized news about mothers  Many mothers struggle with “intrusive thoughts” Dr. Shaw’s Public Service Announcement about mothers you should hear now The important clue for providers on how to manage a mother’s intrusive thoughts How providers should handle mothers with suicidal thoughts  Pediatricians and their responsibility in taking care of mothers 

[34:54] Dads Experiencing Postpartum Depression and Anxiety  Virtual support groups that mothers can participate in  There are groups even for dads! We talk about dads going through postpartum depression and anxiety  Normalizing shame and eliminating stigma among mothers  Dr. Shaw shares her message for her resident self  The beautiful thing about motherhood

[42:25] Closing Segment   Final takeaways: Mothers with PMAD may have difficulty bonding with their babies Are medications safe? SSRIs are safe to use  Atypical antipsychotics can be used during pregnancy and postpartum period Lithium does pose some cardiovascular risk Depakote and Tegretol are big no no’s during pregnancy Teaming with psychiatry is essential for complex drug regimens  Psychiatric programs can be pediatric and perinatal Dealing with a mother’s intrusive thoughts Think twice about contacting CPS or referring families to the emergency room One in 10 dads may experience PMAD Suicide risk is real It is our job as champions for babies to care about and protect our mamas.

Key Quotes: “Whether you're depressed, whether you're anxious has no bearing on how good of a mother you are.” - Dr. Samantha Shaw “There’s no shame in struggling.” - Dr. Samantha Shaw “It's been lovely to see how many different niches there are, I guess, in medicine. It's so broad, and there's so many incredible things that you can do with so many different patient populations.” - Dr. Samantha Shaw Email samantsh@med.umich.edu to connect with Dr.  Shaw or check out https://medicine.umich.edu/dept/psychiatry/samantha-shaw-md (https://medicine.umich.edu/dept/psychiatry/samantha-shaw-md) to know more about her work. 

Resources Mentioned: https://www.nncpap.org/map (Child Psychiatry Access Programs) by state https://www.mcpapformoms.org/Toolkits/Toolkit.aspx (Toolkit) for primary providers treating women with perinatal mood and anxiety disorders...

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(Trigger warning: suicide) In this episode, Faith McDonald, a writer and an assistant professor at Penn State University, shares her experience helping her son who struggles with mental illness. His struggle is a familiar one to many parents and clinicians as they are prevalent among children and young adults, and the journey to wellness is often a difficult one. Faith talks about the power of “sharing your brokenness” with others as a way to find wholeness. The weight of worry is lightened knowing that you are not alone. We have the incredible honor of being with our patients and families and the opportunity to weather the journey through the highs and the lows. In times of distress, Mr. Rogers advised to "look for the helpers." We are the helpers. [00:01] Faith McDonald Shares Her Story With Us  Faith talks about her experience as a parent Dealing with her son’s mental health issues   Determining the trigger  How she realized her son needed help 

[07:06] A Young Adult’s Mental Health  Mental health issues on young adults Dealing with a young adult’s mental health issues From a physician’s perspective  We talk about privacy and how it factors into a young adult’s mental health  The possible physical symptoms of a mental health issue  Here are Faith’s suggestions for doctors to better serve their patients 

[17:31] “He's Going to Get Better”  The questions that parents should expect from physicians  We have a conversation about suicide  Faith’s experience of dealing with her son’s paranoia  The different kinds of support available for parents and their children  Being comfortable with the uncomfortable  The words that brought Faith hope  The different types of therapy for young adults 

[27:37] Sharing Our Brokenness  The benefits of exercise and meditation  You should not be silent about your problems Faith explains  Parents asking permission to help their children  Faith gives us a sneak peek about her book, “On the Loving End of Crazy” Sharing our brokenness

[37:22] The Purpose of Suffering  The impact of sharing her son’s story  What Faith realized about helping her son with his mental health challenges  The purpose of suffering according to Faith 

[45:10] Closing Segment   Final takeaways: Parenting is hard regardless of the child’s age The connection between the mind and the body Parents don't always think that their child could be thinking about suicide Safe talks and the Question-Persuade-Refer approach  Parents working with partners in the mental health and school spaces  Routine screening and why it’s important  Balancing giving support and nurturing independence  Caregivers need to take care of themselves Sharing brokenness is healing

Key Quotes: “Our kids are paying attention in ways we don't maybe necessarily realize.” - Faith McDonald “We have to, as people functioning as a community of faith, be comfortable with sharing our brokenness.” - Faith McDonald “There's purpose in your suffering. For me, it's strengthened my faith, it's enlarged my compassion for people...” - Faith McDonald

Email newman.coordinator@newmancom.com to connect with Faith or check out her https://faithmcdonald.com/ (personal website) to know more about her work.  GRAB a copy of Faith’s book, “https://amzn.to/3eDKabp (On the Loving End of Crazy)”

Resources Mentioned: Pediatric Meltdown previous episodes https://apple.co/3kDU80m (Talking About Suicide With Our Patients) https://apple.co/3rl7Jet (Screening Youth For Suicide Risk) https://apple.co/3isNtn9 (Suicide Prevention in Primary Care) Individuals to follow https://brenebrown.com/ (Brené Brown) https://drhallowell.com/ (Dr. Ned Hallowell) Other resources https://www.healio.com/apps (Healio) Web article: https://bit.ly/3imy2MY (I...

On the Loving End of Crazy: Finding Hope and Help to Face Your Loved One's Crippling Anxiety and Depression
Walking on Eggshells: Navigating the Delicate Relationship Between Adult Children and Parents

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Welcome back to Pediatric Meltdown. Ethics is not just for philosophers! The field of bioethics infuses medicine with a thoughtful process for decision making when the choices are not clear. The choices between what we can do and what we should do is often a murky place. Dr. Tyler Gibb has authored dozens of peer-reviewed publications on the intersection of health law and medicine and examines clinical ethics, medical narratology, the politics of medicine, medical education pedagogy, and professional misconduct and professionalism in healthcare. His work and expertise can ease our own distress when faced with moral and ethical dilemmas and can guide us as we seek clarity for our patients, families and for our teams. [00:01] Dr. Tyler Gibb Shares His Story With Us  Dr. Gibb shares his background in the medical bioethics space  The question that clinical ethics answers  

[06:20] Making the Tough Decisions  Dealing with end-of-life situations the clinical ethicist way  Here’s a story from Dr. Gibb about “moments of introspection” What does this mean? When team members don’t agree with one another… 

[16:34] Divulging All Information to the Patient  Telling everything to the patient, even the bad news  How Dr. Gibb approaches this situation  Ethical considerations during the COVID-19 pandemic  Putting yourself first before anyone else

[26:28] Primary Care and Ethics The interaction of primary care and ethics  We have an interesting exchange about handling transgender patients  Addressing mental health issues among patients 

[36:24] Takeaways for Clinicians  Share your burden Find your moral voice  Dr. Gibb’s message for his younger self 

[46:44] Closing Segment   Final takeaways: Bioethics is the meta ethics and focuses on the theoretical. Clinical medical ethics brings theory into practice. The question, “Why is this decision a concern versus another decision?” What we should do vs. What we can do  Ethical considerations and issues rose to the top and became familiar due to COVID-19 Ethical dilemmas often arise within medical teams when individuals don't agree Primary care specialists should also consult with ethicists  You are not alone in your struggles The burden you feel can be shared Be vulnerable, ask for help Find your moral voice and train yourself to hear the moral voices of others. Preserve your humanity by drawing boundaries 

Key Quotes: “Mental health is not something that physicians can tackle alone. It's not something that social workers can tackle alone.” - Dr. Tyler Gibb “You are not alone...the burden that you feel can be shared and ought to be shared.” - Dr. Tyler Gibb Email tyler.gibb@med.wmich.edu to connect with Dr. Gibb or check out https://med.wmich.edu/ (Western Michigan University Homer Stryker School of Medicine) to know more about his work. 

Resources Mentioned: Dr. Gibb’s podcast: https://www.bioethicsforthepeople.com/about (Bioethics for the People Podcast) Journal article https://bit.ly/3kubXiz (Ethical and Professional Considerations in Integrated Behavioral Health) https://bit.ly/3kieYSO (Caring for the Transgender Adolescent: It Takes a Village) Books https://amzn.to/2Vx38d4 (Integrated Behavioral Health in Primary Care) https://amzn.to/3ehsMJw (Being Mortal) Other resources https://www.tinypoetryproject.com/ (Tiny Poetry Project) Pediatric Meltdown: https://apple.co/3kg5p6R (Child Abuse and Neglect: Asking the Hard Questions)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a...

Being Mortal: Medicine and What Matters in the End
Integrated Behavioral Health in Primary Care: Step-by-Step Guidance for Assessment and Intervention

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Welcome to another episode of Pediatric Meltdown. My guest for today is Dr. Lisa Namerow, a Board-certified psychiatrist triple-boarded in pediatrics, child psychiatry, and general psychiatry. She has been in the pediatric healthcare space for almost 30 years, directing the consultation services to in-patient pediatrics, and the access to mental health programs for pediatricians.  Her areas of research have been pharmacogenetics, and the impact of clinical pathways and standardized care for eating disorders, somatic symptoms, and related disorders, and delirium, and serves on the American Academy of Child and Adolescent Psychiatry Committee on the physically ill child. [00:01] Dr. Lisa Namerow Shares Her Story With Us  Dr. Namerow shares how she became a child and adolescent psychiatrist  She introduces the field of Pharmacogenomics Pharmacogenomics vs. Pharmacogenetics 

[06:12] Genetics 101  Myths about Pharmacogenomics Pharmacodynamic Genes and Pharmacokinetic Genes What we need to know Dr. Namerow’s analogy for genes  The relationship between medicines and gene findings 

[16:19] Deciding if Gene Testing Can Be Helpful What oncologists should know about prescribing medicines How a pediatrician can utilize genetic testing  The screening questions to help pediatricians decide on genetic testing

[26:37] Genetic Testing in ADHD, Depression, and Anxiety Talking with parents about genetic testing How the serotonin transporter works in the body  Genetics in the context of ADHD, depression, and anxiety 

[36:10] The Best References for Primary Care  Dr. Namerow’s interesting insights about primary care Her message for clinicians that you should not miss  Dr. Namerow’s message for her younger self 

[46:10] Closing Segment   Our advice for all working moms out there Final takeaways: The role of certain relevant genes in drug response The industry's detailing can be misleading There are some very relevant gene medication pairs An analogy about Gentamicin you should not miss Using Venlafaxine  Facts about Cytochrome P450 Screening questions to decide if genetic testing can be helpful Select medications based on evidence and guidelines

Key Quotes: “What is true is that genes do code for both the enzymes that metabolize medicines, and they also code for the proteins that are the site of the action of medication.” - Dr. Lisa Namerow “[It’s] heartbreaking that we don't have a system that cares for these kids in the way that they should be cared for, and that it falls on primary care.” - Dr. Lisa Namerow Email lnamerow@connecticutchildrens.org to connect with Dr. Namerow or check out https://www.connecticutchildrens.org (Connecticut Children’s Medical Center) to know more about her work.  Resources Mentioned: https://bit.ly/3jIxpQf (Pharmacogenomics: An Update for Child and Adolescent Psychiatry) https://www.nncpap.org/map (Child Psychiatry Access Programs by state) https://ki.se/en (Karolinska Institutet) https://www.cincinnatichildrens.org/bio/S/jeffrey-strawn (Dr. Jeffrey R. Strawn)

If you’d like to connect with me, you can find me on https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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My guest today is Dr. Jeffrey Strawn, a Professor of Psychiatry, Pediatrics and Clinical Pharmacology at the University of Cincinnati and at Cincinnati Children’s Hospital. He is the Director of the University of Cincinnati Anxiety Disorders Research Program and the Associate Vice Chair of Research in the Department of Psychiatry & Behavioral Neuroscience at the University of Cincinnati. In his clinical practice, he works with youth with anxiety and related disorders and with their families and supervises residents and fellows. Dr. Strawn has authored more than 160 peer-reviewed publications and co-authored two textbooks on the treatment of children and adolescents and on contemporary psychotherapy. He is a distinguished fellow of the American Academy of Child & Adolescent Psychiatry and has received multiple awards for teaching, mentorship and research.   [00:01] Dr. Jeffrey Strawn Shares His Story With Us  Dr. Strawn shares how he landed in the child psychiatry space  The potential of over-screening patients Dr. Strawn shares his thoughts  Dealing with different levels of anxiety per Dr. Strawn’s experience 

[06:54] The Severity and Frequency of Anxiety  The criteria that Dr. Strawn uses to determine the level of anxiety of his patients  The  questions to ask to tell how severe the anxiety is and how frequent it happens  What parents should expect in assessing their kid’s anxiety  The factors that can affect moods, not necessarily anxiety disorders  Does your child need medications? Listen to Dr. Strawn’s explanation  

[16:35] The Right Medication for Anxiety  Dr. Strawn shares his approach to giving medications on anxiety  Giving medications is one thing, managing the dosage is another  Avoid making the patient expect they will have problems with this simple statement  Overlaps between anxiety and depression symptoms 

[26:18] Side Effects of Medications  How do we know if the medicines are working? Mania vs. difficulty in sleeping and bipolar disorder  Dr. Strawn talks about boxed warnings  Managing insomnia and sleepiness 

[36:25] Managing Panic Attacks  Taking medications with or without food Dr. Strawn shares his thoughts  Dr. Strawn shares his thoughts about managing anxiety among young adults  His clever strategy to handle panic attacks among young adults  He shares his thoughts about cannabis use 

[47:29] Marijuana Use Among Young Adults  The difference between alcohol and marijuana users  Dr. Strawn’s parting advice for listeners  The impacts of anxiety about the growth of a child 

[52:46] Closing Segment   Final takeaways: The question, “How often do you worry?” Treatments for different levels of anxiety  Severe symptoms of anxiety we should watch out for  The SCARED tool for anxiety  SSRIs are safe as first line of medication for anxiety and depression in children “start low and go slow” The time to onset of actions of different medicines Side effects of medications that we should know Managing side effects  Monitoring can be done in person or via televisits  A more strategic approach to handle panic attacks The adverse effects of selected medicines we should not forget FDA boxed warnings  Be prepared with false positives 

Key Quotes: “Don't ask, ‘Do you worry?’ Ask, ‘How much do you worry?’ or terms of a younger child, ‘How good are you at worrying?’” - Dr. Jeffrey Strawn, MD “Spend as much time as you can with your family.” - Dr. Jeffrey Strawn, MD Email strawnjr@ucmail.uc.edu to connect with Dr. Strawn or check out https://www.cincinnatichildrens.org/bio/S/jeffrey-strawn (Cincinnati Children’s Hospital) to know more about his work.  Resources Mentioned: http://www.nncpap.org (Child Psychiatry Access Programs)...

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My guest today is Dr. Stephanie Nelson, a board-certified peadiatric neuropsychologist. Dr. Nelson walks us through the nuances of neuropsychological assessments and how they can help us coordinate care for our patients.   Dr. Nelson specializes in complex differential diagnosis. Her day-to-day work involves comprehensive neuropsychological assessments and outreach to the community through presentations, workshops, and volunteer work. She also spends half her time providing consultation to psychologists and neuropsychologists who specialize in pediatric assessment.   [00:01] Dr. Stephanie Nelson Shares Her Story With Us  Dr. Nelson  wanted to be a teacher at first but ended up as a neuropsychologist She tells us what happened  Dr. Nelson tells us the difference between clinical psychology and neuropsychology

[06:55] Differentiating Dyslexia from Other Learning Disabilities  Neuropsychologists like to say they’re psychologists first, then neuropsychologists second Dr. Nelson tells us why The other things that neuropsychologists test aside from memory  Should you go to a neuropsychologist or clinical psychologist first?  Don’t be confused with Dyslexia, Dysgraphia, and Dyscalculia with these explanations from Dr. Nelson!  She talks about Rapid Naming  Factors that affect comprehension 

[18:07] Determining the Right Intervention for the Child  Determining the true situation of the child to choose the right intervention  The top question that neuropsychologists get from parents and pediatricians  Special education in schools  Qualifying for special education services  Resources with informative content for pediatricians and parents  Links below 

[28:11] Determining the Right Intervention for the Child  The role of neuropsychologists in helping children with Down syndrome  Learning multifactorial skills  What Dr. Nelson always tells the parents when asking for a neuropsychological evaluation  How pediatricians should read neuropsychological reports  3 things for families to know more about their children 

[38:32] The Right Time to Seek Evaluation  How Dr. Nelson writes her neuropsychological reports  The challenge in giving treatments to kids who exhibit learning disabilities  Dr. Nelson shares her insights about seeking an evaluation for children  Dyslexia is heritable 

[44:29] Closing Segment   Final takeaways: A neuropsychologist goes one step farther than the clinical psychologist A neuro psych evaluation may be really helpful for specific cognitive concern Neuropsych testing tackles cognitive domains language, sensory-motor, executive function, and social cognition, just to name a few. Consider Dyslexia Math and writing disorders are also multifactorial Special education in schools should address the needs of students  Dr. Nelson's goal of creating a roadmap of needs that meets challenges and come up with a diagnosis that makes sense Family history is crucial  When to consider neuropsychology 

Key Quotes: “Writing is just language on paper. So if you have trouble with language, it's going to show up in your writing.” - Dr. Stephanie Nelson “ADHD has similar heritability numbers as well. So getting that family history, of course, is really important.” - Dr. Stephanie Nelson Email snelson@skylightneuropsychology.com to connect with Dr. Nelson or check out https://www.skylightneuropsychology.com/ (Skylight Neuropsychology) to know more about her work.  Resources Mentioned: Pediatric Meltdown Episode 42: https://apple.co/3h0NZYw (Deciphering Psychological Assessment Reports: What You Need to Know) https://bit.ly/3h4WUs9 (The Orton Gillingham Method) https://www.understood.org/ (Understood.org) https://dyslexiaida.org/ (International Dyslexia Association) https://www.wrightslaw.com...

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On this episode of Pediatric Meltdown, I welcome Dr. Chris Barnes, Chief Executive Officer at Kalamazoo Counseling and Assessment Center. We discuss psychological assessment reports and why we should still read and understand them. Dr. Barnes also shared some tips to write these reports in an engaging manner and in a language that the target readers can understand.     This is because psychological reports are often too long and use language most can't comprehend. This leads Dr. Barnes to an ever-flowing state of creativity and translates this into his clinical work through refining clinical assessment documents and leveraging technology to meet the needs of providers and other stakeholders. Chris's hope is to increase the efficiency of clinical communication without sacrificing clinical care. Dr. Barnes is a licensed clinical psychologist whose clinical work is focused on integrative clinical assessment. As an assessment psychologist, he is passionate about effective communication and customer service. He will join us today to talk about psychological assessment reports and why medical practitioners should still make an effort to understand them.    [00:01] Dr. Chris Barnes Shares His Story with Us     Why Dr. Barnes wanted to be a clinical psychologist Science and human interactions in one  What revealed Dr. Barnes’ “inner nerd?” Dr. Barnes makes a difference among social work, counseling psychology, clinical psychology, and assessment psychology The thing is that they should not be lumped together 

[07:10] The Right Assessment to Determine the Patient’s True Situation  Dr. Barnes shares his thoughts about pediatricians partnering with psychologists when assessing patients Specificity and sensitivity in utilizing measures  We talk about the key differences between screening tools and diagnostic tools  You should consider psychological assessments if the situation meets these criteria  The right assessment should be administered to fully determine the situation and think of a plan for the patient  Why feedback is important 

[17:34] A Readable and Engaging Psychological Assessment Report   Communicating the results of a psychological assessment report  Many of us are actually over-documenting and here’s Dr. Barnes’ advice to break this habit  It’s about identifying the target audience groups of the report  How to spot a good psychological report  Diagnosing learning disabilities The challenges of school systems not following the recommendations of a psychological report 

[32:53] The Right Way to Refer Someone for an Assessment  Dr. Barnes talks about the metaphor he often uses for his patients  The two common reasons for holding an Individualized Education Program meeting as discussed by Dr. Barnes  Why we should keep our colleagues close to us according to Dr. Barnes  A better understanding among kids about why they will be diagnosed with a treatment plan is crucial If you’re referring someone for an assessment, here’s what you need to do

[47:19] Closing Segment  Dr. Barnes shares some points to consider when referring a patient to someone like him  Is writing assessment reports boring? Dr. Barnes weighs in  Final Takeaways:  Referral to a therapist or psychologist can mean several things.  A psychological assessment helps to clarify diagnoses using evidence-based diagnostic tools that have sensitivity and specificity.  The assessment includes parent and patient interviews, and forming a hypothesis, choosing tools, both a standard battery of tools and then adding on additional tools that might be more helpful to really hone down the diagnosis.  What looks like ADHD maybe something else and a psychologist can help sort this out. The reports can be long because they serve many, including parents and...

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Welcome to Pediatric Meltdown! I’m your host, Dr. Lia Gaggino. Today, I'm welcoming both of my daughters Elyse and Julia and they're going to be talking about parenting styles; their dad’s and mine.  I just thought it might be fun to hear from an adult “kid's” perspective what it's like growing up in a household when Mom's a doctor and dad is way more fun. My husband has gotten us through the ups and downs of parenting. And I really couldn't have done it without him. So this podcast is really a tribute to him. And this conversation with my daughters was just really fun! So sit back and enjoy. I hope it's something light and that you'll find something you can relate to.  [01:55] A Fun Chat with Elyse, Julia and Dr. Lia on Childhood Memories Walking through Elyse and Julia’s lives and what it was like parenting them from birth to toddler years  Elyse and Julia share fun things about bath time that they remember as children  Healthy meals, nutritious food, and Pop-Tarts: Mom vs. Dad While Dad let the girls eat in front of the TV, bought Pop-Tarts, and packed the girls fun lunches with cards, Mom preferred to feed the girls nutritious food. Mom makes a killer noodle casserole and Dad’s culinary creativity went a little too off the rails, sometimes.   Fun activities with Dad and Mom  Dad was the supportive, easy-going coach who brought snacks to the girls' games and took them to the carnival. Mom did fun activities outdoors, bike rides, swimming, and crafts. Mom gets extra points for party planning! Gift giving  Dad gives very interesting gifts. 

[14:23] Personality Differences Between Mom and Dad   Dr. Lia, Elyse, and Julia talk about more differences between ‘Mom and Dad’ especially mentally and emotionally. Mom and Dad’s differences balanced each other out and in a way completed each other.    Dr. Lia talks about lessons learned in wanting to always rescue her girls from emotional discomfort right away.  

[20:32] Parenting Advice From the Adult ‘Children’   Dad’s Fashion Collection Advice from Elyse and Julia on parenting  Find your complement, not your clone Try not to take it so seriously    If you're going to break the rules. talk to dad, not mom

[24:17] Closing Segment   Final words from Dr. Lia 

Key Quotes: “Find your compliment, not your clone. You need a little balance.” - Elyse Parzyck “How about you do also like tie knots take it so seriously.” Julia Parzyck  “And I just want to reassure you not to worry too much about being perfect and that our kids are resilient. And if we have those safe, stable, nurturing relationships with adults and kids, we can get them through and be resilient. So trust yourself, do the best you can, and give yourself a break.” - Dr. Lia Gaggino   “Don't take yourself too seriously, relax, and you get a lot of brownie points just for trying.” - Dr. Lia Gaggino  

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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On this episode of Pediatric Meltdown, I welcome Dr. Jenn Kuhn. We discuss everything from baby worries to how we as practitioners can help our patients as they enter parenthood. Being a parent is difficult, but it does bring some of the greatest rewards, so it’s ok to give yourself a break.   Dr. Jenn Kuhn is a pediatric psychologist working in integrated primary care at Nemours Alfred I duPont Hospital for Children in Wilmington, Delaware. She received her bachelor's degree and master's degree in psychology from Tulane University in New Orleans and received her Ph.D. in clinical psychology from Western Michigan University in Kalamazoo, Michigan in 2016. Dr. Kuhn and I crossed paths when she completed her pre-doctoral internship in Pediatric Psychology at the Munroe Meyer Institute at the University of Nebraska Medical Center in Omaha, Nebraska, and completed her postdoctoral fellowship in pediatric integrated behavioral health at Nemours Alfred I duPont Hospital for Children.  In her current role, she works in two pediatric primary care clinics. Her clinics serve patients aged 0 to 21. She is responsible for providing prevention-based services, psycho-educational services, consultation and education to medical trainees and staff, warm handoffs and consultation with patients, short-term therapy, and brief intervention assessments.  Her specific areas of interest include early intervention services, postpartum depression, and anxiety screening, postpartum wellness, management of disruptive behaviors, ADHD, assessments, anxiety, and sleep in providing clinical services. She supervises psychology residents, postdoctoral fellows, and provides behavioral health education to medical students and residents.  Clearly, Dr. Kuhn is very busy in pediatric clinics. Stay tuned for the interview and hopefully, you can see where this might fit into your practice.   [00:01] Dr. Jenn Kuhn Shares Her Story with Us     Why Dr. Kuhn wanted to be a clinical psychologist Dr. Kuhn first heard of integrated behavioral health from a book and then in the middle of her graduate school career. Wanting to get involved in more preventative measures rather than reaching kids at their breaking point, she began to pursue integrated behavioral health How integrated behavioral health serves the patients Dr. Kuhn sees and why it should be regularly practiced 

[13:23] New Babies and Postpartum Mothers    On Dr. Kuhn’s newborn baby! And whether or not being a pediatric psychologist prepared her to be a mom  Why OBGYNs should ask how mothers are doing mentally and administer the Edinburgh Postnatal Depression Scale (EPDS)  Looking to patient’s partners to know them best and when to get help  40% of moms have some risk factor

[22:07]  What Do Parents Need From Their Pediatrician?      Guidance, education, reassurance, and validation  With so much fear, shame, and bad advice surrounding motherhood, we as practitioners need to support our patients by giving them a nurturing environment in which they are comfortable to ask questions and not ashamed.    Ask how your patients are doing: The asking is in and of itself therapeutic, because it helps kind of chase away shame that if I'm asking you, it must not be that bad, that you would share that something difficult happening  Don’t worry if every moment of motherhood doesn’t feel magical  Even if all you can do is provide some resources, and be there to listen, that helps immensely    

[42:31] Closing Segment  Wishing Dr. Jenn Kuhn well as she returns to work  Final Takeaways:  1. Integrated behavioral health is the integration of mental health professionals in medical settings, working side by side 2. Parents are beginning to seek out integrated behavioral health clinicians 3. Being a psychology professional

Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong-and What You Really Need to Know
Cribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, from Birth to Preschool (The ParentData Series)

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I am so excited to welcome another pediatric trainee to the podcast. My guest, Dr. Nina Kuei, MD has always aspired to be a physician. After a long journey, including 6 years of working in the medical field between undergrad and medical school, she’s found herself in her happy place; Pediatrics. Nina received her medical degree from the Medical College of Georgia and completed her pediatrics residency at the Grand Rapids Helen DeVos Children's Hospital in Michigan. She'll be moving to Cleveland, Ohio for her Developmental-Behavioral Pediatrics Fellowship and wishes to pursue a Sleep Medicine Fellowship afterward.   Nina has a passion for diversity, equity, and inclusion topics in clinical medicine. Nina co-founded the pediatric program’s Diversity and Inclusion Committee. Today, we’ll be talking about Microaggressions and how we can improve the clinical medicine workspace for everyone. [00:01] Dr. Nina Kuei Shares Her Background With Us    Growing up and receiving her medical training in the south, Dr. Kuei moved out to Grand Rapids, MI to be a Pediatrics Specialist   She didn’t plan to go into pediatrics initially, but she discovered how fulfilling it was for her.   She initially wanted to pursue a fellowship in Sleep Medicine, but then decided to go for Developmental-Behavioral Pediatrics first 

[06:05] What Are Microaggressions?    With the current social climate of rampant hate crimes against Asians and the unrest surrounding George Floyd’s death, microaggressions are a topic we need to be discussing.    Dr. Kuei explains what microaggressions are Acts or language that communicates bias towards another person or group  Stems from systemic racism  Often times are subconscious    How microaggressions feel to the receiver Dr. Kuie explains microassaults, microinsults, and microinvalidations   Educating ourselves and seeking to understand 

[16:53]  How We Can Educate Ourselves To Understand and Avoid Causing Microaggressions      Implicit bias testing  See links below for articles, podcasts, and resources for self-educating on this topic  If you witness a microaggression, do something about it  Microaggressions that are prevalent in the medical field  Microaggressions from patients  Microaggressions within an interprofessional team  Dealing with microaggressions as the receiver  The power of self-affirmation  

[27:14]  Dr. Nina Kuei’s Quality Improvement Project Regarding Microaggressions    An educational intervention  Taking medical providers from a 17% to a 63% level of confidence in their ability to identify microaggressions  Standing up for victims helps validate them and opens up doors for conversation  The importance of discussing microaggressions  Being comfortable with being uncomfortable  We all have our own innate biases We have to be vulnerable enough to admit our own weaknesses without shaming    

[37:24]   Closing Segment  What advice would you give your younger self?  I would allow myself a lot of grace  Final Takeaways:  Nina describes microaggressions as small signals towards marginalized populations that may demean, insult or hurt the receiver  Systemic racism is built on micro and macro aggressions  Microassaults; are explicit and intended to hurt Microinsults; comments, rudeness that may demean or snub another  Microinvalidation; comments that nullify or negate someone  What can we do? Start with educating ourselves  Be an ally if you are a witness or a bystander and use your power How? Acknowledge that the microaggression occurred, validate the negative feeling it caused, and counter the action   If you are the receiver or victim, try...

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Today’s episode is a wrap-up of May’s Mental Health Month on our Suicide Prevention series and will feature a clinician who is using the Ask Suicide-Screening Questions (ASQ) Toolkit in real life.  Dustin Bogan is a Board Certified Pediatric Physician Assistant and a Fellow of the American Academy of Physician Assistants, The Virginia Academy of Physician Assistants, and The Society for Physician Assistants in Pediatrics. After growing up in rural Virginia, he attended Shenandoah University for his bachelor's degree in Biology. He minored in Psychology and then got his master’s degree as a Physician’s assistant. After graduation, he began working immediately in primary care pediatrics.  He is at Pediatric & Adolescent Health Partners and strives to combine his personal background, medical knowledge, and passion for mental health in his career. He serves as a care coordinator and facilitates the trauma-informed leadership team in his practice. He is also an adjunct professor at South University, educating students on pediatrics and topics related to mental health.     The Hotline for Suicide Prevention is 1-800-273-8255. Crisis Text Line: text HOME to 741741    [02:31] Dustin Bogan Shares His Background     Growing up in a rural area in Virginia, Dustin didn’t have access to a pediatrician Seeing so much needed around him inspired Dustin to go into a helping profession  At Pediatric & Adolescent Health Partners Dustin met Dr. Abernathy      There are only 8000+ Child Physiatrists in the whole country  

[07:02] The Impact Dustin Sees on Mental Health in His Practice   The uptick of suicidality due to COVID-19   

[09:28]  Why Dustin’s Practice Decided to Start Generalized Screening for Mental Health     Dr. Abernathy and Dr. Horowitz opting to do a research study which led to findings of 12% of patients with suicidal ideations  Barriers to implementation Are parents upset about it?  workforce issue in terms of flow   How are nurses and staff able to get involved Dustin shares a story of how the ASQ Toolkit identified a patient in his practice with suicidal ideations and help save his life  Being able to convince the staff to adopt general screening when they saw its necessity firsthand  Parents reactions to the general screening  The ages that Dustin’s practice screens  How to screen kids that come in with chronic headaches, tummy aches  Research has proven that kids that come in with chronic abdominal pain, chronic headaches, etc., are likely to have a history of trauma or an underlying mental health disorder   How to handle positive screening results Building a smooth process for handling patients that screen positive  Zero Suicide Framework Lead, Train, Identify, Treat, Engage, Improve, and transition Creative ways practitioners can partner up with experts    Get comfortable with being uncomfortable Tools and resources (Links below)  Creating a Trauma-Informed Leadership Team 

[41:53]   Closing Segment  What advice would you give your younger self?  Embrace the moment, learn from the present and not take opportunities for granted.   Final Takeaways:  Dustin’s group started screening for suicide risk intentionally after Dr. Abernathy attended a conference teaching on using the ASQ Toolkit   The group committed to routine screening for well-child visits and then frequent use for chronics, frequent injuries, and any time there was a concern; It's not about the kids who would say but about the kids who would not say Parents embraced the screening after a trial run In order to prepare for the implementation, partners attended conferences and accessed other educational materials on suicide prevention, and educated the...

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Today’s episode is an encore of an interview I did with Dr. Lisa Horowitz last fall. Suicide is the second leading cause of death in youth 15-24. Dr. Horowitz talks about how pediatricians can incorporate the Ask Suicide Screening Questions (ASQ) screening tool into their practice to help identify children and adolescents at risk of suicide and to link them to coordinated care.    Dr. Lisa Horowitz is a Staff Scientist and Pediatric Psychologist at the Nation Institute of Mental Health Intermural Research Program at NIMH. The major focus of her research has been detection of suicide risk in the medical setting. She is the head PI in several ‘Suicide Prevention Protocols’ using the ASQ Toolkit. She assists hospitals, schools, and pediatric centers in implementing Suicide Screening of patients.    The Hotline for Suicide Prevention is 1-800-273-8255. Crisis Text Line: text HOME to 741741  [00:01 - 10:54] Dr. Lisa Horowitz Shares Her Story    I introduce my guest, Dr. Lisa Horowitz Dr. Horowitz shares a bit of her background  How Dr. Horowitz got into her line of work  Realizing the need for developing a suicide screening tool  The Creation of ASQ   

[10:55 - 22:25] How To Implement Suicide Risk Screening When It’s Outside of Your Medical Training  The pushback Dr. Horowitz experienced when trying to implement Ask Suicide Screening Questions (ASQ) Toolkit Creating a script for Nurses or practitioners that will help parents and patients feel comfortable  Using appropriate language when checking up on patient’s mental health  Doctor’s fear about patient’s screening positive for suicide risk   

[22:26 - 49:48]  How What Dr. Horowitz Did in the Emergency Room Translates To Primary Care   Despite suicide being the 2nd leading cause of death, most health care professionals are not trained in dealing with it  Dr. Horowitz tells a pediatrician superhero story about Dr. Ted Abernathy “He’s not worried about all the ones he’s going to catch. He’s worried about the ones he’s going to miss.”   What a practitioner should do if they get a positive screening  Conducting the 2nd tier safety assessment Creating safety plans for the patient with the ASQ toolkit   Having experts with mental health experience and training in the clinic is ideal Partnering with mental health professionals or partnering with your local crisis hotline  Having the patient return to your office in a few days until you can secure them with a mental health professional     Asking about access to lethal means particularly firearms Disrupting at-risk patient’s means of suicide can be a big lifesaver  Fostering resilience  Checking your own emotional regulation 

[49:48 - 00:00]   Closing Segment  Pediatricians can make a difference  To learn more about the ASQ, please refer to the link below  Final Takeaways:  The ASQ is a lot more sensitive than the PHQ9  It is OK to ask parents to step outside the room  It’s a myth that asking will put suicidal ideas who weren’t thinking about suicide  This can be implemented in a primary care setting; Listen to next week's episode on how it can be implemented in a way it makes sense  We can make a difference by using these 5 questions  Never forget to ask about lethal means of access.  

Tweetable Quotes: “If you’re really thinking, ‘I went into medicine to save lives.’ Suicide prevention is saving lives.” - Dr. Lia Gaggino  “People are so worried about the liability of asking [about suicide risk]. What about the liability if you don’t ask.” - Dr. Lisa Horowitz “Let this be a call to action because every single health care worker can make a difference in somebody’s life by asking.” - Dr. Lisa Horowitz

Resources Mentioned: Video:...

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My guest today is  Christopher Thomas Veal, a 4th-year medical student at The Larner College of Medicine in Vermont. Christopher earned his bachelor of science in Studio Art and Biochemistry at The University of Vermont. He has served on the Vermont Governor’s Council for Child and Family Prevention Programs and has led several activist groups while in medical school. He has also published essays centered on mental health advocacy and social justice in the annals of internal medicine and academic medicine. Currently, he is directing a film series centered on medical student’s mental health called The Larner Stories Project   Caution: This episode discusses the subject of suicide and may be a trigger for some. If you or someone you love struggles with suicidal thoughts, please reach out. The Hotline for Suicide Prevention is 1-800-273-8255 or Crisis Text Line: text HOME to 741741      [00:01 - 36:20] Christopher Shares His Story   As Christopher journeyed into medical school, the heavy pressure of failure, expectation, discrimination, and isolation drove him into depression.  Calling his late friend’s mother saved his life. Christopher began going to therapy, got the support system that he needed, and embraced failure as an avenue for growth.   In 2020 Christopher experienced an awakening in recognizing the role he had in activism after experiencing the pain, death, discrimination and financial turmoil COVID-19 brought onto minorities Christopher began sharing stories of lived experiences in order to help others 

[36:20 - 46:54] The Longing for Belonging  Christopher felt the importance of letting people know suicide is not the only option.  Dr. Lia and Christopher discuss how the privilege of accessing mental health may not even have been something people of color realized was an option for them.  

[46:55 - 54:14]  Christopher’s Activism in Kenosha  Mental and Physical health care is a right, not a privilege.  Christopher’s pursuit into psychiatry and primary care comes from a hope to serve his community and provide a place of belonging for people of color who have been minoritized

[54:15 - 00:00]  If You Could Go Back and Give Yourself Advice What Would It Be?   To recognize that failure will build you into who you will become. To not live in fear but to live honestly, passionately, and authentically.   To connect with Christopher Veal please visit the links and resources below  Main Takeaways:   It is critical that medical training programs create a safe and welcoming place for medical students. Out of hopelessness, there is hope and help.  Medical training continues to promote the stigma of failure and culture of perfectionism  As a black man Christopher shared a painful reality. “There is a target on my back that follows generations of racism and dehumanization.”    Black patients may not seek mental health because it historically has not been seen as an option. This is exclusionism.   Activism is an obligation to change minds and change hearts.  A message to medical students; Asking for help works, therapy help and there is no shame in failure.  

Tweetable Quotes: “When I started looking at failure as an opportunity instead of a liability, that’s when things started to turn around.” - Christopher Veal “We burn out, we break from the pressure and we die. Whether it’s by suicide or by an accident that could have been prevented, these are things that are majorly affecting our profession and what's sad is that it’s not being talked about.” - Christopher Veal “When that ‘Why to live’ becomes obscured and distant, getting to that ‘How I’m gonna live’ is very difficult to envision.”  - Christopher Veal “ I've failed over and over and over again in my life. And that is why I succeed.” - Micheal...

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May is Mental Health Awareness month and today’s episode begins a 4 part series dedicated to suicide prevention.  My guest today is Anne Moss Rogers the Emotionally Naked public speaker, registered suicide prevention trainer, TEDx storyteller, and NAMI Virginia fundraising chair. Anne Moss is the author of the award-winning book, Diary of a Broken Mind, and her second book Emotionally Naked: A Teacher's Guide to Preventing Suicide and Recognizing Students at Risk will be out in August of 2021. Anne Moss helps people foster a culture of connection to prevent suicide, reduce substance misuse, and find life after loss. Caution: This episode discusses the subject of suicide and may be a trigger for some. If you or someone you love struggles with suicidal thoughts, please reach out. The Hotline for Suicide Prevention is 1-800-273-8255 or Crisis Text Line: text HOME to 741741      [00:01 - 16:43] Anne Moss Shares Her Story About Her Beloved Son, Charles  Anne Moss highlights the difficulty in being able to get a diagnosis or the help they needed from health professionals Charles had seen 3 health professionals in the 2 week period prior to his suicide In Trying to deal with the devastation Anne Moss started the Emotionally Naked blog and started writing about her experience.  Her writing went viral, reaching those who shared her story  The moment Charles lost faith in the Mental Health system  Shame is a focus on self, guilt is a focus on behavior. Shame is “I am bad.” Guilt is “I did something bad.” - Brene Brown 

[16:44 - 27:02]  What Do Pediatricians and Primary Care Practitioners Need to Know?      Looking out for signs of self-harm and drug use Anne Moss’ Free Ebook resource titles ‘Signs of Drug Use’ (links below) Relationship disruptions Transitions Susceptible to physical illness  Identity issues  Mental health issues Previous attempts  Exposure to suicide  Pediatricians need to be prepared for their patients’ honesty and answers if they are going to be screening for suicide prevention  

[27:03 - 32:10] Get Comfortable Being Uncomfortable Set the expectation that you will be uncomfortable  Asking and listening with empathy is the best thing one can do    We need to make kids a part of their treatment process   Ensure the child to know that somebody is in their corner 

[32:11 - 40:49] Things Pediatricians Can Do If Their Patient Admits to Being Suicidal    Brief assessments Ask Suicide-Screening Questions (ASQ) Toolkit (link below)  The potential that universal suicide screening for every visit has to intervene and save lives    Approaching and having the conversation with the patient’s parents  Taking a gentle but authoritative approach  Recovery is possible and probable. We can offer hope by listening and riding the ride.  

[40:50 - 48:15]  Closing Segment  To connect with Anne Moss check out her links and resources below  Anne Moss shares her finals thoughts My Takeaways:  Medical Personal didn’t want to discuss suicide and ignored mental health subjects because they felt frozen  Get comfortable with being uncomfortable   If someone has disclosed that they have suicidal thoughts, the next strategy and phase is to ask  Listen  Offer hope and help  Parents may not be ready to hear. Denial is real  Have a plan, a process, and a team to rely on Listen to the upcoming episodes and plan  There are extensive resources in the show notes 

Tweetable Quotes: “I think the main thing is knowing whether children are experiencing some kind of relationship disruption…  Those peer relationships are the center of their universe. And those relationship disruptions seem to trigger children who are already vulnerable.”

Emotionally Naked: A Teacher's Guide to Preventing Suicide and Recognizing Students at Risk

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This May for Mental Health Month, I have dedicated 4 episodes to suicide prevention. Suicide is the second leading cause of death in youth and we have to know what to do and how to help. Our kids and families are depending on us! .  [00:01 - 03:39] An Upcoming Series for Mental Health month In the upcoming episodes, you will hear stories of lived experiences, suicide prevention screening, and universal suicide screening.  

[03:40 - 05:40]  Being an Advocate for Our Patient’s Well-Being Please send feedback and share this series with others.  How we provide mental health care in this country is flawed and fractured. We are aiming for change and a better system for all   Every patient must have access to mental health care as well as physical health care    

[05:41 - 06:40] Trigger Warning A word of caution, some of the topics discussed are going to be very sensitive. If they are a trigger for you or a loved one the Hotline for Suicide Prevention is 1-800-273-8255 or Crisis Text Line: text HOME to 741741 

Tweetable Quotes: “We have to start looking at children and all of us as whole beings. No matter where you are, your emotional being is with you and it's with our patients too. If we’re not paying attention to that then we're going to miss the boat and we may even make the wrong diagnosis.” - Lia Gaggino    “My goal is that everyone will take this to heart and be an advocate for our patients’ emotional well-being.” - Lia Gaggino    Resources Mentioned: https://youth.gov/feature-article/may-national-mental-health-month#:~:text=Mental%20Health%20Month%20raises%20awareness,children%2C%20families%2C%20and%20communities. (Youth.Gov: May is National Mental Health Month) https://wonder.cdc.gov/controller/datarequest/D76;jsessionid=AE4907001A9B5732ECED806B5E3D (CDC: Underlying Cause of Death in Youth, 1999-2019)

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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In this special episode dedicated to medical students, residents and fellows, Dr. Josh Prudent and Dr. Amrit Misra join me as we talk about mental health training, mental health advocacy, addressing our own biases as practitioners, how ACE impacts the populations we serve, and the stigmatization around practitioners' own mental health struggles. Mental health concerns affect all areas of medicine and pediatrics is no different. Because pediatrics provides an opportunity for prevention and early identification, it is critical that our trainees receive in-depth mental health training in order to promote emotional well-being. Josh Prudent is a 2nd-year Pediatric Resident at Nationwide Children's Hospital in Columbus, Ohio, and the District 5 resident representative to the American Academy of Pediatrics. He completed medical school at the John Hopkins School of Medicine. Dr. Prudent is pursuing a fellowship in Pediatric Hematology-Oncology. His advocacy interests include immigrant and refugee rights, vaccine advocacy, youth mental health and behavioral health, and secure patient pediatric research funding.  Amrit Misra is a 3rd-year Pediatric Cardiology fellow at Children's Hospital of Michigan. He completed medical school at the University of Michigan and completed his Internal Medicine-Pediatrics training at Detroit Medical Center. He served as one of the Pediatric Chief Residents at Children’s Hospital and his clinical interests include adult congenital cardiology, community and global health, and transitional medicine.  Please join me in welcoming Dr. Prudent and Dr. Misra    [00:01 - 03:54] Opening Segment Dr. Amrit Misra talks about his background and his involvement in the American Academy of Pediatrics.   

[03:55 - 8:54] Advocacy Projects for Mental Health   Dr. Misra talks about the AAP’s Section On Pediatric Trainees’ focus on mental health for this year’s annual advocacy campaign 

[08:55 - 15:42] Are Medical Students, Residents, and Fellows Receiving Adequate Mental Health Training?    Dr. Misra’s thoughts on how medical school and residency can further bridge the gap of training required to fit the vast needs of mental health.   Dr. Josh Prudent joins the interview and gives his thoughts.

[15:43 - 29:41] How Are You Integrating Your Adverse Childhood Experiences Training Into the Work You Are Doing?    Dr. Prudent incorporates ACEs into his patient’s medical care and talks about the nuances of approaching these conversations with clients.     Dr. Misra shares where he sees ACEs impact his patients  The need to provide more holistic care and for pediatricians to uncover biases within themselves in order to properly diagnose   Approaching biases with a level of humility and desire to improve patient care. 

[29:42 - 44:06] Medical Students and Mental Health  The stigmatization around mental health and the shame and fear of failure surrounding getting help.   Burnout and the shift in perspective of making sure medical students are aware of their wellness  Dr. Prudent and Dr. Misra share their appreciation for very good attendings 

[44:07 - 49:37] IWhat Advice Would You Give Your Younger Self?   Dr. Misra would tell his younger self to relax and enjoy the process.  Dr. Prudent advises to maintain strong relationships with your friends at every stage in your life.  How does a resident find out about the Section on Pediatric Trainees (SOPT)? (Links below) 

[49:38 - 52:11] Closing Segment Finals takeaways Trainees have a very special place in the AAP’s Section On Pediatric Trainees The SOPT dedicated all their activities to mental health for their annual advocacy campaign We need more mental health training in medical training  They have seen the impact of ACE on the populations they serve

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Children that exhibit aggressive and disruptive behaviors can be hard to manage and treat especially if the root causes are not clearly understood. Paresh Patel, M.D., PhD, joins us in this episode to talk about exploring what may be behind difficult behaviors and offers management and treatment strategies. Dr. Patel emphasized that behaviors are often symptoms of deeper problems. Pediatric clinicians can begin to peel back the layers, and with the support of mental health professionals, find strategies that address what is really going on with kids. He also believes that medication should only be administered with the intent to stop the medication. Take a listen to his thoughts about the role of psychotropic medications and aggressive and disruptive behaviors and when we can lean on our colleagues in psychiatry. Although the first stop for many parents whose kids are struggling with difficult behaviors is the pediatric office, it is really about a team approach that includes our friends in psychiatry and mental health. Tune in for a thoughtful discussion about aggression and disruptive behaviors in kids with Dr. Patel! [00:01 - 07:23] Opening Segment Let’s welcome, Paresh Patel, M.D., PhD His path to child psychiatry 

[07:24 - 21:57] Disruptive Behaviors  What Paresh learned under the MC3 Program Medication is only a smart part of treatment  Handling children with disruptive behaviors  Paresh shares his experience  Behaviors are symptoms Non-verbal vs. verbal communication Some key insights from Paresh 

[21:58 - 36:13] Free Will Among Children  Paresh’s message for parents on how to be “super parents” He talks about the notion of free will among children Here’s a true story from Paresh you should not miss 

[36:14 - 51:29] Longitudinal Relationships and Trust Building relationships and trust among pediatricians When to resort to antipsychotic medication for children  We break down the different therapies available to children

[51:30 - 58:21] Closing Segment Paresh’s message for his resident self Finals takeaways Children do well if they can Behavior is a symptom  Turning parents into “super parents” No bad kid or bad parent Start medication to stop medication  Involve the therapist in the therapy  Jump with both feet and pay attention

Tweetable Quotes: “The behavior is just a symptom of a deeper problem, and a deeper problem can be along the child continuum.” - Paresh Patel, M.D., PhD “Start medication with the intention to stop it.” - Paresh Patel, M.D., PhD

Resources Mentioned: https://mc3.depressioncenter.org/ (Michigan Child Collaborative Care Program) Pediatric Meltdown previous episode: https://apple.co/3mJRlld (Autism Spectrum Disorders in Primary Care: Recognizing Early Signs and Initiating Treatment‬) Book: https://amzn.to/3teO4wJ (The Explosive Child)

Email pdpatel@med.umich.edu to connect with Paresh and check out http://med.umich.edu/ (Michigan Medicine) to learn more about his work. 

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Explosive Child [Fifth Edition]: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children

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Dr. David Hill, author of “Dad to Dad,” and a co-host of the AAP Pediatrics on Call podcast joins me to discuss social media use and our kids. He shares thoughts on how to reinforce its positive impacts and to navigate the pitfalls Dr. Hill outlines strategies to share with parents and talking points for pediatric clinicians Take a listen and learn to promote the positive use of social media among kids! [00:01 - 06:53] Opening Segment Let’s welcome, Dr. David Hill His path to broadcasting and podcasting 

[06:54 - 16:15] Impact of Social Media on Kids  The positive impact of social media on kids  Care for yourself with these tips from us David talks about divorce and separation

[16:16 - 28:56] Self-Efficacy Among Kids  The negative effects of social media on kids  Reinforce self-efficacy among kids David tells us how  Listen to David’s thoughts about gaming disorders 

[28:57 - 39:25] Advice for Parents  Hear David’s insights about the role of sleep in our lives  What parents should learn from David  David’s message for his resident self 

[39:26 - 46:35] Closing Segment Finals takeaways Social media can be positive  When does social media become a concern? Problematic internet behaviors  Suggestions for parents to regulate social media use among kids

Tweetable Quotes: “This line that separates the electronic world and the real world is a very fuzzy, fuzze line, and sometimes it’s just not there at all.” - Dr. David Hill “We want to put our kids in charge of their own wellbeing.” - Dr. David Hill Resources Mentioned: David’s books:  Sole authorship: https://amzn.to/2Q2j9F3 (Dad to Dad) Co-authorship: https://amzn.to/3sXtkcL (Co-parenting Through Separation and Divorce) Other books:  https://amzn.to/2PASfUY (The Body Keeps the Score) https://amzn.to/3mp4OP7 (Caring for Your Baby and Young Child, 7th Edition: Birth to Age 5) Individuals to follow: https://www.davidsedarisbooks.com/ (David Sedaris) https://bit.ly/3sXJdA6 (Dr. Joanna Parga-Belinkie) Pediatric Meltdown previous episodes:  https://apple.co/31MJYQf (Mental Health Advocacy: A Conversation with AAP President Lee Beer‪s‬) https://apple.co/2Q0X4XK (Kids and Sleep Why Getting Enough ZZZ's Matter‪s‬) https://bit.ly/31Pbdtz (Family Media Plan) YouTube video: https://bit.ly/2R1hrEu (Caring for yourself)

Email davidhillmd@gmail.com to connect with David and check out his https://doctordavidhill.com/ (website) to learn more about his work. Listen to his https://apple.co/3wsXI0N (podcast).

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/)

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
Co-parenting Through Separation and Divorce: Putting Your Children First
Caring for Your Baby and Young Child, 7th Edition: Birth to Age 5
Dad to Dad: Parenting Like a Pro

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Dr. Arthur Lavin returns to the podcast and offers practical advice on parent-child conflict and problem solving strategies. Tantrums are a teaching opportunity where children learn to solve the problem and parents are the guides. Dr. Lavin shares highlights from his book “Who's the Boss: Moving Families from Conflict to Collaboration” that he authored with colleague Susan Glaser and presents a framework to tackle tantrums and meltdowns Let’s listen to this primer for parents and pediatric providers from Dr. Lavin! [00:01 - 03:57] Opening Segment Let’s welcome back, Dr. Arthur Lavin Let’s all be cautious for a few more months Listen to Arthur’s message 

[03:58 - 14:09] Teaching Children to Solve Problems  How Arthur turned a 12-year collab into a book He did it with his colleague  Teaching children to solve their problems  Why Arthur likes “neutral questions”

[14:10 - 24:04] Like A Computer Freezing  Understand tantrums better with this analogy  How to handle tantrums better Arthur talks about anger flares among adults 

[24:05 - 35:40] The Line of Concern  The alternative to listening and problem solving  Arthur shares a sneak peek about his next book Listen to his message to his resident self

[35:41 - 41:38] Closing Segment Finals takeaways Teach children to solve problems themselves  Who will find the solution, the parent or the child? Adopting a neutral tone Structuring conversations better The approach with 100% success rate  Children create the consequences, aside from solutions  Tantrums are like computers freezing  Teen tantrums are more complicated 

Tweetable Quotes: “The secret to success always lies in finding some way to create a situation or an understanding or a stance freely whereas the child [has] the freedom and the ingenuity and the creativity to solve that problem themselves .” - Dr. Arthur Lavin “Listen to that voice, stay close to that voice, and stay true to that voice.” - Dr. Arthur Lavin Resources Mentioned: Pediatric Meltdown episode 9: https://apple.co/3rB58LE (School Struggles ADHD or is it‪?‬) Arthur’s books https://amzn.to/31wpf3m (Who's the Boss) https://amzn.to/31vgHJR (Baby and Toddler Sleep Solutions For Dummies)

Email alavinmd@gmail.com to connect with Arthur and visit https://www.advancedped.com/staff/ (https://www.advancedped.com/staff/) to learn more about his space. 

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Who's the Boss: Moving Families from Conflict to Collaboration, 2nd Edition
Baby and Toddler Sleep Solutions For Dummies

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It is my great pleasure to welcome Dr. Mark Sloane back to the podcast for the second time to talk about mood regulation in children using Goldilock’s “just right” metaphor We can all imagine a rambunctious Tigger, a forlorn Eeyore and a contented Goldilocks. Now use that imagery and apply it to children’s behaviors and you come away with a unique perspective and framework for understanding the ultimate meltdown and a harmonious middle ground. Put your headphones on and take a listen to Dr. Sloane’s thoughts on mood regulation and how we can better help kids find their “just right” place. [00:01 - 12:03] Opening Segment Let’s welcome back, Dr. Mark Sloane  Listen to Mark’s mindset when he’s asked for help Don’t miss this story from Mark about an untreated ADHD

[12:04 - 26:00] Behavior Regulation   What does Mark mean by regulation? The connection between regulation and resilience  Regulating a baby? Listen to Mark

[26:01 - 40:43] Intrinsic Motivation  Listen to Mark and learn how regulation works in the brain!  Mark breaks down intrinsic motivation  What do kids call this motivation?  He talks about the fight-or-flight response From Eeyore to Tigger

[40:44 - 56:44] Power of Mindfulness  How powerful is mindfulness?  Different strategies that doctors use to train mindfulness What are overwhelmed brakes? 

[56:45 - 01:04:51] Regulation in Social Models  Mark talks about their social model and how regulation fits in it Listen to our interesting exchange about marijuana use  Mark’s message to his resident self 

[01:04:52 - 01:08:51] Closing Segment Finals takeaways Consider an integrated lens for children with difficult behaviors Resilience is not automatic The prefrontal cortex or the “breaks” Think about Tigger, Goldilocks, and Eeyore Strategies to get from Tigger to Goldilocks  Widen the Goldilocks Zone  Any adult can make a difference 

Tweetable Quotes: “Regulation is the epicenter of our universe.” - Dr. Mark Sloane  “Mindfulness is powerful.” - Dr. Mark Sloane  Resources Mentioned: https://apple.co/396S2PT (Pediatric Hero: Building Safe Spaces for Kid's Emotions with Dr. Mark Sloan‪e) https://bit.ly/2PkCQrm (The Brain-Behavior-Resilience Connection)

Email mark.sloane@wmich.edu to connect with Mark and visit https://wmich.edu/ (https://wmich.edu/) to learn more about his space. 

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Mary Barkholz is a special education teacher and mother of 2 young men on the autism spectrum. She is passionate about giving support and guidance to families and their children with special needs. In this episode, she shares her experience as a parent raising her children, how her work as a special education teacher plays in the situation, and how healthcare providers can better connect with families.  Let’s listen to Mary and learn what parents want and need from us! [00:01 - 06:05] Opening Segment Welcoming today's guest, Mary Barkholz How she realized her children are on the autism spectrum 

[06:06 - 17:00] The Importance of Honesty  Mary recalls how she landed in the special education space  Educational diagnosis vs. Medical diagnosis Mary breaks them down  The importance of honesty for Mary 

[17:01 - 29:46] Connection Between Families and Healthcare Providers  Mary’s approach in raising children in the autism spectrum  How starting a conversation is crucial to a child’s growth  The disconnect between families and healthcare providers 

[29:47 - 41:45] Guardianship and Parent Networks  Are there any parent networks you can join?  Mary’s thoughts about guardianship on children in the autism spectrum  How parents can assist children in making decisions 

[41:46 - 50:55] Relationship-Building Advice  Listen to this parenting advice from Mary you don’t want to miss! The power of building relationships with children 

[50:56 - 59:01] Closing Segment Finals takeaways The parents’ readiness to be informed on autism  Emotions are a mixed bag  Medical diagnosis vs. Educational diagnosis  Path to adulthood for children with special needs  Bridges that connect healthcare, community, and education sectors  Giving children options  Guardianship  Children in the autism spectrum are not numbers but persons  Letting the child take the lead 

Tweetable Quotes: “I always say that honesty is the only way I can function.” - Mary Barkholz “We do have to let [our children] fall down, let them figure things out.” - Mary Barkholz Resources Mentioned: https://bit.ly/3lfqQmU (An Approach to Transition Assessment and Planning) https://bit.ly/3bM8bft (Guardianship) https://autismallianceofmichigan.org/ (Autism Alliance of Michigan) Book: https://amzn.to/3qMEQpx (Raising Your Spirited Child) Pediatric Meltdown episode: https://apple.co/3tkWx0W (Pediatric Hero: Building Safe Spaces for Kid's Emotions with Dr. Mark Sloan‪e ‬) Pediatric Meltdown episode: https://apple.co/38EAKtw (Across the Divide: Building Bridges between Primary Care and Community Mental Health Providers with Dr. Zakia Alav‪i‬) Pediatric Meltdown episode: https://apple.co/3rU6Mt6 (Caring for Kid's Mental Health During Covid: How Parents Can Help with Dr. Zakia Alav‪i‬) Pediatric Meltdown episode: https://apple.co/3cCvXdg (Meeting the Educational Needs of Children - Collaborating with Our Colleagues in School‪s‬)

Email mbarkholzingber@gmail.com to connect with Mary and or follow her on https://www.linkedin.com/in/mary-barkholz-ingber-576501146/ (LinkedIn). 

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Raising Your Spirited Child, Third Edition: A Guide for Parents Whose Child Is More Intense, Sensitive, Perceptive, Persistent, and Energetic (Spirited Series)

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Victims of child abuse and neglect and sexual assault should be handled carefully by healthcare providers due to the sensitivity and severity of what happened to them. Dr. Sarah Brown joins us in this episode to talk about the difficult questions we must ask children and families in order to keep kids safe. We also discussed when and where to ask them and when to call authorities, if needed. Timing is as important as the questions themselves.  Let’s listen to Dr. Brown and learn how to ask the hard questions to victims of child abuse and neglect! [00:01 - 04:45] Opening Segment Welcoming today's guest, Dr. Sarah Brown Her path to child abuse and neglect and pediatrics 

[04:46 - 14:54] Let The Child Talk    How to build a safe space for children and adults  Our role as healthcare providers  The power of small words  The first step in asking about abuse from children What are the right questions to ask? Introducing things that are NOT okay 

[14:55 - 26:17] Talk About Abuse Somewhere Else  The protocols in handling sexual assaults for healthcare providers  How to efficiently report sexual assault What Dr. Brown does not recommend on talking about abuse 

[26:18 - 38:44] Be Careful with Telehealth Services  The overlap between domestic violence and child abuse and neglect  Hear Dr. Brown’s thoughts about telehealth services  Don’t miss Dr. Brown’s insights about the Safe and Together model 

[38:45 - 43:52] Relax and Take One Day At a Time How healthcare providers can take better care of themselves Listen to Dr. Brown’s advice Dr. Brown’s message for her resident self 

[43:53 - 50:06] Closing Segment Finals takeaways Believing the child is important  Asking when you suspect child abuse  Having an exam as soon as possible  Informing the Child Protective Services  Remembering that domestic violence and child abuse  Being mindful with telehealth services  Taking care of yourself 

Tweetable Quotes: “That goal of not interrupting as long as the child is narrating is important.” - Dr. Sarah Brown “Relax and take things one day at a time.” - Dr. Sarah Brown

Resources Mentioned: https://safeandtogetherinstitute.com/ (Safe and Together Institute) https://bit.ly/3rwQPZo (National Health Resource Center on Domestic Violence) https://bit.ly/30nX4mz (CUES: an Evidence-Based Intervention) https://bit.ly/3v9aLE4 (Sexual Behaviors in Young Children: What’s Normal, What’s Not?) https://www.nationalchildrensalliance.org/ (National Children's Alliance) https://bit.ly/30ssrw5 (Effective Discipline to Raise Healthy Children) https://bit.ly/3rvo13C (The Evaluation of Suspected Child Physical Abuse) https://bit.ly/38ojlF1 (Understanding the Behavioral and Emotional Consequences of Child Abuse) https://bit.ly/3eqF1UT (The Evaluation of Children in the Primary Care Setting When Sexual Abuse Is Suspected) Pediatric Meltdown episode: https://apple.co/3caeM2i (Provider Wellness: Are You Taking Care of Yourself‪?‬)

Email brownsa@bronsonhg.org to connect with Dr. Brown and know more about her space https://www.bronsonhealth.com/ (here). If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Anxiety is normal. In fact, anxiety is “a perfectly normal, natural, [and] not actually dangerous” behavioral response according to Dr. Colleen Cullinan. It is the body’s response when we feel scared, threatened, or stressed, which happens to all people. The primary care’s job is to not allow that anxiety to interfere in a person’s daily life, not to take it away completely. The former is achievable; the latter is impossible.   Let’s listen to Dr. Cullinan and learn how to manage anxiety better! [00:01 - 08:53] Opening Segment Welcoming today's guest, Dr. Colleen Cullinan Her path to clinical psychology Hear her wake-up call

[08:54 - 20:53] Normalizing Being Anxious   Mental healthcare and physical healthcare are the same Dr. Cullinan explains The role of primary care in a child’s mental healthcare  It’s normal for people to be anxious  Listen to Dr. Cullinan 

[20:54 - 35:17] Managing Anxiety  How to manage anxiety and other negative emotions  What is Cognitive Behavioral Therapy (CBT) at its core?  We would not want anxiety to disappear Dr. Cullinan tells us why

[35:18 - 48:59] Accessing Available Resources  The most challenging part of managing anxiety The resources you can access right now  Links below Why partnerships are important in primary care 

[49:00 - 52:43] Closing Segment Finals takeaways Primary care and parent-patient trust are key components of integrated behavioral health Normalize anxiety  Brain, body, and behavior: one activates the next Grounding strategies “to manage anxiety “Feelings are not facts The rules of emotions  Cognitive behavioral therapy at its core  How to start a conversation with patients 

Tweetable Quotes: “Whether we like it or not, primary care is the de-facto mental healthcare system in the country, especially for kids.” - Dr. Colleen Cullinan “Anxiety is designed to protect us. It’s an essential feature of who we are as humans. It’s an evolutionary function.” - Dr. Colleen Cullinan Resources Mentioned: https://kidshealth.org/ (KidsHealth) Book: https://amzn.to/3kBEOPP (Raising An Emotionally Intelligent Child) Book: https://amzn.to/3sGJ2s9 (The Thriving Adolescent) Pediatric Meltdown episode: https://apple.co/3rdnnaW (Mental Health Advocacy: A Conversation with AAP President Lee Beer‪s) https://bit.ly/3e0ukIt (Facts For Families Guide)

Email colleen.cullinan@nemours.org to connect with Dr. Cullinan and know more about her space https://www.nemours.org// (here). If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Thriving Adolescent: Using Acceptance and Commitment Therapy and Positive Psychology to Help Teens Manage Emotions, Achieve Goals, and Build Connection
Raising An Emotionally Intelligent Child The Heart of Parenting

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Dr. Hovig Artinian found his way to sleep medicine after teaching 8th grade science and happily says that practicing medicine is much easier! Sleep is critical to our physical and mental health from infancy into our golden years. The behaviors that surround sleep determine the quality and quantity of sleep. Medications for sleep difficulties fall way down the list on interventions with behavior modification rising to the top. Primary care providers can help parents teach their children about good sleep habits and emphasizes that parents need to pay attention to their own sleeping habits too. Listen in as Dr. Artinian shares strategies and insights to ensure that everyone gets a good night's sleep. [00:01 - 07:04] Opening Segment Welcoming today's guest, Dr. Hovig Artinian  His transition from education to medicine His path to sleep medicine 

[07:05 - 16:50] Getting Your Baby Sleep Through The Night Why you should have enough sleep according to Dr. Artinian How long should you sleep? Bedtime solutions for babies  There’s no one right solution 

[16:51 - 26:20] Training the Child To Sleep Easily and Quickly Toddlers know how to control adults  How can adults reclaim control?  Overnight awakenings are actually normal Dr. Artinian explains Getting toddlers to go to sleep Patience and consistency are keys 

[26:21 - 38:19] Waking Up Teenagers With Enough Sleep  Dr. Artinian’s message for parents in the postpartum period  How Dr. Artinian do sleep treatment  The best medicine he can give you  What about the sleeping habits of teenagers? Listen to light therapy here 

[38:20 - 50:55] Using Marijuana To Sleep  Using your phone before sleeping? Don’t miss this reminder from Dr. Artinian What about marijuana use? Hear Dr. Artinian’s thoughts about it  Facts about pediatric sleep you should know

[50:56 - 55:52] Closing Segment Dr. Artinian’s message for his resident self Finals takeaways Most problems are totally curable and work within weeks  Sleep environment Cognitive bliss about sleep Sleep schedule on non-schedule days vs. schedule days  Circadian rhythm shifts  Parents regaining control  Light therapy  Take a deep breath and forgive yourself 

Tweetable Quotes: “You are not alone when you need to ask for help.” - Dr. Hovig Artinian  “Take a deep breath. Forgive yourselves for the mistakes that you’ve made, Know that you’re growing...and know that you belong.” - Dr. Hovig Artinian 

Resources Mentioned: https://www.instagram.com/postpartumstress/ (The Postpartum Stress Center) https://bit.ly/2P1vsBn (Bedtime Problems) https://bit.ly/2OOR7we (Tip about sleeping)

Email hovig.artinian@helendevoschildrens.org to connect with Dr. Artinian and know more about his space https://bit.ly/37yDxnq (here).

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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As healthcare providers we pour our energy into caring for our patients and often we forget to take care of ourselves, leading to burnout. It is crucial that we take time to take a breath and to recharge. Dr. Martha Middlemist shares the work of the AAPs Wellness Advisory Group and offers concrete steps we can all take to manage stress. Let’s listen to Dr. Middlemist and learn how healthcare providers can take better care of themselves!  [00:01 - 06:13] Opening Segment Welcoming today's guest, Dr. Martha Middlemist  Dr. Middlemist’s talks about her background 

[06:14 - 16:55] Taking Care of Healthcare Providers Better  The steps they’ve taken to take better care of healthcare providers  How healthcare initiatives are conceptualized  Don’t miss Dr. Middlemist’s tips for healthcare providers!

[16:56 - 27:01] Going on a Therapy and Other Wellness Services  Dr. Middlemist talks about this kind of stress among healthcare providers  The importance of realizing that things are not working well  Therapy is an option too for healthcare providers Dr. Middlemist explains 

[27:02 - 39:34] Giving More Time For Yourself  Dr. Middlemist shares her observations during the COVID-19 pandemic  She gives a few creative suggestions for healthcare providers to have fun Her message to her resident self

[39:35 - 43:42] Closing Segment Finals takeaways An idea can go a long way  Wellness silos should be considered Peer support and networking with like-minded individuals are important  What you can do to take care of yourself better Exercise Eat well Get enough sleep Speak up and speak out  Ask for help  Wellness activities you can practice 

Tweetable Quotes: “I think you also have to have workplace wellness by...having supportive caring people around you...” - Dr. Martha Middlemist “From the beginning, take more time for yourself.” - Dr. Martha Middlemist Resources Mentioned: https://nam.edu/ (National Academy of Medicine) https://bit.ly/2Zcmtio (Clinician Resilience and Well-Being) https://bit.ly/3jOOIgp (Physician Health & Wellness) https://bit.ly/3d8mpbL (Improving Physician Well-Being, Restoring Meaning in Medicine) https://bit.ly/2Nr60Eg (What can individuals, organizations do to promote joy in pediatrics?) Pediatric Meltdown episode: https://apple.co/3b2iMkQ (Caring for Kid's Mental Health During Covid: How Parents Can Help with Dr. Zakia Alav‪i‬)

Connect with Dr. Middlemist and know more about her space https://bit.ly/3rWtLDp (here).

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Pediatrics and Psychiatry are two distinct fields that Dr. Nasuh Malas wants to marry. As a consultation-liaison psychiatrist, his personal philosophy is to deliver timely care for young people and families. He joins us today to talk about how psychiatry support can be integrated into an in-patient pediatric setting. We also have a great exchange about how healthcare professionals can take care of themselves better.  Let’s listen to Dr. Malas to learn more about psychiatric support in a pediatric setting!  [00:01 - 05:29] Opening Segment Welcoming today's guest, Dr. Nasuh Malas  Dr. Malas talks about his background 

[05:30 - 16:46] Delivering Healthcare Services Virtually  Dr. Malas’ role as a consultation-liaison psychiatrist Are telepsychiatry services possible?  The rise of virtual psychiatric care 

[16:47 - 29:08] Improving the Youth’s Mental Health  Dr. Malas talks about psychiatric services in a pediatric setting  His thoughts about the effects of the pandemic on the youth’s mental health The steps that adults can take for the youth’s mental health 

[29:09 - 40:24] Take Care of the Healthcare Professionals  How healthcare professionals can avoid burnout Here’s Dr. Malas’ reminder for healthcare professionals The importance of having a supportive team 

[40:25 - 50:57] Being an Effective Physician  The reflections that should happen in a residency training  The privilege of working with families to address health issues  What’s his message for his resident self? 

[50:58 - 56:36] Closing Segment Finals takeaways The role of consult liaison  A psychosocial lens for psychiatry and pediatrics Unique issues due to the pandemic  Fostering care for healthcare professionals  Medicine is a marathon, not a sprint 

Tweetable Quotes: “My philosophy as a consultation liaison psychiatrist is to really facilitate getting the right type of care to youth and families in a timely way.” - Dr. Nasuh Malas  “The more we can spotlight and highlight the importance of mental health for our youth, the more that things will change to really support patients and families.” - Dr. Nasuh Malas 

Resources Mentioned: https://mc3.depressioncenter.org/ (Michigan Child Care Collaborative Program) Pediatric Meltdown episode: https://apple.co/2YO7T0w (Psychiatric Consultation: The Doctor is In‪!‬)  https://www.aap.org/ (American Academy of Pediatrics) https://www.aacap.org/ (American Academy of Child & Adolescent Psychiatry) https://bit.ly/2YPxUME (Practice Parameters for the Psychiatric Assessment of Children and Adolescents) https://bit.ly/3rofpLF (Depression in Medically Ill Children) https://bit.ly/3pR5kGQ (Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department)

Email: nmalas@med.umich.edu to connect with Dr. Malas. Also, visit https://medicine.umich.edu/ to learn more about his space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Today, we are going to talk about genetics and behavioral health with Dr. Caleb Bupp, Division Chief of Medical Genetics and Genomics Spectrum Health at Helen DeVos Children's Hospital. You might be wondering why we have invited a geneticist on a podcast about emotional and mental health in the pediatrics space. Well, our space intersects with genetics more frequently than you can imagine. Dr. Bupp will break these intersections down, explain genetics in a manner that you can also explain it to others, and highlight the importance of genetic testing with consent.    Let’s listen to Dr. Bupp to learn more about genetics in behavioral health!   [00:01 - 06:55] Opening Segment Welcoming today's guest, Dr. Caleb Bupp Why Dr. Bupp chose genetics

06:56 - 16:49] Genetic Issues  We talk about the 3 intersections of genetics and mental health Understand genetics better with this analogy from Dr. Bupp Dr. Bupp tells us why every health issue is genetic 

[16:50 - 27:49] Genetic Testing What is Dr. Bupp’s advice for children with autism  Genetics will be of no use under one certain scenario Dr. Bupp elaborates Genetic testing will be valuable in learning about behavioral health issues Dr. Bupp explains The worst part of being a geneticist for Dr. Bupp

[27:50 - 39:22] Genetic Data  We talk about the importance of consent in genetic testing The value of a person’s genetic data as explained by Dr. Bupp What is pharmacogenomics and why we should understand it 

[39:23 - 47:22] Closing Segment Listen to Dr. Bupp’s reminder for us  What’s his message for his resident self?  Finals takeaways Consent is a must in genetic testing Genetic testing has become mainstream  The different types of genetic testing Children with autism should be offered genetic testing or consultation about it A main barrier right now in genetic testing is cost

Tweetable Quotes: “When you’re working underneath somebody who loves what they do, it’s just infectious.” - Dr. Caleb Bupp “... every health issue is genetic. In some way, shape, or form, we just have to get granular enough to figure out what exactly the genetic cause for that [issue] is.” - Dr. Caleb Bupp

Resources Mentioned: https://bit.ly/2NPrqeE (Genetic Information Nondiscrimination Act of 2008) https://bit.ly/3j0fCSg (What is informed consent?) Locating a genetics clinic https://www.acmg.net/GIS/ (here) https://bit.ly/2L0Ma1S (Pharmacogenomics FAQ)

Email caleb.bupp@spectumhealth.org to connect with Dr. Bupp. Also, visit https://www.spectrumhealth.org/ to learn more about his space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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We always say that “prevention is better than the cure,” but prevention won’t happen if the necessary infrastructures, institutions, and support systems are not in place. Dr. Lee Beers, the new President of the American Academy of Pediatrics, recognizes this problem and aims to advocate for an integrated approach that can also address the issues that plague our children, particularly those relating to their mental health.  Let’s listen to Dr. Beers to learn how to advocate for mental health services better!   [00:01 - 06:01] Opening Segment Welcoming today's guest, Dr. Lee Beers Her story as a navy physician 

[06:02 - 17:23] Parenting Impacts Her memorable 18-month experience as a physician overseas Dr. Beers talks about the impact of parenting on infant development  The challenges of dealing with mental health among children

[17:24 - 29:04] Integrated Behavioral Health  Dr. Beers breaks down integrated behavioral health  She talks about the status of mental health in the United States Are there enough pediatric mental health providers? Is there enough access to quality health care?  How to advocate for an established mental health support system 

[29:05 - 40:27] Accessible Health Services  Why health services should be accessible in the long-term Here’s an old reminder from Dr. Beers that you should hear  The services that the American Academy of Pediatrics offers

[40:28 - 49:32] Closing Segment Dr. Beers’ message for her resident self you should also hear  Final Takeaways The parents’ wellbeing and health are crucial too The importance of family support  Integrated behavioral health  Delivery of health services  The place to make a change  Don’t be afraid to take risks 

Tweetable Quotes: “It’s really important for us to make sure that access to [health] services is sustainable.” - Dr. Lee Beers “Each and everyone of us has that power to make a change.” - Dr. Lee Beers

Resources Mentioned: https://www.aap.org/ (American Academy of Pediatrics) https://bit.ly/2YdPwl5 (Through a Different Lens: Examining How We Care for Adolescent-Headed Families) https://bit.ly/3qXQBKp (Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting) Healthy Children https://www.healthychildren.org/ (website) Pediatric Meltdown episode: https://apple.co/2Yg52wQ (Caring for Children in Foster and Kinship Care: Keeping a Trauma-Informed focus with Moira Szilagyi)

Email lbeers@childrensnational.org to connect with Dr. Beers. Also, visit https://childrensnational.org/ to learn more about her space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Sex and drugs remain taboo in society, and the reluctance to talk about these topics only leads to misinformed and misguided teenagers who feel unnecessary judgments for themselves. It’s now high time to raise the awareness of teenagers about these topics to let them know of the safe spaces where they can freely express themselves. Dr. Lisa Lowery, an Adolescent Medicine specialist at the Helen DeVos Children’s Hospital-Spectrum Health Medical Group, joins us today to give tips on how to normalize these topics that should have been normal already. We are sexual beings after all and we should not deny it.  Let’s listen to Dr. Lowery to learn how to stay in the non-judgment zone!  [00:01 - 05:40] Opening Segment Welcoming today's guest, Dr. Lisa Lowery Her path to adolescent medicine 

[05:41 - 17:42] Build a Safe Space  Dr. Lowery talks about the importance of mentors Hear Dr. Lowery’s interesting insights about teenagers Why they’re easier to work with than babies Honesty and consistency are keys Dr. Lowery shares a patient story that you should hear! Why we do what we do 

[17:43 - 32:18] Normalize Sex Talks  We talk about the responsibility that physicians carry A humbling experience Normalize sex and talking about it Dr. Lowery explains  The right questions to ask We discuss intimate partner violence 

[32:19 - 44:21] Take Care of Yourself Better The proper way to talk about sex trafficking with teenagers Behavioral health should be present in all practices Dr. Lowery tells us why Physicians should know social and mental health workers in their circles We talk about the benefits  Physicians should take care of themselves too

[44:22 - 50:04] Closing Segment Parting words from Dr. Lowery   Final Takeaways Providing a no-judgement zone  Strategies to ask teenagers about sex  Tips to discuss drugs and relationships with teenagers How to get into an adolescent’s head? Link below 

Tweetable Quotes: “Your mentor doesn’t have to look like you.” - Dr. Lisa Lowery “We [physicians] have to learn how to take better care of ourselves emotionally.” - Dr. Lisa Lowery

Resources Mentioned: https://bit.ly/3nFxKS3 (Getting into adolescent heads: An essential update)

Email lisa.lowery@helendevoschildrens.org to connect with Dr. Lowery. Also, visit http://www.helendevoschildrens.org/AdolescentMedicine to learn more about her space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/)

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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We have a special episode for today because of two important guests. Dr. Sheila Marcus is the Section Chief of the Child and Adolescent Psychiatry of Michigan Medicine at the University of Michigan while Dr. Sarah Mohiuddin is the Director of the University’s Multidisciplinary Autism Program. They join us to discuss autism spectrum disorders and how we can detect them in as early as 4-12 months. We will learn that the symptoms of these disorders are often subtle and that early detection is critical Let’s listen to Dr. Marcus and Dr. Mohiuddin to learn more about autism spectrum disorders. [00:01 - 02:51] Opening Segment Welcoming today's guests, Dr. Sheila Marcus and Dr. Sarah Mohiuddin,  We introduce our topic for this episode

[02:52 - 13:24] Observe the Baby Dr. Marcus tells us what to look out for in a 4- to 12-month old baby A baby should learn how to love the parents by this time  Listen to Dr. Mohiuddin’s advice for pediatricians Encourage the patient’s parents to come back Use appropriate language that only subtly expresses your concern  Observe the baby with the parent without your presence

[13:25 - 23:31] Consider Virtual Evaluations They talk about the pros and cons of virtual evaluations  Hear the parents’ voice, see the baby The importance of early interventions for babies exhibiting signs of autism Dr. Marcus explains

[23:32 - 34:02] Explain the Spectrum  They explain why autism disorders are located in a spectrum Not a matter of “you have it” or “you don’t have it” Dr. Marcus talks about the common tests to detect autism spectrum disorders early What are the usual treatments for autism spectrum disorders? 

[34:03 - 47:43] Don’t Always Fill in the Gaps  Adults can let the conversation with a kid remain uncomfortable Dr. Mohiuddin explains  Why should adults “not fill in all the gaps?” We talk about how kids with autism build social relationships  Dr. Mohiuddin reminder on giving medications 

[47:44 - 57:53] Think About the Kid’s Future We share some useful resources to educate you more about autism Links below The challenging part of transitioning to adolescence and adulthood They talk about the importance of thinking about the kid’s future Independent living skills, work, and preferences, among others

[57:54 - 01:06:15] Closing Segment Parting words from Dr. Marcus and Dr. Mohiuddin  Final Takeaways Always listen to parent concerns and take them seriously Early identification and evaluation make all the difference Delivering the diagnosis can be hard and painful for patients  Early symptoms are sometimes too subtle  Applied Behavior Analysis and Early Start Denver Model Older language with strong language skills can be missed easily  Don’t always fill in the gaps Think early about the kid’s trajectory in the future  Medications should only be considered in extreme cases As adults, kids may do well regardless of their skills 

Tweetable Quotes: “...if a parent who’s an astute observer and somebody whose opinions you’ve always trusted sensed [the possibility of autism], number one, believe them.” - Dr. Sheila Marcus  “In doing an evaluation of an older kid who has not had a diagnosis of autism yet but there has been suspicion, part of the trick of doing the evaluation is...you as an adult have to not fill in all the gaps.” - Dr. Sarah Mohiuddin 

Resources Mentioned: https://mc3.depressioncenter.org/ (Michigan Child Collaborative Care Program) https://bit.ly/35eUuCh (Autism: AAP guidance includes updates, searchable topics, executive summary) https://bit.ly/3rXUss3 (What are the Early Signs of Autism?) https://bit.ly/2XhYUng (Autism Spectrum Disorders) https://bit.ly/3hOewIK (Applied Behavior Analysis) Netflix Show: https://bit.ly/3rW9P4d (Love on the Spectrum)

Email smmarcus@med.umich.edu to connect with Dr. Marcus and...

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In this episode, I invite Dr. Zakia Alavi, a child and adolescent psychiatrist and an assistant professor at Michigan State University who teaches medical students about the integration between basic and clinical sciences to the podcast. She has been providing psychiatric services to underprivileged children in Jackson, Michigan, and has published many peer-reviewed articles on psychopharmacology and polypharmacy. Let’s listen to Dr. Alavi and learn more about building bridges between primary care and community mental health providers! [00:01 - 06:02] Opening Segment Welcoming today's guest, Dr. Zakia Alavi Her path to child and adolescent psychiatry Touching one generation with one child

[06:03 - 16:12] Convincing Families  A supportive community mental health system How to convince “professional” families to treat mental health Building a two-way communication with children

[16:13 - 25:35] Building Networks and Relationships Primary care providers shouldn’t go beyond their comfort level Find out why How can physicians make a change within their systems?  The importance of network- and relationship-building 

[25:36 - 32:09] Creating a Safe Space for Children Trust and comfort among children as priorities  Mental health stigma during and after the COVID-19 pandemic

[32:10 - 41:53] Closing Segment Dr. Alavi’s parting words Trust the patients more Final Takeaways Connect with child psychiatrist The importance of humility among child psychiatrists Supportive systems in the community mental health world Building relationships and work on a team  Trust the system and the patient more Sometimes, it’s better to not do anything 

Tweetable Quotes: “If I can touch one life, one child, that’s like a whole generation. You can affect so many people by just touching one child’s life” - Dr. Zakia Alavi “Remember that you work in a community. You’re not in a silo.” - Dr. Zakia Alavi Resources Mentioned: https://mc3.depressioncenter.org/ (Michigan Child Care Collaborative) https://apple.co/37UiRWb (Ep. 13: Psychiatric Consultation: The Doctor is In!) https://bit.ly/3qL5zny (National Network of Child Psychiatry Access Programs) https://bit.ly/37MopSs (Understanding the Use of Psychotropic Medications in the Child Welfare System: Causes, Consequences, and Proposed Solutions) https://bit.ly/2W0PrjP (When stimulants “fail” for children with attention-deficit/hyperactivity disorder)

If you’d like to connect with Dr. Alavi, email alavizak@msu.edu. Also, visit https://raind.msu.edu/ to learn more about his space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/)

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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I have the pleasure of having Dr. Zakia Alavi for the second time (you will hear from her again in 2021!) to talk about a very relevant topic for pediatricians, mental health professionals, and parents – Covid and its effects on children’s mental health. Dr. Alavi is a child and adolescent psychiatrist and an assistant professor at Michigan State University. She teaches medical students how to integrate basic and clinical sciences and provides psychiatric services in Jackson, Michigan to those children who are in most need. Dr. Alavi offers age-specific coping strategies to mitigate the impact Covid on our children’s emotional well-being. Join me and learn from Dr. Alavi about the ways pediatricians and parents can help children cope during the COVID-19 pandemic.   [00:01 - 03:51] Opening Segment Welcoming today's guest, Dr. Zakia Alavi I introduce the topic for this episode

[03:52 - 18:43] Children’s Responses to COVID-19 Dr. Alavi’s insights on the effects of COVID-19 to 5-year olds and younger Parents and caregivers should also be considered Her thoughts on the most affected age group of the COVID-19 Teenage meltdowns to watch out for according to Dr. Alavi

[18:44 - 32:36] Parents’ Routines  What parents should realize about their routines or lack thereof Parents are the children’s personal clocks  The age group where verbal reassurance has the most impact  Dr. Alavi’s tips for teenagers that parents should know Her reminders for parents in coping with COVID-19

[32:37 - 37:01] The Right Questions to Ask Now Dr. Alavi’s insights about mental health issues during COVID-19 What questions to ask for spouses and children  Other related issues that should be addressed

[37:02 - 47:49] Closing Segment Dr. Alavi’s parting words Silver linings in the pandemic Educating people about vaccines Final Takeaways COVID-19’s impact on children of different ages Sense of safety for kids under 5 years of age Parents’ response to COVID-19 Children regressions and meltdowns Sleep should be addressed for all children  Routines will go a long way Mark the passage of time Verbal reassurance for middle schoolers Saving grace for teenagers Safety from lethal means

Tweetable Quotes: “As long as the home environment remains safe and their attachment, as well as the figures that they are attached to, remains safe and accessible and available, these younger kids can actually do really well.” - Dr. Zakia Alavi “Parents are in charge in many ways and now more than ever their self-regulation is how the kids are going to regulate.” - Dr. Zakia Alavi

Resources Mentioned: https://bit.ly/3mCF4gU (COVID-19 Parental Resources Kit – Early Childhood) https://bit.ly/34AXyrQ (Helping Kids Cope with the Holidays During the Pandemic) https://bit.ly/2WH5Mdz (Resources for Helping Kids and Parents Cope Amidst COVID-19) https://bit.ly/2KMM6T9 (Parenting in a Pandemic: Tips to Keep the Calm at Home) https://amzn.to/2Kvvf7h (Body Keeps The Score) https://apple.co/37GLdEs (The Art of Conscious Parenting with Dr. Robert Saul)

Connect with Dr. Alavi at alavizak@msu.edu or visit https://raind.msu.edu/ to learn more about her space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

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Today, my gift to you is Dr. Michael Klein’s inspiring words that has carried me forward since the first time I heard them. Dr. Klein is a retired pediatric surgeon who served as chief of pediatric surgery at the Children’s Hospital of Michigan in Detroit for almost 40 years. His swan song in clinical surgery was a two-month service in Liberia with Doctors Without Borders. He joins us in this episode to share his unwavering commitment to invest in children, who he believes are the driving force that can move the world forward. In order for children to change the world they need guidance and care, and this is where pediatricians can help shape the future. Let Dr. Klein’s words inspire you!  [00:01 - 08:13] Opening Segment Welcoming today's guest, Dr. Michael Klein Dr. Klein’s road to pediatric surgery Overseas work Two greatest medical inventions for Dr. Klein

[08:14 - 24:44] Pediatricians are Awesome! Dr. Klein talks about the American Academy of Pediatrics Democracy at its best Dr. Klein tells us why pediatrics is wonderful Who are we serving? What’s the most important force for human progress? Vaccine education is a must

[24:45 - 37:08] Pediatricians are Crucial Dr. Klein talks about thriving under pressure He tells us why pediatricians are crucial in the community Why should pediatricians join chapters and national associations?  Issue-based politics benefitting children 

[37:09 - 42:26] Closing Segment Love your pediatricians Dr. Klein’s parting words Final Takeaways The American Academy of Pediatrics A pediatrician’s role in making the world better Children are the answer Return of Investment of children Toxic stress

Tweetable Quotes: “It really takes a lot of courage to go into the office, see a patient, make a decision, and walk out and realize that you’re gonna be wrong.” - Dr. Michael Klein “If we want to improve the economy, if we want better symphonies or better jazz, if we want better athletic teams or better social relationships, the way to get them is to invest in children.” - Dr. Michael Klein

Resources Mentioned: https://bit.ly/2VczXc4 (Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults) https://amzn.to/3fK8FTI (Thinking Developmentally) https://bit.ly/36fXq24 (Heckman Early Childhood Development ROI) https://bit.ly/37hNJPZ (Doctors Without Borders)

If you’d like to connect with Dr. Klein, email mdkleinmd1@me.com. Also, visit https://www.miaap.org/ to learn more about his space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health

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We have an important discussion today about LGBTQIA+ patients. Dr. Dan Shumer, Clinical Director of the Child and Adolescent Gender Clinic at Mott Children’s Hospital, will join us to share his story about caring for his transgender youth patients. His observations are promising as the youth are now becoming more and more vocal about their sexual orientation, gender identity, and gender expression (SOGIE). It is critical the healthcare providers understand the needs of this population. Creating a safe space in our practices supports not only the youth but also their families. Let’s listen to Dr. Shumer and learn how pediatricians can care for transgender youth with compassion. [00:01 - 05:59] Opening Segment Welcoming today's guest, Dr. Dan Shumer Dr. Klein’s talks about his clinic for transgender youth  Melting anxiety and shame 

[06:00 - 13:37] The Tasks of Adolescents  Dr. Shumer’s thoughts about transgender youth  The difference between gender identity and gender dysphoria The role of parents on their child’s growth

[13:38 - 23:48] Caring and Compassion Mental health of LGBTQIA+ patients Building a safe space for trans patients A difference in gender identity and biological sex is normal Find out why this is not a problem Educational materials about caring for transgender youth Links below

[23:49 - 32:21] Ethics of Care  Dr. Shumer’s treatment approach  “Pausing” puberty Ethical issues to consider 

[32:22 - 38:48] Closing Segment Dr. Shumer’s parting words Compassion is the first step to care for trans patients Final Takeaways Difference in gender identity and biological sex is normal  Parents’ dreams for their kids might differ from what the kids really want Parent education is a must  Relevant educational resources are available Timing and intervention are crucial in treatment  We need to look for mentors who can guide us Compassion can make a big difference

Tweetable Quotes: “...there are some things that parents can do to show that they love and support their kid even if they’re having some internal conflict...” - Dr. Dan Shumer “Gender identity is a normal human characteristic and having a difference in gender identity compared to biologic sex itself is not a medical problem or a mental health problem.” - Dr. Dan Shumer

Resources Mentioned: https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf (UCSF Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People) https://www.wpath.org/media/cms/Documents/SOC%20v7/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf?_t=1605186324 (World Professional Agency for Transgender Youth – Standards of Care)

If you’d like to connect with Dr. Shumer, email dshumer@med.umich.edu. Also, visit https://www.mottchildren.org/ to learn more about his space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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The impact of racism on the health and wellbeing of children is significant and we must first examine our own implicit biases if we are to bring about change. We need to understand the differences between equity and equality and to advocate for our children, but in order to do so we have to educate ourselves and begin the change within. In this episode Dr. Lynn Smitherman, Vice Chair of pediatric education at Wayne State University School of Medicine walks us through definitions and constructs to better understand racism and antiracism.  Dr. Smitherman is the AAP District V champion for equity, diversity and inclusion and has long been advocating for children’s social wellbeing. Let’s dive right in and hear Dr. Smitherman’s thoughts about the impact racism has on children and the need to change the narrative.   Dr. Smitherman offers strategies for change at the institutional, practice and individual level and provides multiple resources to drive change. [00:01 - 08:39] Opening Segment Introducing today's guest, Dr. Lynn Smitherman Dr. Smitherman path to pediatrics Comfort in talking with children and parents

[08:40 - 26:09] Racism  Dr. Smitherman talks about restorative justice She talks about some terms related to racism Bias Explicit Implicit Discrimination Prejudice Racism Institutional/Structural Interpersonal Internalized  

[26:10 - 40:01] People of Color Dr. Smitherman talks about racism in the context of medicine  She talks about ways to handle racism For children For pediatricians Having allies from different backgrounds is crucial

[40:02 - 52:07] Education  We talk about addressing racism in the medical field Educate yourself Reflect on your current values Dr. Smitherman shares some relevant resources. Links below.  How to tackle racism in childhood and adolescence  Positive messaging The root of the problems

[52:08 - 58:00] Closing Segment Dr. Smitherman tells us why we should stand against racism  Children are vulnerable Final Takeaways Differences among bias, prejudice, and discrimination Racism’s impacts on children Equity, diversity, and inclusion Intentional effort to participate in change Trust as a bridge to people of color Personal change, practice change, and organizational change Representation in the medical field

Tweetable Quotes: “We all have biases because we are all human beings and we all have ideas and thoughts of things we like and don’t like.” - Dr. Lynn Smitherman “...for racism to exist, there has to be not only that prejudice but also a feeling of superiority that one group is superior over another group.” - Dr. Lynn Smitherman

Resources Mentioned: For Kids: https://bit.ly/2HDOSZD (Your Kids Aren't Too Young to Talk About Race: Resource Roundup) https://bit.ly/37bCI2U (They’re Not Too Young to Talk About Race) http://www.embracerace.org (Embrace Race) https://bit.ly/3fyDDOG (How to Talk to Kids About Race: Books and Resources That Can Help” by Olugbemisola Rhuday-Perkovich) https://bit.ly/2J1Ahbe (ReadBrightly) http://www.raceconscious.org/ (Raising Race Conscious Children) https://bit.ly/33kkpqX (Healthy Children) BOOK: https://amzn.to/39wJbs7 (Uncomfortable Conversations with a Black Man)

Videos https://bit.ly/3o2h47N (A Gardener’s Tale) https://bit.ly/37a0Wuj (A Class Divided) https://bit.ly/3l9LtiI (How microaggressions are like mosquito bites) https://bit.ly/365KBYc (White Doll, Black Doll. Which one is the nice doll?) https://bit.ly/37aOZo7 (TED TALKS LIVE Short - Unconscious Bias) https://bit.ly/365dTGy (Muslim Parents' Open Letter to Their Children) https://bit.ly/2HE6aG3 (Get Home Safely: 10 Rules of Survival) https://bit.ly/3nQgiLg (Native American Students Respond to American Education) https://bit.ly/39uIT51 (LATINO | How You See Me S1, E9) https://bit.ly/3m8LF3l (Uncomfortable Conversations With A Black Man)

Uncomfortable Conversations with a Black Man

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Today’s guest is Dr. Joanna Quigley, a clinical associate professor of psychiatry at the University of Michigan. She trained in pediatrics, general psychiatry, and child and adolescent psychiatry at the University of Kentucky and is part of the Michigan Child Collaborative Care (MC3) project at the University of Michigan, an outreach consultative program for primary care pediatrics, family medicine, and obstetrics. Let’s dive right in and hear Dr. Quigley’s thoughts about common mental health concerns we see in primary care and how psychiatric child collaborative care programs can offer us support. [00:01 - 08:47] Opening Segment Introducing today's guest, Dr. Joanna Quigley Dr. Quigley’s path to child psychiatry The differences between pediatrics and child psychiatry

[08:48 - 13:36] Collaborative Child Care We talk about the benefits of collaborative child care programs Learning from one another Leveraging one another’s resources Looking for collaborative care programs State health departments Keywords Telephone consultation programs Collaborative care consultation programs Psychiatric collaborative consultation 

[13:37 - 25:13] Psychiatric Consultation Dr. Quigley shares some tips to make consultations easier Current condition Trauma history  Symptoms  She talks about a few best practices on selecting medications Where to access these best practices? Links below

[25:14 - 40:27] Child Psychiatry  Managing screen time and media exposure of children  Setting limits is okay Practical tip: Turn off the WIFI Dr. Quigley talks about collaborations with primary care providers Be intentional in your collaborative efforts Be open to the fact that one visit won’t solve everything We talk about this game-changing service in child psychiatry

[40:28 - 46:24] Closing Segment Finding joys with patients and colleagues  Final Takeaways Collaborative child care Difficulties of primary care providers Psychiatric and pediatric trainings Trauma and anxiety  Symptom relief Resources of best practice guidelines Parent management of children’s social media use  “No question is too small, too stupid”

Tweetable Quotes: “I do think that...it is okay [for parents] to set limits. Kids thrive on structure and consistency with expectations.” - Dr. Joanna Quigley  “You don’t need to solve everything that’s going on in one visit.” - Dr. Joanna Quigley

Resources Mentioned: https://bit.ly/361B18S (Michigan Child Collaborative Care) https://bit.ly/36607Ua (HealthyChildren) https://bit.ly/2V1vitm (American Academy of Child and Adolescent Psychiatry) https://bit.ly/3m0dRVQ (National Network of Child Psychiatry Access Programs) https://amzn.to/2J8oXtw (Stahl's Essential Psychopharmacology) https://www.aap.org/ (American Academy of Pediatrics)

If you’d like to connect with Dr. Quigley, email joannaq@med.umich.edu. Also, visit https://medicine.umich.edu/dept/psychiatry (https://medicine.umich.edu/dept/psychiatry) to learn more about her space.

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications

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Physician’s rely on our mental health colleagues to provide comprehensive behavioral health treatment but we often speak different professional languages. Today’s guest leads us through the mental health alphabet soup of therapies and explains what we can expect when we make mental health referrals. Sheryl Lozowski-Sullivan, MPh, LP, PhD, is a clinical psychologist specializing in evidence-based interventions and psychological assessments for adults and children. Dr. Lozowski-Sullivan founded the Integrated Behavioral Health Psychological Services, which provides talk therapy, testing and assessment, feeding, toileting, and parenting support, cognitive behavioral therapy for insomnia, hypnotherapy, occupational therapy, and intuitive art therapy. Building collaborative relationships with our mental health colleagues benefits our patients and families and improves our skills as well. I am delighted to welcome Sheryl to the podcast and she has been a trusted colleague in the development of interprofessional partnerships. [00:01 - 05:55] Opening Segment Introducing today's guest, Sheryl Lozowski-Sullivan, MPh, LP, PhD Expertise and work  Sheryl gives some background on her story  Personal battle against cancer External practicum program with me Integrated behavioral health   Health interventions on pediatric conditions

[05:56 - 17:55] Why You Should Not Always Believe Your Thoughts Choosing a specific type of therapy Sheryl talks about mental health in the United States Clinical psychology and social work  Mental health as a discipline Behavioral therapy  Referral source rates   Combination of behavioral therapy and medication Cognitive Behavior Therapy Automatic thoughts Counter thoughts Thought-restructuring  Need for a coach

[17:56 - 33:50] 7 Things to Feel Better  We talk about “selling” therapy to the child’s family Recognizing that whatever the child experiences is real Listening to the child Dealing with anxiety disorders Sheryl walks us through the Activation Therapy Experiential Determined by and dependent on the patient She talks about not needing to know the diagnosis always Changing behaviors in therapy We talk about how to feel better, especially during the COVID-19 pandemic

[33:51 - 43:01] Collaborating with our Mental Health Colleagues Sheryl shares how to increase visit rates to therapy  Mind-body dichotomy is artificial, not real Educating parents and guardians about pediatric conditions The importance of a mental health professional near you Can we separate the mind from the body?

[43:02 - 49:38] Closing Segment I give my thoughts about the role of mental health professionals in therapy We need to address low patient referral rates Final Takeaways Types of therapy Areas of expertise of therapists Integrated behavioral health This should be advocated and funded Mental health has long been waited by psychologists

Tweetable Quotes: "Don’t believe everything you think … Just because a thought pops in your head doesn’t mean you have to believe it.” - Dr. Sheryl Lozowski-Sullivan "Make sure, if you’re suspecting anxiety of any sort, of which OCD is one, please make sure that you’re referring to someone who’s doing evidence-based practice. Talking about anxiety doesn’t fix anxiety.” - Dr. Sheryl Lozowski-Sullivan

Resources Mentioned: https://bit.ly/2UYf04y (Cochrane Library) https://amzn.to/33egSuq (Body Keeps The Score) https://amzn.to/3meppVP (Integrated Behavioral Health in Primary Care) https://amzn.to/3m07XEl (Integrated Behavioral Health in Primary Care: Your Patients Are Waiting)

Training and Consultation services: Dr. Gaggino – consultation services gagginol@medicalbhs.com Cherokee Health https://www.cherokeehealth.com/professional-training/integrated-care-training-academy

Connect with Sheryl at sheryllozowskisullivanmphphd@gmail.com. Visit http://ibhps.com/ to learn...

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
Integrated Behavioral Health in Primary Care: Step-By-Step Guidance for Assessment and Intervention
Integrated Behavioral Health in Primary Care: Your Patients Are Waiting

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Dr. Scheid is a practicing Child and Adolescent Psychiatrist and Associate Professor at MSU whose primary research interests are in the area of mental health services and public policy for children and adolescents with limited resources and multiple needs. Dr. Scheid’s work encompasses the full scope of child and adolescent psychiatry including disruptive behaviors, mood, and anxiety disorders, and eating disorders and much of her focus is on improving the health and well-being of the youth served by the Michigan Department of Health and Human Services. She welcomes collaboration with primary care providers to promote optimal care to some of our most vulnerable children.  Let’s dive right in and hear Dr. Scheid’s thoughts about improving psychiatric care for all children and particularly those in the child welfare system.   [00:01 - 09:13] Opening Segment Introducing today's guest, Dr. Jeanette Scheid  Expertise and work  How we know each other  Dr. Scheid gives some background on her story  Started in pediatric hematology  Always wanted to work with kids  First rotation in psychiatry  First mentors at MSU Dr. Scheid talks about shifting careers  What is it that excites you Look around and look at your colleagues  Thinks about the day to day aspects 

[09:14 - 24:45] Dealing with Child Trauma in the Welfare System Dr. Scheid talks about her consultancy with the Child Welfare System Interests in trauma  Working in Pittsburgh  Open doors to become a consultant  Dr. Scheid’s training focuses  Understanding the other point of view  Foster parents lack empowerment You can’t assume  Everyone brings in their own experience  Experiences and lessons with children in bio-families  Everyone has a unique experience  How can we support the parent  Strengths and weaknesses analysis  All or nothing may not be the answer  Dealing with gaps in background information How do you find out the best practices for the individual  Acknowledge what we don’t know 

[24:56 - 36:56] Deprescribing and Polypharmacy Dr. Scheid’s insights on polypharmacy  The presence of other problems  Hard to know a single diagnosis  Take a step back and look at the history Is there evidence of benefits  Back away based on risk  Start slow as you go down  I summarize my own experience  Dealing with dependency  Depression example  Gauging this impact of symptoms  Aggressive behavior assessment  Psychosocial intervention Links you can find below  The issues of diagnosing  The levels of confidence 

[36:57 - 44:12] Building Relationships with Psychiatry Colleagues  Dr. Scheid’s thoughts on relationships with colleagues in psychiatry  It all requires time and energy  Getting the most recent documentation and records  Having open communication  Dr. Scheid’s example  Getting to know your colleagues  It’s fun and informative  Making friends and connections

[44:13 - 53:19] Closing Segment Dr. Scheid talks about resources that can help  Links below  Dr. Scheid’s advice to her younger self Dealing with the answer no  Don’t be afraid to name your lack of knowledge  Cultivate your interest and capacity as a teacher Final Takeaways Propelled to do work because of a book It’s ok to change tracks  Step outside the hospital walls  Identifying trauma in the welfare system  Notes on deprescribing  Follow your passion  Look into your field  Cultivate teaching capacity Ask for releases  Build relationships and network

Tweetable Quotes: “Everybody comes to every situation wearing their own experience… step back and ask, ‘How do my partners view this situation and how can we try to make sure that...

A Circle of Children (A Signet book)

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Let’s have some tough conversations around special needs, race and disabilities in school. I’ll be discussing this with today’s guest and my friend Rikki Saunders. Rikki is the director of special education at Kalamazoo Public Schools. She has als worked as a social worker in school and the community. Her role today is to find and identify children with disabilities who are enrolled in public schools in the Kalamazoo district and in need of special education and related services. She also helps educate staff to ensure they have the capacity to fulfill their responsibilities to execute Child Find under the Individuals with Disabilities Education Act.  I’m excited to learn more from Rikki on meeting the educational needs of children, and how to collaborate with colleagues in the schools.   [00:01 - 08:45] Opening Segment Introducing today's guest, Rikki Saunders Expertise and work  Rikki gives some background on her story  Always had a love for children  Time and degree at UMich  School social work  Passionate about special education  Preparing them for life  We can do better 

[08:46 - 14:54] Changing Our Thinking of School Rikki talks about needing to change our approach  We are here to serve  We don’t turn people away People come in with trauma  Some are even homeless Consistency is key  This system has everything the kids need  The impact on children  It’s their day to day existence  Teachers spend as much time with kids as parents  It goes beyond reading and writing 

[14:55 - 26:56] How Schooling Involves the Medical Community  Rikki talks about kids coming into school with disabilities  Qualifying for 504 Diabetes example  The options you have  Teachers are responsible to accommodate needs  Qualifying for IEP covered through IDEA The school has to show qualifications  The issue of behavior  Determining if behaviors are a disability  Can you progress? Response to an Intervention RTI  Burden of proof  The autism example  It has to impact education to qualify  The social side of disabilities  Rikki’s procedure Can they do what their peers are doing? Social is part of the disability 

[26:57 - 53:56] Speaking to Bias and Race and Asking the Questions Rikki talks about her responsibility  The main mission  Environmental vs. eligibility  The African American Male example Rikki talks about analyzing the race and social climates of certain communities  Diversity is in the school  Home is separate  Cultural relevance training  Being culturally aware  We need to be included in the conversation  It’s not the answers, it’s the discussion  It’s uncomfortable but we need to talk about it  What Rikki does to enter the conversation  What do you know for sure, and what do you think?  Challenging certain ideas  Be clear on what you know for sure  You can’t ignore the issues  How Pediatricians should go about talking about police safety  Having The Talk  Know that it can be stressful for families  How certain areas are affected over others  Ask the questions  Do you feel safe? Giving the feeling of acknowledgment  The AAP response  The importance of feeling safe  Being at the discussion table  My experience may not be yours  Remember the parents  Show that you care 

[53:57 - 1:03:41] Closing Segment I give my thoughts on childhood experiences around race Government sanctioned childhood abuse Take it one day at a time We’re all in this together  We’ll have to repair one day Be the safe haven  Final Takeaways Partner with the school No one is turned away  RTI for Special Needs 504 plan  IEP Chronic trauma vs acute  School...

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Maybe it’s not ADHD, maybe it’s something else we’re not seeing. I’ll be discussing this with today’s guest Dr. Arthur Lavin. Dr. Lavin was educated at Harvard (BA) and Ohio State (MD). At Harvard, Boston Children’s Hospital, and MIT, he completed training, became board-certified in general pediatrics and the subspecialty of newborn medicine, taught, and published original research in such journals as Science. He has been in pediatric practice for more than 25 years and has served on several national committees of the AAP, as president of the Northern Ohio Pediatrics Society. Dr. Lavin is also co-author of the book, “Who’s the Boss? Moving Families from Conflict to Collaboration. Let’s dive into Dr. Lavin’s incredible insights on school struggles, childhood experiences, and ADHD.    [00:01 - 07:57] Opening Segment Introducing today's guest, Dr. Arthur Lavin Expertise and work  Dr. Lavin gives us a bit of his background  Experience in Harvard training  Passionate to work with people through relationships Dr. Lavlin’s experience in the Neo-Natal ICU  Building trust with families   Dr. Lavin’s thoughts on psycho-social  It’s our entire experience  Connecting with people 

[07:58 - 19:05] Let Them Solve the Problems They Started  Dr. Lavin talks about writing his book  Meeting the co-author  The collaboration process  Dr. Lavin shares about speaking on struggles and family dynamics  Most intense discussions  It’s not the parent’s job  If the child creates the problem let the child solve it  Person A can’t solve the problem that person B started  The adolescent makes the choices  Looking at yourself as the parent  What makes you care so much about this issue  It may not be all about the child 

[19:06 - 34:32] Impairing Childhood Behaviors; Is it Really ADHD? Dr. Lavin shares his insights on ADHD  Coming at ADHD like it’s a fever  Why do you have a fever?  It is a symptom of underlying issues  When you treat the better explanation  A 3rd of the kids coming in for ADHD didn’t actually have it AAP article - link below  Understanding the underlying issues  My own analogy  Do the drugs work?  Learning disabilities, anxiety, messy family  How relationships come into play  An opportunity to help  These issues tend to be mutually exclusive  What is the engine driving the issues?  Good relationships get answers  The diagnosis is in the history 

[34:33 - 40:50] The AAP Guidelines  Dr. Lavlin talks about the changes in the AAP  The two papers on the guidelines - links below  Differential Diagnosis  Looking at all the possibilities and resources  We talk about other helpful resources Look at the resources below 

[40:51 - 52:03] Closing Segment What would you say to a younger Dr. Lavin?  Recognize that the MD carries a lot of power  Thoughts on burn out and relationships  The music analogy  Final Takeaways It’s all about relationships  Child behavior problems take reframing  Think bigger to include other issues  The fever analogy  Use your title  Do what you love and love what you do Dance 

Tweetable Quotes: "That’s when I learned, in my time in the ICU, that I was more suited, more interested, more passionate really, about working with people through relationships rather through crises.” - Dr. Arthur Lavin “If you take care of someone, it’s as if you are an honored person in a king or queen’s court.” - Dr. Arthur Lavin “How do you know it’s a better explanation? Because when you treat the better explanation, the ‘ADHD’ symptoms go away.” - Dr. Arthur Lavin

Resources Mentioned: Books: https://amzn.to/2JlDIcj (Who’s the Boss? - Arthur Lavin) https://amzn.to/3ej0ygj

Who's the Boss: Moving Families from Conflict to Collaboration, 2nd Edition
Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health

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As a pediatrician screening for suicide, It’s not about the ones you find positive for suicide, it’s about the ones you may miss. Today’s guest Dr. Horowitz is a Staff Scientist and Pediatric Psychologist at the Nation Institute of Mental Health Intermural Research Program at NIMH and for years she has been helping health care professionals not let kids slip through the cracks. She excels in Suicide Risk Detection and is head PI in several ‘Suicide Prevention Protocols’ using the ASQ Toolkit. She assists hospitals, schools, and pediatric centers in implementing Suicide Screening of patients.   Let’s dive in a learn how we as busy professionals can incorporate this suicide screening in our practices.  [00:01 - 10:01] Opening Segment Introducing today's guest, Dr. Lisa Horowitz Expertise and work  Dr. Horowitz gives us a bit of background on his story  How Dr. Horowitz got into her field of work  Late 90’s, mental health patients flooding hospitals  Saw the need for a suicide screening tool  Used as a Fellowship Project  Push back from nurses  Moved to DC to get a job at NIH Dr. Horowitz story developing screening for the hospital  Creation of ASQ

[10:02 - 15:56 How To Implement Screening Even if You’re Not an MH Expert Dr. Horowitz talks about how doctors who aren’t mental health experts can ask screening questions Pilot study results  60%-80% response rate Asking parents to step out Nurses asking the kids without parents in the room  Creating a Script to model  Most parents responsive  Are there risks to the screening? Studies show that you can’t plant the idea of suicide if it’s not there Asking the questions help, they don’t hurt

[15:57 - 22:07] Getting Comfortable with the Whole Script for the Busy Practitioner  Dr. Horowitz talks about giving the whole script A fear for busy doctors  Don’t change the questions  Getting comfortable with the language  Getting over the worry of screening positive  Positive screenings are very rare  When you have one, you can save a life  It’s not one size fits all, not everyone has to go to the emergency room 

[22:08 - 41:38] Translating From Emergency Room to Primary Care  Dr. Horowitz talks about how this can translate into Primary Care Suicide is the second leading form of death  Training that pediatricians receive is very little towards what actually kill kids The problem of don’t ask don’t tell  The facts of fighting suicide We haven’t made a dent in rates in over 50 years  Dr. Horowitz story of Pediatrician using the screening  Worried about the ones you miss, not the ones you don’t  A lot of people go to health care before their death  The difficulties of these screenings  Are they safe? What to do if you get a positive  What is included in the ASQ toolkit  Screening vs. assessment  BSSA for Pediatricians  Very rare if you need to get them to an emergency room  The value of having MH experts in your practice  My own experience in risk assessment  Clinical pathway  Using the guide is not as hard as you think  Other ways to learn and work with families at risk 

[41:39 - 55:07] Closing Segment Alternative measures to preventing risk Ex: safe storage of guns  Distraction and disruption Making it harder can buy time  Available resources  Screening is an intervention  You may be the one to foster positivity  Where to start  Links below  Final Takeaways Ask the questions You can offer hope  Be prepared for the positive  You can do this and need to 

Tweetable Quotes: "I had a parent tell me she was so glad that someone was asking these questions because she didn’t know how to do it.” - Dr. Lisa Horowitz  “Fostering resilience is a big part...

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It’s apparent now more than ever, our children need advocacy. Today I’ll be speaking about this with Dr. Robert Saul. Dr. Saul completed his pediatric training at Duke University Medical Center. He deeply cares for all children, and after seeing the need for child advocacy in society he was led to write several books for parents. Dr. Saul believes we need constant reminders about the optimal nurturing of children, and his work provides a multi-dimensional approach to parenting that is refreshingly new.  Let’s dive in and learn the art of conscious parenting for our own family, and for the parents of our patients.  [00:01 - 07:03] Opening Segment Introducing today's guest, Dr. Robert Saul Training and studies  Author of several books - links below Dr. Saul gives us a bit of background on his story  Finished residency in the mid-’90s A need to connect to the community  Devoting resources to be the solution  The impact of Columbine on Dr. Saul Wrote articles in the newspaper to educate  The 5 steps to community improvement   Inspired to write books to teach himself

[07:04 - 14:59] My Children’s Children  Dr. Saul’s own experience from childhood Parents divorced at the age of 9 Verbally abusive household  Read back on his mother’s journals when she passed  Becoming the evil parent for your parent  Dr. Saul’s insights on parenting and pediatrics  The paternalism and maternalism of pediatrics  Child advocacy project  SSNR vs. SSRI  You need both, but SSNR will create lasting change Identifying and boosting SSNR’s 

[15:00 - 24:15] The Art of Conscious Parenting  Dr. Saul talks about the basis of Conscious Parenting  Dr. Saul’s story with his own child  Based on forgiveness  The model of the Parental Awareness Threshold  Dr. Saul’s story of Conscious Leadership  Above the line vs. Below the line  Being conscious of where you are on the line  Parenting works the same way  How to make a conscious effort as a parent  Pause, assess, and choose  Example 

[24:16 - 33:06] Being and Raising a Good Citizen  Separating approaches by age range  The value of having a partner along the journey  Another point of view Safe stable relationships are for parents as well Dr. Saul talks about how his book aids parents  Short read  Step by step approach  From someone who is also learning  Raising a good citizen  Don’t become elderly, become an elder Getting socially reconnected  Get involved and stay involved  Practice forgiveness personally and communally Be part of the solution 

[33:07 - 46:45] Closing Segment A word for parents in hard living environments  3 levels of intervention  Active integration and support for these families  Advocacy can be part of the solution  Engaging the well-being of pediatricians  Seek out people who share your values  Don’t do it alone  Refuse to become discouraged  How Dr. Saul stays engaged  Dr. Saul talks about his book for children  Growing in wisdom Final Takeaways The 12 words Become good citizens and happiness as a second effect Conscious parenting Awareness Threshold 5 steps of being the best parent  SSNR’s beat SSRI’s all the time Outlined model for providing guidance to stressed out families Get involved in the community 

Tweetable Quotes: "For anything that happens in your community you should say: ‘I am the problem, I am the solution, I am the resource.’” - Dr. Robert Saul “If you’re a conscious leader you’re open, you’re curious, you’re willing to learn.” - Dr. Robert Saul “So how can you consciously try to make a difference? I think you need to pause, assess, and choose…” - Dr. Robert Saul

Resources Mentioned: Books https://amzn.to/3jfQeqg (My...

The 15 Commitments of Conscious Leadership: A New Paradigm for Sustainable Success
Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health
My Children's Children: Raising Young Citizens in the Age of Columbine
Conscious Parenting: Using the Parental Awareness Threshold
Bowling Alone: The Collapse and Revival of American Community
From Age-ing to Sage-ing: A Revolutionary Approach to Growing Older

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Have you ever looked at your child or a patient and just thought, ‘oh my God, I don’t know how to fix this’? You’re not alone and we’ll talk about this today with our guest Sandy Fowler, host of the https://podcasts.apple.com/us/podcast/mighty-parenting-raising-teens-parenting-young-adults/id1348530012 (Mighty Parenting Podcast). Sandy is a stress relief and wellness coach, a wife, mom, and business owner whose passion is teaching people to make powerful choices that impact their lives in the best possible way and help them take back their life from the busyness and stress of modern-day living.  Let’s get right into the episode and learn from Sandy how we as pediatricians don’t always have to know everything, and what it looks like to partner with parents to learn together.   [00:01 - 08:13] Opening Segment Introducing today's guest and my friend, Sandy Fowler, and what we will be talking about Met on her podcast to talk about the topic of suicide prevention for parents Listen to my guest appearance on her podcast https://podcasts.apple.com/us/podcast/what-parents-need-to-know-about-teenage-emotions-suicidal/id1348530012?i=1000473494967 (here) Sandy gives us a bit of background on her story  Help parents learn emotional wellness tools  Why this age group  You don’t have to know the answer, just understand that you’re not alone

[08:14 - 13:01] Shhhh, Just Listen and Check Yourself  Sandy talks about common themes she finds on her show  Our teens still need us, but it needs to look different Listening - a safe place to talk Coaching Modeling what it is we want them to do  Listening and coaching for kids  Parents need to be willing to check themselves  Pediatricians should help, not judge  Recognize and acknowledge things in yourself  Self-regulation  Try not to blow up 

[13:02 - 24:56] We Don’t Always Have to Know  Sandy shares her experience with pediatricians  Expectation of partnership  Sometimes the doctor just doesn’t know what to do and end up doing the wrong thing  Be okay not knowing as a pediatrician  Be honest with the parents  Explore options as partners  Sandy talks about a positive story with her daughter and her doctor  Non-disclosure  Gave the option to speak directly  There is help  I talk about our training as a pediatrician  Acting on things you may not know  A parent wants to know they have help, not just an answer  Sometimes it’s a skills issue  “I don’t have a pill for a messy family”  Chaos impacts behavior  Sometimes we can’t just fix the kid  Sandy talks about what we can do to help the family  Non-judgmental  Partnership and options   Realize that the issues can connect to a still-developing brain 

[24:57 - 30:07] Calmness is Key  Communication with the child is key Don’t panic  Our calmness helps the child  Pause and let the silence sit until the child is ready    I give an example with a code lead manager 

[30:08 - 39:34] Closing Segment A word for parents Your kids will be okay  Accept what you don’t know  We can be there for parents  The silence is necessary for processing things  Let parents and children absorb the info  As parents, let the kids let out their chaos  Where can people find you?  Links below  Live curiously  Final words Final takeaways from me Listening, Coaching & Modeling  It’s okay not to know what to do  Check yourself  Calmness is key  Be present with parents and kids - ride the ride with them 

Tweetable Quotes: "Even if someone doesn’t have an answer, at a minimum you know that you’re not alone and that it’s not that you’re doing something wrong or that there’s something wrong with your child.” -...

Brainstorm: The Power and Purpose of the Teenage Brain
Yes, Your Teen is Crazy!: Loving Your Kid without Losing Your Mind

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I had the honor of speaking with Dr. Allek Scheele. Dr. Scheele is  currently doing her pediatric hospitalist fellowship at the https://www.spectrumhealth.org/patient-care/childrens-health/general-pediatrics (Helen DeVos Children’s Hospital) in Grand Rapids. Her research focuses on pediatric and adolescent substance abuse and exposure. Let’s dive into Dr. Scheele’s expertise so we can learn the hard truths behind child substance abuse and what we can do to arm ourselves, the children, and parents with tools and strategies to prevent problems in their lives. [00:01 - 04:24] Opening Segment Introducing today's guest, Dr. Scheele, and what we will be talking about Dr. Scheele talks about how she got into her field  Opioid epidemic conference sparked her first interest  Led a project on marijuana exposure  Became addiction medicine certified  Reflected on her passion and decided to do a Pediatric hospitalist medicine fellowship in her second year of residency

[04:25 - 17:53] The Shocking Truth Behind Substance Use and What To Do Dr. Scheele talks about the truths behind adolescent and adult addictions The average age of addiction starts around 12 Preventative pediatrics can make a difference  I talk about my experience with a 9 year old patient http://www.monitoringthefuture.org/ (Monitoring the Future Study) “You can’t tell who’s a good kid” Anyone can have a use disorder Dr. Scheele breaks down how to deal with prescriptions  Talk with the family Don’t over-prescribe  Not all pharmacies take back opioids  Promote putting out notices for when there is an event  Dr. Scheele talks a bit about vaping  The last two to three years has shown the largest substance increase we’ve ever had These vaping products are obviously geared towards children  All Juul products have nicotine and most teens are being tricked into getting hooked  One pod equals a pack of cigarettes 

[17:54 - 32:55] What We’re Seeing in the ER Dr. Scheele talks about the dangers of marijuana vaping Increase in accidental ingestion   Decreasing stigma  Marijuana ingestion is getting more creative causing kids to take in higher volumes  Kids coming in with altered mental status  What to screen for Dr. Scheele talks about preventative pediatrics  Work asking about substances into your check with the adults The Vapors in the house can cause an infant to test positive for THC This can also be absorbed into their skin affecting long term brain development  ADHD Schizophrenia  Substance Abuse Issues  I talk about promoting awareness  How to work with adolescents  Get to know who their friends are  Make it nonchalant  Be non-judgmental Ask what it is they like about what substance they’re taking  Know stopping smoking weed will stop cyclical vomiting 

[32:56 - 37:28] How to Deal With Alcohol Abuse Dr. Scheele talks about the current state of AA  Know that it is part of the culture  Fortunately there is a decline in binge drinking  Gear the conversation towards keeping them safe Don’t antagonize them  You are on their side  Arm parents with strategies for their children

[37:29 - 44:29] Closing Segment Pediatric advocacy and what we can do Have an idea of what is going on in the local government  Get involved with your local https://www.aap.org/en-us/Pages/Default.aspx (AAP )chapter Dr. Scheele talks about how she was able to change some legislation I talk about belonging to your state chapters Final takeaways from me ‘Good kids’ may have substance issues too Opioid disorders may often begin with...

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In today’s episode, I have the pleasure of speaking with my amazing friend and co-chair of the Kalamazoo Perinatal Mood Disorders Coalition, alongside myself, Kristina Ledlow ICCE, CD, CPD. After two very challenging pregnancies and postpartum periods, Kristina became especially passionate about educating families and other healthcare professionals about Perinatal Mood and Anxiety Disorders. Kristina holds certifications as a Childbirth Educator, Birth Doula and Postpartum Doula in Kalamazoo, Michigan. She also works for OB-GYN, P.C. as their Patient Educator, and teaches classes for Bronson Methodist Hospital.  Let’s dive into Kristina’s story and expertise so that, whether you are in pediatrics, a parent, or someone who knows a parent, you can be well equipped to help moms or even yourself get connected and be okay. [00:01 - 07:50] Opening Segment Introducing today's guest and my friend, Kristina Ledlow, and what we will be talking about Certified in https://www.postpartum.net/ (Postpartum Support International) (PSI) Doula Patient educator Kristina talks a bit of journey to expertise in PMAD and prevention Severe depression and anxiety during two births Several Risk factors going into both pregnancies Manifested OCD tendencies  Connected with a therapist and put on medication  Went into childbirth education and perinatal mood disorders

[07:51 - 12:44] The Effects of PMAD I talk about my shared experience with postpartum depression Kristina talks about the impact on partners and babies Mothers mood affects everyone Losing function 1 in 5 moms affected, 1 in 10 dads affected Dad’s can also break down from the stress and exhaustion  Each baby comes with their own personality and challenges 

[12:45 - 25:30] Ask Mom’s if They’re Ok Screening moms during pregnancy and postpartum  Worry of opening a pandora's box Kristina talks about the importance of asking  Using the http://perinatology.com/calculators/Edinburgh%20Depression%20Scale.htm (Edinburgh tool ) Negative hormones in the mom affect the baby during pregnancy  Social workers and network to work with patients  Asking is therapeutic  You’re not crazy, this happens, let me get you connected  PMAD Virtual Care  Get them connected Have a plan  We need to get moms connected to the right people  Use  https://www.postpartum.net/ (Postpartum Support International) and get a coordinator involved 94% of moms have ‘scary thought’ 1: OCD thoughts  2: Postpartum psychosis (rare but dangerous) Believing the thoughts to be true and acting on it  It’s common to feel like this, it’s ok and there is help Putting strategies in place Getting good sleep by chunking 

[25:31 - 34:46] Practical Advice and Actions to Face PMAD These disorders can last up to two years The strongest moms can feel like a failure  https://www.instagram.com/postpartumstress/?hl=en (Postpartumstress Instagram) Don’t tie your self worth to social media It’s ok to feel the way you do Kristina shares self care tips Reach out and ask for help Support is key Ask: how can I help?  https://momsbloom.org/ (Mom’s Bloom) mom to mom support  Write Post-It’s that are ready for people to read for help I talk about other options Reach out to medical contact Research safe medications  Specialized therapy Kristina talks a bit more about her work and support group Edinburgh and risk assessment quizzes  Assess if they need support and other resources  Capability of letting moms support other moms Virtual attendance during Covid-19 Kristina talks about her work with https://pmhapoc.org/ (Perinatal Mental Health Alliance for People of Color)

[34:47 - 43:38] Closing Segment Ways to reach out PSI conferences can inform and educate you  We all have risk factors even as physicians  Kristina talks about her work with...

Good Moms Have Scary Thoughts: A Healing Guide to the Secret Fears of New Mothers
Moods in Motion: A coloring and healing book for postpartum moms
This Isn't What I Expected: Overcoming Postpartum Depression
Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood
The Art of Holding in Therapy: An Essential Intervention for Postpartum Depression and Anxiety
Beyond the Blues, Understanding and Treating Prenatal and Postpartum Depression & Anxiety
Traumatic Childbirth

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I brought in Dr. Mark Sloane. He is a board-certified pediatrician and an adolescent medicine specialist. Let’s dive into Dr. Mark’s story of how important it is to build a safe space for kids with mental illnesses and how to get involved in your community to help with kids’ healing process. This is a movement that is not restricted to medical practitioners alone, everybody can make an impact on kids’ lives and we are all in this together. [00:01 - 11:02] Opening Segment Introducing today's guest, Dr. Mark Sloane Dr. Mark talks about his career He wasn't ready to practice because of limited training He did ADHD-related work Worked in a Trauma Center Most moms were exposed to drugs, alcohol and domestic violence How can we help kids with their functional outcomes? Working across different systems How do we achieve better outcomes and success?

[11:03 - 28:11] Building Safe Spaces for Kids’ Emotions Dr. Mark talks about continuing to improve the medication process dealing with kid's mental illness Looking for a holy grail pay off How do we make things safe for kids with trauma? Dr. Mark talks about using the same med-model on kids of different ages Some families have no problems with their older kids but struggle on the younger ones Kids being traumatized by the system Getting compared to their siblings Where do kids feel safe? With school, teachers and their doctors Helping them remember somebody they trusted The Power of Adult's Resilience If a kid has an adult that is crazy about them, this will help them big time with their healing process

[28:12 - 38:36] Collaborating with Other People Medicine and Prescriptions are just not enough Medicine only works to a certain extent Anybody can make an impact on kids' recovery process You don't have to be a psychiatrist Dr. Mark talks about bringing in different people to help with primary care work for kids Making connections Schools need to work with doctors and vice versa How do you get everybody on the table? Having the right infrastructure buildings and personnel We will all benefit from doing it. It's hard but worth it!

[38:37 - 44:40] Closing Segment There are so many ways that we can help and support these programs We are all in this together Final words from me and Dr. Mark

Tweetable Quotes: "If a kid has one adult that's irrationally crazy about them that can matter and that's enough." - Dr. Mark Sloane "Primary care has been traumatized and the answer is relational change by reaching out to other people to help us mend our own trauma" - Dr. Lia Gaggino Resources Mentioned: https://amzn.to/2XO5UJe (Thinking Developmentally)  - Andrew Garner https://wmich.edu/traumacenter (Children's Trauma Assessment Center) - WMU Kalamazoo Bruce Perry, MD, PhD – http://www.bdperry.com/ (www.bdperry.com) Ross Greene, PhD – http://www.drrossgreene.com/ (www.drrossgreene.com)

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com . To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/) LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I had the honor of speaking with Dr. Moira Szilagyi. Dr. Szilagyi is regarded as one of the leading experts on the health of children in foster and kinship care and has served as chair of multiple AAP groups over the last 25 years leading the development of health care standards for children and teens in out of home care. Let’s dive into Dr. Szilgayi's incredible story of how important it is to know the Three R’s and be a catalyst for change in the child welfare field, as well as to have trauma-informed focus as you learn, grow and impart skills to your fellow workers and the parents of your patients.  [00:01 - 11:08] Opening Segment Introducing today's guest, Dr. Moira Szilagyi, and her achievements Dr. Szilagyi talks about how she got into her career Medical school at 28 Realized she wanted to work with high risk kids Began working in Foster Care “These kids deserve better” Dr. Szilagyi tells a story of the one patient that inspired her to work in this field She realized the foster kinship care needed higher standards and better systems. And that there wasn’t literature on the subject or training.  Begins to work on a task force Charged with making different models of care Centralized care Opening 24/7 Run like a regular practice

[11:09 - 25:52] Trauma Informed Focus Dr. Szilagyi tells a story of handling a child victim of fetal alcohol syndrome Dr. Szilagyi now mentors many young people as an academic pediatrician Remain open and find your passion Children in Kinship Care became Dr. Szilagyi’s passion Realizing these kids are coming in with so much grief and loss Most return into family Some disappear  Lifelong trauma  Dr. Szilagyi talks about their grant with AAP funding Dr. Szilagyi talks about the kids in her foster care You need the skill to actualize love  The kids can’t think they are going to be abandoned again even though the foster parent can’t promise a permanent home They need to know they always have a home in the heart of the foster parent

[25:53 - 36:15] The System of Foster and Kinship Care Dr. Szilagyi talks about her time in Rochester  Developmental path of psychology literature Learning what children need to thrive https://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/ (The Adverse Childhood Experience) Found problems leading to obesity back from childhood Divided into 10 issues  The importance of healthy attachments from a young age https://learndojo.org/gcse/aqa-psychology/development/ (Early Brain Development: AQA GCSE) https://www.gse.harvard.edu/office/center-developing-child (Harvard Developing Child) Children exposed to a chaotic environment adapt to living in such conditions Knowing that you have to stay with the child THROUGH their trigger response

[36:16 - 46:53] Advice for the Busy Pediatrician and Parent  Dr. Szilagyi talks about the needed skills of the pediatrician  “What happened to you” Give tools to the children and the parents Praise the parent on their positives I tell a related story from my personal experience  Human kindness and positive reinforcement Dr. Szilagyi talks about “Miss Jenny” They found 2 inconsolable children in the office alone, crying hysterically   Miss Jenny comes in and gets down on her knees and talks softly The children calm down and within 10 minutes walk out of the building Three R’s Reassuring safety Routines: flexible but predictable  Regulate: helping kids to regulate Remain as an emotional container

[46:54 - 57:15] Closing Segment If you could develop a system that was “dream tier”

Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health

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Hello and welcome to the Pediatric Meltdown Podcast, the podcast for busy pediatricians who want to better understand emotional health and behaviors, and gain the skills and knowledge to help them thrive. I’m your hostess Dr. Lia Gaggino, and I’d like you to come on this journey with me to hear from leading experts in the field as well as other parents to become the best health care practitioners and parents/guardians we can be, in a way that feels less like a lecture and more like a conversation over dinner. We need all the help we can get to take care of our kids, and I believe that the more we learn the better this world will become. [00:01 - 01:05] Opening Segment Introduction for the podcast Created with pediatricians in mind but hope parents and other professionals will listen in as well

[01:06 - 06:30] Why Pediatric Meltdown? Imagine and put yourself in the place of children who can’t get through their struggles and their parents who don’t know how to help them I’ve learned that these are unmet needs that are expected to be handled  The responsibility is on primary care You will hear from professionals and parents alike I want to share my passion and their voices These won’t be lectures but conversations with friends I will be linking resources form these conversations The goal is inspiration See one, Do one, Teach one Let’s work together to help children thrive 

[06:31 - 8:36] Closing Segment I’d like to hear from you I know how hard it can be  Thank you for joining me Please give me your input and reach out to me Links below Closing 

Tweetable Quotes: “Imagine a conversation with a parent of a fifteen year old who doesn’t know what to do with their son who’s using drugs, or maybe it’s a six year old who’s throwing chairs at school, or a thirteen year old who overdosed after a bad argument with his dad, a foster child who can’t sleep at night, or one of your patients on the autism spectrum who wants to have friends but just can't figure out the social queues and so on. Imagine these kids’ meltdowns just dripping into puddles and the meltdowns parents have and, well, maybe even our own.”  - Dr. Lia Gaggino  

“We need hope, we need ideas, we need each other, to ensure that children thrive.” - Dr. Lia Gaggino

“When you listen I hope you will find a pearl, maybe a spark of excitement or creativity to help others out of dark places.” - Dr. Lia Gaggino

If you’d like to connect with me, you can find me at https://www.linkedin.com/in/dr-lia-gaggino-80322a31/ (LinkedIn), https://www.facebook.com/DrLiaGaggino/ (Facebook), and https://twitter.com/gagginol?lang=en (Twitter) or email me at gagginol@yahoo.com to let me know your thoughts and what you would like to hear in upcoming episodes. To learn more about me visit https://www.medicalbhs.com/ (https://www.medicalbhs.com/)

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I brought in my very own daughter, Julia Parzyck. She works in the eating disorder recovery space and has recovered from an eating disorder, herself. Let’s dive into Julia’s story of how society impacts the mental health of patients suffering from eating disorders because of the BMI metric that tells them they are unhealthy or obese and how tough it is to have conversations and educating people more about food. [00:01 - 04:52] Opening Segment ●     I introduce and welcome my guest and daughter, Julia, to the show ●     Julia talks about her eating disorder recovery journey ○     She grew up in a family with body image issues ○     She got bullied because of her weight ○     She went to a therapist to help her with her eating disorder recovery [04:53 - 14:10] Children and Eating Disorders ●     Julia talks about the turning point of why she decided to recover from her eating disorder ●     Pediatricians goal with monitoring children's growth ○     How we try to prevent kids from having eating disorders ●     Julia shares her BMI issues ○     According to BMI, she was considered unhealthy and obese ○     Navigating her eating disorder in a healthier way ●     Julia weighs in on the mental aspect of patients with eating disorders ○     Eating healthy and exercising more is not very helpful advice ○     Living in a Fatphobic society ○     Having the right resources and education of what should their kids eat or not ○     Being compassionate in dealing with these patients [14:11 - 22:48] Talking about weight and BMI ●     Julia weighs in on doctors dealing with kids' nutrition ○     BMI is not a measure of health ●     Having tough conversations with patients ○     Listening to patients ○     Dealing with families with a history of obesity ●     Feeding children the right information about food ○     Educate yourself so you can guide your kids ○     Children getting bad information online ●     Julia talks about intuitive eating ○     Emotional response to eating certain foods that are considered as "Good" or "Bad" ○     Society told us that being healthy means you have to be thin [22:49 - 30:07] Taking The Right Approach ●     Having a team to have conversations and educate people about food ○     Adding on things instead of taking them out ■     The next time you eat a burger, have some salad with it. ●     Telling people they shouldn't have certain kinds of food in their homes ○     Do I have to be a certain weight in order to have these conversations? [30:07 - 34:51] Closing Segment ●     Julia's takeaways ○     Be mindful ○     Educate yourself more ●     Plug to this episode’s resources. See links below ●     Final words from me   Tweetable Quotes: "There's no harm in educating yourself more and continuously learning, that's just how

Health at Every Size: The Surprising Truth About Your Weight
The Intuitive Eating Workbook: Ten Principles for Nourishing a Healthy Relationship with Food (A New Harbinger Self-Help Workbook)