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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...
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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 methodsResearch presented at the Pediatric Academic Society's meeting compared ancient pranayama to current medical scienceThe book serves as a textbook for meditation and pranayama research, as well as a practical guideThe 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-beingChildren were particularly affected by the inability to see friends and grandparentsThe crisis emphasized the crucial role of community in maintaining hope and mutual supportThe 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 beneficialRegular practice of meditation helps maintain mental equilibrium, like a movie screen unaffected by the imagesThe intention to meditate and practice self-care is 95% of the journey towards happinessResearch 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:...
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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 familiesThe saying "when someone dies by suicide, they take their skeleton and put it in your closet" highlights the complex impact on survivorsShifting from individual therapy to family therapy can provide new insights into family dynamics and behaviorsBalancing 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: [email protected] LinkedeIn:
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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 growthGratitude for amazing guests and their contributionsAcknowledgment of initial challenges in podcast productionIntroduction 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 interactionsChallenges of electronic health records vs. paper chartsEncouragement to look away from screens during consultationsHope for future improvements through AI scribing technology[08:11 -10:19] Fostering Professional Growth and Community
Upcoming national meeting in Orlando for pediatric professionalsInvitation for listeners to connect with Lia at the eventEncouragement to find and create magical moments in practiceTeaser for interesting upcoming podcast guestsLinks to resources mentioned on the show
Podcast Production
MouthyBroadMedia.com
Social Media Management
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
205. Social Media and Families: Creating Culturally Relevant Content
182. 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...
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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 lifeMaintain balance to prevent burnout in medical careerImportance of having interests beyond healthcare[02:21 - 08:10] Physician self-care: Reading and traveling experiences
Make time for non-medical reading, even in snippetsTravel to gain new perspectives and experiencesDon't postpone personal experiences for a "magical time"[08:11 - 13:08] Work-life balance for healthcare professionals: Relationships
Nurture relationships outside the medical fieldMake time for people despite demanding work scheduleBalance professional commitments with personal lifeResources mentioned on the show
aap.org
Other episodes mentioned on the show:
https://pediatricmeltdown.com/episodes
190. 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,
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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 concentrateOpen-book tests: Time-consuming but aligned with real-world practiceReturn to proctored exams: Disliked by many professionalsMOCA Peds: A modern, quarterly assessment approach[5:08 - 07:14] Navigating MOCA peds and Continuous Learning
Utilize pediatric board review materials for preparationApproach questions as real-life cases, not trick questionsTake advantage of the 5-minute time limit per questionEmbrace continuous learning through various CME opportunities[07:15 - 12:30] Expanding Mental Health Knowledge in Pediatrics
Seek out mental health sessions at national conferencesAttend specialized mental health conferences for pediatriciansConsider long-term training programs like the REACH InstituteUtilize resources from AAP and ACAP for ongoing educationResources 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
116. Physician Wellness Coaching: Proven Benefit!
98. Anxiety? Inattention? Depression?: Prescribe Nature! Dr. Stacy Beller Stryker
76. Pediatric Practices: Find Your Balance
Building Better Workflows Podcast
Building Better...
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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 pediatriciansAddresses the pressure parents face, especially from social mediaEmphasizes 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 failingImportance of praising parents for their effortsReminder 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 problemsEncourages pediatricians to "ride the ride" with parentsSuggests 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 experiencesExplains how supportive adults can help children overcome adversityEmphasizes teaching parenting skills, as they're not innateResources 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
202. Functional Neurologic Disorders: Recognition and Management
175. Beyond Trauma: Strengthening the Caregiver-Infant Dyad
162. Migraine Headaches: Assessment, Management and Relief
152. The Mysteries of Abdominal Pain: Disorders of the Gut-Brain Interactions
115. Chronic Pain Syndromes: Assessment and Management
114. 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...
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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 neededAimed to build rapport and trust, answering questions families hadApplied the trusted messenger model to an online spaceEach 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 contentLonger content, up to 45 minutes, delves into specific topics like speech delay or summer safetyContent is community-led, responding to questions and analytics from social mediaVideos 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 countriesPlans to develop content specifically for grandparents and fathers Implementation of the Digital Health Youth Fellowship ProgramTraining 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:
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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
185. 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...
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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... -
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:
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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... -
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.
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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:
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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 OCDOCD 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
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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... -
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 ...
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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 HealthParenting Adult Children and advice from her favorite book.Respecting children’s different parenting methods.Calls to action:
Click Here for your BBW WorkbookClick here for your Freebie #1Click here for your Freebie #2Book 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...
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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:
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