Pediatric Meltdown

https://swiy.co/WhatAreYourThoughtsWelcome 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...

https://cutt.ly/WhatAreYourThoughtsHello 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 SegmentIntroduction for the podcastCreated 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 themI’ve learned that these are unmet needs that are expected to be handled The responsibility is on primary careYou will hear from professionals and parents alikeI want to share my passion and their voicesThese won’t be lectures but conversations with friendsI will be linking resources form these conversationsThe goal is inspirationSee one, Do one, Teach oneLet’s work together to help children thrive [06:31 - 8:36] Closing SegmentI’d like to hear from youI know how hard it can be Thank you for joining mePlease give me your input and reach out to meLinks belowClosing 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 GagginoIf you’d like to connect with me, you can find me at LinkedIn, Facebook, and 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/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.

https://swiy.co/WhatAreYourThoughtsWelcome 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 SegmentIntroducing today's guest, Dr. Moira Szilagyi, and her achievementsDr. Szilagyi talks about how she got into her careerMedical school at 28Realized she wanted to work with high risk kidsBegan working in Foster Care“These kids deserve better”Dr. Szilagyi tells a story of the one patient that inspired her to work in this fieldShe 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 forceCharged with making different models of careCentralized careOpening 24/7Run like a regular practice[11:09 - 25:52] Trauma Informed FocusDr. Szilagyi tells a story of handling a child victim of fetal alcohol syndromeDr. Szilagyi now mentors many young people as an academic pediatricianRemain open and find your passionChildren in Kinship Care became Dr. Szilagyi’s passionRealizing these kids are coming in with so much grief and lossMost return into familySome disappear Lifelong trauma Dr. Szilagyi talks about their grant with AAP fundingDr. Szilagyi talks about the kids in her foster careYou 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 homeThey 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 CareDr. Szilagyi talks about her time in Rochester Developmental path of psychology literatureLearning what children need to thriveThe Adverse Childhood ExperienceFound problems leading to obesity back from childhoodDivided into 10 issues The importance of healthy attachments from a young ageEarly Brain Development: AQA GCSEHarvard Developing ChildChildren exposed to a chaotic environment adapt to living in such conditionsKnowing 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...

https://swiy.co/WhatAreYourThoughtsWelcome 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 SegmentIntroducing today's guest, Dr. Mark SloaneDr. Mark talks about his careerHe wasn't ready to practice because of limited trainingHe did ADHD-related workWorked in a Trauma CenterMost moms were exposed to drugs, alcohol and domestic violenceHow can we help kids with their functional outcomes?Working across different systemsHow do we achieve better outcomes and success?[11:03 - 28:11] Building Safe Spaces for Kids’ EmotionsDr. Mark talks about continuing to improve the medication process dealing with kid's mental illnessLooking for a holy grail pay offHow do we make things safe for kids with trauma?Dr. Mark talks about using the same med-model on kids of different agesSome families have no problems with their older kids but struggle on the younger onesKids being traumatized by the systemGetting compared to their siblingsWhere do kids feel safe?With school, teachers and their doctorsHelping them remember somebody they trustedThe Power of Adult's ResilienceIf 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 PeopleMedicine and Prescriptions are just not enoughMedicine only works to a certain extentAnybody can make an impact on kids' recovery processYou don't have to be a psychiatristDr. Mark talks about bringing in different people to help with primary care work for kidsMaking connectionsSchools need to work with doctors and vice versaHow do you get everybody on the table?Having the right infrastructure buildings and personnelWe will all benefit from doing it. It's hard but worth it![38:37 - 44:40] Closing SegmentThere are so many ways that we can help and support these programsWe are all in this togetherFinal words from me and Dr. MarkTweetable 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 GagginoResources Mentioned:Thinking Developmentally  - Andrew GarnerChildren's Trauma Assessment Center - WMU KalamazooBruce Perry, MD, PhD – www.bdperry.comRoss Greene, PhD – www.drrossgreene.comIf you’d like to connect with me, you can find me at a...

https://swiy.co/WhatAreYourThoughtsIn 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 SegmentIntroducing today's guest and my friend, Kristina Ledlow, and what we will be talking aboutCertified in Postpartum Support International (PSI)DoulaPatient educatorKristina talks a bit of journey to expertise in PMAD and preventionSevere depression and anxiety during two birthsSeveral Risk factors going into both pregnanciesManifested 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 PMADI talk about my shared experience with postpartum depressionKristina talks about the impact on partners and babiesMothers mood affects everyoneLosing function1 in 5 moms affected, 1 in 10 dads affectedDad’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 OkScreening moms during pregnancy and postpartum Worry of opening a pandora's boxKristina talks about the importance of asking Using the 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 connectedHave a plan We need to get moms connected to the right people Use  Postpartum Support International and get a coordinator involved94% 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 helpPutting strategies in placeGetting good sleep by chunking [25:31 - 34:46] Practical Advice and Actions to Face PMADThese disorders can last up to two yearsThe strongest moms can feel like a failure Postpartumstress InstagramDon’t tie your self worth to social mediaIt’s ok to feel the way you doKristina shares self care tipsReach out and ask for helpSupport is keyAsk: how can I help? 

https://swiy.co/WhatAreYourThoughtsWelcome 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 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 SegmentIntroducing today's guest, Dr. Scheele, and what we will be talking aboutDr. 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 DoDr. Scheele talks about the truths behind adolescent and adult addictionsThe average age of addiction starts around 12Preventative pediatrics can make a difference I talk about my experience with a 9 year old patientMonitoring the Future Study“You can’t tell who’s a good kid”Anyone can have a use disorderDr. Scheele breaks down how to deal with prescriptions Talk with the familyDon’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 hadThese 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 ERDr. Scheele talks about the dangers of marijuana vapingIncrease 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 forDr. Scheele talks about preventative pediatrics Work asking about substances into your check with the adultsThe Vapors in the house can cause an infant to test positive for THCThis can also be absorbed into their skin affecting long term brain development ADHDSchizophrenia 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-judgmentalAsk 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 AbuseDr. 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...

https://swiy.co/WhatAreYourThoughtsHave 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 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 SegmentIntroducing today's guest and my friend, Sandy Fowler, and what we will be talking aboutMet on her podcast to talk about the topic of suicide prevention for parentsListen to my guest appearance on her podcast hereSandy 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 differentListening - a safe place to talkCoachingModeling 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 keyDon’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 SegmentA word for parentsYour kids will be okay Accept what you don’t know We can be there for parents The silence is...

https://302.buzz/PM-WhatAreYourThoughtsIt’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 SegmentIntroducing today's guest, Dr. Robert SaulTraining and studies Author of several books - links belowDr. Saul gives us a bit of background on his story Finished residency in the mid-’90sA need to connect to the community Devoting resources to be the solution The impact of Columbine on Dr. SaulWrote 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 childhoodParents divorced at the age of 9Verbally 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 changeIdentifying 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 viewSafe stable relationships are for parents as wellDr. 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 elderGetting socially reconnected Get involved and stay involved Practice forgiveness personally and communallyBe part of the solution [33:07 - 46:45] Closing SegmentA 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 wisdomFinal...

https://swiy.co/WhatAreYourThoughtsAs 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 SegmentIntroducing today's guest, Dr. Lisa HorowitzExpertise 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 NIHDr. 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 ExpertDr. Horowitz talks about how doctors who aren’t mental health experts can ask screening questionsPilot study results 60%-80% response rateAsking parents to step outNurses 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 thereAsking 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 CareSuicide is the second leading form of death Training that pediatricians receive is very little towards what actually kill kidsThe problem of don’t ask don’t tell The facts of fighting suicideWe 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 SegmentAlternative measures to preventing riskEx: safe storage of...

https://swiy.co/WhatAreYourThoughtsMaybe 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 SegmentIntroducing today's guest, Dr. Arthur LavinExpertise and work Dr. Lavin gives us a bit of his background Experience in Harvard training Passionate to work with people through relationshipsDr. 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 itAAP 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 resourcesLook at the resources below [40:51 - 52:03] Closing SegmentWhat 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 TakeawaysIt’s all about relationships Child behavior problems take reframing Think bigger to include other issues The fever analogy Use your title Do...

https://swiy.co/WhatAreYourThoughtsLet’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 also 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 SegmentIntroducing today's guest, Rikki SaundersExpertise 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 SchoolRikki talks about needing to change our approach We are here to serve We don’t turn people awayPeople come in with trauma Some are even homelessConsistency 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 504Diabetes example The options you have Teachers are responsible to accommodate needs Qualifying for IEP covered through IDEAThe 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 procedureCan 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 QuestionsRikki talks about her responsibility The main mission Environmental vs. eligibility The African American Male exampleRikki 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

https://swiy.co/WhatAreYourThoughtsDr. 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 SegmentIntroducing 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 MSUDr. Scheid talks about shifting careers What is it that excites youLook around and look at your colleagues Thinks about the day to day aspects [09:14 - 24:45] Dealing with Child Trauma in the Welfare SystemDr. Scheid talks about her consultancy with the Child Welfare SystemInterests 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 empowermentYou 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 informationHow do you find out the best practices for the individual Acknowledge what we don’t know [24:56 - 36:56] Deprescribing and PolypharmacyDr. Scheid’s insights on polypharmacy The presence of other problems Hard to know a single diagnosis Take a step back and look at the historyIs 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 interventionLinks 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 SegmentDr. Scheid talks about resources that can help Links below Dr. Scheid’s advice to her younger selfDealing with the answer no Don’t be afraid to name your lack...

https://swiy.co/WhatAreYourThoughtsPhysicians 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 SegmentIntroducing today's guest, Sheryl Lozowski-Sullivan, MPh, LP, PhDExpertise and work Sheryl gives some background on her story Personal battle against cancerExternal practicum program with meIntegrated behavioral health  Health interventions on pediatric conditions[05:56 - 17:55] Why You Should Not Always Believe Your ThoughtsChoosing a specific type of therapySheryl talks about mental health in the United StatesClinical psychology and social work Mental health as a disciplineBehavioral therapy Referral source rates  Combination of behavioral therapy and medicationCognitive Behavior TherapyAutomatic thoughtsCounter thoughtsThought-restructuring Need for a coach[17:56 - 33:50] 7 Things to Feel Better We talk about “selling” therapy to the child’s familyRecognizing that whatever the child experiences is realListening to the childDealing with anxiety disordersSheryl walks us through the Activation TherapyExperientialDetermined by and dependent on the patientShe talks about not needing to know the diagnosis alwaysChanging behaviors in therapyWe talk about how to feel better, especially during the COVID-19 pandemic[33:51 - 43:01] Collaborating with our Mental Health ColleaguesSheryl shares how to increase visit rates to therapy Mind-body dichotomy is artificial, not realEducating parents and guardians about pediatric conditionsThe importance of a mental health professional near youCan we separate the mind from the body?[43:02 - 49:38] Closing SegmentI give my thoughts about the role of mental health professionals in therapyWe need to address low patient referral ratesFinal TakeawaysTypes of therapyAreas of expertise of therapistsIntegrated behavioral healthThis should be advocated and fundedMental health has long been waited by psychologistsTweetable 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.” -

https://swiy.co/WhatAreYourThoughtsToday’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 SegmentIntroducing today's guest, Dr. Joanna QuigleyDr. Quigley’s path to child psychiatryThe differences between pediatrics and child psychiatry[08:48 - 13:36] Collaborative Child CareWe talk about the benefits of collaborative child care programsLearning from one anotherLeveraging one another’s resourcesLooking for collaborative care programsState health departmentsKeywordsTelephone consultation programsCollaborative care consultation programsPsychiatric collaborative consultation [13:37 - 25:13] Psychiatric ConsultationDr. Quigley shares some tips to make consultations easierCurrent conditionTrauma history Symptoms She talks about a few best practices on selecting medicationsWhere to access these best practices? Links below[25:14 - 40:27] Child Psychiatry Managing screen time and media exposure of children Setting limits is okayPractical tip: Turn off the WIFIDr. Quigley talks about collaborations with primary care providersBe intentional in your collaborative effortsBe open to the fact that one visit won’t solve everythingWe talk about this game-changing service in child psychiatry[40:28 - 46:24] Closing SegmentFinding joys with patients and colleagues Final TakeawaysCollaborative child careDifficulties of primary care providersPsychiatric and pediatric trainingsTrauma and anxiety Symptom reliefResources of best practice guidelinesParent 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 QuigleyResources Mentioned:Michigan Child Collaborative CareHealthyChildrenAmerican Academy of Child and Adolescent PsychiatryNational Network of Child Psychiatry Access ProgramsStahl's Essential PsychopharmacologyAmerican Academy of PediatricsIf you’d like to connect with Dr. Quigley, email joannaq@med.umich.edu. Also, visit a...

https://302.buzz/PM-WhatAreYourThoughtsThe 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 SegmentIntroducing today's guest, Dr. Lynn SmithermanDr. Smitherman path to pediatricsComfort in talking with children and parents[08:40 - 26:09] Racism Dr. Smitherman talks about restorative justiceShe talks about some terms related to racismBiasExplicitImplicitDiscriminationPrejudiceRacismInstitutional/StructuralInterpersonalInternalized  [26:10 - 40:01] People of ColorDr. Smitherman talks about racism in the context of medicine She talks about ways to handle racismFor childrenFor pediatriciansHaving allies from different backgrounds is crucial[40:02 - 52:07] Education We talk about addressing racism in the medical fieldEducate yourselfReflect on your current valuesDr. Smitherman shares some relevant resources. Links below. How to tackle racism in childhood and adolescence Positive messagingThe root of the problems[52:08 - 58:00] Closing SegmentDr. Smitherman tells us why we should stand against racism Children are vulnerableFinal TakeawaysDifferences among bias, prejudice, and discriminationRacism’s impacts on childrenEquity, diversity, and inclusionIntentional effort to participate in changeTrust as a bridge to people of colorPersonal change, practice change, and organizational changeRepresentation in the medical fieldTweetable 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 SmithermanResources Mentioned:For Kids:Your Kids Aren't Too Young to Talk About Race: Resource RoundupThey’re Not Too Young to Talk About RaceEmbrace RaceHow...

https://302.buzz/PM-WhatAreYourThoughtsWe 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 SegmentWelcoming today's guest, Dr. Dan ShumerDr. 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 dysphoriaThe role of parents on their child’s growth[13:38 - 23:48] Caring and CompassionMental health of LGBTQIA+ patientsBuilding a safe space for trans patientsA difference in gender identity and biological sex is normalFind out why this is not a problemEducational materials about caring for transgender youthLinks below[23:49 - 32:21] Ethics of Care Dr. Shumer’s treatment approach “Pausing” pubertyEthical issues to consider [32:22 - 38:48] Closing SegmentDr. Shumer’s parting wordsCompassion is the first step to care for trans patientsFinal TakeawaysDifference in gender identity and biological sex is normal Parents’ dreams for their kids might differ from what the kids really wantParent education is a must Relevant educational resources are availableTiming and intervention are crucial in treatment We need to look for mentors who can guide usCompassion can make a big differenceTweetable 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 ShumerResources Mentioned:UCSF Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary PeopleWorld Professional Agency for Transgender Youth – Standards of CareIf 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 LinkedIn, Facebook, and a...

https://302.buzz/PM-WhatAreYourThoughtsToday, 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 SegmentWelcoming today's guest, Dr. Michael KleinDr. Klein’s road to pediatric surgeryOverseas workTwo greatest medical inventions for Dr. Klein[08:14 - 24:44] Pediatricians are Awesome!Dr. Klein talks about the American Academy of PediatricsDemocracy at its bestDr. Klein tells us why pediatrics is wonderfulWho are we serving?What’s the most important force for human progress?Vaccine education is a must[24:45 - 37:08] Pediatricians are CrucialDr. Klein talks about thriving under pressureHe tells us why pediatricians are crucial in the communityWhy should pediatricians join chapters and national associations? Issue-based politics benefitting children [37:09 - 42:26] Closing SegmentLove your pediatriciansDr. Klein’s parting wordsFinal TakeawaysThe American Academy of PediatricsA pediatrician’s role in making the world betterChildren are the answerReturn of Investment of childrenToxic stressTweetable 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 KleinResources Mentioned:Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in AdultsThinking DevelopmentallyHeckman Early Childhood Development ROIDoctors Without BordersIf 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 LinkedIn, Facebook, and Twitter or email me at gagginol@yahoo.com. To learn more about me visit

https://302.buzz/PM-WhatAreYourThoughtsI 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 SegmentWelcoming today's guest, Dr. Zakia AlaviI introduce the topic for this episode[03:52 - 18:43] Children’s Responses to COVID-19Dr. Alavi’s insights on the effects of COVID-19 to 5-year olds and youngerParents and caregivers should also be consideredHer thoughts on the most affected age group of the COVID-19Teenage meltdowns to watch out for according to Dr. Alavi[18:44 - 32:36] Parents’ Routines What parents should realize about their routines or lack thereofParents 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 knowHer reminders for parents in coping with COVID-19[32:37 - 37:01] The Right Questions to Ask NowDr. Alavi’s insights about mental health issues during COVID-19What questions to ask for spouses and children Other related issues that should be addressed[37:02 - 47:49] Closing SegmentDr. Alavi’s parting wordsSilver linings in the pandemicEducating people about vaccinesFinal TakeawaysCOVID-19’s impact on children of different agesSense of safety for kids under 5 years of ageParents’ response to COVID-19Children regressions and meltdownsSleep should be addressed for all children Routines will go a long wayMark the passage of timeVerbal reassurance for middle schoolersSaving grace for teenagersSafety from lethal meansTweetable 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 AlaviResources Mentioned:COVID-19 Parental Resources Kit – Early ChildhoodHelping Kids Cope with the Holidays During the PandemicResources for Helping Kids and Parents Cope Amidst COVID-19Parenting in a Pandemic: Tips to Keep the Calm at HomeBody Keeps The Score

https://302.buzz/PM-WhatAreYourThoughtsIn 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 SegmentWelcoming today's guest, Dr. Zakia AlaviHer path to child and adolescent psychiatryTouching one generation with one child[06:03 - 16:12] Convincing Families A supportive community mental health systemHow to convince “professional” families to treat mental healthBuilding a two-way communication with children[16:13 - 25:35] Building Networks and RelationshipsPrimary care providers shouldn’t go beyond their comfort levelFind out whyHow can physicians make a change within their systems? The importance of network- and relationship-building [25:36 - 32:09] Creating a Safe Space for ChildrenTrust and comfort among children as priorities Mental health stigma during and after the COVID-19 pandemic[32:10 - 41:53] Closing SegmentDr. Alavi’s parting wordsTrust the patients moreFinal TakeawaysConnect with child psychiatristThe importance of humility among child psychiatristsSupportive systems in the community mental health worldBuilding relationships and work on a team Trust the system and the patient moreSometimes, 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 AlaviResources Mentioned:Michigan Child Care CollaborativeEp. 13: Psychiatric Consultation: The Doctor is In!National Network of Child Psychiatry Access ProgramsUnderstanding the Use of Psychotropic Medications in the Child Welfare System: Causes, Consequences, and Proposed SolutionsWhen stimulants “fail” for children with attention-deficit/hyperactivity disorderIf 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 LinkedIn, Facebook, and Twitter or email me at gagginol@yahoo.com. To learn...

https://302.buzz/PM-WhatAreYourThoughtsWe 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 SegmentWelcoming today's guests, Dr. Sheila Marcus and Dr. Sarah Mohiuddin, We introduce our topic for this episode[02:52 - 13:24] Observe the BabyDr. Marcus tells us what to look out for in a 4- to 12-month old babyA baby should learn how to love the parents by this time Listen to Dr. Mohiuddin’s advice for pediatriciansEncourage the patient’s parents to come backUse appropriate language that only subtly expresses your concern Observe the baby with the parent without your presence[13:25 - 23:31] Consider Virtual EvaluationsThey talk about the pros and cons of virtual evaluations Hear the parents’ voice, see the babyThe importance of early interventions for babies exhibiting signs of autismDr. Marcus explains[23:32 - 34:02] Explain the Spectrum They explain why autism disorders are located in a spectrumNot a matter of “you have it” or “you don’t have it”Dr. Marcus talks about the common tests to detect autism spectrum disorders earlyWhat 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 uncomfortableDr. 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 FutureWe share some useful resources to educate you more about autismLinks belowThe challenging part of transitioning to adolescence and adulthoodThey talk about the importance of thinking about the kid’s futureIndependent living skills, work, and preferences, among others[57:54 - 01:06:15] Closing SegmentParting words from Dr. Marcus and Dr. Mohiuddin Final TakeawaysAlways listen to parent concerns and take them seriouslyEarly identification and evaluation make all the differenceDelivering the diagnosis can be hard and painful for patients Early symptoms are sometimes too subtle Applied Behavior Analysis and Early Start Denver ModelOlder language with strong language skills can be missed easily Don’t always fill in the gapsThink early about the kid’s trajectory in the future Medications should only be considered in extreme casesAs 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...