Pediatric Meltdown

How do we help kids and teens when social media is fueling a resurgence of body image issues and eating disorders? In this special conversation, Lia's daughter, Julia Parzyck shares her personal and professional journey navigating the tumultuous landscape of body acceptance in a world obsessed with appearance. The episode explores the influence of social media platforms, like TikTok and Instagram, and the impact they have on pediatric mental health and body positivity. Listeners will discover practical parenting strategies rooted in empathy, compassion, and my own past mistakes. Body acceptance is an ongoing journey, not a destination. Are we ready to support the next generation in building resilience against the ever-present pressures of body image issues?[00:01 - 06:22] The Shifting Landscape of Body Image and Social MediaExplores how diet culture and body expectations have worsened for teenagers in the age of TikTok and “skinny talk,” surpassing early 2000s pressures.The proliferation of pro-eating disorder content, now openly accessible through social media, and how it's masked as harmless tips.Contrasts curated body-positive environments with the harsher realities faced by today's youth on unchecked platforms.Highlights the rise of the “skinny talk” hashtag/movement and its troubling normalization of disordered behaviors and comparison.[06:23 - 11:39]Owning Softness: From Childhood Stories to Social AdvocacyJulia redefines “softness” as a source of strength, both in body and emotions, coining the phrase “soft body baddie” for her community.Childhood anecdotes—ranging from fashion flair to forming the hilariously named "labia band"—remind listeners of the roots of self-expression.Explores how embracing personal quirks and struggles, like anxiety and neurodivergence, leads to greater empathy in work with children and coaching.Reflects on how family dynamics and navigating outspoken personalities shape resilience, communication, and mutual growth.[11:40 -19:47]Healing, Boundaries, and Building a Modern IdentityDiscusses the transformative impact of family therapy, learning emotional independence, and accepting that parents can't always “fix” pain.Julia's journey through heartbreak (a called-off wedding) reveals the non-linear, ongoing process of healing and redefining self-worth.Explores the leap of faith required to pursue a career in body-positive coaching and online content, with all its uncertainties.Highlights the value of embracing risk, letting go of the need to “do it all over,” and recognizing how adversity can fuel growth and new purpose.[19:48 - 42:06] Compassion, Societal Pressures, and Looking ForwardShares insights on how political landscapes influence fashion, body ideals, and the subtle ways women are controlled through image and expectation.Resist setting rigid future goals, focus instead on finding joy, balance, and meaning in work and life, post-trauma.Stresses that body image work is lifelong, and that society will likely never “fix” its obsessions—progress is about grace, not perfection.Leaves listeners with the message that taking up space, nurturing empathy, and living for personal fulfillment, not external approval, is an act of quiet revolution.[29:23 - 35:21] Dr. G's TakeAwaysConnect with Julia Parzyck Instagram: Fit Fat and All That Here are some more episodes...

Have you ever considered that victims of human trafficking might be walking into your clinic, hidden in plain sight, longing for someone to notice their silent signals? In this episode of Pediatric Meltdown, host Dr. Lia Gaggino sits down with Dr. Dena Nazer , a leading child abuse pediatrician, to dispel widespread myths and expose the heartbreaking realities of child trafficking. They dive deeply into what human trafficking truly looks like, why language and empathy shape outcomes, and how pediatricians can recognize and respond to red flags—even when victims don't or can't ask for help. If you've ever wondered how to protect the most vulnerable or questioned your own role in advocacy, this conversation mixes expertise and actionable strategies you can use today. Don't miss this essential episode—sometimes the most critical intervention is simply being prepared to see what others overlook.[00:00 - 06:25] Beyond Kidnapping: The Everyday Reality of Child TraffickingMedia Myths: trafficking is not always dramatic kidnappings—many victims are exploited by someone they know, sometimes in their own homes.Defining human trafficking per US federal law: for children under 18, any commercial sexual act (anything exchanged for perceived value) is trafficking, regardless of force, fraud, or coercion.Labor trafficking in children does require proof of force, fraud, or coercion, unlike sex trafficking.Children cannot legally consent to commercial sexual acts, a fact often misunderstood by practitioners.[06:26 - 18:33] Recognizing Vulnerability: Victims, Prevalence, and Persistent MythsAll children, regardless of socioeconomic status or geography, can be victimized; not just those from impoverished or unstable backgrounds.Adolescents are particularly vulnerable due to developmental, social, and neurological factors—especially girls, though all genders are at risk.The covert nature and underreporting of trafficking, with true prevalence grossly underestimated—actual victims far exceed documented cases.Practitioners should avoid assumptions about victim profiles and recognize that trafficking does not discriminate by background or location.[18:34 -24:41] Language, Reporting, and the Power of EmpathyThere is an impact of language, advocating against terms like "prostitute" or "modern day slavery," as they distort public perception and can harm survivors.There are nuanced preferences between “victim” and “survivor,” emphasizing respect for self-identification.Addresses mandated reporting: outlines state-by-state differences, reminds clinicians to know their local laws, and suggests erring on the side of caution when in doubt.Discusses the complexities of reporting and intervention with 18+ patients, promoting support over “rescue,” and collaboration over dictating solutions.[24:42 - 47:58] Identification, Patient Support, and Multi-Agency CollaborationRed flags in clinical settings: domineering non-parental adults accompanying children, delayed care-seeking, lack of address knowledge, repeated STIs, or signs of fear and withdrawal.Ways to build trust and elicit disclosures: prioritize safety, establish boundaries about reporting, and use risk-factor-based screening questions.Trauma-informed care—responding with empathy, validation, and minimal dramatization—to avoid re-traumatizing patients.Connect with local Child Advocacy Centers and understanding local resources and procedures before a crisis arises.[47:59 - 59:59] Dr. G's TakeAwaysAdditional Resources Mentioned

Can medication truly transform the landscape of pediatric mental health, or are we oversimplifying the complexities of growing minds? In this episode of Pediatric Meltdown, Dr. Lia Gaggino welcomes Dr. Jess Pierce, a hospital-based child psychiatrist whose expertise bridges the worlds of pediatrics and mental health, especially for children in rural areas. Unraveling the fascinating history of psychopharmacology and delving into the mechanisms of action for the antidepressants, this episode offers a roadmap for pediatricians navigating the maze of SSRIs, SNRIs, risks like serotonin syndrome, and difficult conversations about side effects. The nuances matter and Dr. Pierce guides us skillfully.Discover why family history, patient buy-in, and transparent communications are pivotal to successful treatment—and why prescribing for young people demands a delicate blend of science, art, and empathy. This conversation will change the way you see—and approach—medication and the treatment of kids' mental health.[00:08:51] Exploring Pediatric Psychopharmacology's RootsTracing the unexpected origins of antidepressants, including how tuberculosis and hypertension treatments led to modern psychopharmacologyThe monoamine hypothesis: understanding the neurotransmitter focus in early depression treatmentsThe move beyond serotonin, dopamine, and norepinephrine: new research on neurobiology, neurogenesis, and stress responseProzac's arrival and its impact in reshaping the treatment landscape for pediatric mental health[08:52- 18:06 ] SSRIs in Practice: Similarities, Differences, and SelectionAll SSRIs share rapid absorption, high protein binding, and similar side effect profiles—but key differences can matterImportant reasons to avoid Paxil and to use Lexapro over Celexa, particularly due to side effect burdensNuanced considerations: matching specific SSRIs to individual patient needs, such as Prozac's activating profile for low-energy depressionPractical dosing strategies: the art of balancing “start low and go slow” with the urgency to help suffering children[18:07- 27:59] Navigating Risks, Side Effects, and Patient MonitoringThe truth behind the Black Box Warning: clarifying risks of suicidal ideation vs. the dangers of untreated depressionWhy regular, open conversations with families about medication side effects—especially sexual side effects in teens—build trust and adherenceRecognizing and managing serotonin syndrome: how to spot symptoms and when emergency intervention is neededIdentifying high-risk drug interactions, including situations with migraine or neurology medications[28:00-45:19 ] From SNRIs to the Five-Step Prescribing Approach and BeyondHow SNRIs differ from SSRIs in action, side effects, and indication—especially in pain syndromes or where activating effects are desiredThe use of Wellbutrin as an alternative with fewer sexual side effects, and cautions for seizure-prone populationsStrategic guidelines: the five-step approach to medication choice, considering patient history, family response, symptoms, buy-in, and comorbiditiesCritical cautions with genetic testing and the limitations of using these results to guide first-line medication choices[45:20-1:00:00] Dr Lia's TakeAwaysResources Mentioned:Dr. Pierce's PPT on Pediatric Psychopharmacology Hello! Here's the link to the slides: Psychopharm...

Are you struggling to support young patients—and maybe even yourself—with the emotional aftermath of our “new normal”? In this compelling episode of Pediatric Meltdown, Dr. Colleen Cullinan returns to unpack the reality of pediatric depression in a world rocked by uncertainty. Discover why traditional approaches, like focusing solely on symptoms, may actually miss the bigger picture when kids are faced with unprecedented stress. Learn how changing the narrative, adopting techniques such as Acceptance and Commitment Therapy (ACT), and making small, values-driven changes can help children—and parents—find hope, function, and connection again. This episode isn't just about treating depression; it's about transforming how we relate to struggle and building resilience against the tide of ongoing adversity. Tune in for real stories, actionable tools, and a refreshing reminder: even the heaviest feelings can be given a name, a shape, and ultimately, a little less power.[00:00 - 08:40] The Impact: Symptom Overload, and Functional ImpairmentThe pandemic has significantly amplified youth mental health issues, leading to increased rates and severity of pediatric depression and anxiety.Symptom checklists like the PHQ-9 now reveal almost universal distress—so much so that a "normal" score is rare.Chronic uncertainty and prolonged stress (for both kids and adults) exacerbate feelings of hopelessness, helplessness, and irritability.The primary care challenge: shifting from symptom identification to understanding the real-life impact on activities, relationships, and overall well-being.[08:41 - 28:29] Rethinking Depression in Pediatrics: Connection, and Therapy ApproachesConnection—not just checking PHQ-9 scores—is a critical protective factor for youth mental health and should be the heart of clinical encounters.Traditional Cognitive Behavioral Therapy (CBT) and newer Acceptance and Commitment Therapy (ACT) are compared — with ACT focusing on accepting thoughts and changing relationships with them, not just “fixing” or disputing them.Dr. Cullinan explains how ACT techniques, including physicalizing and naming despair, help kids distance from and better manage their feelings.The “beach ball” metaphor illustrates how fighting negative thoughts can cause you to miss life's joys—and how letting them coexist with living can restore function and hope.[28:30 -58:59] Strategies: Playful Experiments, Values-Based Goals, Motivational ToolsPractical examples include using humor, metaphor, and even quick physical challenges (like the “lemon” exercise) to help kids gain distance from distressing thoughts.Naming depressive feelings or thoughts (e.g., “pathetic,” “Bob”) can help externalize and reduce their influence, making them easier to talk about and manage.Motivational Interviewing is highlighted as a powerful tool—but only if it genuinely centers each child's unique values and interests, not the provider's agenda.Avoidance, not just the presence of sadness or fear, is flagged as the true engine of suffering; the focus shifts to acceptance and gentle behavioral activation.[59:00-1:06:47] Building Resilience: Safety, Nurture, New Frames, and Practical PearlsChildren's beliefs and “frames” about themselves and the world are shaped by repeated messages—caregivers can help reframe these with new, nurturing narratives.Safe, stable, nurturing relationships offer the strongest protection and resilience against depression and trauma, as explored through frameworks like toxic stress and child transformation health.Providers can make meaningful impact in just minutes with new language, metaphors, and reframing exercises—even in a busy primary care setting.[1:06:48 -...

Have you ever wondered why anxiety in children can look and feel so physical—and what we as pediatricians, parents, or caregivers can do about it? We're visiting a fan favorite from Episode #26 of Pediatric Meltdown, Dr. Lia Gaggino sits down with Dr. Colleen Cullinan, a leading pediatric psychologist, to dissect the powerful 3 B's approach: Brain, Body, and Behavior. Together, they reveal eye-opening truths about integrated behavioral health, the ways anxiety manifests in kids, and practical, actionable strategies for managing emotional meltdowns in real-time. This is not just about recognizing anxiety—it's about transforming how we support kids inside and outside the exam room. If you want to empower families, level up your clinical skills, and make a tangible difference, don't miss this conversation. This episode could change the way you think about pediatric care—forever.[00:00 - 11:35] Integrated Care Foundations: Building Partnerships in Pediatric PracticeIntegrated behavioral health bridges the gap between physical and mental health, creating seamless care experiences for families.Primary care is often the first—and sometimes only—entry point for children facing emotional or behavioral challenges.Partnerships between pediatricians and behavioral health providers increase accessibility, reduce stigma, and foster earlier intervention.The synergy and trust between pediatricians and psychology professionals leads to holistic, effective patient care.[11:36 - 15:49] The Role of Primary Care in Managing Anxiety and Emotional HealthPrimary care providers serve as trusted anchors, introducing mental health as an essential component of overall health.Familiarity with a child's history allows pediatricians to recognize subtle behavior changes and collaborate meaningfully with behavioral specialists.Normalizing physical symptoms of anxiety (like stomachaches and headaches) helps bridge conversations from medical to emotional concerns.Educating families on the inseparability of physical and emotional health empowers them to seek support without shame.[15:50 - 28:55] Anxiety Explained: The 3 B's and Practical Strategies for KidsThe "3 B's": Brain, Body, and Behavior, are interlinked—anxiety in the brain triggers body sensations, which guide behavior, often leading to avoidance.Psychoeducation is key: Emphasizing to families and youth that everyone experiences anxiety validates their feelings and reduces shame.Simple, actionable distress tolerance tools—breathing exercises, grounding techniques (like the “five senses” method), and focusing attention—can be taught in minutes during a regular visit.Providers can help children recognize “worry thoughts” and redirect their response before anxiety spirals into withdrawal or meltdown.[28:56 - 49:20] When to Escalate: Distress Tolerance, Prevention, and Team-Based SolutionsDistress tolerance techniques can bridge the gap until a child can access specialized behavioral care—or be sufficient for milder cases.Functional impairment is the marker for when anxiety moves from “manageable” to requiring traditional CBT or higher-level intervention.Exposure therapy explained: At its core, CBT for anxiety involves identifying fears and encouraging gradual, manageable exposure to them, with improvement through repetition.Advocacy for integrated behavioral health, resource sharing, and ongoing partnerships with community therapists are essential for sustainable, high-impact child mental health care.[49:21- 53:34] Dr. Lia's...

Are pediatricians prepared for the mental health crisis that's impacting so many of our children today?In this episode of Pediatric Meltdown, host Dr. Lia Gaggino sits down with nationally recognized child psychiatrist and podcast host Dr. Elise Fallucco to uncover the urgent realities facing pediatric practice. From understanding why a simple podcast name change can transform the reach of critical mental health education, to exploring the real-world, stepwise journey pediatricians navigate when facing complex child anxiety and medication management, this episode is a masterclass in practical empowerment. Listeners will discover actionable strategies for burnout, the evolving landscape of pediatric mental health treatment, and authentic stories of resilience, support, and resourcefulness. The stakes have never been higher—and the need to equip pediatric clinicians with the right knowledge and mindset is more critical than ever. Don't miss this invigorating roadmap for providing exceptional care in panicked times.[00:02 - 05:46] Branding, Access, and Reaching Pediatric CliniciansPediatric mental health education is increasingly being disseminated beyond in-person local trainings, leveraging digital platforms like podcasts to amplify access and reach.Clear, descriptive branding ensures the right clinicians can find mental health resources at the exact moment they need support in practice.The main driver in choosing content is what pediatricians most urgently seek: practical, actionable advice about managing medications for anxiety and ADHD.Making specialized knowledge accessible via on-demand, digestible podcast episodes empowers clinicians to feel less isolated and more competent.[05:47 - 13:30] The Ongoing Challenge of Anxiety, Burnout, and Self-CareAnxiety has emerged as the most common and burdensome mental health concern for children, exacerbated by societal stress and recent global events.Differentiating normal anxiety from clinical anxiety is crucial: functional impairment and life disruption are key markers for escalated intervention.Coping strategies for clinicians are vital; the “three pillars” are staying busy with purposeful activity, reaffirming personal/professional mission, and prioritizing self-care.Peer connection, exercise, and carving out time for meaningful relationships are highlighted as essential personal de-stressors.[13:31 - 25:00] Building Skill, Facing Complexity, and the Realities of CarePediatricians experience a four-stage progression from fear and avoidance to high-confidence care in managing pediatric mental health—each with unique challenges and rewards.Access limitations to child psychiatry have forced primary care clinicians to expand their skillsets and comfort zones, often out of necessity.Collaborative consultation programs, like psychiatric access hotlines, accelerate learning, build confidence, and foster an environment where sharing expertise is normalized.Developing fluency with diagnoses and medication management leads to more effective and streamlined care; “herd immunity” and practice culture shifts increase collective capacity.[25:01 - 36:05] Pain Points, Solutions, and Sustaining Progress in Pediatric Mental HealthBarriers to therapy—including logistics, family skepticism, and stigma—limit effective care, even as access improves; motivational interviewing is a partial solution but not a panacea.Integrated behavioral health models and school-based clinics offer promising solutions by reducing friction and meeting children and families where they are.Time constraints and misaligned incentives remain top frustrations; procedures are often reimbursed more than complex mental health care, despite the latter's intensity and impact.Empathy,...

Can one person truly make a difference in the complex world of pediatric healthcare?In this episode of Pediatric Meltdown, host Dr. Lia Gaggino explores how primary care pediatricians can step up amidst the chaos in Washington DC and stand as the trusted advocates children need. While Lia prepares for the pediatric academic society PAS in Honolulu, she is wrestling with the disastrous current health policy challenges and calls for local action. Lia pleads with her peers to organize and cause “good trouble”. This episode underscores that our most vulnerable population — children — deserves the unwavering dedication of empowered and informed advocates. In pursuit of crafting a brighter future for children's health, will you rise to meet the challenge?[00:00:04 - 00:01:21] Preparing for Change and ConnectionPediatric Meltdown is dedicated to children's mental health and emotional well-being.Dr. Lia Gaggino shares her passion for facilitating thoughtful conversations with experts.New and creative medical approaches are thriving and contributing to community upliftment.Enjoying family time and Hawaii's scenic beauty is part of Lia's plan to recharge.[00:01:21 - 00:04:19] The Chaos in D.C. - A Call to ActionThe state of national politics is concerning, described as a "dumpster fire."Staying informed plays a crucial role despite the overwhelming current events.Balancing leisure with staying critically aware of policy changes affecting pediatrics.Connecting with pediatric colleagues to brainstorm actionable steps.[00:04:19 - 00:08:39] Advocacy for Children's NeedsEmphasizing the trust placed in pediatricians and the responsibility that comes with it.Safe health practices are under threat from misinformation spreading rapidly.Vital programs and advisory committees crucial for child safety are being dismantled.Highlighting the unnecessary and detrimental effects of defunding health initiatives.[00:08:39 - 00:12:39] Empower Your Voice and CommunityHighlighting real stories as powerful tools for advocacy.Breaking down scientific data into relatable family narratives aids understanding.Demystifying Medicaid's role as crucial support for countless families.Urging listeners to take definitive action, whether through social media or community forums.Resources Mentioned:AAP Advocacy Guide Member log-in required to accessOn Tyranny Timothy SnyderAAP MMR Vaccine InformationAAP Medicaid State Fact SheetsHere are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186. Immigrant Children and Families 158. Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:"We've witnessed chaos, unprecedented and relentless. The landscape of Washington DC is reflective of a larger societal unrest, a crucible that now must forge strength and

Are you feeling overwhelmed by the world's chaos and seeking hope amidst uncertainty? In this moving episode of Pediatric Meltdown, host Dr. Lia welcomes Dr. Robert Saul to discuss the powerful principles guiding his commitment to advocacy and change. Dr. Saul introduces the transformative 12 words that have anchored his life's work and how these principles can propel communities forward. Together, they examine the impact of truth, trust, and the little-known role of the communal aspect in tackling societal issues. As Dr. Saul passionately delves into historical and modern-day examples of lying within power structures and challenges us to confront uncomfortable truths. Discover where the true power of change lies and how understanding our roles can lead to actionable advocacy. This episode isn't just a conversation—it's a call to action for those yearning to make a difference.[00:00 - 05:09] The Art of Medicine and the Value of ListeningDiscussing the importance of comprehensive clinical encounters beyond quick checkupsStressing that empathy and genuine presence build deeper connections in healthcareHighlighting the responsibility to offer hope and guidance, not merely prescriptionsSuggesting that professionals and caregivers must pause to recalibrate when stress levels rise[05:10 - 12:31] Accepting Responsibility: “I Am the Problem, I Am the Solution”Exploring the idea that acknowledging our collective part in societal problems is the first stepUnderlining the distinction between culpability and willingness to engage in solutionsDiscussing how seeing oneself as part of the issue spurs commitment to meaningful actionReminding listeners that we are interconnected in every community concern[12:32 -31:06] Truth, Trust, and Social FabricDefining trust as the “currency” of relationships and community lifeArguing that telling the truth consistently is essential for building and preserving trustNoting that children thrive when caregivers, professionals, and policymakers work together with integritySuggesting that widespread misinformation undermines the health and wellbeing of communities[31:07 - 42:06] Looking Ahead: Ongoing Work and HopeEncouraging continued involvement in committees, local boards, and mentorship rolesHighlighting the drive to create community programs focused on healing and trauma-informed carePlanning future projects that address truth, trust, science, diversity, and civilityEnding with an affirmation that sustained efforts at all levels can foster a more promising future[42:07 - 55:46] Dr. G's TakeAwaysAdditional Resources Mentionedhttps://mychildrenschildren.com/my-childrens-children-name/https://mychildrenschildren.com/better-is-good-incremental-steps-forward/Power S. The Education of an Idealist: A Memoir. Dey St. 2019; 580 pp. (p. 282)Snyder T. On Freedom. Crown, New York; 2024. 345 pp.https://mychildrenschildren.com/infant-mental-health-part-i/

Have you ever wondered how pediatricians balance autonomy, mentorship, and the pressing demands of modern healthcare? In this episode of “Pediatric Meltdown,” host Dr. Lia Gaggino welcomes Dr. Chris Peltier, MD, FAAP, who describes the rewards and hurdles of serving children through private practice, collaborative initiatives, and academic roles. He underscores the power of supportive peer networks to tackle shifting hospital structures, financial complexities, and the mental health needs of growing populations. His reflections reveal how advocacy, teaching, and flexibility can sustain a genuine passion for pediatrics. Will these strategies ensure a vibrant future for the next generation of caregivers?[00:00 - 22:18] Autonomy and Private vs. Hospital-Owned PracticesShifts toward hospital system acquisitions reduce physician independence.Succession planning gaps leave practices vulnerable to buyouts or closures.Administrative decisions can feel distant from day-to-day patient care.Becoming an employed physician can alleviate the stress of business management.[22:19 - 37:04] Collective Approaches to Independent Practice SuccessCollaborating across independent practices can reduce expenses, such as vaccine costs.Sharing vendors and resources fosters a supportive rather than competitive environment.Group quality improvement projects tackle issues like asthma or anxiety in children.Large networks can negotiate better insurance contracts on behalf of multiple practices.[37:05 -51:42] Preceptor Support and Compensation StrategiesIntrinsic motivation—such as the joy of mentoring—often drives physicians to teach.Efficient time management (e.g., scribing during patient visits) enables bedside teaching.Chapters and national organizations collaborate to advocate for preceptor stipends.Small but meaningful policy changes (like state tax incentives) can bolster teaching efforts.[51:43 - 1:07:43] Local Chapters and Advocacy for Child Health InitiativesMental health screenings, including suicide risk assessments, become embedded in well visits.Working with community partners and even firearm ownership groups promotes harm reduction.Coordinated action with lawmakers helps defend programs that protect vulnerable populations.Sharing successful programs across state lines broadens the reach of proven solutions.[1:07:44 - 1:19:52] Dr. G's TakeAwaysContacting Dr.Peltier FaceBook:: https://www.facebook.com/cpeltier007X:@cpeltier007INstagram:: https://www.instagram.com/cpeltier007/Additional Resources MentionedThe Pediatric Management Institute https://pediatricsupport.comAAP Section on Administration and Practice Management SOAPMAAP Council on Community Pediatrics COCP AAP Advocacy...

What does it really take to guide a teenager toward independence in an ever-changing world? From managing IEPs and beginning transition planning at 14 to fostering self-awareness and skills for adult life, the journey is layered with challenges and growth. Parents like today's guest, Natasha Robertson grapple with teaching social media safety, addressing emotional needs, and balancing day-to-day struggles with long-term goals. The process is both exhausting and inspiring, requiring patience, persistence, and firm advocacy. While the tools like coaching, therapies, and community support help, the weight often falls on families to navigate complex systems, such as educational frameworks and disability services. For teens, building independence means developing judgment, learning routines, and understanding boundaries in a digital age. For parents, like Natasha, it means preparing them for emotional, financial, and social self-reliance while ensuring basic skills are mastered. Are we as a society truly equipping these families and teens with the tools they need, or are we still leaving them to figure it out in isolation?[00:00 - 08:34] Evolving Services and Self-AdvocacyRealizing that past trial-and-error with therapies informs current decisionsThe child's ability to describe symptoms (e.g., stomach pain, insomnia) guides interventionsEmphasizing the shift from purely parent-led advocacy to incorporating the teen's direct feedbackPreparing for ongoing changes in support needs as the child advances academically and socially[08:35 - 15:47] Navigating the Teen YearsAddressing the impact of puberty and hormonal shifts on behaviorConsidering new social interactions and the need for structured supportImplementing coaching strategies for everyday routines (e.g., chores, picking out clothes)Recognizing that independent living skills build gradually through guided practice[15:48 -28:40] Managing Digital BoundariesEstablishing phone usage restrictions (e.g., set times) to protect against late-night browsingFinding monitoring tools (apps that flag concerning words) to balance privacy and safetyRealizing that direct honesty about monitoring builds trust with teensCoaching the teen on responsible online communication and the risks of oversharing personal data[28:41 - 53:19] Caregiver Self-Care and ResilienceCarving out small daily moments for personal relaxation (e.g., a movie break or foot soak)Relieving stress by connecting regularly with supportive friendsObserving that the teen's increased coping skills allow the caregiver to pause before interveningTrusting the cumulative impact of years of therapies and interventions[53:20 - 1:01:50] Dr. G's TakeAwaysContact Natasha Robertson n.robinson8@gmail.com.Additional Resources MentionedCommunity Living Supports: Services that assist with daily living skills and social engagement.Individualized Education Program (IEP) & Transition Planning: Formal educational plans that outline services and future goals for adolescents.Career-Connect Programs: Local agencies or initiatives that help teens explore job training, résumé building, and employment opportunities.Book: A teen parenting guide by Dr. Ken Ginsburg, titled Congrats, You're Having a Teen, referenced for positive perspectives on adolescence.

Have you ever wondered what happens when children's healthcare programs like Medicaid and CHIP face cuts? In this episode of Pediatric Meltdown, Dr. Lia Gaggino emphasizes the urgent need to stand up for kids, who are disproportionately impacted by shifts in policy and funding. She highlights the power of sharing real-life stories and forging unexpected partnerships to protect essential resources. Advocacy takes perseverance and creativity, as complacency only enables political and social obstacles to harm children. Pediatricians and other advocates must unite, use their voices effectively, and push for healthier, safer lives for all kids. So now the only question is….. Will you help safeguard the well-being of the next generation?[00:00 - 05:07] Advocacy Conference Insights for Child HealthA large percentage of children rely on public insurance programs, underscoring the high stakes of legislative decisions.Some decision-makers do not fully grasp the consequences of cutting critical services.Hope fuels long-term efforts and energizes those championing children's well-being.An “advocacy wave,” highlights the need for a strong, collective push for change.[05:07 - 12:32] Medicaid Challenges and Coverage GapsPublic health emergency rollbacks led to reductions in child enrollment due to procedural missteps.Many children lost insurance coverage not because of ineligibility, but because of bureaucratic hurdles.70% of youth are deemed unfit for certain national service due to physical or mental health issues.Call to safeguard essential child services (such as preventive care and immunizations) from budget cuts[12:32 - 21:07] Immunization and Food Security ConcernsRenewed challenges to routine childhood vaccinations, with instances of preventable diseases appearing again.Politicians downplaying vaccines, prompting greater vigilance in safeguarding public health.Proposals to cut school meal provisions, raising ethical questions about denying basic nutrition to children.Caring for children's fundamental needs (like food and healthcare) should not be up for debate.[21:07 - end] The Urgent Call to Protect Future GenerationsRejecting indifference and uniting for children's rights and well-being.Communities where basic resources, such as clean air, safe neighborhoods, and equitable opportunities, are universal.Use every possible platform—professional and community-based—to champion the needs of children.Final rallying cry to stay focused, gather supportive voices, and take concrete steps to safeguard the next generation.Connect with Dr. Gagginowebsite at www.lifeaftercorporatepodcast.com LinkedIn; https://www.linkedin.com/groups/12656341/Resources mentioned in the show:AAP Advocacy Guide: Located at aap.org/advocacyguide (helpful for step-by-step approaches to policy engagement).Store It Safe Program: https://ohioaap.org/storeitsafe A collaborative initiative addressing firearm...

Could coaching be the key to overcoming burnout and moral injury that plagues the medical profession? In this episode of Pediatric Meltdown, Dr. Lia Gaggino welcomes back Dr. Adrienne Mann and Dr. Tyra Fainstad, pioneers in physician well-being research, as they unpack the results from their studies on the impact of group coaching on physicians. Drs. Mann and Fainstad share their journey from a "cute little study" to a groundbreaking national program that offers a lifeline to medical students, residents, and faculty. As they study the struggles and triumphs of physicians battling burnout, moral injury, and self-compassion deficits, they reveal a whole new approach to healing and growth. Hear how their innovative program is providing solace to thousands and lighting a path to flourishing in medicine.[00:05 - 01:17] Transforming Physician Wellness through CoachingExplore the origins of a simple idea during the pandemic that blossomed into a renowned coaching programUnderstand how pivoting to online platforms expanded their coaching reach significantly beyond initial expectationsDiscover the importance of addressing burnout, moral injury, and imposter syndrome in healthcare professionalsLearn about the innovative group coaching model and its profound impacts versus traditional one-on-one methods[01:18 - 03:54] Impactful Outcomes of Group CoachingRecognize the need for a targeted approach focusing initially on women due to higher burnout representationEvaluate the coaching methodology's evolution from novice trials to thousands of residents in randomized control settingsAppreciate insights into baseline distress levels and how these reveal prevailing systemic issuesAnalyze how group coaching effectively elevated self-compassion, reduced moral injury, and tackled burnout[03:55 - 06:06] Inclusivity and Institutional PartnershipsGrasp the expanding scope to now include men and diverse genders, enhancing coaching accessibilityReveal the collaboration with institutions to democratize coaching, offering programs at low costs per participantExamine how privacy and anonymity are maintained to encourage participation without stigmaRecognize the structural evolution from restricted groups to open participation for trainees at all career stages[06:07 - 8:52] The Future Direction of Physician Coaching ProgramsInvestigate the ongoing research into why and how coaching uniquely benefits medical professionalsThe potential restructuring of medical leadership to address autonomy and eradicate systemic burnoutAppreciate the continuous refinement and adaptation of the coaching model based on participant feedbackFact-check how empirical evidence supports the coaching method's resilience against challenges posed by modern healthcare[48:51-32:50] Dr. Lia's TakeAwaysConnect with Dr. Adrienne MannInstagram: @amw1983Connect with Dr. Tyra FainstadInstagram: @TyraindenverResources Mentioned in the EpisodeBetter Together Coaching https://bettertogetherphysiciancoaching.com/-Major updates: You can see our website here for research and peer-reviewed evidence updates. Of high interest is our most

Are today's youth the missing voice in mental health advocacy?In this episode of Pediatric Meltdown, host Dr. Lia Gaggino invites passionate mental health advocate Ria Babaria to talk about the unique struggles and strengths of today's youth. In her journey from high school advocate to college policy specialist, Ria emphasizes the need for youth representation in mental health decisions. She discusses the Youth Power Project's initiatives, access to mental health resources, and the importance of bridging societal and systemic gaps. From personal challenges to state-wide advocacy, Ria highlights the transformative power of youth voices in policy-making. Join us as we explore the potential changes when youth are given a platform to be heard. The future of mental health is their future— but are we ready to listen?[00:05 -15:21] The Birth of Youth AdvocacyThe significance of amplifying youth voices in education and policy through advocacy organizationsImportance of bridging education gaps and providing resources for low-income and vulnerable youthEmpowering youth to assert confidence and influence in advocacy spacesThe transformative impact of including diverse backgrounds in policy discussions[15:12 -22:22] Mental Health Advocacy and Cultural ChallengesAddressing mental health struggles within POC households and breaking cultural taboosThe importance of emotion integration for personal growth and social interactionsBuilding confidence to engage in mental health advocacy at a young ageShaping policy through lived experiences and peer discussions[22:23 -38:50] Expanding the Youth Power Project ReachThe national evolution from initial state-focused youth groups to broader advocacy at YPPStrategizing for impactful health reform through youth collaboration and legislative workNavigating peer-to-peer networks to bolster the youth advocacy movementTailoring mental health and educational policies around authentic youth voices[38:51-48:50] Enhancing Access and System ReformsAddressing consistency and discrepancies in mental health resource access nationwideInnovative strategies to demystify access and eliminate stigma around mental health supportStrengthening first aid mental health training to improve communication and supportDeveloping legislative frameworks to integrate youth insights within mental health policy48:51-32:50] Dr. Lia's TakeAwaysConnect with Ria ria@youthpowerproject.orgResources Mentioned:PHQ-9 Screening Tool for Depression:PHQ-9 QuestionnaireYouth Power Project Website:Youth Power ProjectMental Health First Aid Training:Mental Health First AidYouth Power Project

Have you ever wondered what to do when traditional treatments for chronic pain in children don't seem to help? In this episode of Pediatric Meltdown, Dr. Lia Gaggino chats with Dr. Lonnie Zeltzer and Kim Poston Miller about innovative ways to address pediatric chronic pain. They discuss CHYP (Creative Healing for Youth in Pain), an organization offering hope to families through a creative, holistic approach to healing. Kim shares her personal story of supporting her son Grant's remarkable recovery, showing how creativity can play a powerful role in pain management. Tune in to learn how these approaches are opening new doors for children and families. Could creativity be the missing piece in chronic pain care?[00:02 - 08:46] From Suffering to Hope – Introduction to CHYPKim talks about her personal journey as an advocate for CHYP, and the pivotal role creative arts played in her child's recovery.Unpack the story behind Dr. Zeltzer's influence in reshaping pediatric pain management.Learn about the resourcefulness of a mother navigating her child's illness in a segmented medical landscape.Understand CHYP's role as a free, accessible solution to complex chronic pain issues for any child worldwide.[08:47 - 14:53] Kim's Inspiring Journey: Transforming Tragedy into TriumphSee the power of combining modern medicine with creative healing arts.Examine the interconnected struggles of family members often overlooked in medical treatments.Discover how social engagement became a lifeline for healing and improved quality of life.Find out how a mother's intuition and creative willingness conquered skepticism in professional medical advice.[14:54 - 23:30] The Creative System: Dr.Zeltzer's Vision and CHYP's FoundationExplore Dr.Zeltzer's 30-year journey of treating kids with chronic pain and the birth of the CHYP initiative.Appreciate the need for an online platform providing holistic, no-cost care to children globally.Grasp the significance of the biopsychosocial model in comprehending pediatric pain.Understand the empowerment and education process for both children and parents under the CHYP program.[23:31 - 54:36] Creating Magic: Camp as a Vessel for Change and ConnectionHighlight the access to interactive platforms and workshops designed to enhance creative healing for youth.Recognize the significance of larger social networks in managing pain through shared lived experiences.Celebrate the impactful break-through of barriers, from timidity to friends on social platforms.Appreciate CHYP's strategic growth with events uniquely catering to different age brackets for maximal impact.[54:37 - 1:00:53] Dr. Lia's Takeaways Connect with Lonnie Zeltzerhttps://linktr.ee/mychyphttps://www.instagram.com/my_chyp/https://www.linkedin.com/company/creative-healing-for-youth-in-pain/https://www.facebook.com/creativehealingforyouthinpainConnect with Kimberly MillerLI Kimberly Miller, MBAFB

Did you know that nearly twenty-five percent of adolescents suffer from chronic pain, and for some, it's severe enough to impact daily life? In this episode of Pediatric Meltdown, Dr. Lia Gaggino and guest Dr. Lonnie Zeltzer talk about the complexity of chronic pain in children and adolescents—a subject often misunderstood and inadequately addressed in pediatric medicine. Through personal anecdotes and expert insights, Dr. Zeltzer shares her journey from a curiosity about adolescent medicine to specializing in pediatric chronic pain using modern pain science. This conversation not only unravels the preconceived beliefs surrounding chronic pain but also offers potential pathways and methods to manage and reframe the experience of pain in young individuals. The episode is an eye-opener for anyone seeking to understand and support children grappling with chronic pain.[00:00 - 17:02] Prevalence and Challenges of Pediatric Chronic PainChronic pain affects 15–30% of adolescents globally, with 15% experiencing severe impairment. 70% of adolescents with untreated chronic pain develop adult chronic pain. Pediatricians often lack training in modern chronic pain management concepts. Subspecialists frequently struggle to address chronic pain after ruling out organic causes. [17:02 - 27:55] Neurobiological and Psychosocial Factors Chronic pain correlates with limbic system hyperactivity and prefrontal cortex underdevelopment in adolescents. Neurodiverse individuals may experience heightened sensory sensitivity, amplifying pain perception. Hypnotherapy and cognitive behavioral therapy (CBT) retrain pain-related neural pathways. POTS (postural orthostatic tachycardia syndrome) reflects autonomic nervous system dysregulation linked to chronic pain. [27:56 - 21:06] Gastrointestinal and Autonomic Dysregulation Irritable bowel syndrome (IBS) stems from brain-gut axis dysfunction, not structural gastrointestinal issues. Autonomic dysregulation in POTS requires salt intake, hydration, and compression garments for management. Acupuncture and acupressure offer nonpharmacologic relief, particularly for needle-tolerant patients. Abdominal pain often involves muscular tension, addressed through targeted physical therapy. [21:07 - 48:48 ] Practical Clinical Interventions Brief in-office mindfulness exercises (e.g., guided breathing) provide immediate stress relief. Motivational interviewing helps adolescents identify achievable goals, like gradual physical activity. Parent-child dyads benefit from joint mindfulness apps (e.g., Insight Timer) to reduce household stress. The "five golden minutes" of non-directed play or connection improve emotional regulation.[48:49 - 54:23] Dr. Lia's Takeaways Connect with Lonnie Zeltzerhttps://linktr.ee/mychyphttps://www.instagram.com/my_chyp/https://www.linkedin.com/company/creative-healing-for-youth-in-pain/https://www.facebook.com/creativehealingforyouthinpainResources mentioned in the...

Could a simple cash transfer program hold the key to reducing child poverty? In this episode of Pediatric Meltdown, host Dr. Lia Gaggino chats with pediatrician and advocate, Dr. Brittney Tayler, about an innovative program called Rx Kids. Together, they explore how cash transfers can improve child health and well-being, especially in communities facing deep poverty. Dr. Tayler shares her firsthand experience in Flint, Michigan, detailing the transformation she's witnessed through the Rx Kids program. From addressing housing issues to boosting educational outcomes, this episode uncovers the impact that a single initiative can have. Connect with the importance of advocacy and how one person can drive significant change, leaving a lasting impression on the entire community.[00:00 - 05:07] From Pediatrics to Advocacy: Dr. Tayler's JourneyFind out how an accidental advocacy led to Dr. Tayler's increased involvement in health policy.Understand the significance of Dr. Tayler's meeting with a senator, and the impact it had on health legislation.Learn about the challenges of navigating advocacy as a medical professional.Appreciate the support Dr. Tayler received from experienced mentors to sharpen her advocacy skills.[05:07 - 12:32] Understanding Poverty's Impact on Child HealthExplore the key aspects of poverty affecting child health, including housing and food security.Recognize the critical role of parents' stress levels in influencing children's well-being.Explore the widespread effects of poverty on all domains of health and life.Analyze how poverty can deeply affect educational outcomes and opportunities for children.[12:32 - 21:07] Rx Kids: Transforming Communities Through Direct Cash TransfersThe transition from expanded child tax credit to the creation of Rx Kids.Discover the pivotal role of expanded child tax credits in reducing child poverty during the pandemic.How small studies and data informed the large-scale development of Rx Kids.Discover the impactful results seen so far in communities participating in direct cash transfer programs.[21:07 - 30:21] Pioneering Change and Empowering CommunitiesUnderstand why Flint, Michigan, became the perfect place to pilot the Rx Kids program.Uncover the logistical aspects and eligibility criteria of the Rx Kids cash transfer program.The importance of dignity, trust, and community-wide benefits in program implementation.Future aspirations: how Rx Kids aims to expand and sustain its impact in Flint and beyond.[30:22 - 35:21] TakeAwaysConnect with Dr. Brittney TaylerFacebook – https://www.facebook.com/RxKidsUSInstagram - https://www.instagram.com/rxkidsus/LinkedIn - https://www.linkedin.com/company/rx-kids/Resources mentioned in the show:https://rxkids.org/about/communities/flint/Chevy in the Hole by Kelsey Ronan https://www.amazon.com/Chevy-Hole-Novel-Kelsey-Ronan/dp/125080390X Luke Shaefer PhD

Ever wonder how the current chaotic world and the state of healthcare are affecting our children, the most vulnerable members of society and those of us who care for them? Listen to this episode as Lia shares her angst and hope with the complexities of a world facing climate disasters, political strife, physician burnout, and a dwindling trust in science. This solo episode is a self-reflection about building the courage, commitment, and resilience required to safeguard children's health in these turbulent times. As Lia recounts her own experiences during the pandemic and advocates for unwavering integrity in pediatric care, she challenges listeners to reflect on their role to protect the wellbeing of ALL children.. This episode is a call to action—will you answer it? [00:05- 04:27] Insights on Pediatric Practice The rigorous process of policy creation and revision within the American Academy of Pediatrics (AAP).Importance of adhering to evidence-based practices and adapting policies based on scientific discoveries.The challenges pediatricians face, including making life-and-death decisions.Commitment to upholding the Hippocratic Oath despite mounting difficulties. [04:28 -11:54] Challenges in Pediatric HealthcareLong hours, difficult on-call shifts, and emotionally taxing decisions faced by pediatricians.Inequities in healthcare access, especially for marginalized children.Disinformation surrounding vaccines and its impact on parental decisions.Concerns over administrators dictating healthcare delivery without medical expertise. [11:55 - 17:58] Challenges in Pediatric HealthcareThe exhaustion and disheartenment experienced by pediatricians.Unfair contracts, financial pressures, and charting demands that intrude on family time.Pediatricians' dedication despite overwhelming demands, driven by a sense of calling.The public's misconceptions about pediatricians' financial motivations regarding vaccines.[17:59 - 22:30] Call to Action and AdvocacyA rallying message for pediatricians to support one another and remain resilient.Reinforcement of the commitment to doing what is best for children.The importance of unity and collective efforts to address healthcare challenges.Encouragement to engage with future episodes featuring interesting guests.Resources Mentioned in the EpisodeWebsite: PediatricMeltdown.comAAP (American Academy of Pediatrics): Highlighted as a trusted source for pediatric guidelines.Dr. Anthony Fauci: Mentioned as a prominent figure in guiding healthcare during the COVID-19 pandemic.https://pediatricmeltdown.com/episodes120 ADHD: Part 4 Executive Function119 ADHD Part 3: Executive Function109 ADHD Symptoms: Executive Functions Part IIADHD: Strategies for Boosting Executive FunctionTweetable Quotes:"To my pediatric colleagues, we cannot be intimidated. We cannot be afraid. We have to lean into each other and have each other's backs."... Dr. Lia Gaggino on the power of solidarity"Despite the insanity of misinformation, hyperbole, and conspiracy theories, he prevailed even when he and his family were threatened and continue to be threatened."...Dr. Lia Gaggino on what Dr. Fauci had to...

Raising Good Citizens Through Conscious ParentingWhat does it take to raise thoughtful citizens and build stronger communities while navigating the challenges of parenting, aging, and personal growth? In this episode, Dr. Robert Saul], an author and pediatrician, shares his insights from his career dedicated to advocating for children, families, and communities. Dr. Saul discusses his journey of writing books that cater to parents, children, and physicians, including one described as "Goodnight Moon with a message," using vivid illustrations and meaningful text to engage families. Through relatable examples like managing tantrums, school avoidance, and making tough decisions as both parents and children of aging parents, Dr. Saul emphasizes the importance of fostering responsibility and kindness. Drawing wisdom from the "5 M's" of mentoring, mediating, mobilizing, monitoring, and motivating, Dr. Saul inspires listeners to embrace their roles as sages and positive influences. Will this be the conversation that reshapes the way you see parenting and citizenship? [00:05- 11:27] Foundations of Conscious Parenting Key realization: “I am the problem, I am the solution, I am the resource.”The role of community engagement in addressing societal issues like teenage pregnancy and disengagement.Introduction to the “Five Steps to Community Improvement.”Impact of Columbine (1999) and its role in inspiring advocacy and writing. [11:28 -20:54] Overcoming Adverse Childhood Experiences (ACEs)The significance of nurturing, safe, and stable relationships (SSNRs).Introduction to SSNRs as a buffer against toxic stress.Role of parents in creating environments that foster resilience in children.Emphasis on pediatricians' responsibility to guide and support parents. [20:55 - 35:58] The Parental Awareness Threshold (PAT)Concept of being "above the line" (curious and open) vs. "below the line" (closed and defensive).Strategies for managing stress and frustration as a parent: pause, assess, choose.Frameworks for addressing challenges like tantrums and teenage rebellion.Balancing empathy with practical parenting techniques.[35:59 - 46:30] Advocacy and Community EngagementRole of pediatricians in supporting families facing poverty, domestic violence, or instability.The importance of advocacy for systemic changes to improve family support.Encouraging involvement in organizations like the American Academy of Pediatrics (AAP).The significance of professional networks for mutual support and advocacy.Connect with Dr. Saul: robertsaul@me.comhttps://mychildrenschildren.com/ to learn more.Resources mentioned in the show:BooksMy Children's ChildrenThinking DevelopmentallyConscious ParentingBowling AloneConscious Leadership

This episode was actually published in June 2022, but this is STILL a huge issue, so we thought we would take another listen …How can pediatric primary care effectively integrate mental health services amid insurance barriers and coding complexities? In this episode, we tackle the significant obstacles impacting the compensation and delivery of mental health services for children. By examining Medicaid, CHIP and commercial insurance coverage for mental health, we highlight challenges that hinder pediatricians and affect their young patients and families. The conversation sheds light on potential solutions, such as integrated behavioral health and group therapy, which may offer new avenues for improving care and financial viability. Through shared experiences from industry experts, we explore potential strategies to both navigate and potentially reform the delivery of pediatric mental health services. Considering the significant implications this has on future generations, what steps must we take now to ensure a sustainable and effective approach that genuinely meets the needs of children and their families? [00:05- 19:41] Financial and Operational Burdens Household income criteria affect eligibility for Medicaid, impacting family financial planning.Pediatric practices bear costs of unrecognized mental health work because of inadequate reimbursement.Parents' financial stress increased by the lack of integration between medical and mental health services.Complex insurance landscapes necessitate physician adaptability in operations. [19:42 -29:58] Pediatric Practice Challenges Mental health visits require more time but yield less reimbursement compared to physical ailments.Physicians provide extensive unpaid follow-up care via phone calls and messages.Insurance systems do not adequately support mental health coding for pediatricians.Complexity in billing for mental health services creates administrative challenges. [29:59 - 38:51] Economic and Qualitative Outcomes Coordinated care allows pediatricians to manage comprehensive patient care plans.Insurance company partnerships needed for sustainable pediatric mental health initiatives.Effective systems require data to demonstrate long-term cost benefits and outcomes.Organizations should engage with insurance companies to carve out necessary screening costs[38:52 - 1:05:50] Advocacy and Reform Efforts Reform needed in coding and billing processes to reflect the true nature of mental health support.Integrated care models as a potential less visible, but essential cost benefit.Engaging with insurance companies on mutual goals can lead to practice sustainability.Systems must prioritize patient-centered care, integrating mental and physical health.[1:05:51 - 1:13:48] TakeAwaysConnect with our guestsJenna Vallejo Facebook, Instagram, LinkedInDr. Jon Price nationwidechildrens.comGo to https://lifeaftercorporatepodcast.com/ for all episodes166 Chronic Illness and...

In 2020, I had the privilege of being a guest speaker on Sandy Fowler's podcast “Mighty Parenting” for a candid discussion about youth mental health, suicide prevention, and the critical role parents play in supporting their children through emotional challenges. I thought it would be interesting to blow the dust off this episode where I was being interviewed by Sandy. As a medical professional deeply committed to improving mental health care in primary care settings, I shared insights specifically for parents about how to recognize warning signs, have difficult conversations, and access appropriate resources. That conversation became a pivotal moment in my career, sparking my desire to reach a broader audience through podcasting… Pediatric Meltdown was born!Today, as the host of Pediatric Meltdown, I continue to build upon that mission, but I thought it would be worth revisiting this discussion that served as a catalyst for my current role as a podcast host. During our conversation, we tackled the crucial topic of youth suicide prevention, breaking down barriers to communication, and providing practical tools for parents to support their children's mental well-being. Unfortunately, with the impact of the Covid-19 Pandemic, this discussion remains as relevant today as it was then, perhaps even more so. [00:05- 21:59] Brain Development & Behavior Teen brains function differently from adult brainsRole of prefrontal cortex in decision makingImpact of developing brain on behaviorUnderstanding cognitive limitations [22:00 -32:45] Suicide Prevention StrategiesProper approach to discussing suicidal thoughtsImportance of staying calm during difficult conversationsAvailable crisis resourcesSteps for emergency [32:46 - 42:51] Mental Health Statistics25% of youth screen positive for depressionAnnual screening recommendations for ages 12+15% experience suicidal thoughtsImplementation of 54321 coping technique[42:52 - 53:02] Action Steps for Parents Creating safe environment for emotional expressionUnderstanding brain development impactUsing emotional scale assessments (1-5)Knowing when to seek helpGo to https://lifeaftercorporatepodcast.com/ for all episodes169. Lisa Durante's Strategy for Mastering Your Content Marketing Plan!153 A 3-Step Guide to Skyrocketing Your Income137 Marketing, Management, and Metrics: The Keys to Consistent SuccessTweetable Quotes:"But in terms of completed suicides, it's firearms, and the really sad thing is, suffocation mostly by hanging is the most common and becoming more common and that one, of course, is really hard to restrict because you can hang yourself with so many items." … Dr. Lia Gaggino on the harsh reality of suicide methods “"If you set the stage that it's okay to talk about your thoughts and feelings, then and and that's just a habit that you've had all along, then I think it makes the conversation easier." … Dr. Lia Gaggino on communicating with kids about Mental Health**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect...

What happens when a physician who regularly discusses wellness and burnout finds herself in need of her own advice? In this personal episode of "Pediatric Meltdown," host Dr. Lia Gaggino candidly shares her journey through an overwhelming period in late 2024, marked by her father's death, her mother's hip surgery and subsequent move-in, and the unexpected loss of her beloved pet. Despite having a strong support system that includes her husband Rodger, adult daughters, and one-year-old grandson George, she acknowledges her exhaustion and struggles with sleep, nutrition, and exercise habits. This episode is an honest confession of how even wellness advocates can find themselves needing to replenish their own spirit, in other words, to walk the walk in self-compassion. Some deep soul searching led to Lia's decision to take a month-long sabbatical from the podcast while still ensuring weekly content. You can look forward to surprise episodes specially curated by her team just for you.Key Takeaways:1. Self-awareness and vulnerability are crucial steps in addressing burnout, as demonstrated by Dr. Lia's honest acknowledgment of her own struggles despite being a wellness expert.2. Setting boundaries and making concrete changes (like designated phone-free zones, scheduled exercise, and sleep routines) are essential components of self-preservation during challenging times.3. A strong support system and a temporary “leave of absence” makes space for her mental health re-boot. Dr. Lia is privileged to be able to take this break, and recognizes that a break like this may not be an option for many, but she offers some baby steps for herself that can be added to your own self-kindness tool-box. Making time for self-reflection may be the key to long-term sustainability in both personal and professional life. Make sure to tune in all month long for some episodes that you most likely have not heard. They were curated by Dr. Lia, and her team and they hold a special place in her heart.**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/ or on Instagram or our website at www.lifeaftercorporatepodcast.com .

What does it truly mean to cultivate resilience and well-being in today's challenging world? In this insightful episode of Dr. Lia Gaggino's podcast (episode 227), she thoughtfully explores seven fundamental pillars of well-being while reflecting on the transition into 2025. Drawing from both professional expertise and personal experience, particularly while caring for her aging mother, Dr. Gaggino presents a comprehensive approach to health that encompasses sleep, nutrition, movement, family connections, friendships, creativity, and spirituality. She authentically acknowledges the struggles many face, from avoiding overwhelming news to managing daily stresses, while offering practical, judgment-free advice that balances aspiration with self-compassion. Her message resonates particularly strongly when she emphasizes that relationships are the ultimate antidote to loneliness, fear, and sadness, demonstrating a deep understanding of human nature and the complexities of modern life.Key Takeaways:1. Well-being is multifaceted and requires attention to both physical aspects (sleep, nutrition, movement) and emotional/social components (family, friends, creativity, spirituality).2. Perfection shouldn't be the enemy of progress - it's important to maintain healthy habits while showing yourself grace during challenging times.3. Strong relationships and social connections are crucial for emotional resilience and long-term health, whether these connections are with family of origin or chosen family.Let's make 2025 the Best Year EVER!!

Ever wondered what it's like to blend personal traditions with familial expectations during the holidays? In this episode of Pediatric Meltdown, Dr. Lia Gaggino shares her experiences with Christmas celebrations, highlighting the unique blend of Polish traditions from her husband's heritage and her own family's rituals.Family Rituals: Dr. Gaggino discusses the significance of family rituals, such as sharing a wafer similar to the Catholic host and wishing each other well, despite some family members finding it cringey.Meal Traditions: She talks about the specifics of their holiday meal, including mushroom soup and homemade pierogies, and how these traditions evolve over time to accommodate changing family dynamics.Importance of Traditions: Dr. Gaggino reflects on the deeper meaning of traditions, emphasizing their role in creating predictability, routine, and reassurance for children.Merry Christmas and Happy holidays to all of you.

Ever wondered how a simple injury can change the course of one's life? This episode explores the fascinating journey of a sports enthusiast turned medical professional, inspired by a personal encounter with a sports medicine provider after a college injury. The conversation delves into the complex world of concussions, discussing the evolution of treatment protocols, the importance of individualized care, and the severe risks of prematurely returning to play. You'll learn about tools like the SCAT symptom score and the VOMS for monitoring recovery, and the often-overlooked psychological impacts of concussions on young athletes. But perhaps the most crucial takeaway is the stark reminder: concussions are no joke, and honesty about symptoms can be a matter of life or death. Are you ready to rethink what you know about concussions? [00:33- 10:59]Initial Assessment and Management of Concussions The SCAT (Sport Concussion Assessment Tool) is mentioned as a crucial tool for evaluating concussions.The importance of understanding the broad nature of concussions and their varied symptoms.Reassuring patients and their families about the management plan.An emphasis on the need for individualized treatment plans for concussions.[11:00 -16:47] Red Flags and Immediate ConcernsRed flags that indicate a more serious condition, such as worsening symptoms and unusual behavior.Specific symptoms like nausea, vomiting, and severe headaches that should raise concern.Trusting your instincts and gut feelings when assessing a concussion.Immediate action is needed if a patient's condition deviates from expected recovery patterns. [16:48 - 44:47] High-Risk Sports and Gender-Specific Risks High-risk sports for concussions, including for men: wrestling, basketball, soccer: For women: cheerleadingThere is a potential for prolonged recovery in athletes with underlying medical issues.Initial visits should focus on identifying concerning symptoms and ruling out underlying conditions.A comprehensive approach to managing concussions is needed, especially in high-risk sports.[44:48- 58:16] Treatment Algorithm and Activity Management Treatment Algorithm and Activity ManagementAn outline of a general treatment algorithm for managing concussions in the first 48 hours and beyond.The importance of gradually returning to activity while ensuring symptoms do not worsen.Provide physical therapy orders and ensuring PT sites treat concussions effectively.Educate patients and families about the expected recovery process and potential setbacks.[58:17 - 01:10:00] TakeawaysResources:AAP Sports-Related Concussion Recommendations:AAP Concussion Recommendations AAP article and Amsterdam Consensus: Statement: AAP and Amsterdam Consensus StatementAAP Vision and Concussion: Vision and...

Ever wondered how to smoothly transition pediatric patients with complex conditions like ADHD into adult care? This episode talks about the challenges and strategies involved in this critical handoff. Dr. Peter Jensen and Dr. Lia discuss the importance of educating and empowering teens to manage their conditions independently, drawing parallels with other chronic illnesses like asthma and diabetes. They explore the nuances of preparing both the patients and the accepting providers to ensure a seamless transition. Additionally, they discuss resources for understanding adult ADHD and address some of the barriers to care when teens go out of state for college or careers. This episode highlights the importance of systematic, careful planning and open communication to prevent gaps in care during this transition period. [00:05- 17:16] Gender Differences in ADHD DiagnosisLater diagnosis of ADHD in females.Fewer hyperactive symptoms in females leading to delayed diagnosis.Quietly distracted children may be overlooked.Morphing of symptoms towards inattentiveness in teen and young adult years. [17:17 -23:15] Adult ADHD and Mental Health Risks Reduction of hyperactivity and impulsivity symptoms over time.Increased risk of anxiety, depression, and substance use in adults with ADHD.Challenges in recognizing adult ADHD due to comorbid mental health issues.The role of family practice providers in identifying adult ADHD. [23:16 - 43:50] ADHD Medication and Substance Use Concerns There is diversion and misuse of ADHD medications.Holding patients accountable for lost or stolen medication.Comparing ADHD medication misuse to other substance abuse issues.Importance of clear communication between providers and patients.[43:51 - 48:50] Recommendations for ADHDMention of the book "Driven to Distraction" by Ned Hallowell.The importance of education and awareness about adult ADHD.The role of pediatricians in thinking about ADHD in adults.Emphasis on ensuring pediatricians and healthcare providers are aware of the Reach Institute.[48:51 - 57:47] Take AwaysConnect with Dr. Peter JensenWebsite: https://thereachinstitute.org/LinkedIn: https://www.linkedin.com/company/the-reach-institute-resource-for-advancing-children-health/Facebook: https://www.facebook.com/REACHInstitute/Twitter: https://twitter.com/reach4kidsRESOURCES MENTIONED IN THE EPISODEThe REACH Institute: www.thereachinstitute.orgDriven to Distraction" by Ned Hallowell. This book is highly recommended for understanding ADHD in adults. It is easily readable and includes stories and checklists of symptoms that can help readers identify ADHD traits in themselves or others.Go to https://lifeaftercorporatepodcast.com/ for all...

Have you ever wondered if ADHD is being misunderstood or misdiagnosed in children, leading to feelings of failure and unchecked anxiety? In this episode of Pediatric Meltdown, host Dr. Lia Gaggino and Dr. Norrine Russell talk about the complexities of ADHD, from its nuances to the pressing need for systemic change in how it's perceived and treated. They shed light on the importance of recognizing ADHD as non-willful behavior, the role of early intervention, and the imperative of individualized education plans. With data-backed insights and real-world anecdotes, this discussion underscores the urgency of a more equitable and comprehensive approach to ADHD treatment. This is a must-listen for educators, parents, and healthcare providers.[00:38 - 7:37] Unpacking ADHD and Common MisinterpretationsDefinition of "pure ADHD," described as a potential "gift," affecting a smaller segment of diagnosed children.Discussion on comorbidities like dyslexia, dysgraphia, mood disorders, and autism, affecting two-thirds of ADHD-diagnosed children.Issues of whether anxiety stems from late-diagnosed ADHD or contributes to its symptoms.Emphasis on early intervention to prevent ADHD from triggering anxiety and encourages proper diagnosis to avoid misunderstanding behaviors.[07:38 - 14:07] Individualized Educational Approaches and Social SkillsImportance of personalized educational strategies for neurodivergent children, avoiding a "one size fits all" methodology.Benefits of involving children in solution-finding processes for tailored educational support.Highlighting social delays in children with ADHD and the role of structured activities in fostering social interactions.Allowing children to build on their strengths and interests to enhance self-esteem and personal growth.[14:08 - 21:15] Challenges in Diagnosing and Treating ADHDDiscussion on the misconception of oppositional defiant disorder (ODD) and its potential misinterpretation as ADHD symptoms.Need for differential diagnosis to distinguish between ODD and ADHD, particularly in the context of trauma.Advocacy for multimodal ADHD treatment plans, integrating medication, parent education, and school plans as per American Academy of Pediatrics guidelines.Addressing systemic inequities in healthcare affecting children on Medicaid and the impact of racial biases on ADHD treatment.[21:16 - 28:22] Tools, Resources, and the Path ForwardDiscussing genetic links and familial patterns discovered during psychosocial intakes.Importance of early identification to prevent negative academic cycles and enhance engagement.Promoting ADHD acceptance and self-advocacy by normalizing brain differences.Recommendations for educational materials, like "ADHD is Awesome" and "The Anxious Generation," and promoting Norrine's podcast for further insights.Resources Mentioned:Vanderbilt and Connors Symptom Trackers (Symptom Trackers) Vanderbilt ADHD Diagnostic Rating Scale (VADRS) - Psychology ToolsBook: ADHD Is Awesome - ADHD is Awesome: A Guide To (Mostly) Thriving With ADHD: Holderness, Penn, Holderness, Kim, Edward Hallowell: 9781400338610: Amazon.com: BooksBook:

Can a doctor's strongest medicine be kindness to themselves? In this candid conversation, Dr. Kathy Stepien, physician coach and advocate for medical wellness, challenges the notion that self-criticism leads to better performance. Speaking with host Dr. Lia Gaggino, she unpacks how physician coaching has evolved from executive suites to mainstream medicine, backed by clinical trials from institutions like Mayo Clinic and Stanford. Dr. Stepien shares powerful stories about identity transitions in medicine, from early-career challenges to retirement questions, while offering practical ways to find the right support. Her remarkable work in bringing hidden struggles to light proves that no physician needs to walk their professional journey alone. [00:05- 12:29] Challenges Physicians Face in Their CareerIsolation despite being surrounded by accomplished colleagues, leading to internal strugglesDemanding nature of the profession requiring significant self-sacrifice beyond typical 9-to-5 hoursStruggle with maintaining autonomy, especially when transitioning from private practice to employed positionsDifficulty in managing time and energy while trying to balance multiple responsibilities [12:30 -25:14] Navigating Challenges in Medical Training and Practice Seek safe persons to confide in when facing discrimination or difficult situations, particularly those slightly removed from your immediate environmentRecognize that no medical professional needs to handle struggles alone - it's acceptable and beneficial to ask for helpAddress issues strategically and wisely, especially in situations with significant power differentialsRemember that supporting each other is crucial - medical professionals need connection and understanding from peers who share similar experiences [25:15 - 36:22] Power Dynamics and Professional Growth in Medicine Early career physicians often feel vulnerable during training periods, but gain more ability to advocate for change as they advance in their careersThe transition from clinical practice to administration reveals different cultural challenges, including slower decision-making processes and risk aversionThe importance of speaking up against inappropriate behavior, such as public humiliation, despite the professional risks involvedThe value of having witnesses and support systems when addressing workplace issues[36:23 - 39:50] Benefits of Physician Coaching Data shows solid evidence of improved physician well-being and quality of lifeLeads to profound improvement in emotional exhaustion reductionEnhances self-compassion among medical professionalsResults in better patient outcomes when physicians are well-supportedConnect with Dr. Kathy Stepien Website: https://www.instituteforphysicianwellness.com/Instagram: www.instagram.com/kathystepienmdFacebook: https://www.facebook.com/physicianwellnessLinkedIn:https://www.linkedin.com/in/kathystepienmd/Important Links To Share: Anti-Burnout Program for Women Physicians:

What happens when a pediatrician hands a free book to a parent and changes the trajectory of a life? Meet Claudia Aristry whose first encounter as a new immigrant mother with “Reach Out and Read” sparked a remarkable transformation. Through her work with the Health Education and Literacy for Parents (HELP) Project, Claudia demonstrates how pediatricians can encourage literacy through books while supporting immigrant families. Her personal story describes the power of how parent-child reading led to her own high school completion and college graduation. Her work showcases how simple interventions can create lasting impact on children's development. Her conversation with Dr. Lia Gaggino explores innovative ways to promote bilingual literacy and to strengthen parent-child interactions through reading, while turning waiting room time into valuable learning opportunities.This episode proves that when healthcare meets literacy, extraordinary changes happen in families' lives. [00:05- 17:39] Impact of Early Reading Programs in Pediatric Settings A powerful moment of transformation occurs when pediatricians gift books to families during well-child visits, creating a bridge between healthcare and literacyThrough programs like Reach Out and Read, medical providers effectively communicate how daily reading routines contribute to brain development and school readinessFree book distribution in medical settings removes financial barriers, especially beneficial for immigrant families who may find traditional bookstores inaccessible or unaffordablePediatricians serve as trusted messengers, helping parents understand the connection between early reading and cognitive development [17:40 -24:13] Bridging Healthcare and Literacy Through Reach Out and Read Pediatricians serve as crucial advocates for child literacy by incorporating books into medical visits, creating meaningful connections with families beyond just medical careThe program transforms routine medical checkups into opportunities for promoting parent-child reading interactions, making healthcare settings more welcoming and educationalFree book programs integrated into medical visits help break down barriers to literacy, especially for families with limited resourcesPediatric literacy initiatives become more effective when healthcare providers take time to make genuine connections and offer encouragement to parents [24:14 - 35:20] Effective Parent-Child Reading Engagement Positive interactions during reading sessions go beyond literacy - making eye contact and smiling are simple yet powerful ways to connect, requiring no formal education or special trainingParents don't need advanced degrees to make meaningful contributions to their children's development through reading and storytellingCreating joyful memories around books is more valuable than perfect reading skills, especially for parents who may struggle with literacy themselvesDaily reading can be adapted to busy family schedules, acknowledging real-world challenges like multiple jobs and time constraints[35:21- 53:07] Empowering Parents Through Healthcare-Based Literacy Initiatives The HELP (Health Education and Literacy For Parents) project maximizes waiting room time by conducting health literacy activities, transforming passive waiting into active learningPediatricians serve as trusted authority figures who can effectively encourage and validate parents' roles as their children's first teachersFree resources are available through greenlighthelp.org, offering evidence-based information aligned with AAP...

How can we help teens with bipolar disorder manage their symptoms and transition successfully into adulthood? In this (part 2) episode of Pediatric Meltdown, host Dr. Lia Gaggino and child psychiatrist Dr. Jeanette Scheid discuss managing bipolar disorder in young adults during major life transitions. From medications for bipolar disorder in youth to support resources, they explore how parents and healthcare providers can identify early signs of a bipolar manic or depressive episode and implement effective treatments. Dr. Scheid shares practical strategies for maintaining stability, including sleep schedules, substance use prevention, and the vital role of college support services. Whether you're a healthcare provider or parent seeking to understand bipolar disorder treatment for teens, this conversation offers clear guidance for helping young people thrive. [00:33 -10:28] Critical Warning Signs and Transition Risks for Young Adults with Bipolar DisorderPoor sleep patterns often emerge as one of the earliest indicators of potential manic episodesEarly symptom recognition training for both parents and youth helps prevent severe episodesRegular psychoeducational conversations with everyone in the youth's support system enhance management successLiving independently introduces new challenges that require careful monitoring and support[10:29 - 19:29] FDA-Approved Medications for Youth Bipolar Disorder: A Primary Care Guide Key antipsychotics including aripiprazole, quetiapine, risperidone, olanzapine, asenapine, and lurasidone are FDA-approved, for adults with bipolar disorders. There are fewer medications approved for youth due to lack of clinical studies. No anti-seizure medications currently hold FDA approval for bipolar disorder in youth, though some are approved for adultsMost common lithium side effects include headache, nausea, increased thirst, and mild tremorsRegular thyroid function monitoring is essential, often requiring collaboration between pediatricians, endocrinologists, and psychiatrists[19:30 -39:22] Understanding Lithium Treatment in Youth Bipolar ManagementTherapeutic window for lithium is narrow, ranging from 0.6 to 1.2 milliequivalents per liter, requiring careful monitoring and frequent lab workDehydration and changes in salt balance can trigger dangerous lithium toxicity levelsFamily medical history plays a crucial role in treatment decisions, as demonstrated by cases where lithium proved more effective than second-generation antipsychoticsRegular lithium level monitoring (1-2 times yearly) is necessary for stable patients, with more frequent checks during dose adjustments[39:23 - 50:50] Building Knowledge Bridges: What Primary Care Needs to Know About Youth Bipolar CareUtilizing child psychiatry access programs as learning resources for medication managementUnderstanding safety profiles of common medications, even when not directly prescribingRecognition of medication effects similar to monitoring diabetes care in primary practiceValue of ongoing consultation with psychiatric specialists for medication questions[50:51 - 1:04:37] Closing segment TakeawayLinks to resources mentioned on the showResources Part 1:AACAP Facts for Families: Facts for...

In this episode, child psychiatrist Dr. Jeanette Scheid joins Dr. Lia Gaggino to discuss the complexities of pediatric bipolar disorder, and sorting through the diagnostic possibilities is central to making an accurate diagnosis Dr. Scheid offers insights to tease out what are the childhood behaviors that are developmentally normal, for example imaginary friends, and what are concerning symptoms such as auditory hallucinations. Dr Scheid highlights the critical role pediatricians play in the early identification of youth bipolar disorder with enormous implications for decreasing serious illness in adulthood. With mental health in children becoming increasingly important, this conversation offers practical guidance for pediatric clinicians.[00:33 -10:49] Key Diagnostic Criteria for Bipolar DisorderMajor depressive episodes often appear as the first signs, lasting at least 2 weeks with predominantly low moodGrandiosity and racing thoughts are significant indicators, particularly when accompanied by uncharacteristic risk-taking behaviorsSleep patterns change dramatically, with some people feeling rested after less than 3 hours of sleepIncreased talkativeness, faster speech, and heightened distractibility are common symptoms[10:50 - 19:01] Challenges in Early IdentificationDistinguishing between normal childhood behavior and pathological symptomsComplexity increases when combined with autism or intellectual disabilitiesInitial misdiagnosis as oppositional defiant disorder or treatment-resistant ADHDNeed to differentiate between typical defiant behavior and true mood episodes[19:02 -31:42] Understanding Trauma's Relationship with Mental Health SymptomsTrauma symptoms can overlap with other mental health conditions, making diagnosis complexFlashbacks from trauma can present similarly to perceptual disturbances or hallucinationsContent of experiences often connects directly to past traumatic events and safety concernsBoth trauma and other mental health conditions can coexist - it's not an either/or situation[31:43 - 32:13] Adapting Primary Care to Modern Mental Health ChallengesPediatricians can't opt out of mental health care, just as they didn't opt out of COVID carePrimary care providers are being called upon to manage medications when psychiatric access is limitedProfessional relationships and collegial connections make difficult cases more manageableThere's a growing recognition that early intervention in mental health can prevent future complications, including involvement in the juvenile justice system[50:51 - 58:26] Closing segment TakeawayLinks to resources mentioned on the showAACAP Facts for Families: Facts for FamiliesAACAP Resource Center Bipolar DisorderOther episodes you may like:Episodes - Pediatric Meltdown161 Menstrual Equity Changes Lives: The Power of Days151 American...

What happens when the wealthiest nation in the world fails its children? In this short but important solo episode, Dr. Lia Gaggino, speaking as a mother, grandmother, and pediatrician, shares her concerns about the state of children's welfare in America. She addresses multiple challenges facing our youth today, from healthcare and poverty to gun violence and education. As the November 5th election approaches, Dr. Gaggino makes an impassioned plea to voters to consider the impact their choices will have on the next generation. Her message transcends political lines, focusing instead on fundamental human values and the moral imperative to protect and nurture our children. After all, as she poignantly asks, “who will lead, teach, build, and protect our nation if we continue to fail our children today?”Links to resources mentioned on the showCDC https://www.cdc.gov/maternal-infant-health/infant-mortality/index.htmlCommonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison#:~:text=Recent%20Maternal%20Mortality%20Trends,deaths%20per%20100%2C000%20live%20births.Annie E. Casey Kids Count: https://datacenter.aecf.org Other episodes you may like:Episodes - Pediatric Meltdown161 Menstrual Equity Changes Lives: The Power of Days151 American Indian/Alaskan Native Youth: Beyond AdversityKey quotes for Twitter:"In the United States, 25% of children live in poverty. 50% are covered by Medicaid insurance."... Dr. Lia Gaggino on the child poverty crisis"Should they bleed out on waiting room floors? Should they die of sepsis because they can't get the care they need to treat a miscarriage because doctors are afraid in states that ban all abortion?".... Dr. Lia Gaggino on the reality of abortion bansFULL TRANSCRIPTS AVAILABLE UPON REQUESTTHANK YOU FOR YOUR SUPPORT!Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.If you'd like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.comLOVE 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.

What if the key to happiness lies in thinking like a toddler? Dr. Lia Gaggino's Pediatric Meltdown podcast features Dr. Hasan Merali, who unveils the wisdom hidden in toddler behavior. Uncover the science behind child development, learning how to handle toddler tantrums and why the "terrible twos" might be a misnomer. Dr. Merali offers unique parenting tips, from encouraging kindness to establishing sleep routines. Explore how childhood creativity can enhance adult life, and gain strategies for improving work-life balance. This episode challenges conventional wisdom about child behavior, offering fresh perspectives on fostering kindness and learning from kids. This episode will leave you eager to embrace your inner toddler and find joy in life's little moments. [00:33 -11:26] Toddler Brain Development and Adult LearningThe less-developed prefrontal cortex allows toddlers to live in the momentToddlers have enhanced visual attention, noticing tiny details adults might missYoung children think differently due to fewer preconceived notionsToddlers exhibit twice as much laughter as adults[11:27 - 22:28] Positive Mindset: Reframing Tantrums and Embracing Toddler Traits The median time for a toddler tantrum is 3 minutes, occurring on average once a dayChanging vocabulary from "Terrible Twos" to "Terrific Twos" promotes learning from toddlersToddlers have a basic tendency to be nice to others, even when faced with selfish behaviorToddlers focus on building relationships and learning[22:29 -30:14] Self-Talk Strategies: Enhancing Adult Mental Well-beingSelf-talk is prevalent when kids are little, especially in the toddler preschooler ageThey use it to guide themselves through tasks and to encourage themselvesMRI studies show we can decrease our emotional reactivity if we talk to ourselves in 2nd and 3rd personInstead of "What am I feeling right now," ask "What is [your name] feeling right now?"[30:15 - 39:18] Toddler Sleep Routine for Better Adult SleepNo screens 1 hour before bedtimeTake a hot bath or shower to cool down core body temperaturePerform a quiet activity, preferably readingPlug your phone in a different room, not beside your bed[39:19 - 45:41] Closing segment TakeawayYou can reach Dr. Hasan MeraliLinkedIn: https://www.linkedin.com/in/hasan-merali/X: https://twitter.com/Hasan_MeraliFacebook: https://www.facebook.com/HasanMeraliMD/Links to resources mentioned on the showDr. Merali, website: HasanMerali.comBook: Sleep Well, Take Risks, Squish the Peas: Secrets from the Science of Toddlers for a Happier and More Successful Way of Life: https://www.amazon.com/Sleep-Well-Take-Risks-Squish/dp/0757324711 NYT Article:

What if the key to unlocking your child's potential lies in their natural curiosity? In this enlightening episode of "Pediatric Meltdown," host Dr. Lia Gaggino welcomes developmental-behavioral pediatrician Dr. Prachi Shah to explore the fascinating world of child development. Together, they unpack the importance of play in child development and reveal strategies to encourage exploration. Dr. Shah shares her expertise on early brain development and cognitive growth. Discover how play and exploration shape a child's future, and learn easy practical strategies for encouraging your little one's inquisitive nature.This episode is a must-listen for parents and caregivers eager to nurture their child's innate wonder and set the stage for lifelong learning. [00:33 -15:43] Fostering Curiosity in Young Children: Key StrategiesCuriosity starts with the child's intrinsic motivation and captures their attentionEntering a child's world helps adults see things with "a new set of eyes"Observing nature, like watching insects or plants, stimulates curiositySimple activities, like using a "play right here stick," can encourage wonder and exploration [15:44 - 26:32] Impact of Curiosity on Academic Achievement in Early Education Higher curiosity at kindergarten correlated with higher academic achievement in reading and mathAt low levels of curiosity, there was lower academic achievementSafe, stable, nurturing relationships (SSNRs) provide the foundation for exploratory behaviorPromoting curiosity can foster academic resilience in children from under-resourced environments[26:33 -36:22] Early Childhood Curiosity and Parental InteractionChildren from under-resourced areas hear fewer words, creating a 30-million-word gap by kindergartenFrequent conversational exchanges between parents and children are associated with higher curiosityHigh-quality linguistic environments lead to better academic, occupational, and social outcomesServe-and-return conversational exchanges are recommended by pediatric anticipatory guidance [36:23 - 55:50] Promoting Curiosity in Pediatric Care: The American Academy of Pediatrics recommends prescribing play at every well-child visitUnstructured play time and playful learning with parents are crucial for building cognitive and social-emotional skillsSafe, stable, nurturing relationships (SSNRs) are foundational for the development of a child's curiosityPediatricians can encourage parents to engage in scaffolding and special "sunshine time" with their children to boost curiosity [55:51 - 01:02:58] Closing segment TakeawayLinks to resources mentioned on the showAAP Resources Early Relational Health: https://www.aap.org/en/patient-care/early-childhood/early-relational-health/AAP Early Relational Health Implementation Guide: Early Relational Health GuideReading Tips from AAP http://Healthychildren.org Falling in Love with Reading..Reach Out and Read https://reachoutandread.orgOther episodes you may like:Episodes - Pediatric Meltdown176 ACES and the Power of Positive Relationships175 Beyond...

In the realm of pediatrics, can a child's ZIP code be a stronger predictor of health outcomes than their genetic code? Dr. Lia Gaggino examines this critical question alongside pediatric residents Dr. Nicole Hickman and Dr. Kathleen Kelly. These passionate advocates for health equity discuss their innovative work integrating social influencers of health into pediatric residency programs and primary care practices. They address the complexities of tackling food insecurity, housing instability, and other social influencers of health that significantly impact children's well-being. Drs. Hickman and Kelly provide practical strategies for screening patients and implementing community resource referral systems, showcasing how targeted interventions can yield substantial improvements in care. Their groundbreaking approach to the medical education curriculum and inpatient systems interventions aims to reduce healthcare inequities. Their dedication to advocacy and addressing social determinants in pediatric residency will inspire listeners to become catalysts for change in pediatric healthcare. [00:33 -14:46] The Role of Social Influencers of Health in Pediatric CareSocial influencers, such as access to healthcare, education, and neighborhood environment, significantly affect children's health outcomes.Pediatricians must recognize the importance of community context, economic stability, and access to quality resources in shaping child health.Families living in food deserts face challenges in accessing nutritious foods, affecting children's overall health and development.Addressing social influencers can help mitigate health disparities, offering opportunities for intervention to improve pediatric health.[14:47 - 24:08] Addressing Structural Racism and Intersectionality in Pediatric Health OutcomesStructural racism, reinforced through housing, education, and healthcare systems, significantly affects health outcomes, particularly in marginalized communities.In Chicago, a stark 30-year difference in life expectancy exists between predominantly white and Black neighborhoods, exemplifying the impact of systemic discrimination.Pediatric care must acknowledge and address the broader societal factors, like redlining and economic disinvestment, that contribute to health inequities.Developing pediatric training to address structural racism is critical for reducing the health gaps caused by these deeply rooted societal factors.[24:09 -32:16] Trauma-Informed Approaches in Pediatric Social Health ScreeningsUsing sensitive language during screenings encourages trust, which helps families feel comfortable discussing social challenges over time.Normalizing the screening process by introducing it as a routine part of every patient encounter helps build rapport and reduce stigma.Pediatricians should reassure families that resources are available to help address needs identified during screenings, reinforcing that support is ongoing.Offering social work support and providing a list of community resources upfront can prepare families for future needs, even if they don't require immediate assistance​(pm03).[32:17 - 43:44] Pediatric Screening Tools for Addressing Social Determinants of HealthThe hospital system uses a comprehensive screening questionnaire that includes housing insecurity, food insecurity, and physical violence.The tool incorporates questions related to gun access in the home, combining different social screeners and abuse screeners.Pediatricians can track outcomes using a closed-loop referral system, ensuring patients receive the resources they need.Screening tools are integrated...

How do we address the often-overlooked sexual health needs of individuals with Autism Spectrum Disorder (ASD)? Dr. Zakia Alavi, a seasoned child and adolescent psychiatrist specializing in pediatric mental health and developmental disabilities, joins Dr. Lia Gaggino to unpack this critical yet often neglected aspect of care for individuals on the autism spectrum. Drawing from her extensive experience in child and adolescent psychiatry, Dr. Alavi reveals the patterns she's observed in patient referrals, particularly concerning autism and behavior problems, including inappropriate sexual behavior. This frank discussion covers everything from understanding puberty in children with autism to addressing the complex challenges surrounding sexuality education for neurodivergent individuals. Dr. Alavi emphasizes the need for tailored sexual health curricula and the importance of behavioral therapy for youth with autism to manage sexuality-related issues. She also touches on the pressing concern of victimization of youth on the autism spectrum and the role of promoting comprehensive sexual education for these youth.. Listen in and discover why Dr. Alavi believes sexuality is not just a basic human need, but a fundamental right for all, regardless of their neurodevelopmental status, including those with neurodevelopmental disorders like ASD. [00:33 -10:59] Autistic Traits and Abuse Risk Explores the higher risk of abuse due to social awareness and communication deficits in youth with autism. Non-verbal children or those who misinterpret situations are especially vulnerable. Defines sexual awareness as understanding feelings, desires, and sexual situations. Highlights the struggle of youth on the autism spectrum in independently navigating sexual awareness.[11:00 - 22:49] Discussion on Sexual Awareness Defines sexual monitoring as understanding others' impacts on one's sexuality. Emphasizes the importance of sexual assertiveness and consciousness for protection. Single parents, in particular, may struggle with providing comprehensive sexual education. Suggests the presence of another person during these discussions for better handling.[22:50 -28:59] Victimization and the Role of Media Notes the heightened risk of victimization, especially among females with autism spectrum disorders. Emphasizes the need for protective measures and greater awareness. Role of parents and educators in continual skill-building around privacy and sexual norms. Suggests personalized approaches tailored to each child's level of understanding.[29:00 - 32:13] Sexuality as a Human Right: Encourage self-reflection about perspectives on sexuality for oneself and others. Highlight the importance of helping children achieve their fullest potential in all aspects. Reiterates the significance of protecting neurodiverse youth from victimization through education. Encourages proactive approaches to ensure youth understand and navigate normal sexual behaviors[32:14 - 40:00] Closing segment TakeawayYou can reach Dr. Zakia AlaviLinkedIn: linkedin.com/in/zakia-alavi-7289a9118Links to resources mentioned on the...

Vaccine Hesitancy and Refusal: Fact and EmotionHave you ever wondered why vaccines spark such strong opinions, even as they play a pivotal role in infectious disease prevention and public health response?Join Dr. Lia Gaggino and guest Dr. Robert Frenck as they unravel the complexities of vaccine hesitancy in our pandemic-prepared world. They delve into how the effectiveness of the COVID-19 vaccine and childhood vaccinations paradoxically fuels skepticism, and how public health communication strategies can bridge the gap between medical professionals and parents. Dr. Frenck shares real-life stories and explains the benefits of childhood vaccinations, emphasizing straightforward conversation to discuss childhood vaccines including the COVID-19 vaccine, side effects, and the importance of herd immunity. Discover strategies for overcoming vaccine hesitancy and infectious disease outbreak management—listen now to rethink your understanding of vaccinations, their role in our society, and their impact on vaccine preventable disease outbreaks..[00:33 -16:05] Vaccine Hesitancy and Public Health ChallengesInfectious diseases like respiratory illnesses, diarrheal diseases, and malaria are still leading causes of death in children globally.Vaccines play a crucial role in protecting communities through herd immunity.Skipping vaccines can have a significant impact on disease transmission and outbreaks.Healthcare providers have an ethical duty to make recommendations and address vaccine hesitancy.[16:06 - 26:41] Public Health Challenges: Overcoming Politicization and MisinformationRecognize that infectious diseases do not discriminate based on political affiliation, race, religion, or other factors.Address the concerning trend of public health becoming a political issue, rather than a matter of keeping everyone healthy.Combat the misconception that vaccine-preventable diseases are gone or no longer a threat.Highlight the need for expertise, coordination, and preparedness in public health responses to infectious diseases.[26:42 -35:33] Mandatory Vaccination Policies for Healthcare WorkersPrioritizing workplace safety for patients, especially those with compromised immunityAddressing concerns about mixed messaging from unvaccinated healthcare providersConsidering vaccination as a fundamental requirement for healthcare professionsHighlighting the ethical responsibility to protect vulnerable populations [35:34 - 56:57] Pandemic Challenges: Adapting Medical Practices and CommunicationAcknowledging the need to alter recommendations as new data emerges during a rapidly evolving pandemic situation.Emphasizing the critical role of healthcare professionals as experts and trusted sources of information during public health crises.Highlighting the ethical responsibility of leaders and public figures to prioritize public health over personal or political gain.Underscoring the value of respectful dialogue, finding common ground, and starting from areas of agreement in addressing divisive issues.[56:58 - 1:09:23] Closing segment TakeawayYou can reach Dr. FrenckLinkedIn @Robert FrenckLinks to resources mentioned on the showAAP Immunization Resources for Parents:

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 SchoolsChronic 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 SupportFactors 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 StrategiesThe 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 TakeawayYou can reachDr. Heidi Schumacherlinkedin.com/in/heidi-schumacher-md-3504433Links to resources...

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 HealthcareBabies 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 SupportThe 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 ApplicationsEven 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 TakeawayLinks to resources mentioned on the showBook - Pranayam Breathing: Techniques for Health, Healing and TranquilityPranayam Breathing Techniques for Health, Healing and Tranquility:...

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 ChallengesStrategies 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 ChallengesThe 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 TakeawayYou can reach Dr. Nancy RapaportEmail: nancy@nancyrapaport.com LinkedeIn:...

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 InsightsReflection 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 CommunityUpcoming 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 showPodcast ProductionMouthyBroadMedia.comSocial Media ManagementEC8Consulting@gmail.comAAPaap.org2024 Practical Pediatrics CME Course - San Diego, CA2024 Practical Pediatrics CME Course - San Diego, CA | shopAAPMIAAPMIAAPOther episodes you may like:Episodes - Pediatric Meltdown205. Social Media and Families: Creating Culturally Relevant Content182. Social Media Dangers: Protecting and Educating YouthKey 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 connectingFULL TRANSCRIPT WILL BE AVAILABLE UPON REQUESTTHANK YOU FOR...

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 importantSet 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: RelationshipsNurture relationships outside the medical fieldMake time for people despite demanding work scheduleBalance professional commitments with personal lifeResources mentioned on the showaap.orgOther episodes mentioned on the show:https://pediatricmeltdown.com/episodes190. 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 BalanceBuilding Better Workflows PodcastBuilding 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,

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 MethodsProctored 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 PediatricsSeek 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 education Resources mentioned on the showMOCA-PBR www.pediatricsboardreview.com Neuroscience Education Institute https://www.neiglobal.com/REACH https://thereachinstitute.org/nncpap.orgaap.orgaacap.orgAAP National Conference https://aapexperience.org/Other episodes mentioned on the show:https://pediatricmeltdown.com/episodes116. Physician Wellness Coaching: Proven Benefit! 98. Anxiety? Inattention? Depression?: Prescribe Nature! Dr. Stacy Beller Stryker 76. Pediatric Practices: Find Your BalanceBuilding Better Workflows PodcastBuilding Better...

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 NeedsEpisode 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 ApproachAddresses 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 ExperiencesFocuses on fostering positive childhood experiencesExplains how supportive adults can help children overcome adversityEmphasizes teaching parenting skills, as they're not innateResources mentioned on the showhttps://www.healthychildren.orgThe Healthy Children Podcast: Healthy Children (pod.link)Other episodes mentioned on the show:https://pediatricmeltdown.com/episodes202. Functional Neurologic Disorders: Recognition and Management175. Beyond Trauma: Strengthening the Caregiver-Infant Dyad162. Migraine Headaches: Assessment, Management and Relief152. The Mysteries of Abdominal Pain: Disorders of the Gut-Brain Interactions115. Chronic Pain Syndromes: Assessment and Management 114. Palliative and Hospice Care: A Conversation on Grief and JoyBuilding Better Workflows PodcastBuilding Better Workflows Key quotes for Twitter:"Vaccines are the most important public health endeavor that...

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 ResourcesCreated 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 CommunitiesGoal 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 EducationThe 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 TakeawaysLinks to resources mentioned on the showNewsletter Sign Up: Our Kids HealthWebsite: Our Kids Health - Our Kids HealthLinkedIn:

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 DisordersThe 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 PMADsRoutine 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 CliniciansThe 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/episodes185. Cultural Competency: Health Equity and Outcomes175 Beyond Trauma: Strengthening the Caregiver-Infant Dyad161 Menstrual Equity Changes Lives: The Power of Day147 Racial Discrimination and Black Infant Morbidity and Mortality134 Early Childhood Education: Empowering ParentsBuilding Better Workflows PodcastBuilding 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...

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 RacismSystemic 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 ProgramLocal 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 ManagementAddressing 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 FNDEmphasize 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 TakeawaysLinks to resources mentioned on the showTaking Control of Your Seizures: Workbook Joel M. Reiter, Donna Andrews, Charlotte Reiter, W. Curt LaFrance, JRhttps://www.amazon.com/Taking-Control-Your-Seizures-Treatments/dp/019933501X Neurosymptoms.orgFNDhope.orgEpilepsy Foundation:

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 AbusePrevalence 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 ServicesSANE 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...

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 Behaviors128 Trauma and Resilience: “Connect Before You Correct”114 Palliative and Hospice Care: A Conversation on Grief and JoyBuilding Better Workflows PodcastBuilding Better Workflows **Transcript of Episode Available upon request**THANK YOU FOR YOUR SUPPORT!Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.If you'd like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook, Instagram, and Twitter, or email me at gagginol@gmail.com. To learn more about me visit https://www.pediatricmeltdown.com/ or reach out, DM me on IG, FB or LI and if you'd like to chat set up a discovery call to talk about your needs and challenges: https://calendly.com/gagginol/discovery-call

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 HealthConcept 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'sOverview 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 TicsIntroduction 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 TakeawaysLinks to resources mentioned on the showInternational OCD Foundation: https://iocdf.org Tourette's Association of America: https://tourette.orgTLC Foundation for Body-Focused Repetitive Behaviors https://www.bfrb.orgAACAP Facts for Families OCD:

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 SymptomsPANDAS 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 SyndromeStudies 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 PANDASNeed 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 TakeawaysLinks to resources mentioned on the showErica Greenberg, MD PANDA AND PANS Presentation Swipe Files