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Bala A, Pierce J, Pierce K, Song S. Advocacy and Policy: A Focus on Migrant Youth. Child Adolesc Psychiatr Clin N Am 2024; 33:163-180. [PMID: 38395503 DOI: 10.1016/j.chc.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Mental health challenges experienced by migrant children are shaped by multiple factors within the health care system and society at large. It is essential for health care providers to recognize the profound impact of these influences on child well-being. By actively engaging in advocacy and policy initiatives, health care providers can address structural barriers, social inequalities, and stigma that perpetuate mental health disparities. Through their advocacy efforts, providers can contribute to creating an inclusive society that upholds children's rights and ensures equitable access to mental health support and services.
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Affiliation(s)
- Abishek Bala
- Central Michigan University, 1000 Houghton Avenue, Saginaw, MI 48602, USA.
| | - Jessica Pierce
- University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5277, USA
| | - Karen Pierce
- Northwestern University Department of Psychiatry, 2634 N Dayton ST, Chicago, Il 60614, USA
| | - Suzan Song
- Boston Children's Hospital, 1 Brookline Place, Suite 552, Boston, MA 02445, USA
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2
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Bryant KJ, Joanisse MF, Archibald LMD. Responding to parental concern about children's reading. Paediatr Child Health 2023; 28:489-494. [PMID: 38638545 PMCID: PMC11022876 DOI: 10.1093/pch/pxad038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/06/2023] [Indexed: 04/20/2024] Open
Abstract
Objectives This study explored if parents are accurate in their reading concerns, with implications for paediatric practice. Methods Parents of school-aged children in 34 schools in Ontario, Canada responded to a questionnaire about their children's academic development (27% response), and their children participated in standardized, norm-referenced tests of word reading and an oral sentence recall task. Parental concern status was retrospectively cross-referenced with reading difficulty status (<25th percentile on the word reading tests) for grade 2 children with complete data (n = 294); diagnostic accuracy was evaluated. Demographic and reading-related characteristics of children whose parents' concern did not match their reading difficulty status were explored. Results Approximately 22% of parents endorsed concern, while 18.5% of children had word reading difficulty. Parental concern status accurately corresponded with reading difficulty status in 81% of cases (95% CI: 76% to 85%). Specificity was 85% (95% CI: 80% to 90%), while sensitivity was 59% (95% CI: 44% to 73%). Children of unconcerned parents rarely had word reading problems (NPV 91%; 95% CI: 88% to 94%), while children with concerned parents had word reading difficulty in 45% of cases (PPV; 95% CI: 36% to 54%). Apparent inaccuracy (i.e., mismatch between parental concern and reading difficulty status) was related to children's word reading, oral sentence recall skills, and English language learner (ELL) status, but not child age, sex, or parent education. Conclusions Many parents of grade 2 children endorse reading concerns. Parental concern is an overall accurate screener for word reading difficulty, although some children will be missed. Evidence-informed recommendations for responding to parental concern are provided.
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Affiliation(s)
- Katelyn J Bryant
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
- School of Communication Sciences and Disorders, The University of Western Ontario, London, Canada
| | - Marc F Joanisse
- Department of Psychology, The University of Western Ontario, London, Canada
| | - Lisa M D Archibald
- School of Communication Sciences and Disorders, The University of Western Ontario, London, Canada
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Stone LA, Benoit L, Martin A, Hafler J. Barriers to Identifying Learning Disabilities: A Qualitative Study of Clinicians and Educators. Acad Pediatr 2023; 23:1166-1174. [PMID: 36584937 DOI: 10.1016/j.acap.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/02/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The estimated prevalence of learning disabilities (LDs) is nearly 8% of all children. Fewer than 5% of all children are diagnosed in public schools, jeopardizing remediation. We aimed to identify barriers affecting front-line child-facing professionals in detecting LDs in school-aged children. METHODS We conducted a qualitative study with individual interviews of 40 professionals from different areas of the United States identified through theoretical sampling (20 educators, 10 pediatricians, and 10 child mental health clinicians). Clinicians represented academic and community settings, and educators represented public, private, and charter schools. Twenty had expertise in assessing LDs; 20 were generalists without specific training. We also endeavored to maximize representation across age, gender, race and ethnicity, and location. We analyzed transcripts utilizing grounded theory and identified themes reflecting barriers to detection. RESULTS Themes and sub-themes included: 1) areas requiring improved professional education (misconceptions that may hinder detection, confounding factors that may mask LDs, and need for increasing engagement of parents or guardians in identifying LDs) and 2) systemic barriers (time constraints that limited professionals' ability to advocate for children and to delve into their emotional experiences, inconsistent guidelines across institutions and inconsistent perceptions of professional responsibility for detection, and confusion surrounding screening tools and lack of screening by some professionals in the absence of overt problems). CONCLUSIONS Clinicians and other child-facing professionals may benefit from augmented training in screening and identification and enhanced evidence-based and institutional guidance. These efforts could increase efficiency and perceived responsibility for recognition and improve earlier detection.
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Affiliation(s)
- Lauren A Stone
- Child Study Center (LA Stone, L Benoit, and A Martin), Yale School of Medicine, New Haven, Conn.
| | - Laelia Benoit
- Child Study Center (LA Stone, L Benoit, and A Martin), Yale School of Medicine, New Haven, Conn
| | - Andrés Martin
- Child Study Center (LA Stone, L Benoit, and A Martin), Yale School of Medicine, New Haven, Conn
| | - Janet Hafler
- Department of Pediatrics (J Hafler), Yale School of Medicine, New Haven, Conn
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Noritz G, Davidson L, Steingass K. Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy. Pediatrics 2022; 150:e2022060055. [PMID: 36404756 DOI: 10.1542/peds.2022-060055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cerebral palsy (CP) is the most common motor disorder of childhood, with prevalence estimates ranging from 1.5 to 4 in 1000 live births. This clinical report seeks to provide primary care physicians with guidance to detect children with CP; collaborate with specialists in treating the patient; manage associated medical, developmental, and behavioral problems; and provide general medical care to their patients with CP.
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Affiliation(s)
- Garey Noritz
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
| | - Lynn Davidson
- The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Katherine Steingass
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
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Geffel KM, Lombardi BM, Yu JA, Bogen D. Prevalence and Characteristics of Providers' Care Coordination Communication With Schools. Acad Pediatr 2022; 22:1184-1191. [PMID: 35091097 PMCID: PMC9314454 DOI: 10.1016/j.acap.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Care coordination between schools and medical providers promotes child health, particularly for children with physical, emotional, and behavioral challenges. The purpose of this study was to assess caregivers' reports of provider-school communication for their children. Further, the study assessed if communication rates varied by child demographic or health conditions. METHODS This study was a cross-sectional analysis of the 2016-2017 National Survey of Children's Health focused on school-aged children (age 6-17 years; n = 18,160). Weighted frequencies overall and stratified by provider-school communication status are reported. Multivariable logistic regression examined associations of provider-school communication. RESULTS Only 23.5% of the total sample reported provider-school communication. The highest caregiver-reported communication prevalence was for children with diabetes (68.0%). Behavioral/mental health conditions, chronic physical health conditions or having increased medical complexity and needs were significantly associated with increased communication compared to those without these conditions. Odds Ratio (OR) and 95% Confidence Intervals (CI) for children with a behavioral/mental health condition were OR: 1.28; CI: 1.02 to 1.61, for children with a chronic physical health condition were OR: 1.37; CI: 1.15 to 1.63 and for children with special health care needs or with medical complexity were OR: 2.15; CI: 1.75 to 2.64 and OR: 1.77; CI: 1.09 to 2.87, respectively. Significant communication differences existed for every health condition (P < 0.05) except for children who had a blood disorder (P = 0.365). CONCLUSIONS Caregiver perception of provider-school communication is low and differences in reported rates existed between health conditions and complexity status. Further work is needed to support provider-school-family communication for children with physical, mental, behavioral, and complex health conditions.
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Affiliation(s)
- Krissy Moehling Geffel
- University of Pittsburgh, School of Medicine, Department of Pediatrics (KM Geffel, D Bogen), Pittsburgh, Penn; University of Pittsburgh, School of Medicine, Department of Family Medicine (KM Geffel), Pittsburgh, Penn.
| | - Brianna M Lombardi
- University of North Carolina at Chapel Hill, Department of Family Medicine (BM Lombardi), Chapel Hill, NC
| | - Justin A Yu
- University of Pittsburgh School of Medicine, Division of General Internal Medicine, Section of Palliative Care and Medical Ethics (JA Yu), Pittsburgh, Penn
| | - Debra Bogen
- University of Pittsburgh, School of Medicine, Department of Pediatrics (KM Geffel, D Bogen), Pittsburgh, Penn; Children's Hospital of Pittsburgh of UPMC (D Bogen), Pittsburgh, Penn; Allegheny County Health Department (D Bogen), Pittsburgh, Penn
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6
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Nasir LS, Nasir A. Behavioral Problems of Children. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Friedberg RD. Pediatrician-friendly perspectives on cognitive behavioral therapy for anxious youth: Current status and clinical implications for the next normal. World J Clin Pediatr 2021; 10:112-123. [PMID: 34868888 PMCID: PMC8603637 DOI: 10.5409/wjcp.v10.i6.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/04/2021] [Accepted: 09/01/2021] [Indexed: 02/06/2023] Open
Abstract
Pediatric anxiety disorders are common and often debilitating conditions. Cognitive is a psychosocial intervention that represents a potentially powerful antidote to these disorders. This article reviews data from treatment outcome studies, meta-analyses, and systematic reviews as well as from moderation/mediational investigations. The literature supports the efficacy, effectiveness, and durability of positive treatment outcomes for pediatric anxiety disorders. Recommendations for clinical applications are suggested.
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Affiliation(s)
- Robert D Friedberg
- Center for the Study and Treatment of Anxious Youth, Palo Alto University, San Jose, CA 95136, United States
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Stasolla F. Virtual Reality and Wearable Technologies to Support Adaptive Responding of Children and Adolescents With Neurodevelopmental Disorders: A Critical Comment and New Perspectives. Front Psychol 2021; 12:720626. [PMID: 34322073 PMCID: PMC8311117 DOI: 10.3389/fpsyg.2021.720626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/18/2021] [Indexed: 12/16/2022] Open
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Trafalis S, Giannini C, Joves J, Portera S, Toyama H, Mehta A, Basile K, Friedberg RD. A pediatrician-friendly review of three common behavioral health screeners in pediatric practice: Findings and recommendations. Pediatr Investig 2021; 5:58-64. [PMID: 33778429 PMCID: PMC7984009 DOI: 10.1002/ped4.12246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/20/2020] [Indexed: 11/10/2022] Open
Abstract
Behavioral health concerns are surging in pediatric practices. Fortunately, integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings to help shoulder the clinical load. Routine screening of behavioral health problems in primary care facilities enables early identification and treatment. However, deciding on sound, efficient, and scalable screening measures is sometimes arduous. Accordingly, this article presents a clinician-friendly review of three common instruments useful in screening pediatric behavioral health concerns including anxiety, depression, and conduct problems. Psychometric findings and clinical applications of the Pediatric Symptom Checklist-17 (PSC-17), the Patient Health Questionnaire-9 (PHQ-9), and the Screen for Child Anxiety Related Emotional Disorders (SCARED) are delineated. Finally, clinical implications and recommendations for practicing pediatricians and child psychiatrists are offered.
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Affiliation(s)
- Sandra Trafalis
- Center for the Study and Treatment of Anxious YouthPalo Alto UniversityPalo AltoCAUSA
| | - Courtney Giannini
- Center for the Study and Treatment of Anxious YouthPalo Alto UniversityPalo AltoCAUSA
| | - Jeremy Joves
- Center for the Study and Treatment of Anxious YouthPalo Alto UniversityPalo AltoCAUSA
| | - Saige Portera
- Center for the Study and Treatment of Anxious YouthPalo Alto UniversityPalo AltoCAUSA
| | - Hannah Toyama
- Center for the Study and Treatment of Anxious YouthPalo Alto UniversityPalo AltoCAUSA
| | - Anika Mehta
- Center for the Study and Treatment of Anxious YouthPalo Alto UniversityPalo AltoCAUSA
| | - Krista Basile
- Center for the Study and Treatment of Anxious YouthPalo Alto UniversityPalo AltoCAUSA
| | - Robert D. Friedberg
- Center for the Study and Treatment of Anxious YouthPalo Alto UniversityPalo AltoCAUSA
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Curtin M, Butler M, Enneking BA, Kelley M, Keehn RM. Addressing Academic Concerns: A Survey of Primary Care Providers. Clin Pediatr (Phila) 2020; 59:1265-1273. [PMID: 32700564 DOI: 10.1177/0009922820941647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Given new clinical recommendations, we sought to better understand the perspectives and practices of primary care providers (PCPs) around pediatric academic concerns. Practicing PCPs were recruited to complete an 8-item self-report survey; 163 PCPs were included in the final analysis. Results indicated that 84% of PCPs perceived their role in addressing patients' academic concerns as highly important; yet there was variability in the frequency with which PCPs reported engaging in activities around these educational needs. There was a significant positive relationship between perception of role importance and engagement in clinical supports. Some differences were present in responses across PCP specialty area. More information about practice differences between provider types, rural versus urban practices, and how perceptions/practices differ based on provider demographics are likely to be useful areas for future consideration. Our findings highlight the need to advance PCP instruction for practical implementation to increase rates of engagement in these activities.
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Affiliation(s)
- Michelle Curtin
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Melissa Butler
- Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Meagan Kelley
- Indiana University School of Medicine, Indianapolis, IN, USA
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Behavioral Problems of Children. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Promoting education is preventive medicine at its best. Pediatr Res 2020; 87:185-187. [PMID: 31683275 DOI: 10.1038/s41390-019-0656-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/08/2019] [Accepted: 10/21/2019] [Indexed: 12/19/2022]
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