16.3 north carolina ’s approach to medicaid reform: integrating physical, behavioral, and social determinants of health
At the direction of their general assembly in 2015, North Carolina began developing a plan to transform its Medicaid program from a traditional fee-for-service Medicaid plan with a behavioral health (BH) managed care carve-out to fully integrated Medicaid managed care for most beneficiaries. One unique feature of this transformation will be the creation of 2 different managed care products: standard plans that will serve most Medicaid recipients including those with mild-to-moderate BH conditions, and BH/intellectual and developmental disabilities (IDD) tailored plans that will serve Medicaid recipients with more severe BH...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Carrie Brown Tags: Clinical Perspectives 16 Source Type: research

16.4 a payer approach to improving behavioral health access and quality
The objectives of this approach are to improve behavioral health access, efficiency, and effectiveness, and to establish a pathway for other payers to help stem current trends of rising behavioral health disorders, particularly those affecting children and adolescents. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Katherine Hobbs Knutson Tags: Clinical Perspectives 16 Source Type: research

Creating a unicorn: developing a perfect partial hospitalization program
There is great variability in the provisions of intermediate levels of care for youth with serious mental health difficulties. A partial hospitalization program (PHP) is one such service that has served as an alternative to inpatient hospitalization, as well as a step down or step up from other levels of service intensity. A PHP allows for accessible intensive treatment for youth in their home environment, focusing on reintegration into the community and schools. Differences exist in program descriptions, service provisions, and intensity of clinical presentation of youth. (Source: Journal of the American Academy of Child ...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Rameshwari V. Tumuluru, Michael T. Sorter Tags: Clinical Perspectives 17 Source Type: research

17.1 the cares model for long-term treatment in school-refusing adolescents
Early recognition of school avoidance behaviors and prompt intervention are vitally important to keeping students on track. This presentation will give practical strategies for successfully addressing school avoidance in adolescents with school refusal secondary to disruptive behaviors and co-occurring substance use. The Comprehensive Adolescent Rehabilitation and Education Services (CARES) program at Mount Sinai St. Luke ’s provides an integrated approach to address both clinical and educational needs for teenagers and families. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Iliyan Ivanov Tags: Clinical Perspectives 17 Source Type: research

17.2 strengths and challenges of a child and adolescent eating disorder partial hospitalization program
The objective of this presentation is to provide information about the strengths and challenges of a partial hospitalization program (PHP) for children and adolescents with eating disorders (EDs) and comorbid disorders. This PHP is part of a national program that treats a population of children and adolescents with EDs and comorbid conditions from all across the United States and parts of Canada. A conservative collective prevalence of EDs in children and adolescents is 5% to 10%, and the lifetime rate of mental health disorder comorbidity for anyone who has had an ED is between 55% and 88%. (Source: Journal of the America...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Avanti Bergquist Tags: Clinical Perspectives 17 Source Type: research

17.3 crowdsourcing a perfect partial hospitalization program
The objective of this presentation is to actively engage the audience to identify the aspects needed for a perfect partial hospitalization program (PHP). (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Avanti Bergquist, Kalyani Samudra Tags: Clinical Perspectives 17 Source Type: research

17.4 achievement, behavior, cognition: a model for multidisciplinary care for school-age children
This presentation aims to learn about the strengths and challenges of a partial hospitalization program for school-age children with myriad diagnoses who have failed to progress at lower levels of care. The Achievement, Behavior, and Cognition (ABC) Children ’s Programs at the Resnick Neuropsychiatric Hospital at UCLA are dedicated to helping children aged 6 to 12 years and their families to overcome the challenges posed by mental health illness. Youth in our program who present for care with a range of mental health concerns are offered multidiscipli nary care designed to promote recovery and long-term wellness. (So...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Benjamin Schneider Tags: Clinical Perspectives 17 Source Type: research

17.5 what is a partial hospital program? results of a national survey
As psychiatric hospitalization lengths of stay are getting shorter, creation of intermediate levels of care for the children and adolescents who are seriously ill is necessary. One such alternative is the partial hospital program (PHP). There is great variability in programming and not a unifying guideline for such a level of service. To provide quality, evidence-based care guidelines need to be set. Results of a national survey will guide participants to conceptualize the PHP as an important component of the continuum of care. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Rameshwari V. Tumuluru Tags: Clinical Perspectives 17 Source Type: research

Working with patients with limited communication skills and severe problem behavior: reducing staff and patient safety risks in community and various medical settings
The prevalence of problem behaviors in patients with intellectual delay (ID) and communication delays can be as high as 50%. The prevalence of illnesses is higher in these patients as compared with their neurotypical peers. Complex behaviors seen in medical settings include kicking, pinching, noncompliance with exams, biting, head banging, elopement, and spitting. This can lead to higher utilization of emergency services and a failure to receive preventative medical care, increasing health morbidity and care costs. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Pankhuree Vandana, Matthew Siegel Tags: Clinical Perspectives 18 Source Type: research

18.1 working with patients with limited communication skills and severe problem behaviors: reducing staff and patient safety risks in outpatient medical settings
The objectives of this presentation are to: 1) identify medical, behavioral, and environmental triggers of complex behaviors creating barriers to medical care of children and adolescents with developmental disorders and communication challenges; and 2) identify effective, practical, and feasible modifications that can be made to a general outpatient medical setting to reduce staff and patient injuries during visits. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Pankhuree Vandana Tags: Clinical Perspectives 18 Source Type: research

18.2 reducing staff injuries in an acute inpatient psychiatry unit for neurodevelopmental disorders
Employee injuries in health care, particularly on inpatient psychiatry units, are underreported and significantly affect employee well-being, retention, and care delivery. The Cincinnati Children ’s Hospital Medical Center (CCHMC) Inpatient Neurobehavioral Psychiatry Crisis Management Unit is a 10-bed specialized inpatient unit serving children aged 2 to 22 years with autism spectrum disorder, intellectual disability, and comorbid mental illness and severe behavior, including significant a ggression toward others. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Martine Lamy Tags: Clinical Perspectives 18 Source Type: research

18.3 working with patients with limited communication skills and severe problem behaviors: increasing success of medical procedures within a large medical system
This presentation aims to: 1) discuss the barriers to accessing medical treatment in hospital departments for individuals with autism spectrum disorder (ASD)/intellectual or developmental disability (IDD) who present with significant behavioral and/or communication challenges; 2) understand the triggers for behavioral escalation in medical settings; and 3) present strategies to increase acceptability and enhance the success of medical procedures through staff training, active parent involvement, and child preparation and intervention. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Cara Inglis Tags: Clinical Perspectives 18 Source Type: research

18.4 working with patients with limited communication skills and severe problem behaviors: increasing success and safety of crisis intervention in community settings
This presentation aims to: 1) understand the complexities of behavioral crisis situations in community settings for patients with limited communication skills; 2) understand the perspective and training needs of mobile crisis interventionists, emergency response providers, school personnel, caregivers, and other community providers; and 3) learn strategies to safely provide care to patients in crisis in community settings. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Jacquie Wynn Tags: Clinical Perspectives 18 Source Type: research

“sometimes, it’s lupus”: what you should know about neuropsychiatric systemic lupus erythematosus (np-sle)
This Clinical Perspectives reviews the complexities and challenges of the mental health consultation and care of pediatric patients with neuropsychiatric systemic lupus erythematosus (NP-SLE). (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Ruth C. Russell, Susan B. Turkel Tags: Clinical Perspectives 19 Source Type: research

19.1 a review of pediatric neuropsychiatric systemic lupus erythematosus
This presentation reviews the current knowledge about clinical features and care of pediatric neuropsychiatric systemic lupus erythematosus (NP-SLE). (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Lori T. Baltazar Tags: Clinical Perspectives 19 Source Type: research

19.2 case #1
This case study illustrates the complexities of diagnosis and mental health care for a 16-year-old patient with neuropsychiatric systemic lupus erythematosus (NP-SLE). (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Jennifer Picado Tags: Clinical Perspectives 19 Source Type: research

19.3 case #2
The objective of this case study is to present the assessment and management of neuropsychiatric changes in a 15-year-old patient diagnosed with systemic lupus erythematosus (SLE). (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Steven S. Storage Tags: Clinical Perspectives 19 Source Type: research

Dysregulation in children and adolescents: lessons learned so far from the presidential taskforce
The first meeting of the AACAP Presidential Initiative Task Force on Emotion Dysregulation in Children and Adolescents was held at the 2019 AACAP Annual Meeting. This 16-member task force meets monthly to discuss the initiative of Gabrielle A. Carlson, MD, to improve the assessment and treatment of children and adolescents with severe outbursts who are often referred to inpatient and outpatient treatment and are managed in emergency and residential settings. These presentations will present the goals of the initiative, provide early reports from the working groups on measurement and treatment, and allow for membership inpu...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Robert R. Althoff, Daniel P. Dickstein Tags: Clinical Perspectives 20 Source Type: research

20.1 phenomenology and how data guide measures
This presentation aims to flesh out how the Presidential Task Force should focus the initiative to be responsive to member needs. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Gabrielle A. Carlson Tags: Clinical Perspectives 20 Source Type: research

20.2 measurement of dysregulation in children and adolescents
The measurement of emotion dysregulation in children and adolescents overlaps with a number of different constructs including aggression, irritability, and many others. Consequently, the Task Force was tasked with first coming to some consensus over what is meant by dysregulation and then how to measure it. As a whole task force, the discussion attempted to try to resolve the need to specifically quantify behaviors in children with severe outbursts. This conversation and the subsequent rating scales discussion were then moved to a Working Group on phenomenology and measurement. (Source: Journal of the American Academy of C...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Robert R. Althoff Tags: Clinical Perspectives 20 Source Type: research

20.3 issues in treatment of dysregulation in children and adolescents
Agitation, irritability, explosive outbursts, and aggression frequently characterize children who are coming to care and are one of the most common reasons for admission to inpatient treatment. Persistent outbursts of dysregulated emotion may lead to a disabling condition for children and adolescents. Care providers have limited access to evidence-based models of care and too few guidelines on the treatment of dysregulation, aggression, and violence. This presentation will update practitioners on the perspective of the Presidential Task Force on the current state of knowledge regarding treatment approaches and the need for...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Michael T. Sorter Tags: Clinical Perspectives 20 Source Type: research

The effects of cannabidiol (cbd) on mental health disorders among adolescents and young adults: accurately and effectively informing patients and families
The market is saturated with cannabidiol (CBD) products claiming to be a “cure” for a variety of mental health disorders, such as psychotic, mood, anxiety, and substance use disorders. More reliable information is required to inform patients and their families effectively and accurately about CBD. This presentation aims to effectively update the audience about the ef fects of CBD on mental health disorders, including potential efficacy and safety based on existing research evidence from clinical and preclinical studies. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Pravesh Sharma, Kevin M. Gray Tags: Clinical Perspectives 21 Source Type: research

21.1 neurobiology of cannabidiol: putative mechanisms and distinct and interactive effects with Δ-9-tetrahydrocannabinol (thc)
Cannabidiol (CBD), a major chemical compound present in the Cannabis sativa plant, has received significant scientific and popular media focus over the past decade related to its potential promise as a treatment for mental health conditions. Deregulation and legalization have led to CBD products being widely marketed as health supplements and increasingly used by Americans of all ages to self-treat their mental health conditions. These changes have made for a highly challenging practice environment where both patients with mental health problems and providers are confused. (Source: Journal of the American Academy of Child ...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Christopher J. Hammond Tags: Clinical Perspectives 21 Source Type: research

21.2 cannabidiol in the treatment of psychotic disorders: evidence from clinical and preclinical studies
The cannabis plant has gained significant attention not only because of its psychoactive properties due to Δ9-tetrahydrocannabinol (THC) but also for its nonpsychoactive component, cannabidiol (CBD). The studies have shown that the use of high-potency cannabis (high THC-to-CBD ratio or low in CBD) in youth has greater odds of precipitating psychosis. Given this THC-to-CBD ratio-dependent association wit h psychosis severity, CBD is postulated to antagonize the effects of THC or exhibit antipsychotic properties. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Pravesh Sharma Tags: Clinical Perspectives 21 Source Type: research

21.3 cannabidiol for the treatment of childhood mood and anxiety disorders
Parents are increasingly inquiring about or proactively using cannabidiol (CBD)-related products to address symptoms of mood and anxiety disorders in children and adolescents. This presents challenges for clinicians because current training and the evidence base in this area are limited. This presentation will highlight evidence-based treatments for mood and anxiety disorders in children and will survey available research on CBD-related products. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Paul Croarkin Tags: Clinical Perspectives 21 Source Type: research

21.4 cannabidiol as a potential treatment option for substance use disorders
The development of an addictive disorder is a complex process that involves multiple brain areas. Cannabidiol (CBD) has been shown to have anxiolytic, antipsychotic, antidepressant, and neuroprotective properties. With expanding understanding of the biology of addiction, the biochemistry of CBD offers a relatively safe option to treat some aspects of substance use disorders (SUDs). Through this presentation, we aim to update the audience about current preclinical and clinical research using CBD to treat SUDs, and the proposed biochemical rationale for the utilization of CBD in the treatment of SUDs. (Source: Journal of the...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Tyler Scott Oesterle Tags: Clinical Perspectives 21 Source Type: research

Pediatric delirium in special populations: expanding the roadmap
This session aims to provide child and adolescent psychiatrists with the tools and evidence to assess delirium in special populations and settings, to identify risk factors for delirium development, and to appreciate the longitudinal cognitive impact of delirium in children and adolescents. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Maalobeeka Gangopadhyay, Julia A. Kearney Tags: Clinical Perspectives 22 Source Type: research

22.1 delirium in postsurgical populations
No studies have evaluated pediatric patients prospectively for delirium outside the Pediatric Intensive Care Unit (PICU). Given that delirium is a serious complication of pediatric illness, that anesthesia is a known risk factor, and that delirium after anesthesia is linked to poor outcomes, this study was designed to describe the frequency, subtypes, and risk factors for pediatric delirium after general anesthesia for elective surgery, and to assess for the persistence of delirium symptoms at the time of postanesthesia recovery unit discharge. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Gabrielle Silver Tags: Clinical Perspectives 22 Source Type: research

22.2 delirium in palliative care
Pediatric delirium increasingly is being recognized in palliative care populations with life-limiting illnesses. Data on pediatric delirium's etiologies and risk factors, and its impact on mortality, are lacking. Studies of intensive care unit (ICU) populations often include previously healthy individuals with sudden trauma and infections in addition to patients with complex chronic conditions (CCC) more typical of those receiving palliative care. Specific studies of pediatric patients with CCC inside and outside of ICU settings could better characterize important clinical considerations for best practices and approaches t...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Chase Samsel Tags: Clinical Perspectives 22 Source Type: research

22.3 delirium and catatonia: special populations and comorbidity
Comorbidity of delirium and catatonia is recognized in the adult literature. However, the DSM-5 diagnosis of catatonic disorder due to another medical condition precludes the diagnosis of catatonia in the presence of delirium. This restriction creates a potential bias in clinical assessment and management and may impact treatment. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Catherine Fuchs Tags: Clinical Perspectives 22 Source Type: research

22.4 longer-term cognitive dysfunction after delirium and the intensive care unit
The pediatric literature related to delirium in the intensive care unit (ICU) is beginning to catch up to the adult literature regarding diagnosis and incidence. However, the adult literature has also gone on to demonstrate an association between delirium in the ICU with later cognitive dysfunction. Currently, there is a gap in knowledge regarding the relation between delirium and longer-term cognitive dysfunction in children. This presentation will examine new data from a prospective, longitudinal study evaluating children for delirium while in the ICU and then following them after discharge to assess their ongoing cognit...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Lara P. Nelson Tags: Clinical Perspectives 22 Source Type: research

For better and for worse: exploration of gender and sexuality in a virtual world
We will review the ways in which heteronormative and LGBT youth explore gender identity, sexual orientation, sexual health information, and sexual behavior online and through social media, dating applications (apps), video games, and internet pornography. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Erin L. Belfort Tags: Clinical Perspectives 23 Source Type: research

23.1 for better: positive aspects of social media for lgbt youth
This presentation aims to review how marginalized and stigmatized youth, including LGBTQ youth, use social media for education, support, and social justice aims. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Erin L. Belfort Tags: Clinical Perspectives 23 Source Type: research

23.2 for worse: negative aspects of social media for lgbt youth
This presentation aims to review the dangers of certain online behaviors among LGBT youth and ways in which clinicians can keep youth's digital experiences safe. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Jack L. Turban Tags: Clinical Perspectives 23 Source Type: research

23.3 exploration of sexuality and gender via sexually explicit internet materials
The objectives of this presentation are to review current knowledge on the use of sexually explicit internet material (SEIM) by adolescents who are heteronormative or LGBT and the influence of this material on attitudes and perceived norms. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Amy Mayhew Tags: Clinical Perspectives 23 Source Type: research

23.4 gaming: a final frontier for gender equality
This presentation aims to increase the understanding of gender portrayals in video games and player experiences. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Roslyn Gerwin Tags: Clinical Perspectives 23 Source Type: research

23.5 sexting in lgbt youth
In 2016, the CDC published data confirming that youth and adults who are LGBT remain socially marginalized, with high rates of victimization, bullying, and cyberbullying. They suffer from overt discrimination and higher rates of depression, suicide, and high-risk activities. Social marginalization has helped fuel the LGBT community ’s use of the internet for connection and support. Individuals who are LGBT establish meaningful sexual and romantic relationships online, and these may help form protective family relationships as adulthood progresses. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Elizabeth K. Englander Tags: Clinical Perspectives 23 Source Type: research

23.6 helping parents navigate youth sexuality in a media-saturated world
Participants will learn concrete tips for helping parents navigate youth sexuality in the age of online content and social media. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Natalie Ramos Tags: Clinical Perspectives 23 Source Type: research

Kids with autism spectrum disorder in the medical hospital: special challenges for the patient, provider, and hospital system and how to address them
Autism spectrum disorder (ASD) rates are increasing and patients with ASD are more likely to have medical comorbidities and admissions. The limited ability of these patients to communicate needs and utilize coping strategies when stressed or in pain may worsen ASD –related behaviors or symptoms. Hospital staff may be unfamiliar with how to care for these patients, particularly how to manage their behaviors and provide effective comfort and support. Staff education, parent and patient involvement, and overall coordinated care using best practices may improve the overall hospital experience. (Source: Journal of the Ame...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Julienne Jacobson, Jeanne Greenblatt Tags: Clinical Perspectives 24 Source Type: research

24.1 management of aggression in medically hospitalized patients with autism spectrum disorder
Patients with autism spectrum disorder (ASD) often exhibit increasingly agitated and possibly aggressive or violent behavior in the medical hospital setting. Staff may feel threatened, and pediatricians may be unfamiliar with managing uncontrolled behavior. Increased polypharmacy and progressively more restrictive measures are often not effective. The consulting child and adolescent psychiatrist may be looked to for guidance. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Janet Charoensook Tags: Clinical Perspectives 24 Source Type: research

24.2 hospital system challenges for the patient with autism spectrum disorder: strategies for getting "buy-in" from frontline staff
This presentation is designed to: 1) examine the basic tenants of autism spectrum disorder (ASD) that can impact a patient ’s experience in the hospital; 2) recognize that these differences from typical patients can impact how they interpret and react to care; 3) explore how a lack of staff education and innate biases impact patient and staff experiences; and 4) discuss strategies to improve education and address bias es to improve staff empathy for and comfort in caring for this population. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Laura A. Markley Tags: Clinical Perspectives 24 Source Type: research

24.3 insomnia in autism spectrum disorder is likely to worsen with hospitalization: review of insomnia with autism spectrum disorder and strategies to support sleep during hospitalization
It is estimated that 53%-78% of children and adolescents with autism spectrum disorder (ASD) suffer insomnia, which is a rate much higher than reported in typically developing children. When these youth are hospitalized for medical reasons, their baseline insomnia is likely to worsen given the stress experienced and the change in sleep environment. The resultant sleep deprivation can cause or exacerbate disruptive behavior during the day, which in turn may complicate medical care. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Kyle P. Johnson Tags: Clinical Perspectives 24 Source Type: research

24.4 a clinical pathway to improve the experience of medically hospitalized patients with autism spectrum disorder
This presentation aims to describe the development and pilot results of a clinical care pathway to better tailor care to the needs of patients with autism spectrum disorder (ASD) and their families, to standardize care, and to provide staff with appropriate support including mental health consultation. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Serena Fernandes Tags: Clinical Perspectives 24 Source Type: research

International clinical perspectives: global climate change effects on the health and mental health of children and families
Climate change is a crisis. We are witnessing extreme weather in the form of severe hurricanes, flooding, drought, and wildfires. Glaciers are melting and wildlife is at grave risk. Climate disasters cause extreme hardship and lead to poverty, poor nutrition, displacement, conflict, and war. Extreme weather is affecting our health by increasing food, water, vector-borne diseases, and emerging viruses, as well as air pollution from fires, which causes acute and chronic illness. Impoverished, marginalized, and indigenous communities are most vulnerable. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Carol M. Larroque Tags: Clinical Perspectives 25 Source Type: research

25.1 a review of the psychological effects of climate change on children: considering resilience, vulnerability, and inequity
Natural disasters, such as storms, fires, and earthquakes, are increasingly frequent occurrences and consequences of climate change, which significantly affect children, families, and entire communities. Both the direct and indirect effects of climate change, including geographic displacement, place children at risk of mental health problems including PTSD, depression, anxiety, phobias, sleep disorders, attachment disorders, and substance abuse. These in turn can lead to problems with emotion regulation, cognition, learning, behavior, language development, and academic performance. (Source: Journal of the American Academy ...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Lisa R. Fortuna Tags: Clinical Perspectives 25 Source Type: research

25.2 climate change and hurricanes: the effect of hurricane-related stress on infant temperament
This study presents preliminary data on disaster-related stressors experienced by pregnant women in Puerto Rico (PR) during and after Hurricane Maria and evaluates the relationship between these maternal stressors and infant temperament. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Karen G. Martinez Tags: Clinical Perspectives 25 Source Type: research

25.3 fighting an inferno with volunteer firefighters: the impact of bushfires on families in australia
The damage caused by the bushfires in Australia in the last few months is unprecedented. Australia ’s major cities—including Sydney and Melbourne—were filled with smoke. More than half a billion animals died and many people died including American firefighters who had come to help. In total, the area burned by bushfires is almost the size of England, an area approximately the size of Vermon t and New Hampshire combined (13 million hectares). In New South Wales, almost 5 million hectares, which covers an area larger than the Netherlands, have been burned. (Source: Journal of the American Academy of Child a...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Afraz U. Zaman Tags: Clinical Perspectives 25 Source Type: research

25.4 climate change and child and adolescent mental health in asia, middle east, and north africa region: points to ponder
Climate change is a long-term deviation in the weather patterns and is a leading public health threat to vulnerable populations. In the Middle East, climate change is gradually increasing the environmental temperatures, and there is a concern that, in a few decades, several areas in this part of the world will be uninhabitable. These increasing temperatures lead to increased intensity and frequency of rainfall, coastal flooding, drought, hurricanes, and wildfires, and cause havoc on vulnerable communities and affect the most vulnerable populations, including children and the elderly. (Source: Journal of the American Academ...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Ahsan Nazeer Tags: Clinical Perspectives 25 Source Type: research

Treating infants, toddlers, and preschoolers across multiple settings: challenges/innovative strategies/creative solutions
Approximately 1 in 4 young children struggle with emotional behavioral issues that are associated with significant impairments in psychosocial and academic functioning. Frequently, they initially present to primary care settings, as parents feel most comfortable with their primary care providers. Unfortunately, primary care providers are often not well-equipped with the evidence-based resources that families need. There is a need for mental health services that are either embedded in primary care practices or are easier to access in specialty care settings. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Joyce Harrison, Magdalena Romanowicz Tags: Clinical Perspectives 26 Source Type: research

26.1 treating infants, toddlers, and preschoolers: challenges/innovative strategies/creative solutions
This presentation will describe the Young Child Clinic at Children's Hospital of Philadelphia (CHOP), a multidisciplinary clinic serving children from birth to age 5 years in an academic outpatient clinic. The clinic is unique in its structure because the patients have multiple assessments over time to understand the patient and families' responses to internal and external stressors. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2020 Category: Psychiatry Authors: Wanjiku Njoroge Tags: Clinical Perspectives 26 Source Type: research