Category Archives: Pediatrics

Amateur Spotlight: Retired Pediatrician Gives Back And Pushes Forward – The Chronicle of the Horse

In the late 1990s, Angela Millon was a busy pediatrician. Shed worked hard to get where she was, giving up horses for college, working her way through medical school and residency, and starting a family with her husband, John Millon.

But after 20 years out of the saddle, the horses came calling when she and her family moved to Greenville, South Carolina, for her job.

Angela jumped back wholeheartedly, buying a small farm and a horse, and her children, Meagan and Michael Millon, soon caught the horse bug. The trio competed locally and on the A circuit until the children went off to college.

In 2015, Angela had another revelation and realized that in her mid-50s, she still had plenty of lofty riding goals she wanted to achieve. With Johns encouragement, she retired and put all her energy into qualifying for her bucket-list horse shows, like Devon (Pennsylvania) and the indoor circuit.

All of a sudden one day I said, Im not going to be able to do this at this level forever, and Im not getting any younger, she said. I want to go to Devon, I want to qualify for indoor finals; I need to have time to dedicate to that, and working full time, theres just not enough hours in the day. I didnt have enough time to go to as many horse shows as I needed to go to, to get it done. The kids were in college, and I just cut back a little for a year or two, then finally my husband said, Just retire. Go for it.

And she did, making it to Devon, the Pennsylvania National and the National Horse Show (Kentucky) in 2016 in the amateur-owner hunters with Motown, a Hanoverian gelding (Don PrincipeEM Rising Star).

I did get ribbons, not the primary colors, but I did. Those were on my bucket list, to be able to go and do that, she said.

During her retirement, Angela became involved in the local Tryon Riding & Hunt Club in nearby Tryon, North Carolina. The organization, founded in 1925, put on rated and local shows, where Angela and her children were regulars over the years.

Those shows were very special, she recalled. They were very different from the rest of the little local circuit shows. They had such a rich history and tradition, and the exhibitor parties were amazing. The board members would descend on the show grounds, and there this little, small town warmth. Theyd come around and bring drinks and snacks. It was just wonderful. The kids and I looked forward to those shows.

As she got to know more people involved with TRHC, she was asked to join their board of directors. She is now heading into her seventh year as a member and third year as president.

TRHC now supports a steeplechase, horse and hound show, rated hunter/jumper shows, dog shows, horse trials and two charity horse shows.

Theres a lot of really rich, traditional activities that have been on the social calendar in Tryon for decades, Angela said. I love giving back to the community. Over the last five years, TRHC has given $200,000 back to the community and about half of that goes to horse-related places. The worlds been good to me. I like giving back.

For her volunteer work with TRHC and for her work asa founding member and co-chair of the Carolinas Show Hunter Hall of Fame, which honors horses and horsemen tied to the Carolinas, Angela received the U.S. Hunter Jumper Associations Amateur Sportsmanship Award at the organizations annual meeting, held Dec. 4-7 in Concord, North Carolina.

I was so humbled and surprised, she said. You sort of just do what you do and dont think much about it. A lot of people know who I am in Tryon, North Carolina, but on a national scale, to get national recognition, that was huge. Going to that meeting and listening to the lifetime achievement presentation and the visionary presentation, it was so inspiring and sort of gave me a kick in the pants, like, Alright, youve got one more year as the president of TRHC. Youve done a whole lot, youve done well, but dont coast your last year. Dig in and keep going because you can always do what youre doing a little bit better.

Finding A Path

Born in Charleston, South Carolina, Angela was always horse crazy. When her family moved to Connecticut, she started riding with Show Hunter Hall of Fame inductee Rick Fancher. All students had to care for their own horses, so Angela got an education in horsemanship.

He had a great system, she said. If you could clip the school horses and do a great job, then you could clip your own. Of course, it was like Huck Finn! I was like, OK, great! I learned how to clip and bandage and take care of horses from the get-go.

She was a member of the local Pony Club in Weston, Connecticut, and a trip to the National Horse Show helped inspire her interest in medicine.

One of our field trips was to go to the old National Horse Show at Madison Square Garden. A lot of the horses that came into the ring, they would say, Dr. and Mrs. this or Mrs. that, and I was like, Huh, maybe if I grow up and become a doctor, Ill have enough money to have horses, she recalled with a laugh.

Of course, it wasntjustthat which got her through medical school and a residency.

Ive always liked taking care of things, she said. I thought I wanted to be a vet, but I went out with a vet in Connecticut and made rounds with him, and it just so happened that the day or two that I went out with him, I got drug, trampled, stamped, and I was like, I dont know if I can survive being a vet. I always knew I wanted to do something medical, so I ended up doing people medicine instead of horse medicine.

I love taking care of kids and familiesthe continuity of it, she said. You take care of a kid from birth until they go off to high school or college. You get to really know the whole family. It was great. I loved it.

When she got back into riding, Angela kept the familys horses at home and taught her children the importance of horsemanship.

I didnt want to just take a riding lesson once a week. I wanted to have a horse and do it like I did as a kid, she said. I didnt realize what I was setting myself up for, because it was three times the work and expenses, but both my kids rode all the way through high school;my daughter rode through college. We had so much fun doing it together. We were like partners in crime. Those were wonderful days.

Pediatrics and horses are so alike: The little kids cant tell you whats wrong. Youve got to look at them and see the look in their eye and read their non-verbal stuff to know, are they sick or are they well?

After her children went off to collegeand after 25 years of doing the barn work herselfAngela felt lonely riding at home, so she moved her current horse, Jackson Square, to a barn where she could have a sense of camaraderie with other adult amateurs.

To me [horsemanship] is huge. I feel like I know my horses, she said. Pediatrics and horses are so alike: The little kids cant tell you whats wrong. Youve got to look at them and see the look in their eye and read their non-verbal stuff to know, are they sick or are they well? They cant tell you what hurts. I think theres a big crossover when youre looking at a horse. You walk in the stall, glance in, and I can tell you, is he OK or not? Its because youre with them every single day and you know 100 percent what is there normal and what isnt. I think a lot of amateurs dont have that experience because they dont take care of their horses on a daily basis. I think its very important.

Angela rides with Gisele Beardsley OGrady at Clear View Farm in Landrum, South Carolina. She shows Jackson, an 11-year-old Dutch Warmblood gelding (Q Breitling LSUrrike) in the amateur-owner hunters, and OGrady shows him in the 36 performance hunters.

I decided, Im young enough, I can do this, lets move on and try one more time, Millon said. Hes probably the best jumping horse Ive ever owned, but they all come along at different speeds, and hes been slow to mature.

At age 60, Angela still wants to get back to Devon and the fall indoor shows, and possibly earn primary-color ribbons there.

But shes not solely focused on the show ring: Returning to her childhood days in the hunt field, she recently went out for the first time with the Tryon Hounds for fun.

When asked what advice shed give to older adult amateurs, she said, Dont give up. Its out there. Surround yourself with the right village. Make sure youre with the trainer that shares your goals, that supports you. Its a journey. Enjoy every day. Every single day I go to the barn, Im in my happy place, and its just a good day. Especially when I was working, no matter how bad a day I had, as soon as I got to the barn, life was good.

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Amateur Spotlight: Retired Pediatrician Gives Back And Pushes Forward - The Chronicle of the Horse

Stop Children’s Cancer, Inc. renews $1M gift for pediatric cancer research Giving UF Health University of Florida – UF Health

Stop Childrens Cancer presents a renewed gift of $1 million to support cancer research and clinical trials in the UF College of Medicine division of hematology and oncology.

Continuing their support in the fight against pediatric cancer, Stop Childrens Cancer, Inc. has renewed a $1 million gift to the University of Florida College of Medicine division of pediatric hematology/oncology. This contribution will fuel research innovations in therapies and treatments aimed at improving outcomes for children facing cancer.

One researcher leading the fight is UF Health pediatric oncologist Elias Sayour M.D., Ph.D., holder of the Stop Childrens Cancer/Bonnie R. Freeman Professorship for Pediatric Oncology Research chair. Sayour and his team are investigating new nanotechnology vaccines to reprogram the immune system against cancer cells. Their focus is on personalized nanoparticles, designed to educate the immune system to reject pediatric cancer and presents a transformative approach to the fight against this disease. Their work, alongside other pioneering efforts, highlights the cutting-edge advancements taking place at UF.

In the field of pediatric immunotherapy, meaningful progress has been made with new agents like CAR T-cells and rituximab, a type of antibody therapy that can be used alone or with chemotherapy, said Dr. Sayour. UF provides a unique opportunity to develop and trial these agents individually and in combinations.

Cancer is the number one cause of death by disease in children in the United States. Sayour added that the work that is discovered and developed at UF is helping to treat children with pediatric cancer across the world.

Stop Childrens Cancer is a local nonprofit organization committed to the prevention, control and cure of childhood cancers. The organization was founded in 1981 by Bonnie R. Freeman, her parents Howard and Laurel, and her sister Carolyne. Bonnie told her family that her goal was to raise $1 million to fight childhood cancers, so that other children and families wouldnt have to suffer.

With this continued additional gift, our hopes are that more children have the ability to become healthy, Howard Freeman said.

When Bonnie was diagnosed with leukemia, she had a 35% chance of living for five years. Today, children with that same diagnosis have a 90% cure rate, according to the UF College of Medicine department of pediatrics division of hematology/oncology.

Bonnie inspired us so much the way she understood the reality of where she was at, Laurel Freeman said. She was determined to live every day to the fullest and that really motivated us.

Sadly, Bonnie died in 1983 at age 12.

Bonnies legacy endures through the organizations tireless efforts. In the 42+ year history of Stop Childrens Cancer, over $7 million has been contributed for pediatric cancer research, helping to double the number of physicians in clinical trials and boosting cure rates. As a result of the organizations early donations of seed money to UF, more than $23 million in funding has been secured by doctors and researchers.

Stop Childrens Cancer started as the heartfelt response of a 10-year-old diagnosed with cancer. Its one of the purest, altruistic charities, driven by a dream to spare other families the challenges we faced, Carolyne Freeman said. The culture of giving can be seen throughout every part of Stop Childrens Cancer from the board to our sponsors, to our volunteers. Whether contributing financially or with time, its a meaningful investment and its making an impact in the world. We truly hope childhood cancer becomes a disease of the past.

Make a gift

Your gift will support cancer research and clinical trials in the UF College of Medicine division of hematology and oncology

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Stop Children's Cancer, Inc. renews $1M gift for pediatric cancer research Giving UF Health University of Florida - UF Health

Contemporary Pediatrics week in review: Nirsevimab recommendation, AAP updates, and more – Contemporary Pediatrics

Image Credit: Contemporary Pediatrics

Thank you for visiting the Contemporary Pediatrics website. Take a look at some of our top stories from last week (Monday, October 23 to Friday, October 27, 2023) and click on each link to read and watch anything you may have missed.

1.) Steven Selbst, MD, discusses ED trends, highlights mental health admissions

While at the 2023 American Academy of Pediatrics National Conference & Exhibition, Steven Selbst, MD, spoke with Contemporary Pediatrics about current trends in pediatric emergency medicine, and highlighted the ongoing mental health crisis.

Click here for the full article.

2.) Delta-8 accessibility to minors online

In recent research highlighted at the 2023 American Academy of Pediatrics National Conference & Exhibition, investigators sought to evaluate the level of access and marketing of Delta-8 THC (D8) to minors online.

Click here for the full article.

3.) Lessons in asking patients' gender identity and sexual orientation

A recent study presented at the 2023 American Academy of Pediatrics National Conference & Exhibition evaluated how clinicians can ask patients' sexual orientation and gender identity for EHR documentation.

Click here for the full article.

4.) Negotiating to get paid what you deserve

Susan J. Kressly, MD, FAAP, shares tips and aspects of her session, "How to Ensure You Will Be Paid What Youre Worth," presented at the 2023 American Academy of Pediatrics National Conference & Exhibition, in this Contemporary Pediatrics interview.

Click here to watch the full interview.

5.) CDC recommends nirsevimab be prioritized for highest-risk infants amid limited availability

The Centers for Disease Control and Prevention is advising providers to prioritize 100 mg doses of nirsevimab, a monoclonal antibody FDA-approved to prevent respiratory syncytial virus (RSV), for infants at the highest risk of severe RSV disease.

Click here for the full article.

For more from Contemporary Pediatrics, click here.

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Contemporary Pediatrics week in review: Nirsevimab recommendation, AAP updates, and more - Contemporary Pediatrics

UNE Student Pediatrics Club wins national award for its efforts in the … – University of New England

The University of New England College of Osteopathic Medicine (COM) Pediatrics Club has won a national award for excellence in advocacy and programming during the 2022-2023 school year.

Three club representatives traveled to Washington, D.C. on Oct. 21 to accept the American Academy of Pediatrics (AAP) Section on Pediatric Trainees Pediatric Interest Group of the Year Award at the AAP National Conference and Exhibition.

This award really helps to show that our school has a solid interest in pediatrics, and helps to confirm that, as a club, we are dedicated to providing opportunitiesfor our fellow students to engage at both an academic and community level with pediatric populations, said Casey McAndrews, club president and a student doctor in the Class of 2026.

The Pediatrics Club is a student-run organization for medical students who are interested in a career in pediatrics. Club members volunteer with pediatric initiatives in the local community, raise money for charities, and raise osteopathic student awareness of the field.

The award includes an honorarium to help support future club initiatives, McAndrews noted, like its Wellness Warriors Program, which was suspended at the beginning of the COVID-19 Pandemic. The program brings club volunteers to the Biddeford Intermediate School to teach fourth-grade students about various health topics, ranging from dental and sleep hygiene to the importance of physical activity and good nutrition. McAndrews hopes to restart the program this spring.

The club also hosts fundraisers for the local community, including its annual Alexs Lemonade Stand Bake Sale each September, where the club has raised nearly $2,400 for childhood cancer research over the last two years.

We are so proud of our club's accomplishments and are excited to keep providing a variety of opportunities for our club members to engage in service, advocacy, and education to care for pediatric populations,McAndrews said.

The club is now gearing up for its annual Holiday Giving Tree event with Sigma Sigma Phi, the osteopathic honorary service fraternity at UNE, where members collect gifts to donate to students at JFK Elementary School in Biddeford.

The support of UNE and the local community leaders have been an essential part of the clubs success, McAndrew adds.

We could not have hosted any of our events, volunteering opportunities, or fundraisers without the amazing support from our faculty advisors and the Office of Recruitment, Student, and Alumni Services, McAndrews said.

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UNE Student Pediatrics Club wins national award for its efforts in the ... - University of New England

American Association of Critical-Care Nurses Recognizes the Pediatric ICU at K. Hovnanian Children’s Hospital with … – Hackensack Meridian Health

The American Association of Critical-Care Nurses (AACN) recently conferred a gold-level Beacon Award for Excellence on the Pediatric ICU at Hackensack Meridian Childrens Health K. Hovnanian Childrens Hospital, part of Jersey Shore University Medical Center. This accolade adds to quality recognitions K. Hovnanian Childrens Hospital has received in 2023. In June, K. Hovnanian, and Joseph M. Sanzari Childrens Hospital at Hackensack University Medical Center - filed jointly under a single program - were ranked #1 in New Jersey for the third year in a row by U.S. News & World Report.

The Beacon Award for Excellence a significant milestone on the path to exceptional patient care and healthy work environments recognizes unit caregivers who successfully improve patient outcomes and align practices with AACNs six Healthy Work Environment Standards. Units that achieve this three-year, three-level award with gold, silver or bronze designations meet national criteria consistent with the ANCC Magnet Recognition Program, the Malcolm Baldrige National Quality Award and the National Quality Healthcare Award.

I commend the work of our pediatric ICU nurses and team members, said Ellen Angelo, DNP, MSN, R.N., CCRN, CENP, chief nursing officer, Jersey Shore University Medical Center. The gold-level Beacon Award is a welcomed confirmation of the compassionate, exceptional care they provide our youngest patients and community.

AACN President Terry Davis, PhD, R.N., NE-BC, CHTP, FAAN, applauds the exemplary efforts of the Pediatric ICU caregivers at K. Hovnanian Childrens Hospital for working together to meet and exceed the high standards set forth by the Beacon Award for Excellence. These dedicated healthcare professionals join other members of the exceptional community of nurses who set the standard for optimal patient care, Davis said. The Beacon Award for Excellence recognizes caregivers in stellar units whose consistent and systematic approach to evidence-based care optimizes patient outcomes. Units that receive this national recognition serve as role models to others on their journey to excellent patient and family care.

The senior leadership team and I are incredibly proud of our Pediatric ICU team and all of our nurses, said Vito Buccellato, MPA, LNHA, president and chief hospital executive, Jersey Shore University Medical Center. The Pediatric ICU team joins our Cardiac ICU in achieving gold-level Beacon awards this year. Recognitions that are so befitting of a six-time Magnet hospital, recognizing excellence in nursing.

The gold-level Beacon Award for Excellence signifies an effective and systematic approach to policies, procedures and processes that include engagement of staff and key stakeholders; fact-based evaluation strategies for continuous process improvement; and performance measures that meet or exceed relevant benchmarks.

Considering that our Pediatric ICU team cares for our most vulnerable patients, this is a wonderful acknowledgment for the team and highlights their dedication to providing the best care, Harpreet Pall, M.D., MBA, CPE, chair of Pediatrics, K. Hovnanian Childrens Hospital and Hackensack Meridian School of Medicine.

The Pediatric ICU team earned the gold award by meeting the following evidence-based Beacon Award for Excellence criteria:

K. Hovnanians Pediatric ICU is only the second in our state to receive gold-level, one of only 13 Pediatric ICUs in the U.S. to receive gold-level, and add to that, just 13 ICUs in our states 72 acute care hospitals have achieved gold-level Beacon Awards. In light of the rarity of this recognition, the dedication and expertise shown by the Pediatric ICU team is absolutely remarkable and deserves celebration, said Kenneth N. Sable, M.D., MBA, FACEP, regional president, Southern Market, Hackensack Meridian Health.

Four other Hackensack Meridian hospitals intensive care units have received silver awards, including Hackensack University Medical Center, Riverview Medical Center, Old Bridge Medical Center and Raritan Bay Medical Center. Recipients who earn a silver-level award demonstrate an effective approach to policies, procedures and processes that include engagement of staff and key stakeholders; evaluation and improvement strategies; and good performance measures when compared to relevant benchmarks.

For information about K. Hovnanian Childrens Hospital, visit http://www.hackensackmeridianhealth.org/en/locations/k-hovnanian-children-hospital. For a free physician referral, call 844-HMH-WELL.

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American Association of Critical-Care Nurses Recognizes the Pediatric ICU at K. Hovnanian Children's Hospital with ... - Hackensack Meridian Health

Uptick in pediatric mental health ER visits persists through pandemic … – Cornell Chronicle

Mental health crises among children and adolescents requiring emergency department care skyrocketed during the pandemic and have stayed elevated despite a return to normalcy, according to a study by Weill Cornell Medicine and NewYork-Presbyterian investigators.

The study, published Oct. 20 in the journalPediatrics, compared rates of pediatric mental health visits in the emergency departments of five New York City medical centers from a pre-pandemic period through five pandemic waves. Each wave saw elevated rates of youth mental health-related visits compared to before the pandemic.

They found no relationship, however, between pediatric mental health visits and COVID-19 prevalence or how strict mitigation measures were.

The pattern we saw is different than other tragedies because even after the acute COVID-19 emergency was over, we saw that an elevated rate of mental health emergencies persisted, said senior author Dr. Cori Green, vice chair of behavioral health in pediatrics, associate professor of clinical pediatrics at Weill Cornell Medicine and a pediatrician at NewYork-Presbyterian Komansky Childrens Hospital.

Youth mental health was already in a crisis, but (t)he COVID-19 pandemic made the problems more pronounced, noted first author Dr. Deborah Levine, associate professor of clinical emergency medicine, associate professor of clinical pediatrics at Weill Cornell Medicine and a pediatric emergency medicine physician at NewYork-Presbyterian/Weill Cornell Medical Center.

The data analyzed for the study came from the New York-based INSIGHT Clinical Research Network, part of the National Patient-Centered Clinical Research Network (PCORnet).

One of the early epicenters of the COVID-19 pandemic in the United States, New York City faced enormous challenges. As pandemic restrictions shut down many health clinics, schools and other youth services, emergency departments became the only option for those experiencing mental health crises. Consequently, emergency visits for a range of mental health issues increased dramatically:

The researchers also observed that patients who were female, adolescents, Asian, or from communities with more resources were overrepresented compared to what would have been expected pre-pandemic. As this study focuses on New York City, Levine cautioned that the conclusions may not be universal. However, other studies within the United States and around the world have also demonstrated increased rates of mental health emergencies during the pandemic.

Levine and Green hope their analysis helps draw attention to the urgent need for greater pediatric mental health care resources. Post-pandemic families are still struggling to access pediatric mental health care. Many emergency departments must hold young people while they wait for beds to open on psychiatric units, and outpatient settings have limited openings. Community mental health services have a three-to-six-month waitlist, Green added.

The data may also help identify high-risk groups requiring greater attention. For example, Levine and Green found while children from communities with fewer resources did come for emergency mental health visits, there was not as drastic an increase in rates of their visits as expected considering the impact of the pandemic. Youth from more historically marginalized populations may have been less likely to come to the emergency department to access care and silently suffered, said Levine. While some of those patients are now being identified during routine primary care screening, their mental health conditions may have progressed to a more severe stage since they did not seek help earlier.

We are trying to bring this crisis to peoples attention, Levine said. The more we study the problem, the more we may be able to identify solutions, bring them to policymakers and try to get more funding for youth mental health care.

This crisis has reached a point where you cant ignore it, Green added. There has to be action and not everyone is acting as quickly as they need to.

This study was supported by a grant from the RTW Foundation.

Bridget Kuehn is a freelance writer for Weill Cornell Medicine.

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Uptick in pediatric mental health ER visits persists through pandemic ... - Cornell Chronicle

Discussing software that helps track progress after an autism … – Contemporary Pediatrics

Contemporary Pediatrics:

Can you explain what types of software are helping families after their child has been diagnosed with autism?

Lauren Lanzon, MSW, MA, BCBA:

Software and technology have come a long way since I first started in the field about 10 years ago. Back then, paper and pen data collection and graphing through Microsoft Exel was more the standard for Applied Behavior Analysis (ABA). Now, platforms like CentralReach are able to do all of this and more through their system.

This allows us to streamline multiple processes, and now, with CR Care Coordinator, even parent education and training can take place through an online system. Whats so helpful about this is that parents can access specific ABA training and learn how to potentially manage behaviors, teach skills, and navigate daily routines and changes with their children who carry an autism spectrum disorder (ASD) diagnosis.

So, in this sense, technology is not only evolving and helping providers, but is now taking a step further to be a great resource for families as well.

Contemporary Pediatrics:

What questions can parents or caregivers ask their general pediatrician when it comes to this software?

Lanzon:

Receiving a diagnosis of ASD can be a daunting and challenging experience for some families. Then, even once a diagnosis is obtained, getting access to evidence-based and effective treatment like Applied Behavior Analysis can sometimes take a significant amount of time.

Families have to navigate insurance policies, waiting lists, and sometimes years of time between a diagnosis and treatment. In this interim, valuable skill development opportunities are often missed, and families are left on their own to manage sometimes significant challenging behaviors like aggression or self-injurious behaviors.

What parents need to ask, or even better yet, what a pediatrician should share with families, is that tools like CR Care Coordinator are out there and available to help them during this time.

Here at Carolina Behavioral Innovations (CBI), we believe parents are the best advocates for their children and asking questions about online resources and training materials to their pediatricians can help them gain access to this kind of technology to assist them in navigating their daily lives before, during and after ABA treatment.

Contemporary Pediatrics:

How important is it (or how helpful can it be) for families to have a tool like this when it comes to autism?

Lanzon:

Extremely helpful! Applied behavior analysis is a science; it can be technical, confusing, and not always intuitive to a parent or caregiver. However, it is evidence based and when implemented correctly, can be extremely effective in teaching skills and managing challenging behaviors.

At CBI, we really emphasize parent training because empowering and giving our parents skills to teach promotes consistency and generalization of skills. Tools like CR Coordinator help to train parents, at the core, to be able to implement ABA strategies independently. Its lessons can help parents understand the function a challenging behavior may be serving for their child so they can respond to it.

It can help them teach their child how to communicate effectively, through various modalities, to get their wants and needs met. It can help explain to them how to teach their child daily living skills like handwashing or getting ready for school or crossing the street safely.

It can even help them navigate other logistical challenges like understanding their rights as consumers, how to manage stress, or simply to understand the ASD diagnosis.

I would consider all of these to be critical and necessary skills for any family who has a child with an ASD diagnosis.

Contemporary Pediatrics:

Can you explain the market for software like this, or other similar tools? Should the use of these types of tools be discussed with the pediatrician, or what do you recommend to the parents looking into this?

Lanzon:

To be transparent, Im not super familiar with other options that are similar to CR Care Coordinator. I believe there may be perhaps 1 other system out there that may offer this kind of support, but as far as I know, the options for specific parent training and education software are somewhat limited.

While there are countless autism-focused books on parenting along with websites available on the topic, they are often not evidence based, meaning that there is not always research to back up what these resources are directing parents to do.

Trying to sift through all of these resources can often be overwhelming as well, and often parents are pulling from a hundred different sources and spending hours of their time to try and find an answer to their one question.

Parents need to ask pediatricians about evidence-based resources that are cohesive, understandable and individualized to them. Unlike having to read an entire book on ABA or autism which is not individualized to that family, in CR Care Coordinator, parents can jump right to lessons that apply directly to them and their individual challenges and questions.

And those that designed the platform at CentralReach, have already done the painstaking hours of analysis to present material that is grounded in research and proven to be effective, unique to each patient and their family.

Every parent should ask about this and they all deserve access to this kind of training and support.

Contemporary Pediatrics:

Can you talk about the training the software offers? How can the training avoid pauses or setbacks when it comes to care?

Lanzon:

The setup of CR Care Coordinator is fantastic! Its organized into lessons on various topics and each lesson presents the pertinent information for the parent by having them click through a narrated presentation.

After the lesson, it proves the parent with homework to actually apply the material and there is even a Rubric test so the parent can make sure they really understand the material.

Many of the topics are on specific ABA interventions; understanding and identifying functions of behavior, positive versus negative reinforcement, prompting procedures, and so on. CR Care Coordinator even offers topics related to vocational skills, community safety, understanding treatment options, and even data collection.

This can help to create seamless transitions from treatment to daily living for families, ensuring consistency with what occurs during session time and what occurs outside of it. Providers are not in the home 24/7 and parents now have a tool that is with them all the time to help them navigate challenges and questions at all times.

That accessibility also allows for continuity of care for when there may be a pause in care. For example, staffing shortages, insurance changes, sicknesses, and so on can all result in a potential pause in services, but with access to CR Care Coordinator, the resource doesnt just go away when the provider does - it is with them to be that support when a provider may not be able to.

Here at CBI, we really value the individual, not the diagnosis, and I feel that CR Care Coordinator really aligns with this mentality, in that they provide a really unique way for parents to individualize their experience, which is through the integration of values and relationship building with their child.

These lessons walk parents through establishing, integrating, and understanding their values and how those values impact their everyday lives. It can teach them how to connect with their child, how to be present, how to play, how to prioritize and this whole other set of processes that not only focuses on treatment, but the child and family as a whole.

For us here at CBI, we feel that CR Care Coordinator helps share the message to families that they are the biggest part of their childs treatment and that their thoughts, concerns and feelings about treatment decisions and care are valid and extremely valued.

Contemporary Pediatrics:

How can providers navigate patient expectations with a tool like this? Lanzon:

With CR Care Coordinator, as with ABA, or any other therapeutic treatment, there is no quick fix to challenges like maladaptive behaviors or learning communication. Utilizing a platform like this requires work, consistency, and dedication from a family to really see the impacts on their daily lives. Providers need to be transparent about this and let families know that challenges and questions will arise, but that families can focus on progress, not perfection. However, with access to a tool like CR Care Coordinator, families can have gaps filled in for them, where previously there were just voids of information. While waiting for services, during services and after discharge from services, CR Care Coordinator gives families an incredible opportunity to access quality, evidence-based skills and lessons that they can implement to help them, and their child feel empowered, unique and supported, which every family and child deserves to feel!

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Discussing software that helps track progress after an autism ... - Contemporary Pediatrics

New Study In The Journal Of Pediatrics Says Maybe It’s Not Social … – Techdirt

from the correlation-and-causation dept

Weve been covering, at great length, the moral panic around the claims that social media is whats making kids depressed. The problem with this narrative is that theres basically no real evidence to support it. As the American Psychological Association found when it reviewed all the literature, despite many, many dozens of studies done on the impact of social media on kids, no one was able to establish a causal relationship.

As that report noted, the research seemed to show no inherent benefit or harm for most kids. For some, it showed a real benefit (often around kids being able to find like-minded people online to communicate with). For a very small percentage, it appeared to potentially exacerbate existing issues. And those are really the cases that we should be focused on.

But, instead, the narrative that continues to make the rounds is that social media is inherently bad for kids. That leads to various bills around age verification and age gating to keep kids off of social media.

Supporters of these bills will point to charts like this one, regarding teen suicide rates, noting the uptick correlates with the rise of social media.

Of course, they seem to cherry pick the start date of that chart, because if you go back further, you realize that while the uptick is a concern, its still way below what it had been in the 1990s (pre-social media).

In case that embed isnt working, heres an image of it:

Obviously, the increase in suicides is a concern. But, considering that every single study that tries to link it to social media ends up failing to do so, that suggests that there might be some other factor at play here.

A recent study in the Journal of Pediatrics suggests a compelling alternative. Its not social media, but the rise of helicopter parenting, in which kids no longer have spaces to just hang out with each other and be kids. Its titled: Decline in Independent Activity as a Cause of Decline in Childrens Mental Well-being: Summary of the Evidence. If you cant see the full version, theres a preprint version here.

The research summarizes the decline in independent mobility for kids over the last few decades:

Considerable research, mostly in Europe, has focused on childrens independent mobility (CIM), defined as childrens freedom to travel in their neighborhood or city without adult accompaniment. That research has revealed significant declines in CIM, especially between 1970 and 1990, but also some large national differences. For example, surveys regarding the licenses (permissions) parents grant to their elementary school children revealed that in England, license to walk home alone from school dropped from 86% in 1971 to 35% in 1990 and 25% in 2010; and license to use public buses alone dropped from 48% in 1971 to 15% in 1990 to 12% in 2010.11 In another study, comparing CIM in 16 different countries (US not included), conducted from 2010 to 2012, Finland stood out as allowing children the greatest freedom of movement. The authors wrote: At age 7, a majority of Finnish children can already travel to places within walking distance or cycle to places alone; by age 8 a majority can cross main roads, travel home from school and go out after dark alone, by age 9 a majority can cycle on main roads alone, and by age 10 a majority can travel on local buses alone. Although we have found no similar studies of parental permissions for US children, other data indicate that the US is more like the UK concerning childrens independent mobility than like Finland. For example, National Personal Transportation Surveys revealed that only 12.7% walked or biked to school in 2009 compared with 47.7% in 1969.

And then it notes the general decline in mental health as well, which they highlight started long before social media existed:

Perhaps the most compelling and disturbing evidence comes from studies of suicide and suicidal thoughts. Data compiled by the CDC indicate that the rate of suicide among children under age 15 rose 3.5-fold between 1950 and 2005 and by another 2.4-fold between 2005 and 2020. No other age group showed increases nearly this large. By 2019, suicide was the second leading cause of death for children from age 10 through 15, behind only unintentional injury. Moreover, the 2019 YRBS survey revealed that during the previous year 18.8% of US high school students seriously considered attempting suicide, 15.7% made a suicide plan, 8.9% attempted suicide one or more times, and 2.5% made a suicide attempt requiring medical treatment. We are clearly experiencing an epidemic of psychopathology among young people.

But, unlike those who assume correlation is causation with regards to social media, the researchers here admit there needs to be more. And they bring the goods, pointing to multiple studies that suggest a pretty clear causal relationship, rather than just correlation.

Several studies have examined relationships between the amount of time young children have for self-directed activities at home and psychological characteristics predictive of future wellbeing. These have revealed significant positive correlations between amount of self-structured time (largely involving free play) and (a) scores on two different measures of executive functioning; (b) indices of emotional control and social ability; and (c) scores, two years later, on a measure of self-regulation. There is also evidence that risky play, where children deliberately put themselves in moderately frightening situations (such as climbing high into a tree) helps protect against the development of phobias and reduces future anxiety by increasing the persons confidence that they can deal effectively with emergencies.

Studies with adults involving retrospections about their childhood experiences provide another avenue of support for the idea that early independent activity promotes later wellbeing. In one such study, those who reported much free and adventurous play in their elementary school years were assessed as having more social success, higher self-esteem, and better overall psychological and physical health in adulthood than those who reported less such play. In another very similar study, amount of reported free play in childhood correlated positively with measures of social success and goal flexibility (ability to adapt successfully to changes in life conditions) in adulthood. Also relevant here are studies in which adults (usually college students) rated the degree to which their parents were overprotective and overcontrolling (a style that would reduce opportunity for independent activity) and were also assessed for their current levels of anxiety and depression. A systematic review of such studies revealed, overall, positive correlations between the controlling, overprotective parenting style and the measures of anxiety and depression.

They also note that they are not claiming (of course) that this is the sole reason for the declines in mental health. Just that there is strong evidence that it is a key component. They explore a few other options that may contribute, including increased pressure at schools and societal changes. They also consider the impact of social media and digital technologies and note (as we have many times) that there just is no real evidence to support the claims:

Much recent discussion of young peoples mental health has focused on the role of increased use of digital technologies, especially involvement with social media. However, systematic reviews of research into this have provided little support for the contention that either total screen time or time involved with social media is a major cause of, or even correlate of, declining mental health. One systematic review concluded that research on links between digital technology use and teens mental health has generated a mix of often conflicting small positive, negative and null associations (Odgers & Jensen, 2020). Another, a review of reviews concluded that the association between digital technology use, or social media use in particular, and psychological well-being is, on average, negative but very small and noted some evidence, from longitudinal research, that negative correlations may result from declining mental health leading to more social media use rather than the reverse (Orben, 2020)

Indeed, if this theory is true, that the lack of spaces for kids to explore and play and experiment without adult supervision is a leading cause of mental health decline, you could easily see how those who are depressed are more likely to seek out those private spaces, and turn to social media, given the lack of any such spaces they can go to physically.

And, if thats the case, then all of these efforts to ban social media for kids, or to make social media more like Disneyland, could likely end up doing a lot more harm than good by cutting off one of the last remaining places where kids can communicate with their peers without adults watching over their every move. Indeed, the various proposals to give parents more access to what their kids are doing online could worsen the problem as well, taking away yet another independent space for kids.

Over the last few years, theres been a push to bring back more dangerous play for kids, as people have begun to realize that things may have gone too far in the other direction. Perhaps its time we realize that social media fits into that category as well.

Filed Under: age appropriate design, age verification, depression, independent spaces, mental health, social media, studies, suicide, teens

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