ADHD, Anxiety & More: Child Mental Health for Pediatrics

Send us Fan Mail

Where are YOU on your pediatric mental health journey?

If you’ve ever felt nervous when a child’s mental health screen comes back positive, frustrated when straightforward ADHD treatment suddenly becomes complicated, or overwhelmed because you’ve become the “mental health person” in your practice—this episode is for you.

In this episode, Dr. Elise Fallucco introduces the 4 phases of the Pediatric Mental Health Champion Journey: 

Phase 1: Running Scared → 

Phase 2: Basic Treatment Frustration → 

Phase 3: Mental Health Overload → 

Phase 4: Champion Mode. 

She walks through the signs and challenges of each phase and, most importantly, the practical steps you can take to move forward—from building confidence with ADHD evaluation and treatment, to managing anxiety and more complex comorbidities, to creating systems, boundaries, and workflows that prevent burnout.

The goal isn’t to become a child psychiatrist. It’s to become a confident, competent pediatric clinician who can recognize, evaluate, and treat the mental health problems you’re equipped to manage—and know where your boundaries are. Listen to discover which phase you’re in and your next step toward becoming a pediatric mental health champion.

00:00 Pediatric Champion Journey

01:34 Phase One Running Scared

04:25 Phase One Action Steps

07:13 Phase Two Frustration

08:46 Phase Two Level Up

12:20 Systems Templates Boundaries

16:19 Phase Four Champion Mode

17:18 Recap and Next Steps

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

Episode 85 of ADHD, Anxiety & More is for pediatric clinicians who want to know when to prescribe medication for children and teens with anxiety. 

In this episode, you will learn about:

• Which treatment (therapy, medication, or combination of both) offers the highest response for child and teen anxiety 
• Why it is important to treat anxiety to remission 
• The 3 things to do when referring to CBT

She explains why remission matters, citing follow-up findings that remission is associated with better long-term outcomes including lower suicidal behavior and substance use problems. 

She also advises clinicians to ensure therapy is true CBT, track symptoms over time with tools like the SCARED, and revisit treatment within 4–6 week intervals if improvement is not robust.

00:00 Anxiety Treatment Choices

03:01 CBT vs SSRI vs Both

03:35 Evidence From CAMS

04:26 Why Remission Matters

07:43 Option One CBT Done Right

12:20 Option Two SSRI When Therapy Is Hard

14:07 Option Three Combination Gold Standard

15:49 Take Home Points and Wrap Up

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

Anxiety is a normal human emotion.  So, how do you know when it’s developmentally typical and when it has crossed the line into something that needs treatment? 

In this episode, Dr. Fallucco walks through a practical approach pediatric clinicians can use to recognize clinically significant anxiety that requires treatment.  

We talk about Screening, Taking a focused history of Anxiety, and determining whether the anxiety needs treatment.

In this episode, you’ll learn:

• Who to screen for anxiety—and when to keep anxiety on your radar during ADHD, depression, or unexplained physical/behavioral evaluations
• Why the SCARED-5 is a practical anxiety screening tool for pediatric primary care
• Simple questions you can ask after a positive screen to better understand what a child is worried about
• The four questions that can help you distinguish developmentally typical anxiety from clinically significant anxiety: Is it proportional? Is it developmentally expected? Is it causing distress? Is it impairing the child or family?
• How anxiety may look different in younger versus older children, including behavioral symptoms, physical complaints, irritability, and avoidance
• When to consider treatment—and why CBT is an important first-line intervention for many children with anxiety

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

Join us for the latest Mystery Case: A teen with ADHD + Epilepsy

Would you prescribe a stimulant?

How do you treat ADHD in people who have epilepsy?

In this episode, we unpack:
• The surprising relationship between ADHD and epilepsy
• Why ADHD is easy to miss in kids with epilepsy
• Where the concern about stimulants and seizures came from
• What newer research tells us about stimulant treatment in kids with epilepsy
• How I would approach treatment—and monitoring—in people with epilepsy

00:00 Welcome and Mystery Case

00:30 ADHD and Epilepsy Link

01:30 Bidirectional Risk Explained

02:58 Seizure History Details

04:00 Treatment Options Debate

06:03 Stimulants and Seizure Evidence

09:14 Best Answer and Monitoring Plan

10:28 Wrap Up and Thanks

Studies referenced in the episode:

Auvin S et al. Systematic review of the screening, diagnosis, and management of ADHD in children with epilepsy. Consensus paper of the Task Force on Comorbidities of the ILAE Pediatric Commission. Epilepsia. 2018

Brikell I et al. Medication treatment for ADHD and the risk of acute seizures in individuals with epilepsy. Epilepsia. 2019

Cochrane Database of Systematic Reviews. Stimulant and non-stimulant drug-therapy for people with ADHD and Epilepsy 2022.

Kwon CS et al. Psychiatric comorbidities in persons with epilepsy compared with persons without epilepsy. JAMA Neurology. 2025

Liu X et al. Stimulant do not increase the risk of seizure-related hospitalization in children with epilepsy. J Child Adol Psychopharm. 2018.

Wang S et al. Comorbidity of epilepsy and ADHD: a Systematic review and meta-analysis. J Neurology. 2023 

Wiggs KK, Chang Z, Quinn PD, Hur K, Gibbons R, Dunn D, Brikell I, Larsson H, D'Onofrio BM. Attention-deficit/hyperactivity disorder medication and seizures. Neurology. 2018 

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

What ELSE helps ADHD symptoms (in addition to meds?) What does the evidence say about non-medication treatment options for ADHD? We talk about...

• behavioral therapy 
•  exercise - which is an under-prescribed intervention, 
  •  Think 30 minutes of moderate-to-vigorous activity 3 times weekly for 8–12 weeks
• What about Nutrition?
  • omega-3 fatty acids may help with emotional lability in ADHD 
  •  broad-spectrum micronutrients??

00:00  ADHD Treatmetn BEYOND MEDS Overview

02:16 Therapy Evidence Basics

03:47 Medication Hesitancy Case

04:53 Exercise As Treatment

06:34 How Exercise Works

08:14 Exercise Prescription Tips

08:59 Omega 3 For Mood

11:08 Micronutrients Caution

13:22 Recap And Next Steps

14:09 Wrap Up And Subscribe

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

How can we support children and families who struggle with chronic abdominal pain?  Dr. Fallucco shares an episode from The Pediatrician Next Door, an excellent podcast hosted by pediatrician Dr. Wendy Hunter.  Dr. Hunter talks with Dr. Ali Navidi, a psychologist who specializes in disorders of gut-brain interaction. 

• Dr. Navidi explains why some kids experience abdominal pain, nausea, diarrhea in a way that makes sense to families 
• Dr. Navidi talks about the role of psychological treatments—including clinical hypnosis—in helping kids retrain these brain-gut pathways. 

For more helpful episodes for parents and families about 

The Pediatrician Next Door with Dr. Wendy Hunter: 

"I answer the questions you forgot or were too embarrassed to ask your doctor. I mix the science of medicine with the reality of parenting to give you satisfying answers to your parenting questions!"

Website: https://www.pediatriciannextdoorpodcast.com/

Dr. Ali Navidi, PsyD from GI Psychology

https://www.gipsychology.com/

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

 Dr. Elise Fallucco continues this series on non-stimulant medication for ADHD and shares practical tips about using Norepinephrine Reuptake Inhibitors (NRIs): viloxazine ER (Qelbree) and atomoxetine (Strattera) for pediatric clinicians.

Who can benefit from NRIs? What are the potential benefits, drawbacks, and side effects? 

Working through the case of a 12-year-old girl with inattentive ADHD and anxiety  who cannot tolerate methylphenidate or amphetamine , she explains why she generally prefers Viloxazine ER (Qelbree)

• FDA approval for ADHD in children ages 6+
• Quicker onset (often within 1–2 weeks vs 4–6 weeks for atomoxetine)
• Better tolerability
• More straightforward dosing 
• Unlike Atomoxetine (Strattera), you can dose this medication without worrying about significant genetic variability in drug metabolism

00:00 NRIs for ADHD

00:38 When to Use

01:07 Case Introduction

02:51 Stimulant Trials Fail

04:09 Considering NRIs

04:30 Why Qelbree First

05:51 Atomoxetine Caveats

07:23 Treating Sophie

08:45 Clinical Pearls Recap

09:50 Wrap Up and CME

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

While stimulant meds are first-line treatment for ADHD, they do NOT work for everyone... or sometimes they only PARTIALLY help.  So, what can you do in these situations?

• When is the right time to try a non-stimulant medication like Guanfacine and Clonidine (a.k.a - alpha-agonists?)? 
• In which clinical situations can these alpha-agonists be helpful?  
• How do you know when to switch from one stimulant to another stimulant
• When should you try adding on or switching to an alpha-agonist?

In this episode, Dr. Elise Fallucco talks about guanfacine XR (Intuniv) and clonidine (Kapvay/Onyda XR)—and how to decide whether to switch stimulants or augment them. Using an 11-year-old with improved attention on a stimulant but persistent impulsivity/oppositionality and dose-limiting side effects, she explains that switching is best when there’s little benefit or unacceptable side effects, while augmentation makes sense with partial response. She reviews key scenarios for alpha agonists: residual impulsivity/hyperactivity/behavior dysregulation, ADHD with tics, possible adjunct use in ADHD with anxiety (not primary anxiety treatment), and late-day rebound near bedtime. She describes “peanut butter and jelly” synergy with stimulants, monitoring vitals, dosing/titration, sedation differences (more with clonidine), and the need to taper to avoid rebound hypertension.

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

It’s back-to-school season—and that often means a surge of ADHD concerns as academic demands ramp up, especially around key school transitions like 3rd, 6th, and 9th grade. 

In this episode of ADHD, Anxiety, and More, Dr. Elise Fallucco  shares a practical, confidence-building approach to picking stimulant treatment for children and teens, answering questions like:

Which ADHD medication should I start first?

When should you use methylphenidate medications like Ritalin or Concerta?

When should you use amphetamine-salt medications like Adderall or Vyvanse?

How does family history help direct treatment choices?

When does it make sense to try a d-methylphenidate medication like Focalin?

 00:00 Podcast Rebrand Update

00:30 Back to School ADHD Surge

01:09 ADHD Evaluation Basics

02:36 Case Introduction Third Grader

03:04 Rule of Three Transitions

04:09 Parents Nervous About Meds

04:45 Family History Medication Clues

06:06 Step One Start Methylphenidate

06:33 Short Acting First Rationale

08:05 When to Use Long Acting

08:30 Long Acting Coverage Limits

09:27 Step Two Try Amphetamines

10:59 Step Three Consider Focalin

11:52 Wrap Up Simple Stimulant Toolkit

12:43 Bonus Algorithm and Course

14:00 Closing and Next Week Preview

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

Send us Fan Mail

What can we learn from an Elite Coach about how to help young athletes THRIVE through sports? Join us as we chat with Coach Peter Verhoef, head coach and aquatics director at the Bolles School Swimming Program and former Olympic Trials finalist (2x).

We discuss:

•  Why do so many kids quit organized sports by age 13?
• How can we prevent burnout?
• When are teens MOST vulnerable to burnout? 
• How much time off/rest is reasonable? Does it very by sport?

03:36 Benefits of Youth sports

06:04 Preventing Burnout in Youth Sports

06:32 Engagement in Youth Sports and Burnout

06:44 Promoting Individual Achievement

08:35 Managing Physical and emotional exhaustion

09:13 Driver's License BURNOUT

12:00 Tips for Parents to help Preventing Burnout

16:21 TIME OFF

20:58 Multi-Sport Athelte vs. Specialization

Sign-up for our NEWSLETTER: https://child-mental-health-for-pediatric-clinicians.kit.com/3bf4aeedfc

WEBSITE: PsychEd4Peds.com for more resources!

SOCIAL: Instagram or threads @psyched4peds

On-demand CME Course online at:

Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1