Our guest for this episode is Jessica Malmberg, PhD, the Clinical Director of Outpatient Services at the Pediatric Mental Health Institute and assistant professor of child psychiatry at CU School of Medicine.

Dr. Malmberg talks us through a common behavioral issues of school-aged children – school refusal – and provides insights, advice and tools to help prevent, manage and understand this behavior.

In this episode:

• Outlining and identifying the underlying symptoms and signs associated with a child refusing to attend school
• How primary care providers (PCPs) can assist parents who are experiencing guilt
• Identifying the four most common reasons that children refuse to go to school
• Exploring the effects of social media on children's behavior when it comes to school refusal
• How a PCP should approach treatment of school refusal
• The recommended frequency of follow-up care for kids who are refusing to go to school
• The importance of connecting parents to community-based resources
• Preventative practices parents can set up in the home to prevent this behavioral issue
• What an excellent prognosis looks like for children experiencing school refusal
• When it's time to refer to a mental health professional
• PCPs in the Denver Metro Area can refer patients to the Children's Hospital Colorado Outpatient Psychiatry Clinic or to a local community mental health center

Resources for dealing with school refusal:

• School Refusal: Information for Educators (.pdf) from the National Association for School Psychologists
• School Refusal in Children and Adolescents from American Family Physician
• The Functional Assessment of School Refusal Behavior
• Effective Child Therapy
• Division 53 of the Society of Clinical Child & Adolescent Psychology website
• School Refusal from the American Academy of Child & Adolescent Psychiatry

Welcome back Charting Pediatrics listeners! We are so excited to announce the third season of the podcast which will release on August 6th. With the success of Season 2, going from under 500 to almost 20,000 listeners per month, we are expectant to see what Season 3 will have in store. In this new season, we will explore case studies in the nuanced art of practicing pediatric medicine, covering topics from innovative care approaches to bread-and-butter diagnoses that you deal with on a daily basis. The podcast is also going on the road again, where we will be broadcasting live from the American Academy of Pediatrics National Conference and Exhibition in New Orleans from October 25th through to the 28th of this year. On behalf of the host team, thank you for your faithful support in listening and engaging with us and also sharing the content with your colleagues. Be sure to join us weekly for yet another great season!

In today's episode we dive in to the topic of toxicity and the most common overdoses in pediatric medicine. Our guest is Sam Wang, MD, returning from earlier this season when we covered the topic of Marijuana as Medicine (S2:E14).

Dr. Wang is a Pediatric Emergency Medicine Physician and Medical Toxicologist at Children's Hospital Colorado and the University of Colorado School of Medicine.

Let us know what you thought of today's episode: Tweet Dr. Brent (@AlisonBrentMD) or write to us, [email protected].

The practice of pediatric pain management has developed significantly in the last decade with the use and validation of pain assessment tools specific to pediatric patients, yielding evidence-based pain management guidelines in children of all ages.

Still, pharmacological intervention options coupled with practicing safe prescribing can be overwhelming in the primary care setting. In today's episode we are joined by Tom Majcher, DO, to discuss a practical approach to outpatient pain management in pediatrics and the prevalence of conditions associated with acute and chronic pain.

Dr. Majcher is Chair of Anesthesiology at Children's Hospital Colorado and Professor of Anesthesiology at the University of Colorado School of Medicine.

A real public health problem has snuck up on us as pediatricians - vaping and e-cigarettes use. On today's episode, we will unpack the facts about e-cigarettes and vaping, provide you with practical tools to counsel your patients and families and talk about upcoming advocacy and policy work pertaining to e-cigarettes. Our guests today are Jennifer Woods, MD, Medical Director of the Adolescent Medicine Clinic at Children's Hospital Colorado and associate professor of pediatrics at the University of Colorado School of Medicine; and Heather Hoch, MD pediatric pulmonologist at Children's Hospital Colorado and assistant professor the CU School of Medicine.

From today's episode:

• The 2018 NIH Monitoring the Future Survey Results were released last month. The survey found that 37% of 12th graders and 18% of 8th graders have vaped in the last year and the number of kids who used vaping products in the last month jumped from 11 to 21% in 12th graders and from 9 to 16% in 10th graders — those changes are the biggest jumps in adolescent substance use that has been seen in the 4 decades of conducting the Monitoring the Future Survey.
• From the AAP: 5 Facts to talk to Teens about Vaping
• The FDA held a public hearing on January 18, 2019 to discuss efforts to eliminate youth e-cigarette use, with a focus on the potential role of drug therapies to support cessation and the issues impacting the development of such therapies. If this is a topic you are passionate about, we encourage our listeners to visit the FDA website to submit a public comment, those public comment submissions will be available through February 1, 2019 https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm)
• Pediatricians Push for Laws to Prevent Teen Vaping
• Colorado Bill Introduced to Combat Skyrocketing Youth E-Cigarette Use, Clean Indoor Air Act, House Bill 19-1076

Feedback on this episode or suggestions for a future topic? Write to us at [email protected] - we love hearing from our listeners!

In this episode, we discuss abnormal pediatric head growth, shape and treatment options with Todd Hankinson, MD. Dr. Hankinson is a Pediatric Neurosurgeon at Children's Hospital Colorado and Associate Professor of Neurosurgery at the University of Colorado School of Medicine.

Today's guests are Dr. Lori Prok and Pediatric Nurse Practitioner, Julieann Tibbetts, here to discuss the most common clinical presentations, causes, and treatment of Atopic Eczema. Dr. Prok is a Pediatric Dermatologist at Children's Colorado and Associate Professor of Dermatology at the University of Colorado School of Medicine. Julieann is a Pediatric Nurse Practitioner in the Dermatology Department at Children's Colorado and Senior Instructor of Dermatology at the University of Colorado School of Medicine.

Today's guests are Dr. Jens Goebel and Dr. Robert Fuhlbrigge, here to discuss Henoch-Schönlein purpura (HSP). Dr. Goebel is the Section Head of Nephrology at Children's Colorado and Professor of Pediatrics at the University of Colorado School of Medicine. Dr. Fuhlbrigge is Section Head of Rheumatology at Children's Colorado and Professor of Pediatrics also at the University of Colorado School of Medicine.

In today's episode, we're examining a case that started in a primary care pediatrician's office and ended in the Children's Hospital Colorado Aerodigestive Program.

Joining us are the three physicians involved in the patient's care examine: Larissa Applegate, MD, a pediatrician at Pediatrics West in Wheat Ridge, Colorado; RyanCaltagirone, MD, a pediatricemergency room physician at Children's Colorado; and Sven Streubel, MD, an otolaryngologist with Children's Colorado.

In this episode:

• Our three guests examine their roles in the patient's care and share their key takeaways to inform other medical professionals
• The origins of the case and how the patient, baby Rachel, first presented in the hospital
• Steps taken once Rachel's respiratory struggles were evident and next steps to get her to the Emergency Department
• Importance of clear communication between departments and with patient families in complex, multidisciplinary cases
• Approaching a patient who presents with laryngomalacia from an ENT perspective
• Using a bedside scope to determine the severity of the laryngomalacia
• The various elements of Rachel's multidisciplinary care, including: admission procedure, observation of feedings, continued oxygen support and plan for next steps
• Most common medical treatment plan for patients with laryngomalacia
• Designing a long-term management plan for a child with laryngomalacia that supports the patient as well as their family
• Accounting for comorbidities that come along with laryngomalacia
• Update from patient and key takeaways from the case

Treating STDs in adolescent patients can be a challenge for today's busy pediatrician. Eliza Buyers, MD of the Pediatric and Adolescent Gynecology team at Children's Colorado returns to our pediatric podcast to provide practical tools for preventing and treating sexually transmitted infections in teens.

In this episode:

• Why STD rates are higher in adolescents and young adults
• How PCPs can address teen reproductive health challenges
• Why we need to consider age as the primary risk factor for STDs
• Examining the issue of STD rates as a health disparity
• Importance of conducting universal screening in sexually active adolescents
• Expedited partner therapy (EPT) and its importance
• Recommended STD and HIV screening periods for different populations
• Screening guidelines for STD examinations in the absence of symptoms.
• Approaching one-to-one time with teen patients
• Importance of promoting condom use to prevent STDs in teens
• When to consider screening for less common STDs
• Why it's crucial to know confidential screening clinics you can send your patients

STD management resources:

• The CDC STD treatment guidelines mobile app
• CDC STD treatment guidelines for special populations