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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

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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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 

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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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

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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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/

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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 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

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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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.

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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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

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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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

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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Summer sports physical season is here! Before you sign that next pre-participation physical, are you asking the questions that could help prevent burnout, overuse injuries, and early sports dropout? 

In this timely replay, pediatric sports medicine expert Dr. Joel Brenner shares practical, evidence-based strategies to help young athletes stay healthy—and stay in the game. Learn why early sports specialization may do more harm than good, how much rest young athletes really need, and the two simple questions every pediatric clinician should ask during every sports physical. 

Whether you're counseling a recreational athlete or the next aspiring Olympian, this episode will give you practical pearls you can use in clinic today. He shares practical strategies to  reduce burnout and over use injuries in our young athletes. Most importantly, we're going to find out how early is too early for kids to specialize in one sport. 

Our Guest:  Dr. Joel Brenner is the co-author of the American Academy of Pediatrics' 2024 Clinical Report on overuse injuries over-training and burnout in young athletes. Dr. Brenner is a pediatric sports medicine physician and Director of the Sports Medicine, Sports Concussion, and Dance Medicine programs at Children's Hospital of the King's daughters in Norfolk, Virginia. 

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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

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Would you be surprised to learn that there has been a MAJOR INCREASE in child mental health visits in primary care?  A recent study published in JAMA Network Open found clinically significant increases in child mental health visits over a 10-year period.  While ADHD remained the most common MH concern, ANXIETY visits rose by 300% from 2014-2023. 

We know that it can be challenging and sometimes nearly impossible to connect these children and families with specialty child mental health care.  AND we know that families often PREFER to receive care from their trusted pediatric clinician in the comfort of their medical home.  

To support YOU and other pediatric clinicians, we are excited to announce the launch of our new Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians. 

Available online at:

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

This on-demand, AUDIO-BASED course features 5 mini-modules on:

• ADHD Evaluation Essentials
• ADHD Differential Diagnosis: Recognizing Comorbidities and Look-Alikes (Anxiety, Traumatic Stress, mood disorders like BIPOLAR)
• ADHD TREATMENT: Stepwise approach to treatment with stimulants, managing side effects, addressing common parental concerns
• ADHD with ANXIETY TREATMENT: Which to treat first? Algorithmic approach to choosing medications, including stimulants and non-stimulant medications (alpha-agonists, norepinephrine reuptake inhibitors)
• Advanced ADHD Treatment: What to do when meds stop working

In addition, we have downloadable clinical tools, patient handouts, clinical pearls that you can use the next day in your office! We hope you check out the course and share it with a friend!

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

Study: Pediatric Primary Care Visits with Mental Health Needs by Dr. Gallagher KM et al available online at: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2849123

Check out our website PsychEd4Peds.com for more resources!
Follow us on Instagram @psyched4peds

Check out our NEW CME Audio-based, 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