🎙 Episode 19: Building Stability — Supporting Students Through Transitions and Stress

Guests:

• Nicole Beale, M.Ed., High School Counselor

  
  

• Dr. Gretchen Hoyle, MD, Pediatrician
  Host: Matt Butterman
  Duration: ~50 minutes

Overview:

 When students face instability at home, frequent school moves, or life transitions, the impact often shows up in the classroom. How can schools, families, and healthcare providers work together to meet both academic and emotional needs?

In this episode, host Matt Butterman talks with counselor Nicole Beale and pediatrician Dr. Gretchen Hoyle about how instability affects teens — and how stability, connection, and communication can make all the difference. Together, they unpack the challenges of absenteeism, home life stress, and the overwhelming demands families face, while offering practical, compassionate solutions that schools and parents can implement right away.

Topics Covered:

• Why frequent school moves often correlate with academic struggles

  
  

• How schools identify at-risk students early — and the role of trusted adult connections

  
  

• Meeting basic needs: food security, transportation, and access to resources

  
  

• How pediatricians support students through collaborative care and family education

  
  

• The importance of helping parents and grandparents navigate new school technology systems (like Infinite Campus)

  
  

• Healthy communication between schools, families, and healthcare providers — and how to avoid frustration cycles

  
  

Why remembering that school is about more than academics (socialization, development, and meeting basic needs) matters

Key Quotes:

“The biggest difference we can make is removing barriers and connecting students to trusted adults.” – Nicole Beale

 “Healthy communication means asking questions before anger takes over — and giving each other grace.” – Nicole Beale

 “We have to remember: for some students, school is not just about academics. It’s also where they get fed, clothed, and feel safe.” – Dr. Gretchen Hoyle

Resources & Links:

• Nimble Youth Podcast Episodes & Show Notes
  
  
• Salisbury Pediatrics Collaborative Care Program (local model mentioned in discussion)

  
  

• Learn more about Maslow’s Hierarchy of Needs as referenced in the episode

  
  

📢 Share This Episode:
 Know a parent, educator, or healthcare provider working with teens? Share this important conversation with them.

🔗 Visit: www.nimbleyouthpodcast.com for full show notes and past episodes.

🎙 Episode 18: Always More — Anxiety in High-Achieving Teens

Guest: Nicole Beale, M.Ed., High School Counselor
Host: Matt Butterman
Duration: ~45 minutes

Overview:
Today’s high school students are taking more AP courses, joining more extracurriculars, and aiming higher than ever — but it’s taking a toll. In this episode, we explore the hidden cost of high achievement and the anxiety that often lurks behind perfect GPAs and packed résumés.

Matt Butterman speaks with veteran public high school counselor Nicole Beale about the growing mental health strain on ambitious teens and the pressures they face from school systems, colleges, and well-intentioned parents. Nicole shares compassionate, real-world insights from her 25 years supporting students and her own perspective as a parent of a high-achieving teen.

Topics Covered:

• The culture of perfectionism and how it drives academic overload
• Why AP course loads have skyrocketed — and what’s fueling the trend
• The unintended consequences of class rank, college admissions metrics, and school report cards
• How snowplow parenting and peer comparison amplify anxiety
• Signs that anxiety is becoming unhealthy — and when it’s time to intervene
• Practical strategies for families: setting limits, quitting wisely, and restoring balance
• What gives Nicole hope: increasing mental health support in schools, more compassionate teaching practices, and resilient teens finding their own paths

Key Quotes:

Resources & Links:

• The Race to Nowhere (Documentary referenced in the episode)
• More on AP and college admission trends: collegeboard.org
• For mental health support: Speak with your school counselor, pediatrician, or a licensed therapist

📢 Share This Episode:
Know a student, parent, or educator who needs to hear this? Share the episode or leave us a review to help others find Nimble Youth.

🔗 Visit: www.nimbleyouthpodcast.com for full show notes and past episodes.

🎙️ Episode 17: “When Tantrums Go Too Far: Understanding Disruptive Mood Dysregulation Disorder (DMDD)”
 Host: Matt Butterman
Guest: Dr. Gretchen Hoyle, MD, Pediatrician
Duration: ~35 minutes

Episode Summary:
 Chronic irritability, frequent temper outbursts, and emotional volatility—these behaviors may go far beyond typical childhood tantrums. In this episode, host Matt Butterman is joined by pediatrician Dr. Gretchen Hoyle to unpack Disruptive Mood Dysregulation Disorder (DMDD), a relatively new but critical diagnosis that helps explain persistent mood and behavior challenges in some children and adolescents.

Dr. Hoyle explains what sets DMDD apart from ordinary moodiness and how it's different from disorders like bipolar disorder. She explores potential causes, including genetics, trauma, and neurodevelopmental factors, and discusses evidence-based treatment approaches ranging from cognitive behavioral therapy (CBT) and parent management training to medications such as atypical antipsychotics in severe cases. The episode also emphasizes the importance of early diagnosis, school accommodations (like 504 plans), and the effectiveness of collaborative care models in managing this complex disorder.

Key Topics Covered:

• What defines DMDD and how it differs from bipolar disorder

  
  

• Risk factors, including trauma, stress, and neurological dysregulation

  
  

• Why emotional regulation is at the core of DMDD

  
  

• Treatment strategies: CBT, parent training, medication, and trauma-informed care

  
  

• How schools and families can collaborate through 504 plans and support systems

  
  

• The role of pediatricians and behavioral health teams in identifying and managing DMDD

Three Takeaway Facts:

1. DMDD affects approximately 2–5% of children and adolescents, with symptoms typically appearing before age 10.

   
   

2. Unlike bipolar disorder, DMDD is chronic and non-episodic, characterized by persistent irritability and frequent behavioral outbursts.

   
   

3. With early intervention and a multi-pronged approach, many children with DMDD experience significant improvements over time.

   
   

Resources & Links:

• NIMH: Disruptive Mood Dysregulation Disorder Overview

  
  

• AACAP: Facts for Families on DMDD

  
  

• Visit our website for full episode archives and additional resources: www.nimbleyouthpodcast.com

  
  

  
  

About Our Guest:
 Dr. Gretchen Hoyle is a board-certified pediatrician with over 25 years of clinical experience, specializing in pediatric mental and behavioral health. She is a regular guest on Nimble Youth and a passionate advocate for early intervention and integrated care.

This episode explores how to help kids with anxiety and OCD by changing not their behavior—but the parent’s. Our conversation centers around Dr. Eli Lebowitz's book, Breaking Free of Child Anxiety and OCD.

In this episode of Nimble Youth, host Matt Butterman is joined by pediatrician Dr. Gretchen Hoyle for an in-depth look at Pediatric Obsessive-Compulsive Disorder (OCD)—a condition that’s often misunderstood and underdiagnosed in children and adolescents.

Together, they explore the early signs of OCD, common misconceptions, and the deeply disruptive impact OCD can have on school performance, social life, sleep, and family dynamics. Dr. Hoyle also walks through the screening tools clinicians use and outlines a range of treatment strategies—including cognitive behavioral therapy (CBT), exposure and response prevention (ERP), SSRIs, and emerging therapies like digital platforms and transcranial magnetic stimulation (TMS).

🎙️ Episode 14 – Screens, Scores & Students: How Technology Is Transforming the Classroom

Guest: Wyatt Hoyle, High School Math Teacher
Host: Matt Butterman
Duration: ~40 minutes
Listen at: www.nimbleyouthpodcast.com

📘 Episode Summary

In this insightful conversation, host Matt Butterman sits down with Wyatt Hoyle, a high school math teacher in rural Colorado, to explore the promises and pitfalls of technology in the modern classroom. From learning platforms like Google Classroom and Canvas to AI-assisted testing and the growing challenge of cell phone distraction, we take a ground-level look at how digital tools are reshaping education—sometimes for better, sometimes not.

Hoyle shares firsthand experiences with how students engage with tech, how teachers and administrators monitor academic progress, and the surprising ways students—and sometimes parents—struggle to navigate today’s online learning environments.

🧠 What You’ll Learn

• 📱 The Role of EdTech Platforms: How tools like PowerSchool, Infinite Campus, Canvas, and Google Classroom each serve specific—but separate—functions in managing grades, assignments, and communication.

  
  

• 🧾 Digital Transparency vs. Digital Confusion: How tech makes learning progress visible to parents but can also lead to misunderstandings (and sometimes exploitation) when tools are misused or misunderstood.

  
  

• 📵 Cell Phones in the Classroom: Why Wyatt uses a cell phone locker system, how students react, and why even some parents push back.

  
  

• 🤖 AI in Education: When AI tools like ChatGPT and QuestionAI help… and when they hurt. Plus, a look at adaptive testing technologies like MAP testing.

  
  

• 👨‍👩‍👧‍👦 Bridging the Digital Gap: How schools can better support parents—especially older or less tech-savvy caregivers—in understanding these platforms.

  
  

• 🧑‍🏫 The Teacher’s Take: Why AI can never replace the human presence in the classroom—and why face-to-face meetings still matter.

  
  

🛠️ Resources Mentioned

• PowerSchool & Infinite Campus – Used for attendance and official grades

  
  

• Canvas & Google Classroom – Used for assignments, daily communication, and real-time progress

  
  

• MAP Testing – Adaptive standardized testing that adjusts based on student responses

  
  

• AI Tools (e.g., ChatGPT, QuestionAI) – Used for both support and, unfortunately, academic dishonesty

  
  🔗 For quick-reference guides to these platforms and parent tutorials, visit the show notes at www.nimbleyouthpodcast.com
  
  

💬 Quotable Moments

“If your kid is missing assignments, you can probably find them online—but you need to know where to look.” — Wyatt Hoyle

“Even as a teacher, my students often know more about gaming the system than I do.” — Wyatt Hoyle

“Everyone—parents, schools, teachers—wants the same thing: student success.” — Wyatt Hoyle

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 🌐 www.nimbleyouthpodcast.com

🎧 Episode 13 – The Youth Mental Health Crisis: A Therapist’s Perspective

Host: Matt Butterman
Guest: Michael Hayes, LCMHC – Licensed Clinical Mental Health Counselor, Pathways Counseling, Winston-Salem, NC
Duration: ~40 minutes

In this powerful and timely episode of The Nimble Youth Podcast, host Matt Butterman sits down with Michael Hayes, a licensed clinical mental health counselor who works directly with teens and young adults navigating the growing mental health challenges of our time.

From skyrocketing anxiety and depression to digital overload and disconnection, Michael brings a therapist’s front-line insight into the emotional and developmental storm many young people are weathering. He also offers hope — not just through clinical wisdom, but through practical strategies for parents, teachers, and caregivers who want to support the next generation with clarity and compassion.

Together, Matt and Michael explore:

• 📈 How the youth mental health crisis has evolved since the rise of smartphones and through the COVID era

  
  

• 😟 The link between untreated anxiety, depression, burnout, and self-diagnosis

  
  

• 📱 The impact of technology, social media, and information overload on brain development and identity

  
  

• ⚠️ Mixed messages from authority figures, and how they fuel confusion and mistrust among teens

  
  

• 🧭 Why too many choices and a shifting job landscape can paralyze rather than empower young people

  
  

• 🧠 How screen addiction mimics substance withdrawal — and how to set healthy boundaries early

  
  

• ❤️ The importance of modeling resilience, curiosity, and boundaries as a parent or mentor

  
  

• ✨ Why embodied, real-world experiences — like volunteering — are essential to healing and growth

  
  

• 🙌 Glimmers of hope in a generation that, despite the noise, still shows empathy, engagement, and purpose

Key Quote:
 "You cannot afford to be intimidated by your children or by the fact that they have a perspective that differs from yours. They are watching closely — and your example matters more than you know." — Michael Hayes

🔗 Resources & Mentions:

• Together: The Healing Power of Human Connection in a Sometimes Lonely World by Dr. Vivek Murthy

  
  

• Arthur C. Brooks, Professor at Harvard and author on happiness and purpose

  
  

• Fred Rogers’ quote: “Look for the helpers.”

  
  

• Pathways Counseling, Winston-Salem, NC
  
  

🎓 Next Episode:
 We’ll speak with an experienced educator about the use of technology in the classroom — both the drawbacks and the exciting possibilities of new tools in shaping how kids learn. Stay tuned!

📬 Subscribe and share:
 Visit www.nimbleyouthpodcast.com for more episodes and detailed show notes. If you find this episode helpful, please share it with someone who cares about youth mental health.

🎧 Episode 12: Spotting the Signs – A Pediatrician’s Frontline Role in Eating Disorders

Guest: Dr. Gretchen Hoyle, MD, Pediatrician
Host: Matt Butterman
Duration: 30–40 minutes

Eating disorders often begin quietly—but their impact is serious and, in some cases, life-threatening. In this episode, host Matt Butterman speaks with returning guest Dr. Gretchen Hoyle about how pediatricians play a critical role in identifying eating disorders early and helping families take action before things become more severe.

While Dr. Hoyle is not an eating disorder specialist, her position on the front lines of pediatric care means she’s often the first professional to spot concerning patterns and refer families to appropriate treatment.

In this episode, we cover:

• 🚩 How eating disorders present in a primary care setting

  
  

• 🧠 The importance of early detection and trust in the pediatrician-family relationship

  
  

• ⚠️ Medical red flags that may signal the need for hospitalization (low heart rate, blood pressure, body temp, weight %iles, lab values, etc.)

  
  

• 🏥 What “refeeding syndrome” is and why it can be life-threatening

  
  

• 🏡 The difference between residential and outpatient care—and how treatment decisions are made

  
  

• 👨‍👩‍👧‍👦 The role of the care team: doctor, therapist, and nutritionist

  
  

• 💊 Medications sometimes used in treatment (SSRIs, hydroxyzine)

  
  

• 📈 What recovery looks like—and why early action matters

  
  

• 💬 Advice for parents who are worried about their child’s eating or behavior around food

Dr. Hoyle reminds us that families don’t need to have all the answers to take the first step. If you're concerned, bring it up with your pediatrician—it’s never too early to start asking questions.

Key Quotes:

“Most of the time, it starts when a parent says, ‘Something’s not right.’ They may not be able to name it—but they know.” — Dr. Gretchen Hoyle

“Recovery isn’t just about weight—it’s about mindset, function, and emotional health.” — Dr. Hoyle

Resources & Links:

• National Eating Disorders Association (NEDA)
  
  
• Veritas Collaborative – Residential and outpatient treatment programs

  
  

• The JAMA Pediatrics Study on ED Hospitalizations Post-COVID

  
  

📲 Subscribe to The Nimble Youth Podcast on Apple Podcasts, Spotify, or your favorite app.

🔗 Visit www.nimbleyouthpodcast.com for all episodes and show notes.

🗣️ Have a question or topic you’d like us to cover? Reach out via our website or social media!

🎧 Nimble Youth – Episode 11

“The Absenteeism Spiral: Understanding and Addressing Chronic Absenteeism”
Guest: Dr. Gretchen Hoyle, Pediatrician

Chronic school absenteeism is surging—and it’s not just about skipping class. In this episode, pediatrician Dr. Gretchen Hoyle joins us to unpack the many factors driving today’s absenteeism crisis. From the long shadow of the pandemic to rising anxiety, screen-time habits, and shifting cultural norms, Dr. Hoyle shares practical insights for families navigating this complex issue.

Whether your child has begun missing days here and there or is already caught in a cycle of extended absences, this episode offers concrete strategies to help you intervene early, set clear expectations, and get back on track—without shame or panic.

🧠 What We Cover:

• What defines chronic absenteeism and why the numbers have spiked
• How post-pandemic routines and mental health struggles contribute
• Why keeping your child home “just in case” can backfire
• When a child is truly sick: the importance of limiting screen time during school hours
• How technology—especially phones—is affecting school engagement
• Why schools need support from parents on phone-free classroom policies
• What to do if physical symptoms mask deeper emotional or developmental concerns
• The role of pediatricians and therapists in breaking the cycle
• Encouraging embodied, in-person experiences that rewire motivation
• How schools are beginning to respond with community-focused solutions

🛠️ Takeaway Tips for Parents:

• Catch it early – Missing a few days can spiral into weeks. Treat even small patterns seriously.
• Stick to routines – Structure, morning rituals, and expectations help children feel safe and ready.
• Limit tech use at home – Especially during school hours, even when your child is sick.
• Support school phone policies – Unified messaging from parents and schools matters.
• Don’t wait for a diagnosis – Continue school attendance during medical evaluations when possible.
• Get help early – Therapists and pediatricians can uncover underlying issues and guide the next steps.
• Know you're not alone – Up to 1 in 4 kids may now meet the criteria for chronic absenteeism.

Chronic absenteeism isn’t a moral failing—it’s a warning sign. With empathy, clarity, and the right supports, families can help kids return to the classroom and thrive again.

🔗 Resources Mentioned:
Visit www.nimbleyouthpodcast.com for transcripts, past episodes, and links to related tools and references.

💬 Like what you heard?
Leave us a review, subscribe, and share this episode with a fellow parent, educator, or caregiver. Your support helps us reach more families with practical guidance and hope.

Episode 10: A Gut Feeling—Constipation, Anxiety, and ADHD in Children
 Guest: Dr. Gretchen Hoyle

In this enlightening episode of Nimble Youth, pediatrician Dr. Gretchen Hoyle returns to tackle a topic that’s both common and frequently misunderstood: chronic constipation and stool withholding in children. What may seem like a simple digestive issue is often a complex interplay between physical discomfort, behavioral habits, and underlying mental health challenges such as anxiety and ADHD.

Dr. Hoyle unpacks how children can fall into a cycle of withholding stool—often due to discomfort, embarrassment, or fear—which leads to abdominal pain, functional constipation, and in some cases, encopresis (involuntary stool leakage). She explains how these physical symptoms are not always isolated but can be part of a broader mind-body connection, especially in children with diagnosed or emerging anxiety or ADHD.

Key Topics Covered:

• Why children may begin withholding stool and how it becomes a chronic issue

  
  

• The connection between constipation and mental health conditions like ADHD and anxiety

  
  

• Understanding the feedback loop between physical symptoms and emotional distress

  
  

• Dr. Hoyle’s step-by-step approach to treatment, including clean-outs, maintenance with MiraLAX, and behavioral retraining

  
  

• Practical toileting routines and environmental supports to prevent recurrence

  
  

• How parents, schools, and pediatricians can work as a team to support a child

  
  

• Screening for anxiety and ADHD when GI symptoms don’t resolve

  
  

• Why summer is the perfect time to build healthy bathroom habits before school resumes

  
  

Resources:

• Mind-Body Cycle of Constipation (Downloadable Graphic)

  
  

• SCAS (Spence Children’s Anxiety Scale) and other screening tools

  
  

• Sample letter for school to support flexible bathroom access

  
  

Quote of the Episode:
"For kids with anxiety or ADHD, constipation is rarely just about the gut—it’s about how the brain processes pain, embarrassment, urgency, and control. The good news? It’s highly treatable with a team approach." —Dr. Gretchen Hoyle

Next Episode Teaser:
Join us next time as we explore eating disorders in adolescents, debunking myths and examining the serious impact these conditions can have—regardless of gender.

Subscribe & Share:
 If this episode resonated with you or you know a family facing these challenges, please share it. You can find all past episodes, full transcripts, and helpful resources at www.nimbleyouthpodcast.com.