Pediatric Meltdown

https://302.buzz/PM-WhatAreYourThoughts

Do you have a picky eater in the house? Then this is the episode you’ve been waiting for. Dr. Lia Gaggino’s guest this week is Dr. Natalie Prohaska where they’ll discuss avoidant, restrictive food intake disorder (ARFID), which was previously referred to as feeding disorder of children. They will break down the three different types of ARFID and discuss how they affect children's psychosocial and nutritional functioning. As the COVID-19 pandemic continues to affect our daily lives, mental health concerns such as eating disorders have seen a resurgence. Whether it's a fear of choking or contamination, this episode will provide valuable insight on how your clinician properly diagnoses and treats ARFID in order to improve the overall health and well-being for the child.

[00:33 -13:37] Understanding Avoidant Restrictive Food Intake Disorder (ARFID)

• ARFID is not related to body image distress, but rather caused by sensory sensitivity, lack of interest in eating, or fear of inversive events
• ARFID can affect nutrition, weight, and psychosocial functioning, and can be seen in both children and adults  
• ARFID is characterized by three types of symptoms: sensory sensitivity, lack of interest in eating, and fear of inversive events.
• ARFID can progress from one category to another and may require specific treatment for feeding-related anxiety or OCD.

[13:38- 25:54]  How to Manage Picky Eating in Children: Strategies and Tips  

• Breaking down food into smaller portions and gradually adding ingredients can help make it more manageable for picky eaters.
• Children with oral aversions, such as those who were in the NICU and had tube feedings, may benefit from occupational therapy.
• Encouraging children to describe the appearance, texture, smell, and taste of food in non-judgmental language can reduce their disgust response. 
• Using a five question approach, children can approach new foods more like a scientist and think objectively about what they are experiencing.

[25:55 -37:14]  Overcoming Fear of Food in Kids: The Step-by-Step Approach

• Aversive events such as choking on food can lead to a fear of eating, which can be treated similarly to OCD.
• Treatment involves creating a hierarchy of manageable steps in challenging fears, starting with softer or liquid foods. 
• Parents play a crucial role in this treatment, as they need to provide education, empowerment, and motivation to their child.
• Children with intellectual disabilities or autism may require a different feeding program tailored to their unique needs.

[37:15 - 44:41] Understanding ARFID: Diagnosis, Comorbidities, and Resources for Families

• ARFID is a distinct illness from anorexia, though picky eating can sometimes lead to anorexia later on.
• ARFID patients typically have a limited diet high in dairy and carbohydrates, while anorexia patients prefer produce and proteins.
• Comorbidities with ARFID include anxiety, ADHD, autism, and medical issues like reflux or celiac disease
• Families can find helpful information and support through resources like FEAST, AED, and the book "ARFID: A Guide for Parents and Caregivers. 

[44:42 -51:00]  Closing segment Takeaway

Links to resources mentioned on the show

AAP Pediatrics article:  

Classification of Children and Adolescents with Avoidant/Restrictive Food Intake Disorder 

https://302.buzz/PM-WhatAreYourThoughts

School-based healthcare centers (SBHC) are playing an important role in providing equitable access to healthcare for children who are not able to access a regular medical home. Today, host, Dr. Lia Giggino talks with Dr. Sara Bode about the benefits of a SBHC and the challenges they face in ensuring that every child has access to quality care. They discuss the challenges that school-aged children face in accessing healthcare, such as transportation issues, location, and competing priorities for parents. Dr. Bode emphasizes the importance of school health in providing a safety net for children and the need for collaboration between healthcare providers and educators to ensure that children receive quality healthcare and education. This episode highlights the benefits of a partnership between the health and education systems, demonstrating how working together can improve the overall health and well-being of students. If a school-based health center is something you want in your own community, you’ll hear information on exactly how you can make it happen.        

[00:33 -15:08] The Benefits of Having an SBHC

• They provide a safety net for kids who do not have access to a regular medical home due to various reasons such as transportation issues, location or access, and competing priorities for working parents
• They can partner with primary care providers to provide comprehensive primary care to the underserved population of kids and connect them to a medical home for continued care  
• They offer opportunities for collaboration with specialty providers to provide better health outcomes for kids with chronic health conditions such as diabetes
• They can help with wraparound care and observation to identify and address underlying health issues

[15:09- 22:07]  How SBHCs Co-Manage Children's Health: Funding and Services  

• Students without an established medical home can receive care at the center
• Partnership between school-based health centers and primary care providers can support medication management and follow-up care
• School-based health providers have a unique understanding of social determinants of health for students  
• Funding for school-based health centers typically comes from traditional insurance sources such as Medicaid and private insurance

[22:08 -31:07]  The Role of SBHCs in Addressing Mental Health Care Needs for Students

• Lack of mental healthcare providers for students is a crisis in schools
• School-based health centers can be a part of the solution to bridge the gap in services
• Comprehensive primary care mental health services can be provided through school-based health centers
• Telemedicine services, such as telepsychiatry, can be used to provide care and maintain appointment attendance
• Advocacy and community pediatrics play a crucial role in transforming the systems of care provided to meet the needs of the community

[31:08 37:11]  Opportunities for Pediatricians to Get Involved in School Health 

• The AAP Council on School Health provides resources for pediatricians to partner with schools, including working with school nurses and teachers.
• The Council on Community Pediatrics offers opportunities for pediatricians to engage in advocacy and learn about community initiatives.
• The Community Pediatric training initiative offers training opportunities for pediatricians interested in tackling issues like food insecurity in their communities.
• It is important for pediatricians to keep their eyes...

https://302.buzz/PM-WhatAreYourThoughts

Aggression in children is a complex issue that can leave parents feeling helpless and desperate for a solution. Many turn to medication as a quick fix, but according to Dr. Lia Gaggino’s guest, Dr. Peter Jensen, multiple medications are not always the answer. It's important to assess the situation correctly and consider alternative approaches before turning to medication. In this episode, Doctors Gaggino and Jensen explore the various causes of aggression in children and provide tips on how to handle it effectively without resorting to excessive medication. Whether you're a parent, caregiver, or educator, the information provided in this episode can help you better understand aggression in children and how best to support them. Get your pad and pencils ready, you’ll be taking notes on this one.        

[00:30 -27:46] Understanding the Different Types of Aggression in Children and How to Treat Them

• The Importance of Assessing and Diagnosing before Prescribing Medication
• Aggression in children can fall into different categories, such as chronically irritable and explosive or misinterpreting social cues
• Diagnostic Skills Help in Identifying the Underlying Causes of Aggressive Behaviors in Children
• Bipolar disorder and schizophrenia are unlikely causes of aggressive behavior in children

[27:47- 38:02]  Understanding and Treating Aggressive Behaviors in Children  

• Treatment for ADHD should be maximized before turning to other medications
• Resperidone and Aripiprazole have been approved by the FDA to treat aggression in children
• Primary care providers need to get comfortable with atypical medications  
• Guidelines for treating maladaptive aggression in youth are available in the journal Pediatrics

[38:03 -48:14]  Evaluating Medication for Children with Mental Health Disorders

• Trauma should be considered when treating children with psychiatric medications.
• Avoid the "pharmacotherapy of desperation," which involves adding multiple medications without clear rationale. 
• Deprescribing, or slowly decreasing medication use, can be helpful for children on multiple medications that may not be effective.
• A thorough evaluation of the underlying disorder, using rating scales and input from multiple sources, is essential for choosing the right medication.

[48:15 - 57:06]  Top Screening Tools for Child Mental Health

• Vanderbilt Rating Scale is essential for monitoring ADHD in kids on stimulants
• PHQ-9 is a quick and free depression scale that is recommended by the US Preventive Services Task Force and Academy of Pediatrics
• SCARED is an effective tool for tracking and screening anxiety in children and can be given to parents or youth
• PSC-17 is ideal for well-child visits as it has only 17 items and screens for inattention, ADHD, anxiety, and depression
• Suicide specific tools like ASK Screening Questions and Columbia should be used alongside PHQ-9 for better screening of suicidal ideation and behavior; CRAFFT can be used to screen for substance use in teenagers. 

[57:07 - 1:04:54]  Closing segment Takeaway

You can reach Dr. Peter Jensen

Website:  https://thereachinstitute.org/

LinkedIn:

https://302.buzz/PM-WhatAreYourThoughts

Childhood can be a challenging time for many young individuals. As they try to navigate the world around them, they often display aggressive behaviors in different situations. But not all aggression is harmful, as it can be a normal part of development. Understanding what constitutes normal childhood aggression and identifying its triggers is essential for parents and clinicians alike to help children thrive. In this 2nd of a 3-part series on childhood aggression, Dr. Lia Gaggino talks with Dr. Elizabeth Wallis from the REACH Institute. They discuss the nature of childhood aggression, how parents and clinicians can identify its triggers, and how trauma can affect children's brains. By recognizing the signs of concerning behavior early on, parents and clinicians can intervene appropriately to help young individuals grow into healthy adults. Get ready for a thought-provoking conversation.          

[00:33 -14:54] Understanding Normal Aggression in Children and Identifying When to Worry

• Normal aggression is a part of development in children and can be seen in frustration, emotion dysregulation and communication difficulties.
• Consider the scenario around aggressive behavior, including who, what, when, where, and why, can give insights into the causes of aggression.  
• Trauma and neglect can greatly affect a child's brain and make them more reactive to situations.
• Trauma, neglect, and abuse can change children's brains and lead to hyperarousal and increased reactivity to situations

[14:55- 29:01]  How to Address Aggressive Behavior in Children: Tips for Parents and Pediatricians  

• Teaching prosocial skills and positive reinforcement
• Teach positive social skills and give positive reinforcement for good behavior
• Implementing natural consequences for damaging behavior, such as having the child save up allowance to pay for damage  
• Discuss gun safety with families and ask about access to firearms in the home in a thoughtful manner.

[29:02 -37:23]  Partnering with Schools and Mental Health for Resilience-Building in Children

• The impact we can have on a child's life as mental health professionals
• Approaching schools and mental health professionals with humility, compassion, and empathy  
• Being an advocate for the child when working with schools and mental health professionals
• The need for communication and collaboration between mental health professionals, schools, and parents for the child's success

[37:24- 45:27]  The Impact of Reach Program on Pediatricians

• Reach Program helps pediatricians to realize that psycho pharm is a small part of things and communication skills matter a lot more.
• The program reinforces the importance of motivational interviewing and negotiation skills.
• The answer to all problems is not a pill; development, learning difficulties, environment, and trauma are also key factors.
• Fresh perspectives from child psychiatrists can be helpful for complex cases, and resources like the Child Psychiatry Access Program are available for pediatricians. 

[45:28 -51:24]  Closing segment Takeaway

You can reach Dr. Elizabeth Wallis

Social Media:  

REACH Website: https://thereachinstitute.org/

REACH LinkedIn: https://www.linkedin.com/company/the-reach-institute-resource-for-advancing-children-health/

REACH Facebook: https://www.facebook.com/REACHInstitute/

REACH Twitter:...

https://302.buzz/PM-WhatAreYourThoughts

This is the first of three episodes on aggression in youth and violence prevention.

Dr. Gaggino’s guest is Cindy Marble, who retired from the US Secret Service after 27 years, including two tours in the protective intelligence division. Cindy now trains individuals across various sectors on behavioral threat assessment and prevention, including K-12 schools, campuses, and private industry. In this podcast, she emphasizes the team approach to threat assessment, drawing on the insights of mental health providers, physicians, and local law enforcement. Cindy highlights that there is no single profile of a potential aggressor, and that prevention requires an understanding of the individual's behavior and circumstances. She underscores the role of physicians and mental health providers in identifying potential threats, as well as considering factors such as home environment and law enforcement history. Cindy emphasizes that understanding the "why" behind a person's behavior is critical to preventing violent acts

• Many thanks to the AAP and the MIAAP for making these 3 episodes possible by funding guest honorariums and podcast editing costs.  In full disclosure, I have not received any funding from either entity for this series. 

First, some facts:

• According to the Washington Post, there have been 376 school shootings since Columbine (1999)
• 348,000 students have experienced gun violence since Columbine shooting

[00:33 -12:57] Understanding the Pathway to Violence: A Multidisciplinary Approach

• Threat assessment is a community process that requires a multidisciplinary team.
• There is no specific profile of someone who carries out violent attacks.  
• It's essential to focus on a person's behavior rather than their traits.
• Taking a multidisciplinary approach can help identify a pathway to violence and prevent violent incidents.
• Threat assessment is a community process involving partnerships with healthcare providers, mental health professionals, and local law enforcement.

[12:58 -28:22  Key Indicators and Intervention Strategies  

• Warning signs may include a change in behavior, loss of interest or connections, and inappropriate interest in past mass violence attacks.
• Capability, access to weapons, and mental and physical ability are all considered in the threat assessment process.
• Assessing a person's capability to carry out an act of violence, along with their mental and emotional state, is crucial in determining the level of risk.  
•  Interventions should focus on connecting the individual to support systems and responsible adults to prevent isolation and marginalization.
• Punishment or disciplinary action may not be the most effective solution and may exacerbate behavioral issues. Instead, focusing on intervention and support can lead to positive outcomes.

[28:23 - 40:40] The Importance of a Collective Approach in Threat Assessment

• Physicians cannot be expected to single-handedly assess and manage a threat
•  Building relationships with schools and law enforcement can lead to a more effective community-based threat assessment process 
• Understanding HIPAA and FERPA laws can provide comfort in sharing information for the safety of an individual
• Threat assessment is a collective effort that shares liability and considers different perspectives to create a management plan
• Best practice in threat assessment involves a systematic process of gathering information, documenting decisions, and creating a management...

https://302.buzz/PM-WhatAreYourThoughts

Join your host, Dr. Lia Gaggino, on this episode of Pediatric Meltdown as she chats with Dr. Danny Mallen, a pediatric gastroenterologist and medical educator at Cincinnati Children's Hospital Center. Dr. Mallen talks about his interest in nutrition, the puzzle that is the gut, and his passion for helping children with celiac disease. He also discusses his article on finding your “One Thing” and how mentors and opportunities play a role in one's career. Burnout is real. We look to physicians to take care of us, but let’s make sure that your doctor is getting everything they need for their own wellness. Dr. Mallen’s insights on the importance of finding joy in your work will ring true for every profession and he continues his efforts to improve medical education for general pediatricians and fellows. Don't miss this fascinating conversation about the challenges and rewards of physician’s wellness!          

[00:33 -12:42] Daniel's Journey to Pediatrics and Interest in Wellness

• During his training, he found himself happiest and smiling more when working with children, ultimately leading him to specialize in pediatric gastroenterology.
• Daniel is passionate about medical education and mentoring trainees, recognizing the importance of wellness in the medical profession.  
• Through his own experiences in training and becoming a parent, Daniel recognized the need for addressing physician burnout and is involved in research on the topic.
• His interest in wellness came about through his own experiences with stress and recognizing the importance of self-care in the medical field

[12:43 - 24:32]  Addressing Burnout in Medical Professionals: Insights from a Pediatrician  

• The culture of overworking and sleep deprivation has been prevalent in the medical field for a long time, with long shifts and being on call for extended periods being seen as a "badge of honor."
• Institutional changes such as shorter shifts and better work-life balance policies are being implemented. However, progress is slow, and more needs to be done to sustain a healthy work environment for medical professionals.
• Burnout is a real issue that can impact the quality of care medical professionals provide and their well-being. It is important for medical professionals to recognize the signs of burnout and take steps to address it, seeking taking time off to recharge, and finding hobbies or activities outside of work can all contribute to a healthier work life balance. 
• Personal experiences with burnout and overwhelm are common among pediatricians, and recovery often involves taking time off, seeking support from colleagues and loved ones, and practicing self-care.

[24:33 -40:17]  Strategies for a Work-Life Balance in Academic Medicine: The Eisenhower’s Box Method

• Importance and urgency are the key factors to consider while managing tasks
• Urgent tasks with low importance can be delegated or automated
• Restorative activities, even if they are not productive, can help reduce burnout
• Tasks that are not important and not urgent can be avoided to reduce unnecessary stress.

[40:18 - 51:46] Creating a Supportive Environment for Healthcare Professionals: Strategies and Best Practices

• Providing anonymous peer-to-peer support can make a significant difference in mental health for healthcare workers.
• Critical Incident Stress Management (CISM) teams can be instrumental in helping individuals process traumatic events and feel less isolated in their experiences.
• It's important

As an educator and administrator, Meadow Nuyen acknowledges the challenges faced due to the pandemic, such as staffing shortages and virtual learning for early childhood education. Meadow talks about the importance of empowering parents and recognizing them as the first educators during a child's developmental years. She believes that parents should feel comfortable advocating for their child's needs and speaking up if they have any concerns. She stresses the importance of recognizing the family unit, (regardless of traditional family structures), and valuing their knowledge about their child's needs and development. Meadow’s passion for early childhood education and empowering parents shines through in this episode. She stresses the importance of providing high-quality pre-K experiences, monitoring children's milestones, and working together to support a child's development. You’ll walk away from this episode anxious to implement the “Parent-Teacher-Clinician” superpower that all kids deserve.          

[00:33 -10:09] The Importance of Early Childhood Education

• Parents should speak up if they have concerns and advocate for their child's needs.
• The human brain develops most before age five, making early education a critical time for youngsters.  
• Youngest learners need the support and encouragement of role models from all walks of life.
• Parents, educators and clinicians can share information to best support the child's development.
• Children who experience separation anxiety during the transition into preschool require special attention.

[10:10- 22:22] Trauma-Informed Teaching and Supporting Families  

• Adverse Childhood Experiences (ACEs) study and understanding the impact of trauma on children's development.
• Cultivating empathy and compassion for children and families who have experienced trauma.
• Shifting perspective to ask "What happened to?" instead of "Why are you doing this?"  
• Listening to families and letting them talk to feel heard and validated.
• Normalizing conversations about trauma and its possible effects to open communication and healing.

[22:23 -30:15]  Combating Food Insecurity in Schools

• Providing free meals for all enrolled students
• Reducing stigma around receiving free meals
• Addressing the issue of food insecurity in all communities, regardless of wealth
• Acknowledging the impact of food insecurity on learning and health
• Encouraging healthy eating habits and access to nutritious foods

[30:16 - 42:59]  Assessment and Evaluation in Schools 

• The NWEA assessment is a standardized test that is administered nationwide.
• The assessment is conducted three times a year in some districts and twice a year in others.
• A 504 plan is a legal document that provides additional support to students with learning difficulties upon parental request.
• An IEP is a more intensive individualized education plan given to children who have been evaluated and tested by a school district's psychologist.
• The IEP team includes the special ed director, teacher, special education staff, principal, and family to create goals and interventions to support the child's needs.

[43:00 - 52:04]  Some of the Takeaways include:

• Children are all learners.  The educator’s job is to identify struggles and to build skills and mastery.
• Educators' best strategy for learning is to empower parents.  They are the first teachers.  They know their child best.
• All adults can use the trauma-informed lens to support

https://302.buzz/PM-WhatAreYourThoughts

Childhood trauma can have a lasting impact on mental health and well-being, but addressing it in therapy requires a careful and compassionate approach. In this episode, child psychologist, Conni Lutes, shares her unique strategies on working with young children who may be experiencing behavior issues or challenges related to autism. Your host, Dr. Lia Gaggino and Conni discuss the importance of using language and creative outlets, such as art and play therapy, to help kids express themselves and make progress. By taking these steps, practitioners can help children feel heard and supported. By creating a safe and comfortable environment and meeting children where they are, therapists can help children process their trauma and move towards healing.          

[00:33 -15:56] Strategies for Working with Children in Therapy

• Create a colorful and comfortable therapy environment with bean bag chairs, pillows, and other calming tools.
• Encourage artistic expression and play to help children feel more comfortable and have a voice when they feel silenced.
• Focus on the child's strengths first to build trust and establish a foundation for future therapy sessions.
• Approach trauma and behavioral issues by first getting to know the child as a whole, not just focusing on the problematic behaviors or experiences.
• Start sessions by focusing on the child's strengths, rather than immediately addressing any traumatic experiences or behavior issues.

[15:57- 30:41] Strategies for Supporting Children with Autism and Anxiety  

•  Continually assess children to understand their behavior and the underlying factors that contribute to it.
•  The powerful role of art therapy in helping children with limited language skills
•  Using social stories and role-playing as effective strategies to help autistic children learn how to join and feel understood
•  The importance of understanding developmental stages and expectations in managing anxiety and worry in elementary-aged children
•  Introducing the concept of a "smart part" of the brain and "red alert" to teach children how to gain control over their feelings and move from a state of anxiety to a more rational, problem-solving state.

[30:42 -42:23]  Promoting Collaboration between Doctors, Therapists, and Schools

• Recognize the importance of all the adults in a child's life, including pediatric clinicians, schools, and therapists.
• Emphasize a strength-based approach to working with children, focusing on their unique abilities and passions.
• Encourage shared control between parents and children, giving children choices and opportunities to feel empowered.
• Use strategies such as the five senses exercise to help children shift from reacting to thinking.
• Facilitate cross-disciplinary communication and collaboration to ensure that everyone has a complete picture of the child's strengths and challenges.

[42:24 -51:46]  Creating a Multidisciplinary Team: Tips and Strategies

• The importance of multidisciplinary teams, involving OT, PT, and speech.
• Humility is essential for physicians to recognize they are not aware of everything.
• Teachers must understand that the child can behave differently in different settings.
• Collaboration between therapists, clinicians, teachers, and parents is necessary.
• Accepting the child's strengths alongside their weaknesses is fundamental.

[51:47 - 56:44]  Closing segment...

https://302.buzz/PM-WhatAreYourThoughts

Dr. Brooks Keeshin, a triple-board trained child psychiatrist with a focus on trauma, shares his journey into child psychiatry, and discusses the idea of it being a subspecialty of pediatrics. The conversation leads to a discussion on the role of pediatricians in prescribing psychotropic medication and the importance of identifying and recognizing mental health concerns in children. Dr. Keeshin highlights the pitfalls of thinking about mental health as a catch-all, and reminds pediatricians to consider individual diagnoses to guide treatment options. He also points out that psychotherapeutic interventions are usually at the top of the list, and that medication is only one consideration. Get your pencils out…. You’ll want to take notes… 

[00:33 -13:56] The Importance of Identifying Mental Health Concerns

• Identifying mental health concerns should begin with listening to the family's concerns and the child's or adolescent's voice.
• Using measurements such as universal screening or targeted screeners can help inform the differential diagnosis.
• It is important to move away from the thinking that mental health is a catch-all, and instead focus on individual diagnoses that will guide treatment recommendations.
• Early identification and treatment of mental health concerns can improve outcomes and prevent future problems.
• Having a process to rule out other contributing factors to distress, such as adjustment disorders, can lead to more accurate diagnoses and effective treatment.

[13:57 - 26:01]  Choosing Treatment Options for Pediatric Anxiety  

• The importance of getting a full picture of the child's symptoms, including using screeners such as SCARED
• Considering evidence-based interventions for pediatric anxiety, such as anxiety-focused CBT or SSRIs
• Combination therapy with psychotherapeutic intervention and SSRIs may offer the best chance of complete remission
• SSRIs such as Fluoxetine, Sertraline, and Citalopram have the greatest evidence base and experience in youth
• Assessing the level of impairment and degree of symptoms in making a decision about medication vs. psychotherapeutic intervention

[26:02 -38:10]  Addressing Anxiety Symptoms in Traumatized Kids

• Stepped approach involves addressing other contributing factors before using SSRIs
• Ensure physical safety of environment before trauma-focused therapy
• Address sleep first as chronic insomnia can drive anxiety symptoms
• Maximize other interventions like social determinants of health and trauma therapy before giving SSRIs
• Aggressively titrate SSRIs to effective doses for robust response

[28:11 - 51:33]  Improving Access to Expert Child Psychiatric Care

• Improving access to comprehensive psychiatric evaluations by child psychiatrists is essential for identifying children with severe psychiatric needs.
• The limited number of child psychiatrists means better triage is needed to ensure the most severely impacted children receive the necessary care.
• Educating child psychiatrists about the comfort levels and limitations of ongoing psychiatric treatment in primary care can be helpful in improving collaboration.
• Consider outpatient programs or day treatment programs for kids after inpatient treatment to help them prepare for a return to their normal life.
• Consider partnering with primary care if it would be more appropriate for the child in the long term.

[51:34 - 59:59]  Closing segment Takeaway

Links to resources mentioned on the...

https://302.buzz/PM-WhatAreYourThoughts

The American Academy of Pediatrics Section on Pediatric Trainees is an active group that offers a variety of leadership roles for medical students, residents, and fellows. Dr. Madeleine Norris shares her journey from child neurology to pediatric mental health and her involvement in the AAP. Your host, Dr. Lia Gaggino, a leader in the AAP, explains how trainees can submit abstracts to the SOPT Abstract Competition and become a member of the Section on Pediatric Trainees or the Section on Early Career Physicians. Madeleine also discusses her role as a Deputy Editor for the Feature in the journal Pediatrics. If you are or know someone who is a trainee, medical student or resident, make sure that you share this episode with them.  They’ll thank you for it.         

[00:33 - 6:11] Introduction to Madeleine’s Pediatric Journey

• Madelyn is a PGY two resident in a categorical pediatrics tract at NYU.
• Her initial interest in child neurology before switching to pediatric mental health.
• Her future goal of becoming a triple boarded child psychiatrist.

[6:12-8:43]  Her role with the AAP’s Section on Pediatric Trainees  

• Importance of getting involved in trainee leadership.
• Opportunities for medical students and residents to join the section.
• Various leadership roles available within the section
• Encouragement for trainees to apply even if they don't feel fully qualified.

[8:44 -13:35] What her duties are as the Deputy Editor for the Pediatrics Journal Feature

• Coaches and mentor's trainees in the developmental editing process
• Focuses on education and encouraging trainees to write and share their perspectives.
• Offers feedback and support to authors even if their piece is not accepted.
• Three-year term for the Deputy Editor position

[12:36 -23:23]  Details for Submitting Narrative Work for the Pediatrics Journal Feature  

• Essay competition offered in relation to the Races Against ACEs campaign.
• Submissions open on March 3rd and close on April 14th.
• Criteria for submission, word count and author number, can be found in show notes
• All trainees are eligible to apply.

[23:24 - 27:08]  Closing segment Takeaway.

You can reach Dr. Madeleine Norris. 

Twitter: @Maddie__MD

Instagram: @maddie_.norris

Links to resources mentioned on the show

ACES Too High website:  https://acestoohigh.com/

1998 ACES Study:  https://pubmed.ncbi.nlm.nih.gov/9635069/

AAP Peds Trainees (On Twitter):  @AAPSOPT                                                                                             Use #RacesAgainstACEs and #PedsPerks.

Submission Info for the 2023 Essay Competition: “Races Against ACEs”