Pediatric Meltdown

https://302.buzz/PM-WhatAreYourThoughts

Dr. Dennis Flores’ first study looked into the circumstances that contributed to the recent HIV infection of young gay men in Atlanta. This was done with an awareness of the personal and contextual factors that increase sexual and gender diverse individuals' vulnerability for HIV/STI infection and poor care-related outcomes. His subsequent HIV/STI prevention work, which includes community education in both urban and rural areas, serving as the national spokesperson for HIV testing campaigns, and workforce development with about 1400 nurses across three continents, has been inspired by that study. Serving in numerous leadership positions for the Association of Nurses in AIDS Care is only one example of the man's career-long dedication to nursing leadership and HIV/AIDS care. Dr Gaggino and Dr. Flores talk about his work over the years in the community and the Social Stigma of LGBTQ+ and its Effects.

 Heteronormative: * adjective

            denoting or relating to a world view that promotes heterosexuality as the normal or

preferred sexual orientation.

            "This is believed to stem from heteronormative and patriarchal setups of

traditional heterosexual relationships"

Cisgender * adjective

             denoting or relating to a person whose sense of personal identity and gender

corresponds with their birth sex.

              "If you were born a male and you identify yourself as a male, you are considered

cisgender."

 [00:30 -12:36] Opening Segment

• Dr. Gaggino introduces us to Dennis Flores, PhD, ACRN
• Dennis’ passion is facilitating conversations between the LGBTQ+ child and the parent
• The US has a different way of looking at sexuality vs the rest of the world.
• Removing stigma around sexuality is the first step
• Don’t let fear of the myth that just talking about sex with your child will make them want to have sex

[12:37 - 24:58]  Is Gatekeeping an American trait?  

• Insecurity is magnified even more when they don’t see representation in the media.
• A parent that provides a supportive , accepting and inclusive context is the most that you can do
• Media is finally coming around regarding depictions of LGBTQ+ in commercials, movies, TV shows
• Dennis’ talk about his in depth research on LGBTQ+ youth and the relationship they have with their parents
• Establish open lines of communication during those elementary years.

[24:59 -32:26] Resources that clinicians can offer parents

• Construct these conversations over a period of several years; personal space, permission, consent, etc.
• Clinicians can facilitate these conversations
• Be open to perhaps the parent isn’t ALWAYS the expert

[32:27 -44:53]  Normalize the LGBTQ+ conversations 

• A TV show can initiate “difficult” conversations.
• Watching shows together lightens the mood and makes it so much easier to talk 
• Capitalize on teachable moments
• Advice for clinicians: language / visual cues to establish a welcoming atmosphere (a “safe place”)

44:54 - 49:22]  Closing segment Takeaway

You can...

https://302.buzz/PM-WhatAreYourThoughts

The eight key executive functions are Impulse control, Emotional Control, Flexible Thinking, Working Memory, Self-Monitoring, Planning and Prioritizing, Task Initiation, and Organization. Early identification and intervention is important for helping individuals with ADHD to reach their full potential. Dr. Colleen Cullinan is back for part 2 in Dr. Gaggino’s series on ADHD. They pick up where they left off on Episode #88 (the link to the episode is below). You’ll hear a deeper dive into the strategies and specific techniques of caring for the ADHD child.  According to a 2016 CDC report, about 3 in 4 US children with current ADHD receive treatment. Let’s take a closer look at some of the other stats on that report.

• 62% were taking ADHD medication
• Ages 2–5: 18%
• Ages 6–11:  69%
• Ages 12–17: 62%
• 47% received behavior treatment
• Ages 2–5: 60%
• Ages 6–11:  51%
• Ages 12–17: 42%
• Altogether, 77% were receiving treatment. Of these children:
• About 30% were treated with medication alone.
• About 15% received behavior treatment alone.
• About 32% children with ADHD received both medication treatment and behavior treatment.
• About 23% children with ADHD were receiving neither medication treatment nor behavior treatment.

 [00:30 - 08:17] Opening Segment

• Dr. Gaggino introduces us to Dr. Colleen Cullinan
• Dr. Gaggino and Dr. Cullinan pick up where they left off from Ep 88

[8:18 - 10:37]  The diagnosis should be a “strength based model”  

• The Hyper focus of an ADHD child will activate that chemical excitement in their brain.
• “Attention Deficit” is a misnomer
• What is the true definition of ADHD?

[10:38 - 24:00] How do we adjust to meet where kids are?

• Redirect the attention that they DO have 
• Tolerating the experience of “Chemical Boredom”?
• The ADHD child can strengthen their weaknesses in a planful, stepwise, gradual way
• The executive function of INTERNAL SPEECH

[24:01 -54:26]  The Golden Ratio for ADHD

• This is not to be used as a reward
• 14 positive interactions to neutralize 1 negative interaction
• It only takes 5 minutes a day
• The parent’s job is to listen, reflect and praise

[54:27 - 1:01:48]  Closing segment Takeaways

You can reach Dr. Colleen C. Cullinan

Email:  [email protected]

Twitter:  @ColleenCullinan

Resources:

Episode #88

https://cutt.ly/ADHD-Ep88

Parent Child Interaction Therapy (PCIT)

pcit.org

Book Mentioned in the Episode

https://cutt.ly/RaisingAnEmotionallyIntelligentChild

Key quotes for Twitter:

“When we think about a 7 y/o, who, when it comes to internal speeches, actually looks more like a 5 or 4 y/o, we really do need to think about how we can start to teach this skill of pause, reflect, look around, use your...

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers. 

https://302.buzz/PM-WhatAreYourThoughts

When Dr. Kemia Sarraf's 13-year-old son was diagnosed with leukemia in 2014, her world — at least for the next three years — came to a full stop. And as he regained his health—which, by the way, he's great now—it led her down a path that would ultimately become her life's work. In this episode, she discusses with Dr. Gaggino, the trauma she experienced that inspired her to develop a special trauma-responsive coaching paradigm that is especially well-suited for frontline workers who are exposed to chronic toxic stress and who are therefore directly affected by the numerous ways that vicarious and secondary trauma "show up" in everyday life. Dr. K established Lodestar in 2016 with a focus on coaching techniques that are trauma-responsive for medical colleagues who are suffering from severe burnout, vicarious trauma, and moral injury.

[00:30 - 11:15] Opening Segment

• Dr. Gaggino introduces us to Dr. Kemia Sarraf
• How her son’s illness started her on the path of helping other medical professionals
• The discovery of the common thread: Trauma among medical professionals

[11:16 - 16:00]  Being mindful about building a “Trauma Informed” practice 

• People who are in intense pain and want to be coached toward something
• The client holds the outcome
• The concept: we all carry wounds
• Unbearable “Stuckitude”

[16:01 - 38:28] The impact of chronic, toxic stress

• Both Dr. K and Dr. Gaggino talk about what they experienced during the early days of the pandemic 
• How children of different ages handle stress 
• An underutilized tool: curiosity 
• The shift from “how do we take care of our patience” to “how do we take care of ourselves”
• “We are hemorrhaging colleagues”

[38:30 -41:44] The factors that move us toward Trauma

• The unrelenting nature of trauma itself
• Lack of rest and recreation
• Real or perceived loss of control
• Lack of resources (emotionally as well as physically)
• Loneliness (disconnection)
• The toxic story of “I’m the only one”

[41:45 -52:45] So…. What’s the way out?

• Actively connect with others
• There’s power in naming and sharing
• The asking is therapeutic 
• Self-Compassion
• It’s ok to ask… “are you having thoughts of hurting yourself”

[52:46 - 58:15]  Closing segment and Takeaways

**For More episodes on Suicide Awareness**

Listen as Dr. Gaggino interviews her own sister (Ep105)

https://cutt.ly/show105

Website 

https://www.lodestarpc.com

social media links

Facebook:  Kemia Sarraf | Facebook

Twitter:  @DrKemia

Linkedin: Dr. Kemia Sarraf...

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers. 

https://302.buzz/PM-WhatAreYourThoughts

A national project called Zero Suicide aims to address the issue of suicide in the medical and mental health systems. The effort is founded on the idea that suicide can be stopped and that systems of medical and mental health care can do more to do so. Seven elements make up the entire Zero Suicide prevention strategy: LEAD, TRAIN, IDENTIFY, ENGAGE, TREAT, TRANSITION and IMPROVE. These elements insure a practical comprehensive approach to suicide care. In this episode, Dr. Gaggino interviews Dr. Julie Goldstein Grumet. Dr. Grumet is a clinical psychologist and public health expert. Dr. Grumet is the director of the Zero Suicide Institute at EDC, Inc. and she developed the Zero Suicide Toolkit to assist health and behavioral care leaders and leadership teams in implementing the seven elements (mentioned above) of the initiative.   Her goal has been to develop the framework, tools, and work schedules required for the Zero Suicide effort to be implemented effectively.

[00:30 - 06:29] Opening Segment

• Dr. Gaggino introduces us to Dr. Julie Goldstein Grumet
• Dr. Grumet tells us about her background and how she came into the field
• Julie recognized that the healthcare system had been left out of the first national strategy for Suicide Prevention.

[6:30 - 9:41] How Dr. Grumet came to develop the Toolkit 

• First launched in 2014
• Taking the guesswork out of implementing the recommendations   
• An organized, concise blueprint that outlines the seven elements

[09:42 - 22:07] What makes this program so different? 

• Evidence based Fidelity 
• The Core Clinical Components: Screen, Risk Assessment followed up with a safety plan
• The seven elements: LEAD, TRAIN, IDENTIFY, ENGAGE, TREAT, TRANSITION and IMPROVE
• The clinical data and being completely “evidence based” is what makes this program work as well as it does.
• How Zero Suicide is about a culture shift
• These components bundled with the seven elements will not only keep the patient safe but will also keep the staff safe as well.

[22:08 -48:39] Get comfortable having that conversation 

• Removing lethal means
• There are online courses you should take (see link below)
•  “I GOT THIS” ....

[48:40 - 54:26] Closing segment - Takeaways

• Thank you to Julie for her time today and to the entire ZS team at EDC for offering guidance and support for system change and ZS implementation.
• Zero Suicide is an aspirational goal and a methodology for suicide prevention.  In 2012, The Action Alliance included ZS as part of the National Strategy to transform healthcare systems. 
• ZS is a bundle of strategies that include both clinical components and implementation components.  Strap on your seat belt, this is your roadmap to better care.
• LEAD, TRAIN, IDENTIFY, ENGAGE, TREAT, TRANSITION, IMPROVE.  You can start at any spot though would HIGHLY recommend LEAD then TRAIN!!!  
• Many of you are already doing IDENTIFY with PHQ screening as we were.  With the new BF guidelines to add suicide screening this is a perfect opportunity to use TRAIN to implement ASQ or CSSR-S screening.
• Clinical components include screening, risk assessment, safety planning, lethal means...

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TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers. 

https://galas.fm/episode/08d6fc7c-09cb-59bb-a0d4-865ece3e4580

 In the United States, suicide is the second leading cause of death for children and adolescents between the ages of 10 and 24. Suicide rates have been increasing in recent years, with the rate for girls aged 15-19 doubling between 2007 and 2015. While boys are more likely to die by suicide, girls are more likely to attempt it. There are many factors that contribute to pediatric suicide, including mental health disorders, bullying, social media, and family stressors. Teenage girls are particularly at risk for depression, which is the most common mental health disorder among adolescents. Depression can be a precursor to suicide and lead to self-harming behaviors, such as cutting.  Here are some hard core facts:

• There are more suicide deaths than motor vehicle accidents
• There are more suicide deaths than homicides 

 In this episode, Dr. Gaggino speaks with Sarah Mead and Erica Espinoza, from Gryphon Place (the local crisis center in Kalamazoo Michigan). They give us their unique perspective on working with people in crisis.  

 [00:30 - 10:16] Opening Segment

• Dr. Gaggino introduces us to Sarah and Erica
• Erica tells us what it takes to be a crisis volunteer
• There’s been over 20 million calls since the hotline started in 2005.
• Erica tells us the different ways to de-escalate a situation

[10:17 - 12:54]   988 is not a new program…. They just gave us an easier way to get to the hotline 

• Myth: 988 goes directly to the police… Fact: 988 is actually made to reduce the amount of emergency involvement
• 988 is there to de-escalate the situation and not involve the police  
• There was a 45% increase in volume the week that 988 was implemented compared to the week before (that’s a 66% increase from the same week last year)

[12:55 - 15:10] Some Things To Look Out For

• Risk Factors: Depression or substance use disorder, traumatic brain injury, chronic pain, any serious health conditions
• Risk Factors:  bullying, unemployment, any sudden drastic change in a person's life. (i.e. divorce, a death of a loved one, a suicide), a history of childhood trauma or a family history of suicide 
• Warning signs: They might talk openly about killing themselves or use language like I'm feeling hopeless. I feel overwhelmed. I just don't know what to do. I don't see another way out. Nobody can understand the situation that I'm in and they may talk about the unbearable pain that they feel.
• Warning signs: increased use in alcohol or drugs, if they're buying a gun or stockpiling pills, if they start saying goodbye or giving away priceless possessions. 

[15:11 -29:30] Asking someone if they’re having thoughts of suicide will not encourage them to kill themselves

• Why we should not use the phrase, “Committed Suicide”
• Why we should not refer to it as a “failed” or “unsuccessful attempt”,
• One of the goals of SPAN is to educate the gun retailers on how to pick up on the warning signs of someone who may have thoughts of suicide.

 [29:31 - 34:04]  Closing segment

• Takeaways

Resources:

Gryphon.org and for Kalamazoo

TRIGGER WARNING: Please note that this episode contains a discussion of suicide, self-injurious behavior, depression and/or reference of other mental health disorders that may act as triggers. 

https://302.buzz/PM-WhatAreYourThoughts

 In this very personal episode of Pediatric Meltdown, Dr Gaggino talks with her sister, Alyssa, who attempted to take her own life 19 years ago. As with many who attempt suicide, there were many factors that may have contributed. Risk factors include a history of trauma, mental health disorders, relationship difficulties that can all add up until the individual is overwhelmed and feels hopeless. Dr. Gaggino and her sister talk about the dark times, but also talk about Alyssa’s recovery and incredible resilience. But first, some facts and figures 

• Suicide is defined as death caused by self-directed injurious behavior with intent to die as a result of the behavior.
• A suicide attempt is a non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior. A suicide attempt might not result in injury.
• Suicidal ideation refers to thinking about, considering, or planning suicide
• Suicide was the second leading cause of death among individuals between the ages of 10-14 and 25-34 , the third leading cause of death among individuals between the ages of 15-24, and the fourth leading cause of death among individuals between the ages of 35 and 44.
• There were nearly two times as many suicides (45,979) in the United States as there were homicides (24,576)

[00:-5:26] Opening Segment

• Lia introduces us to Alyssia
• Together, they talk about the trauma they went through growing up
• How trauma manifests itself.

[5:27-15:22] How Alyssa started her journey “into the system”

• Finding the right regiment
• The one clinician that made the difference 
• After bottoming out, how Allyssa recovered 

[15:07-26:03] Closing Segment

• The “Rewired version” of Alyssa
• Signs to look out for
• Alyssa brings us up to date on her life

[26:04-30:15] Dr. Gaggino’s Takeaways

• 9 takeaways to think about
• Closing Goodbyes

Tweetable Quotes:

“I got to a point where….. I just couldn’t try anymore…"  - Alyssa Gaggino, LMSW  (on her suicide attempt)

 “I think people worry sometimes that they’re going to make someone suicidal by asking the question There’s lots of evidence that that isn’t the case….”  Dr. Lia Gaggino

Resources mentioned in the episode:

-Child Psychiatry Access Network Program locator map:  www.Nncpap.org 

-Suicide warning signs and risk factors:  https://afsp.org/risk-factors-protective-factors-and-warning-signs

Numbers to reach out to for help

• 1-800-273-TALK (8255) National Suicide Prevention Lifeline
• Talk: 988  Suicide & Crisis Lifeline
• Crisis Text: Dial 741-741 and Text the word “HOME”

For Veterans (wasn’t mentioned, but still good to know)

• Talk: 988 then press 1   (Veterans Crisis)
• Text: Dial 838-255 (For Veterans)

MC3 (Michigan Medicine)

https://302.buzz/PM-WhatAreYourThoughts

Welcome to Pediatric Meltdown! In Today’s episode, our guest is Travis Atkinson. 

Travis has worked in the crisis intervention field for over 20 years and describes how our mental health system of care was created with a medical model that does not meet the needs of our patients. Our offices and emergency departments are facing enormous numbers of kids who are struggling, and it is up to us to create a patient-centered system that works based on choice, agency, and freedom. Many models work: mobile crisis response and stabilization teams, peer support and recovery coaches, and integrated behavioral health in outpatient clinics. When treating mental health historically we have been wrong so many times. We must do better now. Travis closes with advice for change - lead with a servant's heart and consider the serenity prayer - grant me the serenity to accept the things I cannot change; the courage to change the things that can be changed, and the wisdom to know the difference.

[00:30 - 09:02] Opening Segment

• Travis Atkinson is a skilled clinician and musician who has worked in behavioral health services for 20 years.
• He is the president of the Crisis Residential Association and former Crisis Services Committee chair for the American Association of Suicidology.
• He received his BA from the University of Michigan and his master's degree from National Lewis University.
• Travis lives in Grand Rapids, Michigan with his wife and three daughters.

[09:02 - 17:04] Community Responds to Behavioral Health Emergencies with Dedicated Mental Health Crisis Lines and Mobile Crisis Teams

• There are dedicated mental health crisis lines available that can help divert people from psychiatric hospitals or emergency departments.
• Mobile crisis teams are a type of intervention that can be used to meet people in the community who are experiencing a mental health crisis.
• These teams are available in most communities and can provide support for up to 90 days.

[17:04 - 25:25] TD Solutions: How to save $5,000 a day by using mobile crisis teams

• The community mental health services are often responsible for the operation of mobile crisis teams.
• One type of team that we haven't talked about yet is the co-sponsor model, in which a clinician and a police officer or law enforcement work together.
• Reaching out to your community mental health center or your local law enforcement to find out if these teams are available and who they are available for is important.
• People with mental illness are more likely to be a victim of crime than they are to be a perpetrator of the crime.

[25:26 - 33:14] Mental health services should be available to everyone

• There is a need for psychiatric hospitals to provide high-quality treatment that meets the goals of the individual, not just keeping them safe.
• The goal of psychiatric hospitals should be to help patients develop meaningful life skills that will carry on beyond their stay.
• There is a trend toward treating patients as individuals and leveling the hierarchy between doctors and other professionals.

[33:14 - 41:22] Intervening Found Strategies to Help You

• Intervening found that other strategies...

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Welcome to Pediatric Meltdown! In Today’s episode, our guest is Ken Ginsburg, MD, MSEd. Dr. Ginsburg re-frames adolescence - not peril and drama, but instead, a time marked by exploration, curiosity, and joy. Parents often believe that they won't matter anymore, but in reality, they matter more than ever. While teens are embarking on their journey to independence, the adults in their lives, us too, serve as guides and teachers. We are the emotional containers for big feelings and "lend our calm". Teens are "super learners" and the world is their oyster if we paint the journey with hope and excitement. Pediatric clinicians offer a safe space to share all the ups and downs. For teens and parents, knowing that we have their back is golden!

Dr. Ginsburg is the Founder & Program Director, of the Center for Parent and Teen Communication He is a physician, adolescent medicine specialist, and Professor of Pediatrics at Children’s Hospital of Philadelphia. He is committed to preparing adults to be the kind of people that adolescents deserve in their lives. He supports local, regional, and national organizations in developing programs and policies that strengthen families and see young people through a strength-based lens. He speaks to parent, professional, and youth audiences nationally and internationally and is the author of 5 award-winning parenting books as well as a toolkit for youth-serving professionals. CPTC is rooted in his strength-based philosophy and resilience-building model.

[00:30 - 08:59] Pediatric Meltdown: Dr. Ken Ginsburg on the Importance of Adolescence

• Dr. Ken Ginsburg is the founder and program director of the center for parent and teen communication.
• He is a physician adolescent medicine specialist and professor of pediatrics at the children's hospital of Philadelphia.
• He supports local, regional, and national organizations in developing programs and policies that strengthen families and see young people through a strength-based lens.
• He speaks to parent-professional and youth audiences nationally and internationally, and is the author of five award-winning parenting books as well as a toolkit for youth-serving professionals.
• CPTC is rooted in his strength-based philosophy and resilience-building model.

[08:59 - 17:37] How to Raise a Resilient Child

• At some point, parents need to learn how to do things independently, and adolescence is a crucial time for this.
• Parenting during this time can be difficult because parents are anxious and want to protect their children from harm.
• To help parents navigate this stage successfully, they need to remember that their children are growing and developing and that mistakes are part of the process.
• Parents should also share their strengths with their children and help them develop coping mechanisms for when stress is unavoidable.

[17:37 - 26:38] The Truth About Adolescences

• Adolescents are emotional and rational beings, with brilliant emotional brains.
• The emotional brain takes over during adolescence, and this can be challenging for adults to manage.

https://302.buzz/PM-WhatAreYourThoughts

School Avoidance, social anxiety, and phobias are all common in childhood affecting 5% to 12% of kids. This is a lot of patients showing up in pediatric practices. The gold standard for treatment is exposure therapy, but that model has its limitations. How do you get a kid on an airplane multiple times to help with fear of flying? A new virtual reality (VR) therapy model is an exciting option. Trained psychologists use VR goggles and with sophisticated software create a patient avatar and experiences where patients can gradually face their fears. Research shows in small studies that the experience feels real and that fears diminish. Larger RCT are needed to push this therapy into the mainstream. Dr. Abbie Vanderwege shares her successes with this therapy and walks us through the patient experience. This is an exciting option for children and adolescents who are struggling.

Dr. Vanderwege with a major in Psychology from Kalamazoo College in 2004, quickly transitioned into the master's degree program in Counseling Psychology at Western Michigan University, which she completed in 2006. While working toward that degree, she developed an interest in holistic health and pursued a graduate certificate in Holistic Health Care, which she also received in 2006. Dr. Vanderwege then accepted a position as a family therapist for the Family Reunification Program at Bethany Christian Services. Feeling at home in Kalamazoo, she entered the APA-accredited Ph.D. program at Western Michigan University in Counseling Psychology in 2007 and completed a full-time APA-accredited predoctoral internship at the Battle Creek VA Medical Center where she pursued rotations in outpatient and residential PTSD, outpatient mental health, inpatient mental health, and substance abuse treatment. After completing her Ph.D. in 2011, she joined Child & Family Psychological Services 2011, and then directed the Portage office from 2014 to 2020. In 2020 she joined Teletherapy Group where Dr. Vanderwege sees children and adult clients virtually and face-to-face. Dr. Vanderwege has completed advanced training in psychological evaluation, anxiety and PTSD therapies, and mindfulness

[00:30 - 08:58] Pediatric Meltdown: Dr. Abbie Vanderwege Talks About Social Anxiety, School Refusal

• Dr. Abbie Vanderwege is a pediatric psychologist who has a Ph.D. in counseling psychology from Western Michigan University.
• She has worked as a family therapist for the family reunification program at Bethany Christian services and entered the APA accredited Ph.D. program in counseling psychology at Western Michigan University in 2007.
• After completing her Ph.D., she joined child and family psychological services and then directed the Portage office until 2020.
• In 2020, she joined a teletherapy group where Dr. Vander Wigg sees children and adult clients virtually and face to face.

[08:59 - 17:05] Nurture vs Nature?, School Avoidance: How to help kids

• Specific phobias occur in about 5% of children and can be grouped into a few different areas such as animals, medical procedures, loud noises, storms, and clowns.
• Some changes that may indicate a child is experiencing anxiety include dropping out of school, not wanting to practice driving, sleeping less than the recommended amount, and having little free time.
• If parents notice any changes in their child's behavior that seem out of the ordinary or interfere with their ability to function normally, they should consult a therapist.

[17:05 - 26:01] Exposure Therapy...

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Welcome back to Pediatric Meltdown today we are joined by Dr. Colleen Kraft. Dr. Colleen, the past president of the AAP 2018 and offers an overview of the impact the pandemic has had on child development including safety and security, nutrition, physical health, educational opportunities, and responsive caregiving. These are the pillars that make up the WHO Nurturing Care Framework. Dr. Kraft takes us beyond assessing the damage and instead focuses on the strengths that still stand. She makes the analogy of a house on fire. The house is burnt to the ground, but the foundations remain. Let's build from that. Rooms were damaged, but the house still stands nearly whole. Let's repair and rebuild. The home was filled with smoke, but the fire was extinguished. Let's clean away the soot and repaint. This analogy reminds us of the power of hope and action. As clinicians, we can help families see the possibilities and we can connect them to resources. We can also advocate for an educational reframe that supports college and academics and vocational paths. We need a society that embraces all skills and opportunities. In closing, Dr. Kraft reminds us that we are the child experts and that our voices matter.

Colleen A. Kraft, MD, MBA, FAAP is the Senior Medical Director for Clinical Adoption at Cognoa, a digital medical device company designing products to address the unmet developmental and behavioral health needs of children. Dr. Kraft served as the 2018 President of the American Academy of Pediatrics. Her background includes work in primary care pediatrics, pediatric education, and health care financing. Dr. Kraft received her undergraduate degree at Virginia Tech and her M.D. from Virginia Commonwealth University, and her MBA from the University of Cincinnati. She completed her residency in Pediatrics at Virginia Commonwealth University. 

[00:29 - 08:47] Pediatrician Colleen Craft Shares Her Vision for the Future of Pediatrics

• Dr. Colleen Kraft is a pediatrician and the senior medical director for clinical adoption at Cognoa.
• She has been a pediatrician for 34 years and served as the 2018 president of the American academy of pediatrics.
• Her journey into pediatrics drew her to work with families and children, promoting their optimal physical, developmental, and psychosocial health.
• She is also an advocate for pediatricians and all the work that we can do on behalf of kids.

[08:47 - 16:51] Virtual Reality Therapy for Phobias

• The world health organization promotes the nurturing care framework, which focuses on five pillars of early childhood development: adequate nutrition, safety and security, opportunities for early learning, and healthy relationships.
• During the pandemic, safety and security for children were disrupted by the death of adults and the displacement of secure bonds with parents.
• Housing insecurity was a major problem during the pandemic.

[16:51 - 24:36] Children Suffered from Cognitive and Motor Developmental Deficits during the Pandemic

• There is a disruption in various aspects of children's lives during the pandemic, including their...