Pediatric Meltdown

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Welcome to the 1-year anniversary of Pediatric Meltdown! It’s been a year since I started this podcast, but I am only getting more addicted to it. This podcast has allowed me to do something that I really enjoy and made me realize that I love talking with people. Specifically, I love having conversations where we can just be in our genuine selves. 

Join me today as I look back on the past 52 weeks and reflect on the countless conversations and moments I shared with my guests. As we start another year, may we find hope and courage to face all challenges and celebrate our wins with the people we love dearly. 

[00:01] It’s Been a Year!

• First of all: Thank you for joining me on this ride
• My realizations during the COVID-19 pandemic 

[02:10] My Realizations in Doing This Podcast

• I really thought the public has lost trust in doctors and in science as a whole
• Here’s what I learned
• Medicine, as a practice and as an art, is magical, and here’s why
• Hate can be contagious, and this is the antidote
• My message to all the parents out there
• Are you a therapist? You need to hear this
• My open letter to my pediatrics colleagues 

 [09:58] Closing Segment  

• Final words and reminders

Key Quotes:

“Find time to take care of yourselves, and if you’re struggling, it’s okay to not be okay.” - Dr. Lia Gaggino

“The antidote to [hate] is steadfast courage and commitment to doing the right thing for the right reasons.” - Dr. Lia Gaggino

“Know that those of us in this helping profession do this for love, not money.” - Dr. Lia Gaggino

Resources Mentioned:

• American Academy of Pediatrics 

If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Twitter or email me at [email protected]. To learn more about me visit https://www.medicalbhs.com/

LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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We continue our discussions about birthing experiences, and this time, we’re going to talk about the experience of the Latinx community in our healthcare system. Kristina Ledlow and Dr. Karen Garcia join us to talk about ways to improve the services being provided for the community, especially for Latinx mothers. We can only broaden cultural competence by listening to others experiences and by stepping out of our own perspectives. Pediatric clinicians serve not only our newborns and infants but also support our moms and families. Thinking about how we embrace all of our families through their eyes only improves the care we give.

[00:01] Kristina Ledlow and Dr. Karen Garcia Share Their Story With Us

• Kristina and Karen talk about the kind of work they are involved in 
• They give interesting details about birthing ourselves 

[06:40] Latinx Mothers and Their Healthcare Experiences 

• The experience of Latinx mothers in the healthcare system 
• Kristina shares their approach in taking care of mothers during the prenatal stage
• Karen gives a piece of advice that first-time mothers should hear 
• Ask from a place of curiosity and live with empathy 

[16:46] Better Service for the Latinx Community

• We have an interesting exchange medical insurance 
• How can providers improve how they serve the patients?
• Kristina and Karen explain 
• Even if providers mean well, they might still deal trauma to the patients
• Karen recalls her experience as an immigrant assimilating in the United States

[26:25] Knowing Other People’s Culture 

• How to communicate with your patients the right way
• Kristina and Karen share some tips and resources
• The books you can read and authors you can follow right now
• The beauty of discovering other people’s cultures

[36:14] No Explanations Needed   

• Kristina has a message for her younger self that you should not miss
• Karen sends a message for her resident self you’d want to hear 
• “No” is a complete sentence, and you don’t need to always explain yourself 

 [42:35] Closing Segment  

• Final takeaways:
• It is hard to recognize that much of our medical system is white-centric.
• Culturally, Latinx families see physicians as powerful and are differential
• There are many barriers to accessing care
• The sentence, “Tell me about who is living in your household.”
• The patriarchy in Latinx families
• Don't make assumptions or rush to judgment and other messages for providers
• Be aware of your own biases
• Reading books by Latinx authors can be a start to your awareness and curiosity

Key Quotes:

“I think that if we are validating to our patients, if we validate their stories, and we come from a place of curiosity and empathy, that's a really good starting point..” - Kristina Ledlow

“It’s okay not to know. It’s okay not to be sure what [the patients’] cultural beliefs and backgrounds are so come from a place of curiosity and ask them so you can better support them.” - Dr. Karen Garcia

Email [email protected] to connect with Kristina then [email protected] to reach out to Karen. Check out

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Erica Guthaus has been supporting families in their childbearing years since 2008 and has been part of the professional birth community since 2014. A highly skilled communicator, educator, and encourager, she specializes in transformative growth, empowerment, and wisdom keeping. 

As the Conjuror of Birth Reclamation at Rootead, Erica is bringing her skill set to life by supporting Red Birth Green birth workers and families in claiming compassionate, inclusive, and respectful care for the entire family dynamic during childbearing years. Born and raised in Kalamazoo, she currently lives in Lansing with her husband, 4 kids, and 6 rescue pets.

[00:01] Erica Guthaus Shares Her Story With Us

• Erica shares her journey in becoming a “doula”
• She breaks down what a doula is and why you should have one

[07:05] People Over Policy 

• Erica talks about their mission of restoring humanity
• Do not treat people as numbers and statistics 
• Why her tagline in life is “People Over Policy”
• The simple and easy step to decolonize spaces 
• Why curiosity is uncomfortable according to Erica 

[17:25] A Young Black Woman’s Experience in the Healthcare System 

• The experience of a young Black woman in a healthcare setting
• Erica offers a unique perspective 
• Why delivering information the right way is crucial in interacting with patients 
• Erica shares interesting insights about the healthcare system
• A frightening position and place for a pregnant or first-time mother 

[28:43] Pursuing Racial Reconciliation and Diversity 

• What you should realize about racism according to Erica 
• Why engaging with people is like peeling off an onion 
• Erica gives her thoughts about engaging the youth in their initiatives  
• She talks about our progress in racial reconciliation and diversity 

[39:09] Generating Sincere Patient-Provider Conversations  

• The very first question that providers need to ask to their patients 
• How to generate sincere conversations with patients 
• No is a complete sentence that providers should accept from patients 
• Believe the patients even if you can’t understand them yet 
• The most fulfilling part of working in the healthcare sector 

 [54:45] Closing Segment  

• Final takeaways:
• A doula provides non-clinical, social-emotional support for pregnant mothers 
• Thinking about the people that the healthcare system really serves 
• People over policy
• Why asking questions is important to change the system
• Why people assume and judge others first before understanding them better
• Real experience starts on the phone
• Many women of color still don’t feel like they’re being taken care of 
• What Erica would do if she can change the system
• Many of the things we can do to change the experience of BIPOC patients are free.
• Not seeing color is racist. Period
• No is a complete sentence that should be accepted 
• Incremental change is happening; be part of the change now
• We need to believe the patients, to see them, and to not dismiss them

Key Quotes:

“All of the things that actually would have the most change are free.” - Erica Guthaus

“It should not take a high-profile situation for the situation to be believed.” - Erica Guthaus

Email

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We all picture the joyous new mother. Happy, put together and radiant. The reality is often very different. Many moms are relieved that their baby. A mother’s mental health has a direct impact on her baby and we as pediatric clinicians are in a perfect position to support her. Dr. Rena Menke, a clinical psychologist with 15 years of experience working with pregnant and postpartum mothers, walks us through a model of care that promotes parenting skills and supports infant mental health. Dr. Menke describes how we can help parents by finding “beautiful moments” between a caregiver and their baby.

[00:01] Dr. Rena Menke Shares Her Story With Us

• How Dr. Menke shares her journey to the infant mental health field
• What to expect in infant mental health according to Dr. Menke

[04:13] 3 Moments Between a Mother and Her Baby

• Why pediatricians need to consider mental health in treating patients
• Dr. Menke connects a mother’s mental health to that of her child 
• The reality about motherhood you need to realize 
• She talks about her program, “Early Relational Health”
• Is it exclusive for mothers?
• When is it best implemented?
• The 3 types of moments to watch out for between a mother and her baby

[14:20] Creating Beautiful Moments

• How to advise mothers in overcoming challenging moments with their babies
• Dr. Menke shares how to practice empathy with parents 
• What pediatricians can learn from the infant mental health field 
• Check out some resources on early relational health!
• Links below 
• Building a “partnership” with parents to create beautiful moments 

[24:28] Building Meaningful and Healthy Relationships 

• We talk about the things that pediatricians do best 
• What confidence brings to parents in terms of taking care of their children
• Simple exercise parents can do when talking about their kids 
• How meaningful and healthy relationships are built 

 [32:31] Closing Segment  

• Final takeaways:
• Infant mental health was pioneered by Selma Fraiberg, author of “The Magic Years”
• Perinatal mood and anxiety disorder prevalence is about 40%.
• Early relational health is an intervention developed by pediatrician, David Willis
• A primary care physician or provider may identify an infant-parent dyad that may need some support.
• Identifying the 3 key moments between the mother and her baby 
• We may need to take a breath and pause as we help guide through interactions that we are concerned about
• There's formal online training for interested clinicians to learn more about upstream prevention intervention
• Rena’s contact details below
• Child psychiatry access programs are available across the country. Links below
• For information on how to develop integrated behavioral health in your practice, please reach out to me in the show note links

Key Quotes:

“I think what's wonderful is we now know that there are so many different resources for moms and babies… ” - Dr. Rena Menke 

“When parents are feeling confident and able to care for their children, then they have more ability to choose what they're doing.” - Dr. Rena Menke 

Email [email protected] to connect with Dr. Menke or check out http://med.umich.edu/ to know...

(Trigger warning: suicide)

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My guest today is Dr. Samantha Shaw, a psychiatrist specializing in women’s health, with an emphasis on perinatal health. She drops by the podcast today to talk about women’s experiences and safe treatment options. Dr. Shaw shares information about helpful resources and virtual support groups and encourages clinicians to screen, identify and refer early.

[00:01] Dr. Samantha Shaw Shares Her Story With Us

• How Dr. Shaw became a psychiatrist specializing in women's and perinatal health
• We talk about obstetricians and using the Edinburgh Postnatal Depression Scale

[04:36] A Baby’s Mental and Emotional Well-Being

• When to prescribe Selective serotonin reuptake inhibitors (SSRIs) to women
• Are they safe during pregnancy?
• The impact of a mother’s feeling and emotions to her baby
• We have an interesting exchange about postpartum depression and anxiety
• What could’ve been their evolutionary causes?
• Don’t leave depression and anxiety during pregnancy untreated 
• Dr. Shaw tells us why 
• 30% of babies goes through this kind of experience

[14:24] Mental Health of Mothers

• Dr Shaw breaks down what is called the Poor Neonatal Adaptation Syndrome
• She gives important pieces of information about breastfeeding
• Don’t let the name “antidepressant” fool you
• Dr. Shaw explains
• Dr. Shaw shares her experience on mothers with more complex mental health situations
• Controlling ADHD among women 
• How to find someone like Dr. Shaw
• Common questions you should ask to Dr. Shaw 

[24:01] Responsibility of Pediatricians

• Don’t believe sensationalized news about mothers 
• Many mothers struggle with “intrusive thoughts”
• Dr. Shaw’s Public Service Announcement about mothers you should hear now
• The important clue for providers on how to manage a mother’s intrusive thoughts
• How providers should handle mothers with suicidal thoughts 
• Pediatricians and their responsibility in taking care of mothers 

[34:54] Dads Experiencing Postpartum Depression and Anxiety 

• Virtual support groups that mothers can participate in 
• There are groups even for dads!
• We talk about dads going through postpartum depression and anxiety 
• Normalizing shame and eliminating stigma among mothers 
• Dr. Shaw shares her message for her resident self 
• The beautiful thing about motherhood

 [42:25] Closing Segment  

• Final takeaways:
• Mothers with PMAD may have difficulty bonding with their babies
• Are medications safe?
• SSRIs are safe to use 
• Atypical antipsychotics can be used during pregnancy and postpartum period
• Lithium does pose some cardiovascular risk
• Depakote and Tegretol are big no no’s during pregnancy
• Teaming with psychiatry is essential for complex drug regimens 
• Psychiatric programs can be pediatric and perinatal
• Dealing with a mother’s intrusive thoughts
• Think twice about contacting CPS or referring families to the emergency room
• One in 10 dads may experience PMAD
• Suicide risk is real
• It is our job as champions for babies to care about and protect our mamas.

Key Quotes:

“Whether you're depressed, whether you're anxious has no bearing on how good of a mother you are.” - Dr. Samantha Shaw

“There’s no shame in struggling.” -...

(Trigger warning: suicide)

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In this episode, Faith McDonald, a writer and an assistant professor at Penn State University, shares her experience helping her son who struggles with mental illness. His struggle is a familiar one to many parents and clinicians as they are prevalent among children and young adults, and the journey to wellness is often a difficult one.

Faith talks about the power of “sharing your brokenness” with others as a way to find wholeness. The weight of worry is lightened knowing that you are not alone. We have the incredible honor of being with our patients and families and the opportunity to weather the journey through the highs and the lows.

In times of distress, Mr. Rogers advised to "look for the helpers." We are the helpers.

[00:01] Faith McDonald Shares Her Story With Us 

• Faith talks about her experience as a parent
• Dealing with her son’s mental health issues  
• Determining the trigger 
• How she realized her son needed help 

[07:06] A Young Adult’s Mental Health 

• Mental health issues on young adults
• Dealing with a young adult’s mental health issues
• From a physician’s perspective 
• We talk about privacy and how it factors into a young adult’s mental health 
• The possible physical symptoms of a mental health issue 
• Here are Faith’s suggestions for doctors to better serve their patients 

[17:31] “He's Going to Get Better” 

• The questions that parents should expect from physicians 
• We have a conversation about suicide 
• Faith’s experience of dealing with her son’s paranoia 
• The different kinds of support available for parents and their children 
• Being comfortable with the uncomfortable 
• The words that brought Faith hope 
• The different types of therapy for young adults 

[27:37] Sharing Our Brokenness 

• The benefits of exercise and meditation 
• You should not be silent about your problems
• Faith explains 
• Parents asking permission to help their children 
• Faith gives us a sneak peek about her book, “On the Loving End of Crazy”
• Sharing our brokenness

[37:22] The Purpose of Suffering 

• The impact of sharing her son’s story 
• What Faith realized about helping her son with his mental health challenges 
• The purpose of suffering according to Faith 

 [45:10] Closing Segment  

• Final takeaways:
• Parenting is hard regardless of the child’s age
• The connection between the mind and the body
• Parents don't always think that their child could be thinking about suicide
• Safe talks and the Question-Persuade-Refer approach 
• Parents working with partners in the mental health and school spaces 
• Routine screening and why it’s important 
• Balancing giving support and nurturing independence 
• Caregivers need to take care of themselves
• Sharing brokenness is healing

Key Quotes:

“Our kids are paying attention in ways we don't maybe necessarily realize.” - Faith McDonald

“We have to, as people functioning as a community of faith, be comfortable with sharing our brokenness.” - Faith McDonald

“There's purpose in your suffering. For me, it's strengthened my faith, it's enlarged my compassion for people...” - Faith McDonald

Email...

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Welcome back to Pediatric Meltdown. Ethics is not just for philosophers! The field of bioethics infuses medicine with a thoughtful process for decision making when the choices are not clear. The choices between what we can do and what we should do is often a murky place.

Dr. Tyler Gibb has authored dozens of peer-reviewed publications on the intersection of health law and medicine and examines clinical ethics, medical narratology, the politics of medicine, medical education pedagogy, and professional misconduct and professionalism in healthcare. His work and expertise can ease our own distress when faced with moral and ethical dilemmas and can guide us as we seek clarity for our patients, families and for our teams.

[00:01] Dr. Tyler Gibb Shares His Story With Us 

• Dr. Gibb shares his background in the medical bioethics space 
• The question that clinical ethics answers  

[06:20] Making the Tough Decisions 

• Dealing with end-of-life situations the clinical ethicist way 
• Here’s a story from Dr. Gibb about “moments of introspection”
• What does this mean?
• When team members don’t agree with one another… 

[16:34] Divulging All Information to the Patient 

• Telling everything to the patient, even the bad news 
• How Dr. Gibb approaches this situation 
• Ethical considerations during the COVID-19 pandemic 
• Putting yourself first before anyone else

[26:28] Primary Care and Ethics

• The interaction of primary care and ethics 
• We have an interesting exchange about handling transgender patients 
• Addressing mental health issues among patients 

[36:24] Takeaways for Clinicians 

• Share your burden
• Find your moral voice 
• Dr. Gibb’s message for his younger self 

 [46:44] Closing Segment  

• Final takeaways:
• Bioethics is the meta ethics and focuses on the theoretical.
• Clinical medical ethics brings theory into practice.
• The question, “Why is this decision a concern versus another decision?”
• What we should do vs. What we can do 
• Ethical considerations and issues rose to the top and became familiar due to COVID-19
• Ethical dilemmas often arise within medical teams when individuals don't agree
• Primary care specialists should also consult with ethicists 
• You are not alone in your struggles
• The burden you feel can be shared
• Be vulnerable, ask for help
• Find your moral voice and train yourself to hear the moral voices of others.
• Preserve your humanity by drawing boundaries 

Key Quotes:

“Mental health is not something that physicians can tackle alone. It's not something that social workers can tackle alone.” - Dr. Tyler Gibb

“You are not alone...the burden that you feel can be shared and ought to be shared.” - Dr. Tyler Gibb

Email [email protected] to connect with Dr. Gibb or check out Western Michigan University Homer Stryker School of Medicine to know more about his work. 

Resources Mentioned:

• Dr. Gibb’s podcast: Bioethics for the People Podcast
• Journal

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Welcome to another episode of Pediatric Meltdown. My guest for today is Dr. Lisa Namerow, a Board-certified psychiatrist triple-boarded in pediatrics, child psychiatry, and general psychiatry. She has been in the pediatric healthcare space for almost 30 years, directing the consultation services to in-patient pediatrics, and the access to mental health programs for pediatricians. 

Her areas of research have been pharmacogenetics, and the impact of clinical pathways and standardized care for eating disorders, somatic symptoms, and related disorders, and delirium, and serves on the American Academy of Child and Adolescent Psychiatry Committee on the physically ill child.

[00:01] Dr. Lisa Namerow Shares Her Story With Us 

• Dr. Namerow shares how she became a child and adolescent psychiatrist 
• She introduces the field of Pharmacogenomics
• Pharmacogenomics vs. Pharmacogenetics 

[06:12] Genetics 101 

• Myths about Pharmacogenomics
• Pharmacodynamic Genes and Pharmacokinetic Genes
• What we need to know
• Dr. Namerow’s analogy for genes 
• The relationship between medicines and gene findings 

[16:19] Deciding if Gene Testing Can Be Helpful

• What oncologists should know about prescribing medicines
• How a pediatrician can utilize genetic testing 
• The screening questions to help pediatricians decide on genetic testing

[26:37] Genetic Testing in ADHD, Depression, and Anxiety

• Talking with parents about genetic testing
• How the serotonin transporter works in the body 
• Genetics in the context of ADHD, depression, and anxiety 

[36:10] The Best References for Primary Care 

• Dr. Namerow’s interesting insights about primary care
• Her message for clinicians that you should not miss 
• Dr. Namerow’s message for her younger self 

 [46:10] Closing Segment  

• Our advice for all working moms out there
• Final takeaways:
• The role of certain relevant genes in drug response
• The industry's detailing can be misleading
• There are some very relevant gene medication pairs
• An analogy about Gentamicin you should not miss
• Using Venlafaxine 
• Facts about Cytochrome P450
• Screening questions to decide if genetic testing can be helpful
• Select medications based on evidence and guidelines

Key Quotes:

“What is true is that genes do code for both the enzymes that metabolize medicines, and they also code for the proteins that are the site of the action of medication.” - Dr. Lisa Namerow

“[It’s] heartbreaking that we don't have a system that cares for these kids in the way that they should be cared for, and that it falls on primary care.” - Dr. Lisa Namerow

Email [email protected] to connect with Dr. Namerow or check out Connecticut Children’s Medical Center to know more about her work. 

Resources Mentioned:

• Pharmacogenomics: An Update for Child and Adolescent Psychiatry
• Child Psychiatry Access Programs by state

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My guest today is Dr. Jeffrey Strawn, a Professor of Psychiatry, Pediatrics and Clinical Pharmacology at the University of Cincinnati and at Cincinnati Children’s Hospital. He is the Director of the University of Cincinnati Anxiety Disorders Research Program and the Associate Vice Chair of Research in the Department of Psychiatry & Behavioral Neuroscience at the University of Cincinnati.

In his clinical practice, he works with youth with anxiety and related disorders and with their families and supervises residents and fellows. Dr. Strawn has authored more than 160 peer-reviewed publications and co-authored two textbooks on the treatment of children and adolescents and on contemporary psychotherapy. He is a distinguished fellow of the American Academy of Child & Adolescent Psychiatry and has received multiple awards for teaching, mentorship and research.

[00:01] Dr. Jeffrey Strawn Shares His Story With Us 

• Dr. Strawn shares how he landed in the child psychiatry space 
• The potential of over-screening patients
• Dr. Strawn shares his thoughts 
• Dealing with different levels of anxiety per Dr. Strawn’s experience 

[06:54] The Severity and Frequency of Anxiety 

• The criteria that Dr. Strawn uses to determine the level of anxiety of his patients 
• The  questions to ask to tell how severe the anxiety is and how frequent it happens 
• What parents should expect in assessing their kid’s anxiety 
• The factors that can affect moods, not necessarily anxiety disorders 
• Does your child need medications?
• Listen to Dr. Strawn’s explanation  

[16:35] The Right Medication for Anxiety 

• Dr. Strawn shares his approach to giving medications on anxiety 
• Giving medications is one thing, managing the dosage is another 
• Avoid making the patient expect they will have problems with this simple statement 
• Overlaps between anxiety and depression symptoms 

[26:18] Side Effects of Medications 

• How do we know if the medicines are working?
• Mania vs. difficulty in sleeping and bipolar disorder 
• Dr. Strawn talks about boxed warnings 
• Managing insomnia and sleepiness 

[36:25] Managing Panic Attacks 

• Taking medications with or without food
• Dr. Strawn shares his thoughts 
• Dr. Strawn shares his thoughts about managing anxiety among young adults 
• His clever strategy to handle panic attacks among young adults 
• He shares his thoughts about cannabis use 

[47:29] Marijuana Use Among Young Adults 

• The difference between alcohol and marijuana users 
• Dr. Strawn’s parting advice for listeners 
• The impacts of anxiety about the growth of a child 

 [52:46] Closing Segment  

• Final takeaways:
• The question, “How often do you worry?”
• Treatments for different levels of anxiety 
• Severe symptoms of anxiety we should watch out for 
• The SCARED tool for anxiety 
• SSRIs are safe as first line of medication for anxiety and depression in children
• “start low and go slow”
• The time to onset of actions of different medicines
• Side effects of medications that we should know
• Managing side effects 
• Monitoring can be done in person or via televisits 
• A more strategic approach to handle...

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My guest today is Dr. Stephanie Nelson, a board-certified pediatric neuropsychologist. Dr. Nelson walks us through the nuances of neuropsychological assessments and how they can help us coordinate care for our patients.  

Dr. Nelson specializes in complex differential diagnosis. Her day-to-day work involves comprehensive neuropsychological assessments and outreach to the community through presentations, workshops, and volunteer work. She also spends half her time providing consultation to psychologists and neuropsychologists who specialize in pediatric assessment.

[00:01] Dr. Stephanie Nelson Shares Her Story With Us 

• Dr. Nelson  wanted to be a teacher at first but ended up as a neuropsychologist
• She tells us what happened 
• Dr. Nelson tells us the difference between clinical psychology and neuropsychology

[06:55] Differentiating Dyslexia from Other Learning Disabilities 

• Neuropsychologists like to say they’re psychologists first, then neuropsychologists second
• Dr. Nelson tells us why
• The other things that neuropsychologists test aside from memory 
• Should you go to a neuropsychologist or clinical psychologist first? 
• Don’t be confused with Dyslexia, Dysgraphia, and Dyscalculia with these explanations from Dr. Nelson! 
• She talks about Rapid Naming 
• Factors that affect comprehension 

[18:07] Determining the Right Intervention for the Child 

• Determining the true situation of the child to choose the right intervention 
• The top question that neuropsychologists get from parents and pediatricians 
• Special education in schools 
• Qualifying for special education services 
• Resources with informative content for pediatricians and parents 
• Links below 

[28:11] Determining the Right Intervention for the Child 

• The role of neuropsychologists in helping children with Down syndrome 
• Learning multifactorial skills 
• What Dr. Nelson always tells the parents when asking for a neuropsychological evaluation 
• How pediatricians should read neuropsychological reports 
• 3 things for families to know more about their children 

[38:32] The Right Time to Seek Evaluation 

• How Dr. Nelson writes her neuropsychological reports 
• The challenge in giving treatments to kids who exhibit learning disabilities 
• Dr. Nelson shares her insights about seeking an evaluation for children 
• Dyslexia is heritable 

 [44:29] Closing Segment  

• Final takeaways:
• A neuropsychologist goes one step farther than the clinical psychologist
• A neuro psych evaluation may be really helpful for specific cognitive concern
• Neuropsych testing tackles cognitive domains language, sensory-motor, executive function, and social cognition, just to name a few.
• Consider Dyslexia
• Math and writing disorders are also multifactorial
• Special education in schools should address the needs of students 
• Dr. Nelson's goal of creating a roadmap of needs that meets challenges and come up with a diagnosis that makes sense
• Family history is crucial 
• When to consider neuropsychology 

Key Quotes:

“Writing is just language on paper. So if you have trouble with language, it's going to show up in your writing.” - Dr. Stephanie Nelson

“ADHD has similar...