SMARTer CARE Newsletters
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The Latest on Prazosin for Trauma Associated Nightmares 5/27/2021
Adverse Child Experiences (ACEs), or traumatic experiences, have significant medical and psychological sequelae. ACES may or may not lead to post traumatic stress disorder, and regardless of the presence of a formal diagnosis, exposure to ACEs increase the risk for poor sleep and traumatic nightmares. There are many psychotherapeutic and resiliency enhancing ways to support […]
The Family APGAR: Dimensions of Family Functionality 5/21/21
We are all familiar with the APGAR score as a critical tool in neonatal assessment. Not so, the Family APGAR, which is a tool that measures important elements of a family system that can be helpful in assessing a family’s resources and functionality in responding to the vicissitudes and challenges in their lives. As with […]
Extra-Pyramidal Symptoms (EPS) 5/13/2021
Antipsychotic medications have a variety of indications, and at times are used off-label for treatment of a variety of behavioral problems. The primary mechanism of action of antipsychotic is antagonism (or partial agonism) of centrally located D2 receptors, though most agents have additional targets (including serotonin and histamine pathways). Adults will commonly take these medications […]
Stimulants, Psychosis, and Stressors 5/7/2021
ADHD is a common neurobiological condition among school-age children (Wolraich et al., 2019). The American Academy of Pediatrics recommends primary care providers treat ADHD in school age youth 1) with referrals to evidence supported psychosocial treatment (such as Parent Training In Behavior Management) or other outpatient individual, family and group educational and treatment interventions, and […]
Autism and Repetitive and Restricted Behaviors 4/22/2021
In this discussion of Autism Spectrum Disorder (ASD), we will review the latest evidence in treatment for repetitive behaviors. Individuals and families impacted by ASD can present with a range of challenges and needs, it is important for providers to be familiar with a range of interventions and supports. Most particularly, youth with ASD can […]
Beyond the ACE Score: “As the twig is bent…” 4/16/2021
Spoiler Alert: Traumatic exposures, coupled with impaired parent-child relationships, experienced during early infancy and early childhood years are associated with great risk to children’s cognitive, emotional and social development. The seminal Adverse Childhood Experiences study demonstrated the strong correlation between the number of adverse events experienced in childhood and the risks for negative health and […]
Alternative Treatments for Depression 4/11/2021
Depression is a common, often undertreated mental health for children and adolescents across the country. Front line treatments are well known, and include: various forms and types of psychotherapies (individual and/or family, DBT, IPT, etc.), medications such as the selective serotonin re-uptake inhibitors (SSRIs), selective norepinephrine uptake inhibitors (SNRIs), and others, and various supportive interventions, […]
A Tale of Two Cities: Pandemic Impact on Alcohol Use in Adult and the Pandemic Impact on Adolescents 4/2/2021
The impact of the pandemic on mental well-being across the world and across all age groups has been stark, though the resiliency of most persons is also of note. Clearly the disruptive impacts of the pandemic have been powerful, most particularly for those more vulnerable to becoming infected and those (e.g., elderly, co-morbidly ill, the […]
Addressing Social Determinants of Health on Children’s Mental Health 3/25/2021
The American Academy of Pediatrics recognizes the pervasive effects of systemic racism (Trent et al, 2019) on the health of children and others, most particularly, their mothers, but not excluding fathers. The more we know about the impacts of racism on child development, the more we can tackle the problems head on. A recent review […]
Evaluating for & Treating ADHD in Preschool Children 3/18/2021
The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is becoming increasingly prevalent, in part because of better assessments, but also in part because of misdiagnosis and jumping too early to diagnose. The effect is that the diagnosis of ADHD is being given at younger and younger ages. This leads to the question of the best […]