Up to one in three children and adolescents experience clinically significant anxiety, and it is often under-recognized and under-treated. It is particularly important for primary care providers to be aware of the symptoms of anxiety in pediatric patients, because patients typically present first in this setting. Often the presenting complaint is a physical symptom, rather […]
Category Archives: Pediatrics
Treatment for Anxiety in Children and Adolescents 1/25/2018
The presentation of anxiety in children and adolescents was discussed in last week’s e-Weekly. This e-Weekly will focus on treatment for anxiety disorders in pediatric populations, as many patients first present to their primary care providers for assessment and treatment. Treatment options primarily involve therapy and/or medication. For patients presenting with mild-moderate anxiety symptoms, a […]
“Hallucinations” in Children
Hallucinations in children can be a confounding symptom and it is important to evaluate further if a child is presenting with concerns about hallucinations. It is important to distinguish among true hallucinations (false auditory, visual or other sensory perceptions that are not associated with real external stimuli), illusions (misperceptions of actual stimuli), imaginary friends, fantasies […]
Tips to Reduce the Side Effects of ADHD Medications
Medications for Attention Deficit Hyperactivity Disorder (ADHD) can be very helpful for children who struggle with hyperactivity, impulsivity, and inattention so that they can be more successful in the home and school environments. Often these medications can lead to problematic side effects such as decreased appetite, stomach pain, sleep problems, and moodiness, that can make […]
Signs of a Sensory Processing Disorder
Case Presentation 7 year old boy with chief complaint of “frequent meltdowns”. Additional history: daily meltdowns (crying, hitting) with loud sounds or when asked to wear certain clothing; wants to make friends but poor boundaries and accidentally hurts peers at school when he is playing with them; hard time sitting during seat work at school […]
Depression in Adolescents
Major depression affects 6% of adolescents with an additional 5-10% presenting with sub-syndromal symptoms of depression. There is a 2:1 female:male ratio of major depression in adolescents. Teens frequently don’t present with the typical DSM criteria for Major Depressive Disorder (MDD). Common depressive symptoms in adolescents include: irritability (as opposed to reporting a sad mood), […]
4 Traits That Put Kids at Risk for Addiction
The New York Times had an article in September 2016 (http://www.nytimes.com/2016/10/04/well/family/the-4-traits-that-put-kids-at-risk-for-addiction.html) that discussed the risk factors for addiction. Traditional anti-drug education in schools focuses on scare tactics and the message “Just Say No”, which has been found to be largely ineffective in children and adolescents who at the highest risk for drug abuse. Recent anti-drug […]
Non-stimulant Approaches to ADHD
There are situations that come up in a primary care setting when a pediatric patient presents with symptoms that are concerning for Attention Deficit Hyperactivity Disorder (ADHD) but where there are concerns about prescribing a stimulant medication. These are some of the situations when this can occur: The patient’s presentation meets the symptom checklist for […]
Choosing a Medication Treatment for ADHD
Once a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) has been made, a decision has to be made about treatment. Most children do well with a combination approach of medication and behavioral therapy. The most likely medication to start with is a stimulant medication. And then the provider has to make a decision from many, […]
Link Between Lead Toxicity and ADHD
When a child first presents with symptoms of Attention Deficit Hyperactivity Disorder (ADHD), it is important to assess if there is an underlying medical cause for the symptoms. Lead is a neurotoxin that has been well studied to affect children’s cognition and behavior, and the behavioral profile seen with lead toxicity can mimic ADHD. Children […]