Tapering Antipsychotic Medications in Children and Adolescents: Part 1 3/21/24

Although pediatricians do not often initiate prescriptions for antipsychotic agents, this and a subsequent e-newsletter edition discuss important issues in their use that can be of relevance to pediatric practice, both in managing acute clinical situations and in managing care for youth with longer term needs for these medicines. About 1% of children ages 7-12 […]

Co-Morbidity Between Intellectual Disability and Psychiatric Symptoms 7/25/23

The presence of Intellectual Disability (ID) increases the risk for co-occurring psychiatric disorders in child, adolescent, adult and geriatric patients. Behavioral and emotional problems are three times more likely to occur in these groups and they are frequently not recognized or appropriately treated. This said, problematic behaviors and emotions in this population may also be […]

Disruptive Behavior: Is It Anxiety or Something Else? 7/11/23

It is common for children and families to present to their primary care providers with concerns about behavioral problems and/or wanting to rule out ADHD. The typical presenting problem is severe temper tantrums or disruptive behavior in school. In some of these cases, the appropriate diagnosis is ADHD or another disruptive behavior disorder and treatment […]

Treating Co-Morbid ADHD and Tic Disorders 11/30/2017

A recent SmartCare case consultation highlights an important clinical situation regarding co-morbid ADHD and tics. Case Presentation: 10 yo boy with history of motor tic disorder (eye blinking, shoulder shrugging) who was then diagnosed with ADHD combined type. He was started on Concerta and titrated to 36 mg qAM, which has been helpful for his […]

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 […]

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 […]

ADHD And Co-Morbid Tic Disorder

A call recently came into the SmartCare PC2 line that highlights an important clinical situation. Case Presentation: 10 yo boy with history of motor tic disorder (eye blinking, shoulder shrugging) who was then diagnosed with ADHD combined type. He was started on Concerta and titrated to 36 mg qAM, which has been helpful for his […]