Child Mental Health for Pediatric Clinicians

Elise Fallucco M.D.
  • 4.8 (37)
  • Medicine
  • Updated Weekly

Child Mental Health for Pediatric Clinicians podcast - formerly PsychEd4Peds -is the child mental health podcast designed for pediatric clinicians - helping you help kids. The host, Dr. Elise Fallucco, M.D., is a board-certified child and adolescent psychiatrist and mom of three who teaches pediatric clinicians to identify, manage, and support kids and teens with mental health problems.  Dr. Fallucco interviews experts in the fields of child psychiatry, psychology, and pediatrics to share practical tools, tips, and strategies to help pediatric clinicians take care of kids and teens.

  1. 5d ago

    78. Are Youth Athletes Burning Out? 2 Questions To Ask at Every Sports Physical with Dr. Joel Brenner (Summer Replay))

    Send us Fan Mail Summer sports physical season is here! Before you sign that next pre-participation physical, are you asking the questions that could help prevent burnout, overuse injuries, and early sports dropout?  In this timely replay, pediatric sports medicine expert Dr. Joel Brenner shares practical, evidence-based strategies to help young athletes stay healthy—and stay in the game. Learn why early sports specialization may do more harm than good, how much rest young athletes really need, and the two simple questions every pediatric clinician should ask during every sports physical.  Whether you're counseling a recreational athlete or the next aspiring Olympian, this episode will give you practical pearls you can use in clinic today. He shares practical strategies to  reduce burnout and over use injuries in our young athletes. Most importantly, we're going to find out how early is too early for kids to specialize in one sport.  Our Guest:  Dr. Joel Brenner is the co-author of the American Academy of Pediatrics' 2024 Clinical Report on overuse injuries over-training and burnout in young athletes. Dr. Brenner is a pediatric sports medicine physician and Director of the Sports Medicine, Sports Concussion, and Dance Medicine programs at Children's Hospital of the King's daughters in Norfolk, Virginia.  Check out our website PsychEd4Peds.com for more resources! Follow us on Instagram @psyched4peds Check out our NEW CME Audio-based, on-demand CME Course online at: Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

    26 min

  2. Jun 16

    77. ADHD Unlocked: Earn CME Credit

    Send us Fan Mail Would you be surprised to learn that there has been a MAJOR INCREASE in child mental health visits in primary care?  A recent study published in JAMA Network Open found clinically significant increases in child mental health visits over a 10-year period.  While ADHD remained the most common MH concern, ANXIETY visits rose by 300% from 2014-2023.  We know that it can be challenging and sometimes nearly impossible to connect these children and families with specialty child mental health care.  AND we know that families often PREFER to receive care from their trusted pediatric clinician in the comfort of their medical home.   To support YOU and other pediatric clinicians, we are excited to announce the launch of our new Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  Available online at: https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1 This on-demand, AUDIO-BASED course features 5 mini-modules on: ADHD Evaluation EssentialsADHD Differential Diagnosis: Recognizing Comorbidities and Look-Alikes (Anxiety, Traumatic Stress, mood disorders like BIPOLAR)ADHD TREATMENT: Stepwise approach to treatment with stimulants, managing side effects, addressing common parental concernsADHD with ANXIETY TREATMENT: Which to treat first? Algorithmic approach to choosing medications, including stimulants and non-stimulant medications (alpha-agonists, norepinephrine reuptake inhibitors)Advanced ADHD Treatment: What to do when meds stop workingIn addition, we have downloadable clinical tools, patient handouts, clinical pearls that you can use the next day in your office! We hope you check out the course and share it with a friend! Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1 Study: Pediatric Primary Care Visits with Mental Health Needs by Dr. Gallagher KM et al available online at: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2849123 Check out our website PsychEd4Peds.com for more resources! Follow us on Instagram @psyched4peds Check out our NEW CME Audio-based, on-demand CME Course online at: Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

    11 min

  3. Jun 9

    76. 5 Things That Will CHANGE Your Practice

    Send us Fan Mail Dr. Elise Fallucco reviews five practice-changing lessons from the previous season of Child Mental Health for Pediatric Clinicians:  1 - Ask better questions For example, use Dr. Waxmonsky’s ADHD assessment prompt, “When is the hardest time of day, and what is going on there?” to guide ADHD medication choice2 - Look for the problem behind the problem Ask teens about energy drinks/caffeine and sleep timing, recognizing energy drink use may signal sleep deprivation; 3 - Update how we talk to families about stimulants Emphasize that stimulants support wakefulness, alertness, and motivation rather than directly improving attention (based on Dr. Nico Dosenbach’s Cell study)4 - Remember the brain prefers gradual changeReview Dr. Jeff Strawn’s SSRI cross-titration approach while monitoring serotonergic side effects; 5 -  Prioritize clinician wellbeing!00:00 Season Lessons Overview 00:19 Ask Better ADHD Questions 01:07 Energy Drinks and Sleep Clues 02:37 What Stimulants Really Do 03:54 Brain Prefers Gradual Med Changes 04:29 Cross Titration SSRI Switching 06:41 Clinician Wellbeing Matters 07:26 Thanks and Stay Connected Links to Episodes Referenced: 69. How to Switch SSRIS with Dr. Jeffrey Strawn 71. ADHD stimulants do NOT impact the brain’s attention networks with Dr. Nico Dosenbach 74. Burnout in Healthcare: “The Pitt”, Stats, and Solutions! 75. Beyond the Buzz: Energy Drinks, Teen Health, and Safer Ways to Stay Energized with Roshni Patel Check out our website PsychEd4Peds.com for more resources! Follow us on Instagram @psyched4peds Check out our NEW CME Audio-based, on-demand CME Course online at: Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

    10 min

  4. Jun 2

    75. Beyond the Buzz: Energy Drinks, Teen Health, and Safer Ways to Stay Energized with Roshni Patel

    Send us Fan Mail Highly caffeinated energy drinks are taking the teenage world by storm! While the AAP (Peds) says that these beverages are NOT safe, a growing number of kids and teens use them.  To help us learn the latest about the health risks, join this conversation with Registered Dietitian, Roshni Patel! We talk about: What is really INSIDE these eye-catching, bright, metallic cans?Hint: potentially toxic amounts of caffeine plus sugar  What are risks for teens?What are HEALTHY but practical alternatives for our sleep-deprived, overstretched teens?  Roshni Patel, MS, RD works at the Mayo Clinic in Jacksonville, Florida in the Division of Obesity Medicine. Check out our website PsychEd4Peds.com for more resources! Follow us on Instagram @psyched4peds Check out our NEW CME Audio-based, on-demand CME Course online at: Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

    22 min

  5. May 13

    74. Burnout in Healthcare: "The Pitt", Stats, and Solutions!

    Send us Fan Mail Let's talk about clinician wellbeing and burnout... In this episode, Dr. Elise Fallucco shares results from the recent AMA national survey about physician and APP burnout, and then shifts to talk about the portrayal of burnout and boundaries in a scene from HBO's "The Pitt".   She shared resources to address SYSTEMIC issues that contribute to burnout - The  AMA's “Saving Time Playbook” found at:  https://www.ama-assn.org/practice-management/sustainability/saving-time-playbookFinally, we talk about a  simple, grounding exercise Pay attention to - 3 things you can see, 3 things you can hear, and 3 things you can feel... to reset during stressful moments. Check out our website PsychEd4Peds.com for more resources! Follow us on Instagram @psyched4peds Check out our NEW CME Audio-based, on-demand CME Course online at: Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

    14 min

  6. Apr 28

    73. ADHD Clinical Pearls: Measuring what matters with Dr. James Waxmonsky

    Send us Fan Mail Three Clinical Pearls for Evaluating and Treating ADHD  Dr. Elise Fallucco chats with Dr. James Waxmonsky (Chair of Child Psychiatry at Penn State) about practical strategies to evaluate and treat children and teens with ADHD.  Clinical Pearl #1 - Ask Patients about their biggest Challenge and define their Goals, Set Relevant Finish Lines Dr. Waxmonsky emphasizes starting with family- and patient-defined functional goals rather than symptom scores, Keep in Mind: stimulant sensations like alertness or “academic confidence” can fade with physiologic tolerance and may not reflect real-world improvement. Clinical Pearl #2 - Ask about the hardest time of the day Ask about the family WHEN is the hardest time-of-day and WHAT is the specific problem (e.g., meds may help careless errors and pacing more than organization).  Clinical Pearl #3 Ask about Drift Time He also recommends measuring “drift time” by asking how many minutes of a class period the student is on task00:00 73. 3 ADHD Tips with Dr. James Waxmonsky 01:00 TIP #1 - Ask Patients about their biggest Challenge and define their Goals, Set Relevant Finish Lines 03:07 Measuring Evidence of Real Focus and Motivation 06:22 TIP#2 - Ask about the hardest time of the day 08:37 Need Branded Concerta not generic 10:01 TIP#3 Ask about Drift Time 13:48 Recap of Clinical Pearls About our Guest:  Dr. James Waxmonsky Professor, Vice Chair for Children's Services and University Chair in Child Psychiatry, Department of Psychiatry and Behavioral Health Penn State Neuroscience Institute Check out our website PsychEd4Peds.com for more resources! Follow us on Instagram @psyched4peds Check out our NEW CME Audio-based, on-demand CME Course online at: Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

    16 min

  7. Apr 21

    72. Can we develop Tolerance to stimulants? with Dr. James Waxmonsky

    Send us Fan Mail Does our brain adapt to stimulant medication over time, develop tolerance, so that we require higher doses to achieve the same effect? When patients tell us their stimulant doesn't seem as helpful (after working well for a while), could this be tolerance? ... or could it be something else?  To answer these questions, Dr. Elise Fallucco chats with Dr. James Waxmonsky, co-PI for NIMH-funded study: Examining Tolerance to CNS Stimulants in ADHD.  00:00 Introduction of Dr. James Waxmonsky 01:26 What Is Tolerance? 02:10 Clinical Evidence for Tolerance 02:57 Longer-term Tolerance to stimulants 03:40 "The Brain Moves Its Targets" 04:16 Clinical Considerations in evaluating when "meds not as helpful": Changing Life Demands or true tolerance? 06:30 Management of Stimulant Tolerance 06:56 Clinical Pearl: Ask about increases in executive functioning and life demands 07:40 Taking a break from stimulant medication 08:14 Waxmonsky Longitudinal Study 09:00 Weekend Holiday Design 09:32 Recap - Do weekend holidays matter and reduce the need for higher doses? 11:46 Quicker dose escalation in continuous vs. holiday groups 14:00 Weekend Dosing Tradeoffs 15:45 Growth vs Dose Myth and Mg/Kg Dosing 17:35 Recap of how to Manage Tolerance 17:57 Toolbox for Recapturing Effect 18:37 Closing Thoughts 19:04 Final Recap Dr. James Waxmonsky is the Division Chief of Child Adolescent Psychiatry at the Hershey Medical Center, the University Chair in Child Psychiatry at Penn State and a Professor of Psychiatry at the Penn State College of Medicine. He serves as Co-PI for an NIMH-funded study, Examining Tolerance to ADHD Stimulants. Check out our website PsychEd4Peds.com for more resources! Follow us on Instagram @psyched4peds Check out our NEW CME Audio-based, on-demand CME Course online at: Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

    22 min

  8. Apr 7

    71. ADHD stimulants do NOT impact the brain's attention networks?!?! with Dr. Nico Dosenbach

    Send us Fan Mail Bench to Bedside: How ADHD Stimulants Really Work—Arousal and Reward, Not Attention Networks Dr. Elise Fallucco launches a new “Bench to Bedside” series and interviews Dr. Nico Dosenbach, senior author of a ground-breaking fMRI study published in CELL  that found that  stimulants do NOT significantly change the brain’s attention networks!?!?!  Instead, effects are strongest in arousal (less drowsy, more wide awake) and reward/motivation systems (increasing predicted reward and tolerance of “drudgery”).  We discuss: how these findings align with patient experiencewhy ADHD can be a misnomer how video games/TikTok exploit variable reward scheduleshow this changes what we tell patients and families about stimulantsOur conversation highlights implications for destigmatizing ADHD, reframing stimulants as helping wakefulness and motivation rather than “making you smarter,” and how strategies like habit pairing and gamification can make necessary tasks more rewarding. 00:00 Welcome to Bench to Bedside Series 01:34 What We Thought We Knew about Stimulants 03:30 Examining brain networks in ADHD 04:03 No Attention Network Effect 04:50 Patient reaction to the paper's fundings 05:30 Where in the brain are stimulants working? 05:45 Arousal Signature 06:29 Stimulants also affect the Dopaminergic REWARD and Motivational systems 06:41 "More Tolerant of Drudgery" 07:18 Stimulants affect Arousal 08:08 Stimulants act on Motivation and Reward 08:50 Why motivation matters in kids with ADHD 09:21 Findings consistent with other human behavioral data and macaque data 09:47 Raking Leaves and Hacking the Reward Systems 11:24 Clinical Implications of Study 11:41 Implications for ADHD Treatment 12:58 Did Einstein need stimulants? 13:16 Hyperfocus and Real Life Examples: Deer Hunting 15:24 Reward Hacking : Video Games and TikTok 16:42 Non Prescription Tricks to Hack the Reward System 18:15 Procrastination in ADHD and dopamine 19:01 Different ADHD distribution in medicine? 19:34 Reframing ADHD 20:26 Gamifying Life 22:09 Closing Recap - Clinical Implications About Our Guest, Dr. Nico Dosenbach: https://dosenbachlab.wustl.edu/ For access to the full paper, Stimulant medication affect arousal and reward, not attention networks: https://www.cell.com/cell/fulltext/S0092-8674(25)01373-X Check out our website PsychEd4Peds.com for more resources! Follow us on Instagram @psyched4peds Check out our NEW CME Audio-based, on-demand CME Course online at: Pediatric Mental Health CME Toolkit - Cracking the ADHD Code: Essentials for Pediatric Clinicians.  https://ce.nemours.org/content/podcast-series-cracking-adhd-code-essential-skills-pediatric-clinicians#group-tabs-node-course-default1

    25 min
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Child Mental Health for Pediatric Clinicians podcast - formerly PsychEd4Peds -is the child mental health podcast designed for pediatric clinicians - helping you help kids. The host, Dr. Elise Fallucco, M.D., is a board-certified child and adolescent psychiatrist and mom of three who teaches pediatric clinicians to identify, manage, and support kids and teens with mental health problems.  Dr. Fallucco interviews experts in the fields of child psychiatry, psychology, and pediatrics to share practical tools, tips, and strategies to help pediatric clinicians take care of kids and teens.

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