02. Caring for Children in Foster and Kinship Care: Keeping a Trauma-Informed focus with Moira Szilagyi

https://swiy.co/WhatAreYourThoughts

Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I had the honor of speaking with Dr. Moira Szilagyi. Dr. Szilagyi is regarded as one of the leading experts on the health of children in foster and kinship care and has served as chair of multiple AAP groups over the last 25 years leading the development of health care standards for children and teens in out of home care.

Let’s dive into Dr. Szilgayi's incredible story of how important it is to know the Three R’s and be a catalyst for change in the child welfare field, as well as to have trauma-informed focus as you learn, grow and impart skills to your fellow workers and the parents of your patients. 

[00:01 - 11:08] Opening Segment

• Introducing today's guest, Dr. Moira Szilagyi, and her achievements
• Dr. Szilagyi talks about how she got into her career
• Medical school at 28
• Realized she wanted to work with high risk kids
• Began working in Foster Care
• “These kids deserve better”
• Dr. Szilagyi tells a story of the one patient that inspired her to work in this field
• She realized the foster kinship care needed higher standards and better systems. And that there wasn’t literature on the subject or training. 
• Begins to work on a task force
• Charged with making different models of care
• Centralized care
• Opening 24/7
• Run like a regular practice

[11:09 - 25:52] Trauma Informed Focus

• Dr. Szilagyi tells a story of handling a child victim of fetal alcohol syndrome
• Dr. Szilagyi now mentors many young people as an academic pediatrician
• Remain open and find your passion
• Children in Kinship Care became Dr. Szilagyi’s passion
• Realizing these kids are coming in with so much grief and loss
• Most return into family
• Some disappear 
• Lifelong trauma 
• Dr. Szilagyi talks about their grant with AAP funding
• Dr. Szilagyi talks about the kids in her foster care
• You need the skill to actualize love 
• The kids can’t think they are going to be abandoned again even though the foster parent can’t promise a permanent home
• They need to know they always have a home in the heart of the foster parent

[25:53 - 36:15] The System of Foster and Kinship Care

• Dr. Szilagyi talks about her time in Rochester 
• Developmental path of psychology literature
• Learning what children need to thrive
• The Adverse Childhood Experience
• Found problems leading to obesity back from childhood
• Divided into 10 issues 
• The importance of healthy attachments from a young age
• Early Brain Development: AQA GCSE
• Harvard Developing Child
• Children exposed to a chaotic environment adapt to living in such conditions
• Knowing that you have to stay with the child THROUGH their trigger response

[36:16 - 46:53] Advice for the Busy Pediatrician and Parent 

• Dr. Szilagyi talks about the needed skills of the pediatrician 
• “What happened to you”
• Give tools to the children and the parents
• Praise the parent on their positives
• I tell a related story from my personal experience 
• H