ADHD, Anxiety & More: Clinical Pearls for Pediatrics

Elise Fallucco, MD | Child Mental Health Expert
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ADHD, Anxiety & More - formerly Child Mental Health for Pediatric Clinicians  / PsychEd4Peds - is the podcast for pediatric primary care clinicians who want practical, evidence-based guidance for diagnosing and treating children and adolescents with mental health conditions. Hosted by Elise Fallucco, MD, a nationally recognized child and adolescent psychiatrist and speaker whose educational programs have helped thousands of  pediatric clinicians improve their confidence in caring for children with mental health problems.  This podcast is for pediatricians, pediatric nurse practitioners, physician assistants, family physicians, and other pediatric clinicians who want to confidently care for kids with ADHD, anxiety, depression, autism spectrum disorder, behavioral concerns, trauma, and other common pediatric mental health conditions. Each episode translates the latest evidence into practical clinical pearls you can use in your office the very next day. Through conversations with leading experts in child psychiatry, psychology, pediatrics, and behavioral health, Dr. Fallucco shares real-world strategies, diagnostic tips, medication guidance, and communication tools designed specifically for busy primary care clinicians. Are you looking for answers to questions like:• Which ADHD medication should I start first?• When should I use a non-stimulant?• How do I treat ADHD and anxiety together?• Could this be ADHD, anxiety, autism, bipolar disorder, trauma, or a learning disorder?• Which screening tools should I use?• When should I start an SSRI?• How do I manage common medication side effects?• When should I refer to child psychiatry?• How can I support children, teens, and families with confidence? Whether you're evaluating ADHD, treating anxiety, managing behavioral challenges, prescribing stimulants or SSRIs, collaborating with schools, or navigating complex mental health presentations, ADHD, Anxiety & Beyond delivers practical, evidence-based clinical pearls to help you provide exceptional mental health care for children and adolescents.

  1. Jul 14

    Helping Kids Thrive Through Sports with Coach Peter Verhoef (Summer Replay)

    Send us Fan Mail What can we learn from an Elite Coach about how to help young athletes THRIVE through sports? Join us as we chat with Coach Peter Verhoef, head coach and aquatics director at the Bolles School Swimming Program and former Olympic Trials finalist (2x). We discuss:  Why do so many kids quit organized sports by age 13?How can we prevent burnout?When are teens MOST vulnerable to burnout? How much time off/rest is reasonable? Does it very by sport?03:36 Benefits of Youth sports 06:04 Preventing Burnout in Youth Sports 06:32 Engagement in Youth Sports and Burnout 06:44 Promoting Individual Achievement 08:35 Managing Physical and emotional exhaustion 09:13 Driver's License BURNOUT 12:00 Tips for Parents to help Preventing Burnout 16:21 TIME OFF 20:58 Multi-Sport Athelte vs. Specialization 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

  2. Jun 30

    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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

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ADHD, Anxiety & More - formerly Child Mental Health for Pediatric Clinicians  / PsychEd4Peds - is the podcast for pediatric primary care clinicians who want practical, evidence-based guidance for diagnosing and treating children and adolescents with mental health conditions. Hosted by Elise Fallucco, MD, a nationally recognized child and adolescent psychiatrist and speaker whose educational programs have helped thousands of  pediatric clinicians improve their confidence in caring for children with mental health problems.  This podcast is for pediatricians, pediatric nurse practitioners, physician assistants, family physicians, and other pediatric clinicians who want to confidently care for kids with ADHD, anxiety, depression, autism spectrum disorder, behavioral concerns, trauma, and other common pediatric mental health conditions. Each episode translates the latest evidence into practical clinical pearls you can use in your office the very next day. Through conversations with leading experts in child psychiatry, psychology, pediatrics, and behavioral health, Dr. Fallucco shares real-world strategies, diagnostic tips, medication guidance, and communication tools designed specifically for busy primary care clinicians. Are you looking for answers to questions like:• Which ADHD medication should I start first?• When should I use a non-stimulant?• How do I treat ADHD and anxiety together?• Could this be ADHD, anxiety, autism, bipolar disorder, trauma, or a learning disorder?• Which screening tools should I use?• When should I start an SSRI?• How do I manage common medication side effects?• When should I refer to child psychiatry?• How can I support children, teens, and families with confidence? Whether you're evaluating ADHD, treating anxiety, managing behavioral challenges, prescribing stimulants or SSRIs, collaborating with schools, or navigating complex mental health presentations, ADHD, Anxiety & Beyond delivers practical, evidence-based clinical pearls to help you provide exceptional mental health care for children and adolescents.

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