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    1084 results match your criteria Child and Adolescent Psychiatric Clinics of North America[Journal]

    1 OF 22

    The Interplay Between Digital Media Use and Development.
    Child Adolesc Psychiatr Clin N Am 2018 Apr;27(2):345-355
    Department of Mental Health and Detox, St. Mary's Health System, 93 Campus Avenue, Lewiston, ME 04240, USA.
    Today's youth develop immersed in a digital media world and the effects are specific to their developmental stage. Clinicians and caretakers should be mindful regarding digital media use patterns; however, this complex and reciprocal relationship defies simple linear descriptions. The impacts of digital media can be powerful. Read More

    Treatment Considerations in Internet and Video Game Addiction: A Qualitative Discussion.
    Child Adolesc Psychiatr Clin N Am 2018 Apr 9;27(2):327-344. Epub 2018 Jan 9.
    Department of Psychiatry, University of Connecticut, School of Medicine, Farmington, CT 06030, USA; The Center for Internet and Technology Addiction, 8 Lowell Road, West Hartford, CT 06119, USA. Electronic address:
    Internet and video game addiction has been a steadily developing consequence of modern living. Behavioral and process addictions and particularly Internet and video game addiction require specialized treatment protocols and techniques. Recent advances in addiction medicine have improved our understanding of the neurobiology of substance and behavioral addictions. Read More

    Internet and Video Game Addictions: Diagnosis, Epidemiology, and Neurobiology.
    Child Adolesc Psychiatr Clin N Am 2018 Apr 1;27(2):307-326. Epub 2018 Feb 1.
    Department of Psychiatry, Natchaug Hospital, Hartford Healthcare, 189 Storrs Road, Mansfield Center, Mansfield, CT 06250, USA.
    In the past 2 decades, there has been substantial increase in availability and use of digital technologies, including the Internet, computer games, smart phones, and social media. Behavioral addiction to use of technologies spawned a body of related research. The recent inclusion of Internet gaming disorder as a condition for further study in the DSM-V invigorated a new wave of researchers, thereby expanding our understanding of these conditions. Read More

    Risky Business: Talking with Your Patients About Cyberbullying and Sexting.
    Child Adolesc Psychiatr Clin N Am 2018 Apr;27(2):287-305
    Massachusetts Aggression Reduction Center, Bridgewater State University, Maxwell Library, 201, Bridgewater, MA 02325, USA. Electronic address:
    This article reviews cyberbullying and sexting research and presents new research exploring relatively neglected areas of cyberbullying and cell phone ownership among children and outcomes following sexting in college. Two samples are studied: 4584 elementary school children and 1332 college freshman. Findings include: owning a cell phone increased the risk of becoming involved in cyberbullying in grades 3, 4, and 5; and, of college freshman who sexted, 61% reported no outcomes, 19% reported negative outcomes, 13% reported positive outcomes, and 7% reported mixed outcomes. Read More

    Media Engagement and Identity Formation Among Minority Youth.
    Child Adolesc Psychiatr Clin N Am 2018 Apr;27(2):269-285
    Natchaug Hospital, Hartford Healthcare, 189 Storrs Road, Mansfield Center, CT 06250, USA.
    Clinicians who work with youth should understand how they engage with screen media, including differences between ethnic groups, and how to maximize its positive potential and minimize negative consequences. This article presents data summarizing patterns of media use by youth, with an emphasis on European Americans, African Americans, and Hispanic Americans. The authors explain how identity formation and social identity theory relate to online influences, benefits, and risks of online engagement, including those specific to minority populations. Read More

    Geeks, Fandoms, and Social Engagement.
    Child Adolesc Psychiatr Clin N Am 2018 Apr;27(2):247-267
    Natchaug Hospital, 189 Storrs Road, PO Box 260, Mansfield Center, CT 06250-0260, USA.
    The Internet changed the way the global community interacts and communicates. This cultural shift allows like-minded individuals to connect and share ideas. It creates spaces for stigmatized communities to gather in a virtual presence. Read More

    Youth Screen Media Habits and Sleep: Sleep-Friendly Screen Behavior Recommendations for Clinicians, Educators, and Parents.
    Child Adolesc Psychiatr Clin N Am 2018 Apr;27(2):229-245
    Department of Biobehavioral Health, The Pennsylvania State University, Biobehavioral Health Building, University Park, PA 16802, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Sleep Health Institute, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
    With the widespread use of portable electronic devices and the normalization of screen media devices in the bedroom, insufficient sleep has become commonplace. In a recent literature review, 90% of included studies found an association between screen media use and delayed bedtime and/or decreased total sleep time. This pervasive phenomenon of pediatric sleep loss has widespread implications. Read More

    Adolescent Eating Disorder Risk and the Online World.
    Child Adolesc Psychiatr Clin N Am 2018 Apr 2;27(2):221-228. Epub 2018 Feb 2.
    Department of Applied Psychology, Northeastern University, 404 iNV, 360 Huntington Avenue, Boston, MA 02115, USA.
    The proliferation of social media and rapid increase in the use of the Internet by adolescents generates new dynamics and new risks for the development and maintenance of eating disorders. Here, the authors review different types of online content and how they are relevant to eating disorders within different theoretic frameworks, before examining the empirical evidence for the risks posed by online content in the development and maintenance of eating disorders. They describe pro-eating disorder content specifically and examine the research related to it, before considering its implications, and considering directions for future research, and prevention and intervention strategies. Read More

    Electronic Screen Media Use in Youth With Autism Spectrum Disorder.
    Child Adolesc Psychiatr Clin N Am 2018 Apr;27(2):203-219
    Department of Psychiatry, Massachusetts General Hospital, Shriners Hospital for Children, Charlestown Health Care Center, 73 High Street, Charlestown, Boston, MA 02129, USA.
    Electronic and social media play a prominent role in the lives of children and teenagers. Evidence suggests youth with autism spectrum disorder (ASD) use media differently than typically developing peers, and some of these differences place them at greater risk for negative health outcomes related to unhealthy and improper use of media. Such outcomes include physiologic, cognitive, social, emotional, and legal/safety problems. Read More

    The Interplay of Media Violence Effects and Behaviorally Disordered Children and Adolescents: Guidelines for Practitioners.
    Child Adolesc Psychiatr Clin N Am 2018 Apr 3;27(2):193-202. Epub 2018 Feb 3.
    Beacon Health Options, 520 Pleasant Valley Road, Trafford, PA 15085, USA; Persoma, PC 2540 Monroeville Boulevard, Monroeville, PA 15146, USA; American Academy of Child and Adolescent Psychiatry, 3615 Wisconsin Avenue, NW, Washington, DC 20016, USA; Pittsburgh Psychiatric Society, 777 E. Park Dr., Harrisburg, PA 17111, USA. Electronic address:
    A robust body of scientific research explores the effects of violent media on youths. For practitioners, the volume of interdisciplinary research and controversial findings can be confusing and difficult to generalize for best practice. This article briefly reviews the literature and presents guidelines for parenting and treating youths exposed and enmeshed in violent media. Read More

    Inattention to Problematic Media Use Habits: Interaction Between Digital Media Use and Attention-Deficit/Hyperactivity Disorder.
    Child Adolesc Psychiatr Clin N Am 2018 Apr 3;27(2):183-191. Epub 2018 Feb 3.
    Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorder, Massachusetts General Hospital, 55 Fruit Street, Warren 624, Boston, MA 02114, USA. Electronic address:
    As digital media (DM) access among youths continues to surge, caregivers and clinicians are concerned about problems associated with its excessive use. Children with attention-deficit/hyperactivity disorder (ADHD) have an increased risk of experiencing negative effects on sleep, academic achievement, attention, and cognitive skills. ADHD symptom severity and circumstances of DM access are among the factors that mediate these negative effects. Read More

    #KidsAnxiety and Social Media: A Review.
    Child Adolesc Psychiatr Clin N Am 2018 Apr 22;27(2):171-182. Epub 2017 Dec 22.
    Pediatric Mental Health Institute, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, B130, Aurora, CO 80045, USA. Electronic address:
    This article reviews the available literature regarding the interaction between child and adolescent anxiety and electronic media. It reviews current research contributing to understanding of the correlation of youth anxiety with engagement in social media and other online platforms, including risk and protective factors. mHealth and eHealth prevention and treatment options, available via various digital resources, are discussed. Read More

    Digital Media Use in Families: Theories and Strategies for Intervention.
    Child Adolesc Psychiatr Clin N Am 2018 Apr;27(2):145-158
    Child and Adolescent Psychiatry, Center for Children and Families, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Merck Clinic, Franklin Building, 1st Floor, 1011 Bingham Street, Pittsburgh, PA 15203, USA.
    Family dynamics are increasingly being influenced by digital media. Three frameworks are described to help clinicians to understand and respond to this influence. First, a social-ecological framework shows how media has both a direct and indirect impact on individuals, relationships, communities, and society. Read More

    Assessment of Digital Media Use in the Adolescent Psychiatric Evaluation.
    Child Adolesc Psychiatr Clin N Am 2018 Apr 2;27(2):133-143. Epub 2018 Jan 2.
    Harvard University, 1493 Cambridge Street, Cambridge, MA 02139, USA.
    Digital media (also called "new media") have become an important ecosystem in which adolescents develop biologically, psychologically, and socially. When assessing adolescents in the psychiatric interview, a nuanced understanding of digital media use can inform a more accurate formulation. However, there are few published resources to help the psychiatrist assess the impact of digital media during the initial adolescent interview. Read More

    Co-occurring Medical Illnesses in Child and Adolescent Psychiatry: Updates and Treatment Considerations.
    Child Adolesc Psychiatr Clin N Am 2018 Jan 21;27(1):xi-xii. Epub 2017 Oct 21.
    Hasbro Children's Partial Hospital Program, Department of Psychiatry and Human Behavior, The Alpert Medical School of Brown University, Rhode Island Hospital, Potter Building, 593 Eddy Street, Providence, RI 02903. Electronic address:

    Sports-Related Concussion: Acute Management and Chronic Postconcussive Issues.
    Child Adolesc Psychiatr Clin N Am 2018 Jan 21;27(1):93-108. Epub 2017 Oct 21.
    North Shore Physicians Group, Mass General/North Shore, 104 Endicott Street Suite 104, Danvers, MA 01923, USA. Electronic address:
    Sports-related concussion (SRC) is a common problem in youth sports. Concussion may occur after a forceful hit to the body or head, resulting in transient neuropathological changes that spontaneously resolve with relative rest and activity modification in most patients. Most SRCs are effectively managed by primary care physicians and sports medicine specialists. Read More

    Domestic Minor Sex Trafficking.
    Child Adolesc Psychiatr Clin N Am 2018 Jan;27(1):77-92
    Hasbro Children's Hospital, Providence, RI 02906, USA.
    Commercial sexual exploitation of children and child sex trafficking is a major public health issue globally. Domestic minor sex trafficking has become increasingly recognized within the United States. Sexually exploited minors are commonly identified as having psychosocial risk factors, including histories of abuse or neglect, running away, substance use or abuse, and involvement with child protective services. Read More

    A Review of the Prevention and Medical Management of Childhood Obesity.
    Child Adolesc Psychiatr Clin N Am 2018 Jan 21;27(1):63-76. Epub 2017 Oct 21.
    Hasbro Children's Hospital and Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, USA. Electronic address:
    Prevention and management of childhood obesity remains a public health priority and necessitates an integrated chronic care approach. Obesity prevention efforts should focus on healthy family-based lifestyle modifications. The United States Prevention Services Task Force recommends children older than age 6 of years be screened for obesity and, if clinically indicated, be referred for moderate to high intensity comprehensive behavioral interventions. Read More

    Pediatric Psychogenic Nonepileptic Seizures: A Concise Review.
    Child Adolesc Psychiatr Clin N Am 2018 Jan 20;27(1):53-61. Epub 2017 Oct 20.
    Department of Child and Adolescent Psychiatry, Pediatric Neuropsychiatry Clinic, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, 225 East Chicago Avenue, Box 10, Chicago, IL 60611, USA.
    Psychogenic nonepileptic seizures is a complicated biopsychosocial disorder with significant morbidity and high cost in children's social, emotional, family, and academic functioning as well as health care service utilization. Misdiagnosis and diagnostic delay, resulting from both lack of access to approved standards for diagnosing and service providers comfortable with diagnosing and treating this disorder, impact prognosis. Treatment in close proximity to symptom onset is thought to provide the best chance for remission. Read More

    Evaluation and Management of Autoimmune Encephalitis: A Clinical Overview for the Practicing Child Psychiatrist.
    Child Adolesc Psychiatr Clin N Am 2018 Jan 20;27(1):37-52. Epub 2017 Oct 20.
    Autoimmune Brain Disease Program, Department of Pediatrics, Rheumatology Division, Duke University, Durham, NC, USA.
    Medical conditions that present with psychiatric symptoms are becoming increasingly well-recognized in response to the emergence of the field of neuroimmunology. As the availability of testing for novel antineuronal antibodies has increased, so too has the clinical awareness of this diagnostic spectrum. Psychiatrists may have little exposure to this area of expertise, yet may be called on to assist in the diagnosis and treatment of patients with complex neuropsychiatric syndromes secondary to autoimmune encephalitis. Read More

    Unraveling Diagnostic Uncertainty Surrounding Lyme Disease in Children with Neuropsychiatric Illness.
    Child Adolesc Psychiatr Clin N Am 2018 Jan 21;27(1):27-36. Epub 2017 Oct 21.
    Division of Pediatric Emergency Medicine, Alpert Medical School of Brown University, Rhode Island Hospital - Hasbro Children's Hospital, 125 Whipple Street, UEMF Suite-3rd Floor, Providence, RI 02908, USA.
    Lyme disease is endemic in parts of the United States, including New England, the Atlantic seaboard, and Great Lakes region. The presentation has various manifestations, many of which can mimic psychiatric diseases in children. Distinguishing manifestations of Lyme disease from those of psychiatric illnesses is complicated by inexact diagnostic tests and misuse of these tests when they are not clinically indicated. Read More

    Functional Abdominal Pain and Related Syndromes.
    Child Adolesc Psychiatr Clin N Am 2018 Jan 21;27(1):15-26. Epub 2017 Oct 21.
    Pediatric Gastroenterology, Warren Alpert Medical School of Brown University, Hasbro Children's Hospital, 593 Eddy Street, Providence, RI 02903, USA.
    Functional gastrointestinal disorders are very common. They result from dysfunctional interaction in the brain-gut axis. Although the nature is benign, symptoms may be debilitating. Read More

    The Medical Transition from Pediatric to Adult-Oriented Care: Considerations for Child and Adolescent Psychiatrists.
    Child Adolesc Psychiatr Clin N Am 2018 Jan 21;27(1):125-132. Epub 2017 Sep 21.
    Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. Electronic address:
    More adolescents and young adults are surviving previously fatal childhood illness and need support to transition from pediatric care to adult-oriented care. There are many barriers, but guidelines and tools assist providers with emphasis on gradually addressing transition with patients and families. Child and adolescent psychiatrists should be particularly attuned to the needs of adolescents with previously identified mental illness who are at high risk of falling out of regular care during transition. Read More

    Everywhere and Nowhere: Grief in Child and Adolescent Psychiatry and Pediatric Clinical Populations.
    Child Adolesc Psychiatr Clin N Am 2018 Jan;27(1):109-124
    Division of Child and Adolescent Psychiatry, Hospital for Sick Children, Toronto, ON, Canada; Division of Psychosocial Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Electronic address:
    Grief is ubiquitous in the experience of children and adolescents with illness but not always recognized or named, and as a result grief is not always treated effectively by child/adolescent psychiatrists or pediatricians. Grief can be misinterpreted or treated as stress, anxiety, depression, adolescent moodiness, or behavioral concerns. Pediatricians and child/adolescent psychiatrists are often insufficiently educated on the topic of grief. Read More

    Medical Considerations in Children and Adolescents with Eating Disorders.
    Child Adolesc Psychiatr Clin N Am 2018 Jan;27(1):1-14
    Department of Psychiatry and Human Behavior, Hasbro Children's Partial Hospital Program, Alpert Medical School at Brown University, 593 Eddy Street, Providence, RI 02903, USA.
    Eating disorders are a group of psychiatric disorders with potentially fatal medical complications. Early integrated care including the family as well as pediatric medicine, nutrition, psychology and psychiatry is critical for improving prognosis and limiting negative outcomes. Mental health services are a critical component of treatment; timely weight restoration maximizes efficacy. Read More

    The Basic Science of Behavior Change and Its Application to Pediatric Providers.
    Child Adolesc Psychiatr Clin N Am 2017 Oct 2;26(4):851-874. Epub 2017 Aug 2.
    Silver School of Social Work, New York University, 1 Washington Square North, New York, NY 10003, USA.
    Pediatric primary care providers (PPCPs) are increasingly expected to know how to assess, diagnose, and treat a wide range of mental health problems in children and adolescents. For many PPCPs, this means learning and performing new practice behaviors that were not taught in their residency training. Typical continuing education approaches to engage PPCPs in new practices have not yielded the desired changes in provider behavior. Read More

    Essential Elements of a Collaborative Mental Health Training Program for Primary Care.
    Child Adolesc Psychiatr Clin N Am 2017 Oct;26(4):839-850
    Primary Children's Hospital, 100 North Mario Capecchi Drive, Salt Lake City, UT 841113, USA; Division of Pediatric Psychiatry and Behavioral Health, Department of Pediatrics, University of Utah School of Medicine, 100 North Mario Capecchi Drive, Salt Lake City, UT 841113, USA. Electronic address:
    Mental health integration in primary care is based on creating an environment that encourages collaboration and supports appropriate care for patients and families while offering a full range of services. Training programs for primary care practitioners should include sessions on how to build and maintain such a practice along with information on basic mental health competencies. Read More

    Payment for Integrated Care: Challenges and Opportunities.
    Child Adolesc Psychiatr Clin N Am 2017 Oct;26(4):829-838
    Department of Psychiatry, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC 27705, USA. Electronic address:
    A multidisciplinary team approach to care and robust care coordination services are primary components of almost all integrated care delivery systems. Given that these services have limited reimbursement in fee-for-service payment arrangements, integrating care in a fee-for-service environment is almost impossible. Capitated payment models hold promise for supporting integrated behavioral and physical health services. Read More

    Comparing Two Models of Integrated Behavioral Health Programs in Pediatric Primary Care.
    Child Adolesc Psychiatr Clin N Am 2017 Oct;26(4):815-828
    Pediatric Behavioral Health Services, Montefiore Medical Group, 200 Corporate Boulevard South, Suite 175, Yonkers, NY 10701, USA.
    This study examined how to design, staff, and evaluate the feasibility of 2 different models of integrated behavioral health programs in pediatric primary care across primary care sites in the Bronx, NY. Results suggest that the Behavioral Health Integration Program model of pediatric integrated care is feasible and that hiring behavioral health staff with specific training in pediatric, evidence-informed behavioral health treatments may be a critical variable in increasing outcomes such as referral rates, self-reported competency, and satisfaction. Read More

    Evaluating Integrated Mental Health Care Programs for Children and Youth.
    Child Adolesc Psychiatr Clin N Am 2017 Oct 25;26(4):795-814. Epub 2017 Jul 25.
    Department of Psychiatry, University of Massachusetts, Medical School at Baystate, 759 Chestnut Street, WG703, Springfield, MA 01199, USA.
    Evaluations of integrated care programs share many characteristics of evaluations of other complex health system interventions. However, evaluating integrated care for child and adolescent mental health poses special challenges that stem from the broad range of social, emotional, and developmental problems that need to be addressed; the need to integrate care for other family members; and the lack of evidence-based interventions already adapted for primary care settings. Integrated care programs for children's mental health need to adapt and learn on the fly, so that evaluations may best be viewed through the lens of continuous quality improvement rather than evaluations of fixed programs. Read More

    Integrated Behavioral Health Care in Pediatric Subspecialty Clinics.
    Child Adolesc Psychiatr Clin N Am 2017 Oct 21;26(4):785-794. Epub 2017 Jul 21.
    Department of Psychiatry, 300 Longwood Avenue, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
    Comorbid behavioral and physical health conditions are accompanied by troubling symptom burden, functional impairment, and treatment complexity. Pediatric subspecialty care clinics offer an opportunity for the implementation of integrated behavioral health (BH) care models that promote resiliency. This article reviews integrated BH care in oncology, palliative care, pain, neuropsychiatry, cystic fibrosis, and transplantation. Read More

    Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic.
    Child Adolesc Psychiatr Clin N Am 2017 Oct;26(4):761-770
    Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC 27705, USA.
    An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Read More

    Family-Based Integrated Care (FBIC) in a Partial Hospital Program for Complex Pediatric Illness: Fostering Shifts in Family Illness Beliefs and Relationships.
    Child Adolesc Psychiatr Clin N Am 2017 Oct;26(4):733-759
    The Hasbro Children's Partial Hospital Program, The Alpert School of Medicine of Brown University, 593 Eddy Street, Providence, RI 02906, USA.
    The heuristic model of family-based integrated care (FBIC) was developed from 1998 to 2016 in the context of the development of the Hasbro Children's Partial Hospital Program (HCPHP) along with the development of a family therapy training program for Brown University child psychiatry and triple board residents. The clinical experience of the HCPHP team in treating more than 2000 patients and families in combination with the authors' experience in training residents for diverse practice settings highlights the usefulness of the FBIC paradigm for interdisciplinary family-based treatment for a broad range of illnesses and levels of care. Read More

    Competencies and Training Guidelines for Behavioral Health Providers in Pediatric Primary Care.
    Child Adolesc Psychiatr Clin N Am 2017 Oct;26(4):717-731
    Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3440 Market Street, Suite 410, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
    This article focuses on the cross-discipline training competencies needed for preparing behavioral health providers to implement integrated primary care services. After a review of current competencies in the disciplines of child and adolescent psychiatry, psychology, and social work, cross-cutting competencies for integrated training purposes are identified. These competencies are comprehensive and broad and can be modified for use in varied settings and training programs. Read More

    Incorporating Trainees' Development into a Multidisciplinary Training Model for Integrated Behavioral Health Within a Pediatric Continuity Clinic.
    Child Adolesc Psychiatr Clin N Am 2017 Oct 22;26(4):703-715. Epub 2017 Jul 22.
    Department of Psychiatry, Pediatric Mental Health Institute, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, Box 130, Aurora, CO 80045, USA; Department of Pediatrics, Pediatric Mental Health Institute, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, Aurora, CO 80045, USA.
    Integrated behavioral and mental health systems of care for children require multidisciplinary team members to have specific competencies and knowledge of the other disciplines' strengths and practice needs. Training models for multidisciplinary professionals should consider the developmental level of trainees. The authors describe a model of flexible scaffolding, increasing intensity, and depth of experience as trainees gain skills and knowledge. Read More

    Preparing Trainees for Integrated Care: Triple Board and the Postpediatric Portal Program.
    Child Adolesc Psychiatr Clin N Am 2017 Oct;26(4):689-702
    Child, Adolescent, and Family Psychiatry, Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St. Sebastian Way, Augusta, GA 30912, USA; Pediatrics, Medical College of Georgia, Augusta University, 997 St. Sebastian Way, Augusta, GA 30912, USA.
    Training combining the disciplines of pediatrics, psychiatry, and child and adolescent psychiatry dates back to World War II, but formal combined programs began more than 3 decades ago as the Triple Board Program and 10 years ago as the Postpediatric Portal Program (PPPP). Triple board training was rigorously examined as a pilot program and ongoing surveys suggest that it provides successful training of physicians who can pass the required board examinations and contribute to clinical, academic, and administrative/advocacy endeavors. As evidence grows showing the value of integrated care, physicians with combined training will offer a unique perspective for developing systems. Read More

    From Theory to Action: Children's Community Pediatrics Behavioral Health System.
    Child Adolesc Psychiatr Clin N Am 2017 Oct 21;26(4):677-688. Epub 2017 Jul 21.
    Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, SPC 5766, Ann Arbor, MI 48109-2700, USA.
    Integrated health care models attempt to cross the barrier between behavioral and medical worlds in order to improve access to quality care that meets the needs of the whole patient. Unfortunately, the integration of behavioral health and physical health providers in one space is not enough to actually promote integration. There are many models for promoting integration and collaboration within the primary care context. Read More

    Using Effective Public Private Collaboration to Advance Integrated Care.
    Child Adolesc Psychiatr Clin N Am 2017 Oct 29;26(4):665-675. Epub 2017 Jul 29.
    Department of Child and Adolescent Psychiatry, Georgetown University School of Medicine, 2115 Wisconsin Avenue Northwest, Suite 200, Washington, DC 20007, USA.
    Integrated mental health services within health care settings have many benefits; however, several key barriers pose challenges to fully implemented and coordinated care. Collaborative, multistakeholder efforts, such as health networks, have the potential to overcome prevalent obstacles and to accelerate the dissemination of innovative clinical strategies. In addition to engaging clinical experts, efforts should also include the perspectives of families and communities, a grounding in data and evaluation, and a focus on policy and advocacy. Read More

    Massachusetts Child Psychiatry Access Project 2.0: A Case Study in Child Psychiatry Access Program Redesign.
    Child Adolesc Psychiatr Clin N Am 2017 Oct 11;26(4):647-663. Epub 2017 Jul 11.
    Massachusetts Child Psychiatry Access Programs, Massachusetts Behavioral Health Partnership, Beacon Health Options, 1000 Washington Street, Suite 310, Boston, MA 02118, USA.
    The Massachusetts Child Psychiatry Access Program is a statewide public mental health initiative designed to provide consultation, care navigation, and education to assist pediatric primary care providers in addressing mental health problems for children and families. To improve program performance, adapt to changes in the environment of pediatric primary care services, and ensure the program's long-term sustainability, program leadership in consultation with the Massachusetts Department of Mental Health embarked on a process of redesign. The redesign process is described, moving from an initial strategic assessment of program and the planning of structural and functional changes, through transition and implementation. Read More

    Telemedicine for Child Collaborative or Integrated Care.
    Child Adolesc Psychiatr Clin N Am 2017 Oct 29;26(4):637-645. Epub 2017 Jun 29.
    University of Washington, M/S CPH, PO Box 5371, Seattle, WA 98105, USA. Electronic address:
    Telemedicine with child psychiatry specialists is a useful tool for collaborative and integrated care systems. This article reviews the workforce and care process rationale for using child psychiatric telemedicine for collaborative care, and discusses practical ways to address the technical challenges that arise when using telemedicine. Different systems of using telemedicine discussed include child psychiatry access programs, collaborative and integrated care use of telephone consultations, televideo consultations, and televideo care delivery. Read More

    The Future of Preschool Prevention, Assessment, and Intervention.
    Child Adolesc Psychiatr Clin N Am 2017 Jul 22;26(3):611-624. Epub 2017 Mar 22.
    Division of Child Psychiatry, University of Vermont Medical Center, University of Vermont College of Medicine, 1 South Prospect Street, Burlington, VT 05401, USA.
    Preschoolers are in the most rapid period of brain development. Environment shapes the structure and function of the developing brain. Promoting brain health requires cultivation of healthy environments at home, school, and in the community. Read More

    Partnerships with Primary Care for the Treatment of Preschoolers.
    Child Adolesc Psychiatr Clin N Am 2017 Jul;26(3):597-609
    Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
    This article reviews mental health access issues relevant to preschool children and data on this population obtained through the Michigan Child Collaborative Care Program (MC3). The MC3 program provides telephonic consultation to primary care physicians (PCPs) in 40 counties in Michigan and video telepsychiatric consultation to patients and families. Attention-deficit/hyperactivity disorder and disruptive behavioral disorders are frequent initial presenting diagnoses, but autism spectrum disorders, parent-child relational issues, trauma, and posttraumatic stress disorder should also be considered. Read More

    Sleep Disorders: Assessment and Treatment in Preschool-Aged Children.
    Child Adolesc Psychiatr Clin N Am 2017 Jul 27;26(3):587-595. Epub 2017 Apr 27.
    Department of Neurology, Washington University School of Medicine, Campus Box 8111, 660 South Euclid Avenue, St Louis, MO 63110, USA. Electronic address:
    Sleep issues are common in preschoolers, defined in this article as ages 3 to 5 years. Sleep deprivation can cause behavioral and cognitive issues. Sleep issues seen in the preschool years include insomnia, obstructive sleep apnea, parasomnias, and restless legs syndrome. Read More

    Feeding Disorders.
    Child Adolesc Psychiatr Clin N Am 2017 Jul;26(3):571-586
    Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan Medical School, D2232 MPB, 1500 East Medical Center Drive, SPC 5718, Ann Arbor, MI 48109-5718, USA. Electronic address:
    Feeding disorders often present in children with complex medical histories as well as those with neurodevelopmental disabilities. If untreated, feeding problems will likely persist and may lead to additional developmental and medical complications. Treatment of pediatric feeding disorders should involve an interdisciplinary team, but the core intervention should include behavioral feeding techniques as they are the only empirically supported therapy for feeding disorders. Read More

    The Early Origins of Autism.
    Child Adolesc Psychiatr Clin N Am 2017 Jul;26(3):555-570
    Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St Louis, MO 63110, USA.
    Autism spectrum disorders (ASDs) are neurodevelopmental disorders whose core features of impaired social communication and atypical repetitive behaviors and/or restrictions in range of interests emerge in toddlerhood and carry significant implications at successive stages of development. The ability to reliably identify most cases of the condition far earlier than the average age of diagnosis presents a novel opportunity for early intervention, but the availability of such an intervention is disparate across US communities, and its impact is imperfectly understood. New research may transform the clinical approach to these conditions in early childhood. Read More

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