The Brown University Child and Adolescent Behavior Letter最新文献

Adolescence can be a sensitive time encompassing significant, sometimes challenging, changes in an individual's physical, emotional, and social well-being. This developmental stage can involve challenges for the collective family unit. Caregivers must adjust several aspects of parenting, as the rules and boundaries they established when their child was younger can be the same ones adolescents feel confined by as they continue to develop and mature. This period can be even more challenging for adolescents with mental health challenges. At Bradley Hospital, several programs for adolescents in distress include individual, family, and group outpatient programs, inpatient and partial levels of hospitalization, and intensive outpatient programs. Parents are encouraged to actively engage in treatment in all these modalities, often through family therapy. Family therapy is essential in ensuring sustainable long-term changes outside the therapy environment. Themes of dysregulation or dysfunction in behavior, communication, and family relationships emerge in family therapy sessions. Understanding these themes and potential solutions can benefit families in and out of the Bradley Hospital system. While families have individual challenges and strengths, caregivers and adolescents identified that open communication and adolescent-directed conversations support a high sense of family functioning (Bandura et al., 2011).

The Food and Drug Administration (FDA) has not approved long-acting injectable (LAI) antipsychotic medications for patients under age 18, but researchers have found that for some teens, prescribing these medications off-label is helpful. This is particularly true in teens with bipolar disorder who forget or don't want to take their oral medications, according to the researchers, who found that the LAI antipsychotics were effective, and recommend more FDA trials.

Alarm bells rang through the clinical world when the Federal Department of Health and Human Services (HHS) ordered an investigation critical of some psychiatric medications for children. The time frame for the assessment was brief, and will be completed by the time this issue comes out. However, as soon as the announcement came out from the HHS Secretary Robert F. Kennedy, Jr. in February, the American Academy of Child and Adolescent Psychiatry (AACAP) issued a statement that provided reassurance to families.

Substance use disorders (SUDs) specific to sedative, hypnotic, or anxiolytics — have increased by 3- to 5-times among adolescent and young adult enrollees of Medicaid from 2001 to 2019, but prevalence remained low among adolescents, researchers have found. The study attributed the increase in use disorders of these medications, many of which are benzodiazepines, to the increase in availability of these medications, as well as to the increased awareness and detection of these disorders.

“The school keeps calling me to pick up my child.” “He got asked to leave because of behavioral issues.” These are common stories that we and many other pediatric providers caring for young children with developmental differences hear from families during their visit. Stories of children missing multiple days of school a week, students not having access to necessary sensory supports, parents being unable to work because they have nowhere for their child to go, and eventually stories of children being asked to leave one and often multiple early childhood education centers. These stories are consistent with data demonstrating that preschoolers are expelled at a high and disproportionate rate when compared to school age children in the United States (Gilliam, 2005). On a study of the National Survey of Children's Health there were approximately 50,000 children suspended and 17,000 children expelled at least once from preschool in the year 2016 alone. When focusing on preschoolers with autism spectrum disorder (ASD) in particular, these children are expelled at a 10 times higher rate than non-ASD preschoolers at an average age of 3.3 years old (Novoa & Malik, 2018; Blacher & Eisenhower, 2023) In fact, the same study found that one out of every six children with ASD was expelled prior to entering kindergarten (Blacher & Eisenhower, 2023). These numbers are startling to see but mirror common stories that pediatricians and other providers caring for this patient population hear when speaking with families.

Recently, transgender youth and gender-affirming care have received intense media coverage and been the subject of numerous governmental policies. Messages have tended towards the hyperbolic, but I was curious to look beyond the headlines to better understand what questions these youth and their care bring up. This column concerns transgender youth; stay tuned for a piece on gender-affirming care.

During the school year, psychiatric hospitalization rates for children and adolescents are at their highest (Marshall et al., 2021). A hospitalization may consist of admission to an inpatient unit or a day treatment program, and the length of stay can vary from days to weeks or even months. During hospitalization, youth receive treatment to stabilize symptoms and prepare for a discharge into daily life, including school. However, navigating this transition from hospitalization back to school can be challenging for students, their caregivers, and school staff. Students returning to school often have complex needs that require careful planning by the treatment team to ensure a successful reintegration. This is especially critical given the high risk of readmission during the transition period. This raises an important question: what are the best practices for supporting students returning school after a mental health crisis? In this article, we will explore key strategies and highlight recommended resources for supporting students post-hospitalization.