The Wellness Roundup With Dr. Jill

BCD Health Partners and Healthy Kids Pediatrics Raise Money and Awareness for Autism Speaks

The Healthy Kids Team and BCD Health Partners spent the morning at MetLife Stadium helping some awesome people raise money and awareness for #autism by walking, dancing, and spreading love. 💙 Then it was off to Van Saun Park to enjoy a beautiful sunny afternoon with family and friends.-HKP

Know the Answer Before You Ask the Question: How Was Your Day? -Dr. Tom Gambino

Dr. Tom Gambino, licensed psychologist and professional colleague of Healthy Kids Pediatrics, shares 7 things you can do after you ask your child, “How was your day?” (3:50 second watch)

1) Trust your gut.

2) Meet them where they’re at.

3) Identify someone else.

4) Plan an activity.

5) Circle back.

6) Solve or listen?

7) What do you need from me?

Visit www.GambinoPsych.com to contact Dr. Gambino if you or your child could use a little help. 💛👍

-HKP

Help Is On The Way: Meet Licensed Psychologist, Dr. Tom Gambino

Meet Dr. Tom Gambino, a licensed psychologist and friend of Healthy Kids Pediatrics who is local to the Nutley area.  Dr. Gambino will be sharing his helpful tips with us throughout the year in both video and article format and we will be posting them on our social media platforms. In his first video, which we’ll post next week, Dr. Gambino shares some great advice for parents on what to do when you ask your child, “How was school today?” and the response is a disengaged “fine” or “I don’t want to talk about it” or sometimes nothing at all.

You can check out Dr. Gambino’s website at www.GambinoPsych.com and contact his office directly if you’re in need of individual therapy sessions for your child or if you are interested in parent coaching.

Have a great weekend! -HKP

Why You May See Your Lab Results Before We Do: A Helpful Message from Healthy Kids Pediatrics

We understand it can be hard waiting for, and understanding, test results after you take your child for blood work. That is why we want to tell you about some new changes in how those results will be shared and explain why you may be seeing them before our doctors.
 
In the past, when we ordered a lab or test for your child, the results would be reviewed by one of our doctors before you were notified by phone, electronically, or at a visit. But, if your child has had a test recently, you may have noticed that the results were available to you before our doctors had a chance to review them.

The 21st Century Cures Act is a new federal law that requires health care providers to give patients access to all their health information without delay. So, what does this mean for you and your family, exactly? It means any patient who is using a commercial laboratory (ex. Labcorp or Quest) or a hospital-specific portal (ex. Hackensack University Medical Center’s EPIC system) will be able to see their results as soon as they become available. In some cases, you may see your child’s results before our doctors have had the chance to review them. For some test results, this change is already occurring; and for others it is coming soon.

At Healthy Kids Pediatrics, we realize this change may be unsettling for certain families. While some people like seeing their results immediately, others may feel anxious and would prefer that their doctor review the results first.

Here is some information that we hope will help you understand your child’s results without adding any undue distress and unnecessary Googling:   

  • Some results may be marked as abnormal even though they are normal for your child. This happens because the result is compared to a preset normal range for the lab itself. 
  • Not all abnormal results are clinically relevant. Test results are combined with other markers and factors like symptoms and medical history. This is why it is important for the doctor to interpret the test results. 
  • Be aware that you may see results that are difficult to understand or indicative of serious illness. For that reason, you may want to wait to view your results until Healthy Kids Pediatrics contacts you.
  • Results are published as they become available. You may not see all your results at the same time. 
  • If you are concerned that your child’s test results will make you nervous, consider waiting until one of our staff reaches out to you. This is especially important to consider if it is late in the evening or on a weekend when we may be unavailable. Feelings of uncertainty can make the evening or weekend very stressful.

Rest assured that the physicians at Healthy Kids Pediatrics will always review your child’s results and one of our staff members will always communicate your results as we have in the past. If you do see your child’s results and notice an abnormal reading, try not to worry. Our physicians are more than happy to discuss all your child’s tests with you in detail as soon as possible.


If you have any additional questions, please contact our office. We look forward to continuing to partner with you in your child’s care. 

-HKP

A Helpful Article for Parents on The Current Mental Health Crisis from Dr. Schuyler in The Pediatric News Journal

At Healthy Kids Pediatrics and at nearly every pediatric office in the United States, we are faced with the overwhelming reality that so many of our patients are in desperate need of mental health services, yet the lack of available mental health specialists has created further challenges for already frustrated families. The recent mental health crisis in our country, further amplified by the COVID-19 pandemic, has forced more and more families to struggle as they try to help their anxious and/or depressed child.

Even when a family is able to connect with a mental health professional there are expectations that our patients and families have going into therapy that end up not being met in the way that the patient or family anticipated. 

We came across a short article in one of our pediatric journals that we believe will offer value and insight for our HKP families who are dealing with mental health issues. Dr. Schuyler Henderson, professor of clinical psychiatry at NYU, offers his reassurance that even though families and patients may not think that the coping skills and behavioral interventions they’ve already learned are working, they do work! The article was definitely helpful for us to read and we hope you will get something out of it as well.

-HKP

When coping skills and parenting behavioral interventions ‘don’t work’

By Schuyler W. Henderson, MD

You have an appointment with a 14-year-old youth you last saw for an annual camp physical. He had screened positive for depression, and you had referred him to a local therapist. He did not have an appointment until after camp, and you have only met a few times, but since you had spoken with him about his depression, he set up an appointment with you to ask about medications. When you meet him you ask about what he had been doing in therapy and he says, “I’m learning ‘coping skills,’ but they don’t work.”

From breathing exercises and sticker charts to mindfulness and grounding exercise, coping skills can be crucial for learning how to manage distress, regulate emotions, become more effective interpersonally, and function better. Similarly, parenting interventions, which change the way parents and youth interact, are a central family intervention for behavioral problems in youth.

It is very common, however, to hear that they “don’t work” or have a parent say, “We tried that, it doesn’t work.”

When kids and parents reject coping skills and behavioral interventions by saying they do not work, the consequences can be substantial. It can mean the rejection of coping skills and strategies that actually would have helped, given time and support; that kids and families bounce between services with increasing frustration; that they search for a magic bullet (which also won’t work); and, particularly concerning for physicians, a belief that the youth have not received the right medication, resulting in potentially unhelpful concoctions of medication.

One of the biggest challenges in helping youth and parents overcome their difficulties – whether these difficulties are depression and anxiety or being better parents to struggling kids – is helping them understand that despite the fact that coping skills and behavioral interventions do not seem to work, they work.

We just have to do a better job explaining what that “work” is.

There are five points you can make.

  • First, the coping skill or behavioral intervention is not supposed to work if that means solving the underlying problem. Coping skills and behavioral interventions do not immediately cure anxiety, mend broken hearts, correct disruptive behaviors, disentangle power struggles, or alleviate depression. That is not what their job is. Coping skills and behavioral interventions are there to help us get better at handling complex situations and feelings. In particular, they are good at helping us manage our thoughts (“I can’t do it,” “He should behave better”) and our affect (anger, frustration, rage, anxiety, sadness), so that over time we get better at solving the problems, and break out of the patterns that perpetuate these problems.
  • Second, kids and parents do not give skills credit for when they do work. That time you were spiraling out of control and told your mom you needed a break and watched some YouTube videos and then joined the family for dinner? Your coping skills worked, but nobody noticed because they worked. We need to help our young patients and families identify those times that coping skills and behavioral interventions worked.
  • Third, let’s face it: Nothing works all the time. It is no wonder kids and families are disappointed by coping skills and behavioral interventions if they think they magically work once and forever. We need to manage expectations.
  • Fourth, we know they are supposed to fail, and we should discuss this openly up front. This may sound surprising, but challenging behaviors often get worse when we begin to work on them. “Extinction bursts” is probably the easiest explanation, but for psychodynamically oriented youth and families we could talk about “resistance.” No matter what, things tend to get worse before they get better. We should let people know this ahead of time.
  • Fifth, and this is the one that forces youth and parents to ask how hard they actually tried, these skills need to be practiced. You can’t be in the middle of a panic attack and for the first time start trying to pace your breathing with a technique a therapist told you about 3 weeks ago. This makes about as much sense as not training for a marathon. You need to practice and build up the skills, recognizing that as you become more familiar with them, they will help you manage during stressful situations. Every skill should be practiced, preferably several times or more in sessions, maybe every session, and definitely outside of sessions when not in distress.

We cannot blame children and parents for thinking that coping skills and behavioral interventions do not work. They are struggling, suffering, fighting, frightened, angry, anxious, frustrated, and often desperate for something to make everything better. Helping them recognize this desire for things to be better while managing expectations is an essential complement to supporting the use of coping skills and behavioral interventions, and a fairly easy conversation to have with youth.

So when you are talking about coping skills and parental behavioral interventions, it is important to be prepared for the “it didn’t work” conversation, and even to address these issues up front. After all, these strategies may not solve all the problems in the world, but can be lifelong ways of coping with life’s challenges.

Dr. Henderson is associate professor of clinical psychiatry at New York University and deputy director of child and adolescent psychiatry at Bellevue Hospital, New York.

Dr. Jill and Marcello Pedalino from Healthy Kids Pediatrics present their Healthy Living Tips in Riviera Maya, Mexico

Kudos to Dr. Jill for delivering a dynamic and impactful keynote presentation this week in Riviera Maya, Mexico for the 2022 Think Tank Summer Symposium. Think Tank is a group of #philanthropic women and men from all over the country whom are #business leaders in their local communities.

Dr. Jill and HKP’s CEO Marcello Pedalino spent this past week sharing healthy #lifestyle tips, energy management principles, work-life integration advice, #parenting hacks, #relationship truths, and business #philosophy guidance from the stage and in private one-on-one sessions.

If you know of a group or organization that could benefit from a presentation and event like this, contact our office for more information. 844-437-5455 or info@HealthyKidsNJ.com

-HKP

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