Blog Archive

Ask The Experts | Helping Students with Language-based Learning Disabilities A WORLD OF DIFFERENCE Season 2024 Episode 3 | 26m 46s Succeeding with Language-Based Learning Disabilities Language unlocks our world, but some children, struggle with turning the key. They grapple with reading, writing, and speaking, impacting their ability to learn...

Autism brings unique considerations to custody and visitation arguments, often requiring courts to go beyond traditional arrangements to ensure they’re meeting individual needs. Board-certified psychiatrist and nationally recognized autism specialist Dr. Joshua D. Feder in Solana Beach, California, contributes meaningful consultation and expert witness services in court-mediated custody battles involving...

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4813-navigating-the-transition-to-college   The transition to college can be challenging for any adolescent, but when an adolescent has psychological conditions or they're dealing with other mental health concerns, it is especially difficult to navigate this transition. Mara and I recorded this podcast based on the Summer 2024 of The Carlat Child Psychiatry...

Many government programs exist to provide medical and financial assistance for autistic individuals. For instance, SSI is a federal program designed to help individuals with limited income meet their basic economic needs. Dr. Joshua D. Feder, a board-certified psychiatrist and autism specialist based in Solana Beach, California, is a nationally...

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4787-congenital-disorders-in-psychiatry-screening-and-management Today, we are talking about dysmorphology and genetic disorders in psychiatry. Dr. Marilyn Jones joins us to help us identify and understand these conditions. Dr. Jones tells us about the prevalence and diagnostic considerations for these conditions, such as 22q and Fragile X. Join us as we talk about...

Autism is a developmental condition that affects communication, behavior, and sensory processing. These differences can lead to misunderstandings, misinterpretations, and, in some cases, unfair treatment within the justice system. Board-certified psychiatrist and autism specialist Dr. Joshua D. Feder in Solana Beach, California, has significant experience in helping individuals and families...

Mental health and developmental issues are rarely straightforward and often occur together, and yet the link between autism and trauma is clear. One study found that 32% of participants with ASD had post-traumatic stress disorder (PTSD) compared to 4% of participants who were not on the spectrum. Not only is...

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4675-adhd-algorithm   What steps should clinicians take if psychopharmacologic treatments and school behavioral strategies are insufficient for managing a child with ADHD? We've all been there. ADHD, attention deficit hyperactivity disorder, of course, affects millions of children and adolescents worldwide and can significantly impact focus, impulses, and engagement with friends....

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4656-dissociative-identity-disorder-vs-plural-identity-in-teens-and-young-adults This podcast is inspired by my experiences over the last couple of years with patients who come to me with various difficulties but report as part of their history that they are themselves a collection of several personalities that know each other and take turns being a the front...

https://shop.elsevier.com/books/supporting-the-mental-health-of-migrant-children-youth-and-families-an-issue-of-childand-adolescent-psychiatric-clinics-of-north-america/cary/978-0-443-13031-1 Children, youth, and families who migrate to the United States are driven by need and carried by courage, determination, and resilience. The articles in this issue describe how mental health clinicians can be guided by the experiences, culturally based preferences, and requests of those who have migrated to best...

This webinar helps us: Describe how to use motivational interviewing to reduce marijuana use in youth. Summarize the technique of weighing advantages and disadvantages of a potentially problematic habit or behavior. Differentiate when motivational interviewing is more likely to be effective to reduce marijuana use. Explain how to balance recommendations...

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4577-understanding-callous-and-unemotional-behaviors-in-children-and-adolescents Callous unemotional behaviors can be challenging to understand. One community study of 1136 children (from 3rd-7th grade) found that 10%–32% of those with conduct disorder and 2%–7% of those without conduct disorder met the callous emotional specifier threshold in the DSM-5. In this episode, we will discuss what callous...

Feder, J, Fitzpatrick, S., Ziv, M. (Eds). (2023) Foundations for a Peaceful World: The Transformative Power of Early Childhood Development in building Peace and Social Cohesion. The International Networking Group on Peace Building with Young Children. This week we are launching a new book at the United Nations General Assembly...

Is it autism or psychosis or both? Autistic traits and psychotic symptoms can look a lot alike. How common is psychosis in autism? And how can we differentiate co-occurring autistic traits from psychotic symptoms? Dr. Kristin Cadenhead gives us an approach for sorting through the history and addressing these problems...

https://www.thecarlatreport.com/blogs/3-carlat-psychiatry-webinars/post/4397-aggression-in-psychiatric-practice How can we differentiate volitional aggression from other reasons , eg, sensory problems? How can we help people with  irritability and aggression from nonpharmacological approaches to FDA-approved medications? Listen and learn with my first ever Carlat Webinar!

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4381-treating-irritability-in-autistic-children-functional-and-medication-approaches Irritability can be a significant challenge for autistic individuals, as well as their families. While there are FDA-approved medications for treating irritability in autistic children, such as risperidone and aripiprazole, they can come with some undesirable side effects, including weight gain, neurotoxicity, tardive dyskinesia, and even worsening of catatonia. In this...

Anxiety is perhaps the most frequent symptom for which we are consulted. In this podcast Mara and I cover our new algorithm for approaching common anxiety disorders in children and teens.  https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4344-anxiolytics-in-children-and-adolescents

https://affectautism.com/2023/03/18/medication-2/   This is part 2 because there is a new Child Medication Fact Book for Psychiatric Practice, Second Edition that just came out.Dr. Feder is here to tell us the purpose of the book and to walk us through his new algorithm for supporting autistic kids.  Dr. Joshua Feder...

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4333-assessment-of-non-suicidal-self-injury-in-children-and-adolescents Self-harm can be separated into different forms, including unintentional self-harm, self-injurious behavior, non-suicidal self-injurious behavior, suicide attempts, and completed suicide. Non-suicidal self-injury is the intent to harm yourself without wanting to die. This includes burning, cutting, head banging, or punching a wall. This is different from unintentional self-harm, where...

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4321-improving-sleep-in-children-and-adolescents At this very moment, we are in the midst of the “The Great Sleep Recession”. Children and adolescents who suffer from sleep problems can have a wide range of issues negatively impacting their day-to-day lives. So, how can clinicians enhance their patient’s quality of life by improving sleep outcomes?...

  https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4318-addressing-sensory-processing-challenges   About 5%–16% of the general population have sensory differences that impact daily functioning. Difficulties in sensory processing can profoundly impact quality of life. As clinicians we need to recognize and address these issues so that we can improve relationships and adaptive abilities of individuals at an early age. In this podcast, Mara...

https://www.thecarlatreport.com/blogs/2-the-carlat-psychiatry-podcast/post/4318-addressing-sensory-processing-challenges   About 5%–16% of the general population have sensory differences that impact daily functioning. Difficulties in sensory processing can profoundly impact quality of life. As clinicians we need to recognize and address these issues so that we can improve relationships and adaptive abilities of individuals at an early age. In this podcast, Mara and...

The Reviews Are In! https://www.thecarlatreport.com/products/353-regular-bound-copy-with-pdf-access-and-10-cme-post-test “Practical, thorough, and easy to use.A must for all prescribers!”  —Fred R. Volkmar, MD  Child Study CenterYale University School of Medicine    “From one of the most trusted names in psychopharmacology comes this user-friendly, practical, and extremely useful guide to the treatment of child and...

https://uniquelyhuman.com/2022/11/25/medications-autistic-individuals-josh-feder/ Medications are often prescribed for autistic individuals for a number of conditions co-occurring with autism. Dr. Josh Feder, a child and family psychiatrist, author and researcher, discusses his background leading to a specialization on appropriate use of medications. He discusses his emphasis on seeing medications only as part of...

  https://www.thecarlatreport.com/podcast/interpreting-assessment-discrepancies-from-multiple-sources/ As clinicians, we receive assessments about our child and adolescent patients from multiple sources, such as parents, teachers, clinical staff, trained observers, etc. And when interpreting these assessments, there’s a common tendency to suppress or discount discrepancies and focus on commonalities amongst the reports. But, do discrepant reports...

https://www.thecarlatreport.com/podcast/addressing_weight_stigma_in_clinical_progress/ Every patient and family you see is inescapably impacted by weight stigma or fat shaming and the damage from this bias can be lethal. In this podcast, Mara and I will discuss this cultural conundrum, help you counterbalance the stigma, and help your patients to shield themselves from weight...

When a school placement is a bad fit, medication and therapy are unlikely to make much difference. In this episode, we will help you understand and assist your patients to optimize their success in the least restrictive placement. https://www.thecarlatreport.com/podcast/school-inclusion-what-you-need-to-know-2/

https://www.thecarlatreport.com/podcast/diagnosing-and-treating-avoidant-restrictive-food-intake-disorder/ Nine years after DSM-5, Avoidant Restrictive Food Intake Disorder (ARFID) is still settling into clinical practice. In this podcast, Mara and I will help sort out the differential diagnosis between ARFID, anorexia, and other conditions and plan treatment in the context of comorbid conditions, such as anxiety disorders and...

Dr. Feder: Of approximately one million US children and adolescents, roughly 1% are prescribed second-generation antipsychotics. These medications routinely lead to weight gain in kids and teens even beyond the 7% that the FDA’s calls it’s ‘level of concern’. The worst offenders are olanzapine, quetiapine, and risperidone. Lurasidone and ziprasidone...

The Drawing Together community convened again on Sunday, July 31. Our session was led by Josh Feder and his three-year old sheepdog, Charlie. Here's the link! https://www.graphicmedicine.org/drawing-together-40-do-love/?unapproved=133985&moderation-hash=48eee9aa9b6629acebfb3912fb8c89b9#comment-133985   Josh and Charlie are a family psychiatry team from San Diego California with a focus on autism in the US and on trauma...

https://www.thecarlatreport.com/podcast/how-effective-is-atomoxetine-in-children-and-adolescents/   Since its FDA approval in 2002, Atomoxetine (brand name Strattera) has become a second or third line option (after stimulants and sometimes after central alpha agonists) for ADHD in both children and adults. With the recent approval of another non-stimulant ADHD medication (viloxazine, brand name Qelbree), this is...

https://www.thecarlatreport.com/podcast/discussing-stimulant-treatment-with-parents/ ADHD is one of the most treatable conditions in psychiatry if patients adhere to medication regimens. Stimulants have been widely used and are usually safe when taken as prescribed, however, parents are often skeptical and concerned about psychotropic medications. In this episode, we’ll discuss why  parents are so resistant...

https://www.thecarlatreport.com/podcast/treating-children-of-divorce/

It would be incredibly difficult to effectively manage both schizophrenia and autism without antipsychotics. The extensive research data and strong evidence of efficacy clearly supports the use of antipsychotics in these youth subpopulations. However, we start to run into some serious problems when we start using antipsychotics off-label in youth....

At Positive Development we are deeply committed to the developmental model and have utilized it successfully for decades to build connections and shape futures for children with developmental differences. We know from personal expereince the power of developmental interventions to transform even more lives for the better. Look at our approach...

https://www.amazon.com/Prescribing-Psychotropics-Metabolism-Genetics-Interactions/dp/1732952264/ref=sr_1_1?keywords=Prescribing+Psychotropics+Chris+Aiken&qid=1637095215&sr=8-1 Prescribing Psychotropics bridges the gap between the complexities of drug pharmacokinetics and everyday clinical practice, providing clinicians more insight into how psychiatric drugs behave (or misbehave!) once their patients take them. The book also includes a series of unusually practical charts and tables that prescribers will find invaluable as...

https://www.early-years.org/news/mifc-compassionate-leadership As we begin a new year again within the shadow of the pandemic, Zoe Kernohan Neely from Early Years, Dr. Joshua D. Feder, MD, Child and Family Psychiatry and Jerri Lynn Hogg, Director of Media Psychology at Fielding University present this series of three videos on compassionate leadership. As...

  https://www.thecarlatreport.com/podcast/effect-size-matters-a-mini-master-class-in-autism-intervention/ As clinicians we are often faced with questions from families about the “best” program for autism intervention. While children with autism may receive a range of services including speech and language therapy, occupational therapy, and social skills help, the anchor to most programs is some form of behavioral...

  This week we’re talking about a new company called Positive Development, which offers developmental therapies paid for by insurance, currently in Florida, New Jersey, California, and coming soon to Illinois. Maryanne Nugent is the Chief Operating Officer and the parent of a 23-year-old son who received DIR/Floortime when he...

As clinicians we are often faced with questions from families about the “best” program for autism intervention. While autistic children may receive a range of services including speech and language therapy, occupational therapy, and social skills help, some in the community, the anchor to most programs is some form of...

On April 2, 2021, viloxazine, brand name Qelbree, received FDA approval for the treatment of ADHD in children and adolescents ages 6-17 years old. The latest issue of The Carlat Child Psychiatry Report includes a News of Note covering this newly approved medication for ADHD. In this podcast, we discuss the advantages...

Pharmacogenetics: Not Quite Ready for Prime Time? https://www.thecarlatreport.com/podcast/pharmacogenetics-not-quite-ready-for-prime-time-2/ Clinicians are inundated with ads for genetic testing, but is genetic testing currently helpful for informing clinical care? The latest issue of The Carlat Child Psychiatry Report includes an interview with Dr. Aaron Besterman, who’s an adult and child & adolescent psychiatrist...

For nearly 17 years, since the FDA black box warning about suicidality with antidepressants, our community has been quoting data that downplays this concern. We were wrong. We were deceived. Antidepressants can be lifesaving, but there really is a duty to warn. In this episode, Doctors Martha Ignaszewski and Glen...

  Returning this week as our guest is Dr. Joshua Feder, a child and family psychiatrist in Solana Beach, California using the Developmental, Individual differences, Relationship-based (DIR) model. One of my biggest revelations from being a Floortime parent that I presented at the DIR/Floortime Conference in November was that parents...

https://www.thecarlatreport.com/podcast/reimagining-adhd-with-edward-hallowell-md/

Air pollution, including particulate matter from forest fires, is a leading cause of health problems globally. It is also linked to psychiatric problems in children and adolescents. We take a closer look at the evidence and clinical implications in this episode. https://www.thecarlatreport.com/podcast/air-pollution-and-mental-health/  

Do you remember the movie Bass Clef Bliss? About Terrance Patridge, an autistic teen who blossomed on the trombone?    It was produced locally by Patrick Scott and his company Drama House Productions and has been used as a vehicle for discussion nationwide.   It’s now the centerpiece of an educational program,...

We hope this trio of 60-second psych podcasts is a start at addressing the impact of systemic inequity: How to Address Implicit Bias Promoting Assertiveness in Adolescents Preventing Trauma With Racial Socialization  

This is a short episode with a link to these points from the American Foundation for Suicide Prevention in the description. Please share it far and wide with your colleagues. Here's the brief podcast https://www.thecarlatreport.com/blog/10-facts-about-physician-suicide-and-mental-health-60-sec-psych/ Resource https://www.acgme.org/Portals/0/PDFs/ten%20facts%20about%20physician%20suicide.pdfReferenced: 10 Facts About Physician Suicide and Mental Health, American Foundation for Suicide Prevention from...

Psychotic disorders in children and adolescents include a range of neuropsychiatric problems related to the multitude of underlying neurophysiological differences and the problems created by these differences. Chief among these are cognitive impacts. This interview helps outline and give guidance for managing these cognitive problems related to both.   https://www.thecarlatreport.com/blog/cognitive-rehabilitation-for-youth-with-psychotic-disorders-2/

Zoe Kernohan-Neely and I made these 2-3 min videos for Early Years The Organisation for Young Children in Northern Ireland to offer support for adults during this time of the pandemic: managing stress, structuring the day, wearing masks, etc. Adults in the Lives of Children In these videos, we expand...

Linda Chokroverty, MD, is the attending physician at the Montefiore Health Systems in Bronx, NY; Assistant Professor of Psychiatry and Behavioral Sciences and Pediatrics at the Albert Einstein College of Medicine; and Co-Chair of the Disaster and Trauma Issues Committee with the American Academy of Child and Adolescent Psychiatry. In...

  The COVID19 pandemic has our society locked down and our health care system under extreme pressure. In this episode we’ll talk about telepsychiatry, dealing with insurance companies, refilling prescriptions, strategies for living under lockdown, and how to support families and each other during a global pandemic. Published On: 4/9/20  ...

We live in a new era, going online as much as possible for health care. My puppy and I shot this video during the 2020 National Foundation for Autism Research (virtual) Race for Autism to introduce you to the use of video for therapy and medical care. Enjoy! https://www.facebook.com/NationalFoundationforAutismResearch/videos/208784277060666/  ...

Hope you are all staying safe and healthy. In compliance with San Diego County recommendations, medical practices are moving to telehealth services as much as possible for now. While my hope is that the coronavirus situation is resolved sooner than later, until then my building is closed to foot traffic...

AUTISM IS: The Interactive Classroom Experience (An evidence-based curriculum for General Education K-12)  http://www.autismistheinteractiveclassroomexperience.com/ This curriculum has incorporated the common core standards.  It is designed to sensitize students to kids with Autism.  Ultimately, the students are encouraged to explore their thoughts and feelings about, and describe current interactions with, classmates...

https://www.thecarlatreport.com/blog/coronavirus-and-mental-health/ This is a special episode covering coronavirus for mental health care professionals with a focus on children and adolescents. Dr. Feder discusses basic information on symptoms, minimizing transmission, tips for telepsychiatry, talking about the virus with patients prone to anxiety, and addressing cultural bias.

We interviewed ADHD icon Dr. Russ Barkley. I thought we'd hear about his groundbreaking work on behavioral interventions for ADHD. Instead, Dr. Barkley blew open our entire understanding of the impact of ADHD. Listen and let me know what you think! https://www.thecarlatreport.com/blog/adhd-and-life-expectancy-with-russell-barkley-phd/    

  Child psychiatrists are grappling with the problem of pervasive use of marijuana in an age where legalization of use for adults has led to even greater use in teens. In this episode, Dr. Feder and Mara go over two recent interviews in The Carlat Child Psychiatry Report with Gabriella Gobbi,...

Informed consent is so much more than a quick signature on a form - it is an ongoing process that organizes medical care for doctors, patients, and families. This podcast covers the parts of informed consent process and a free download of a concise form. https://www.thecarlatreport.com/blog/informed-consent-an-ongoing-process-for-focused-care-2/

Getting a bill passed in Sacramento, or anywhere, is a huge process. In this talk, I cover the developmental philosophy of 'fixing the world', the ups and downs of the legislative process, and managing meetings with important people. This is followed by a play by play from our legislative consultant...

  Transcranial Magnetic Stimulation (TMS ) is getting a lot of attention and a lot of marketing. But is it safe and effective for children and adolescents? And if so, what's the cost and what should it be used for? Listen to my Carlat Podcast and find out. /https://www.thecarlatreport.com/blog/should-you-consider-tms-for-kids/

How do you prepare for, live through, and recover from the stress of disasters? This talk covers the nuts and bolts of what to do and what not to do to prevent traumatic stress reactions in ourselves and also in the survivors we serve.   https://www.dropbox.com/s/ph8nfh7dlp4k934/Managing%20Difficult%20Moments%20Community%20Emergency%20Response%20Team%20%28CERT%29%20Solana%20Beach%20Fire%20Station%20Sept%2017%202019%20zoom_0.mp4?dl=0

In this talk, we cover the range of developmental levels of social problem solving - all 16 - described by Drs. Stanley Greenspan and Stuart Shanker in their book The FIrst Idea. This is a great way to assess and support social-emotional development. https://zoom.us/recording/play/sXwAlJgSnq2tKOgzeniRoRUmfqN68GBQtkRJ2pOBjVYkAEnRpei4TMYvf3GgjXn3?autoplay=true&startTime=1554647553000    

https://www.thecarlatreport.com/blog/how-to-address-school-refusal/   This is not just playing hooky! In our new podcast for The Carlat Child Psychiatry Report, Mara Goverman and I talk about understanding and helping kids who just won’t go to school. We cover a bit about assessment, interventions and, when necessary, medications that might help.    

I recently spoke at Fusion Academy on helping teens and tweens on the Autism Spectrum. This rehash at Fielding U is a 27-minute romp featuring an easy to learn, straightforward developmental method and practical ideas for common problems that crop up. Oh, and there are dinosaurs... https://zoom.us/recording/play/P802E75uvQCkeRQWcbfnEdc0vwEwzYPhxcieaIlHMwDvtJwydN4SERI6V2R2FefE?autoplay=true&startTime=1567039305000

Intellivision is bringing family connection back to video gaming. All games will be E or E10 for Everyone and the controllers are designed for accessibility so kids, grandparents, and others can join and connect. As medical director at Quicksilver Software - SymPlay Family Games for Autism - and an accessibility...

https://www.thecarlatreport.com/blog/is-watching-13-reasons-why-bad-for-teens-2/   Join Josh Feder, MD, and Mara Goverman, LICW, for a special episode focused on child psychiatry, suicidality, and the popular Netflix series 13 Reasons Why. The show stirred controversy when it portrayed the bullying and suicide of a teenager. Although the program increased awareness of these issues, some clinicians...

Both a case study in developmental approaches to autism and a thank you to the people who helped 'Matthew' reach high school graduation. Every child is different, but the aim of following the child's lead and building on it to reach a dream is the same. https://www.dropbox.com/s/sho36pvu9wr24yn/AutismFile_US30-Feder%20%20.pdf?dl=0&fbclid=IwAR2ne-8ZKhtZOcUbBtOb5l9FoycyX6-I058GVC1iJcHtGsMOc1nZwkmWfj4  

The right direction: It is great to see the autism field move forward.   These second edition books are the result of research showing that respectful care works.   Naturalistic Developmental-Behavioral Intervention moves the field toward effective support so that parents and  other caregivers (family, teachers, others) can help children...

‘Preventing the 20 year old fighter in the 2 year old biter.’ The Revised Self Regulation Toddler Module of the Media Initiative For Children People are asking me: What are you doing in Northern Ireland - again? As many of you know, about half my work is in my clinic in...

Connection Coder is designed to assist you to look at how interactions between people and help them to be connected in meaningful social communication. It was developed to help caregivers (parents, teachers, and others) as well as researchers track and get feedback on these interactions. Many researchers look at video...

Carlat Child Medication Fact Book for Child Psychiatrists  

The Child Medication Fact Book is a comprehensive reference guide covering all the important facts, from cost to pharmacokinetics, about the most commonly prescribed medications in child and adolescent psychiatry. Composed of single-page, reader-friendly fact sheets and quick scan medication tables, this book offers guidance, clinical pearls, and bottom line...

  Editor-in-Chief of the Carlat Child Psychiatry Report, Dr. Joshua D. Feder, discusses the latest issue about depression in children and adolescents. The double issue features an expert interviews with Danella Hafeman, MD, PhD and Calvin Colarusso, MD.

The TOSCA study focused on children with severe ADHD, who also met criteria for oppositional defiant disorder (ODD) or conduct disorder (CD). These children tend not to do as well with stimulants alone and often end up being prescribed antipsychotics, typically second generation antipsychotics (SGA’s). TOSCA was devised to help...

  Editor-in-Chief of the Carlat Child Psychiatry Report, Dr. Joshua D. Feder, discusses the latest issue about autism in children and adolescents. The issue features an expert interview with Dr. Serena Wieder. Become a subscriber and learn more about The Carlat Child Psychiatry Report here: www.thecarlatchildreport.com

Using Vitamins, specific diets, and herbal remedies, IM focuses on supporting the innate healing powers of the body. IM is not without its disadvantages. Firstly, and chiefly, the evidence base for efficacy is deficient by the standards of conventional medicine. In part, this is due to a lack of financial...

The following tips for overcoming conflict in the medication consent process were excerpted from an article I wrote for the May/June issue of the Carlat Child Psychiatry Report: If it’s not an emergency, take your time. When life and limb are at stake, we should act immediately—but that doesn’t usually mean...

In many cases, it will be immediately clear when an aggressive patient needs to be sent to the ER, says Ruth Gerson, MD, Director at the Bellevue Hospital Children’s Comprehensive Psychiatric Emergency Program in New York, NY. If a patient is hurting people, including himself, and you determine a clear and...

  The following are some recommendations on good medication practice from child psychiatrist Mark Chenven, MD, who offered his expertise in the May/June issue of The Carlat Child Psychiatry Report: Start low, go slow: Most side effects are dose related, so gradual up-titration is simple common sense. This allows for the body’s homeostatic...

Key Take-Aways PDF Last December, we spoke with ​Dr. Joshua Feder about ​repetition in autism therapy​. He returns today to speak with us from his practice in Solana Beach, California about autism and medication. Is medication the missing piece for some of his patients? How does he know whether to...

Just getting adolescents to even find their medicine or remember to take it is a big challenge, says Jess Shatkin, MD, Professor of Adolescent Psychiatry and Pediatrics at the New York University School of Medicine, and author of “Born to be Wild: Why Teens Take Risks, and How We Can Help Keep Them...

There are some ways to help you assess the type of anxiety that leads to inattention. Consider the following tips, which we’ve excerpted from an article in the March/April issue of the Carlat Child Psychiatry Report newsletter: Catalog. Work with the child to develop a list of activities in which the child is...

Google me.  See my one-star reviews.Like skulls on a beach, most from a weathered past, they warn: ‘Beware. Stay away! No guarantees here. Come only if you must.’An awful sight. Pit in my stomach. Cold damp skin. I rack my head: ‘Who wrote this? Can I fix it?’  What did...

In a past issue of the Carlat Child Psychiatry Report, Sara Weekly, MD, child and adolescent psychiatrist and clinical assistant professor at New York University School of Medicine, gave the following advice on BED treatment strategies: Consider cognitive behavioral therapy: CBT currently has the strongest evidence base among psychotherapeutic options for treating BED,...

Because they work better than anything else to help kids focus, stimulant medications are standard treatments for ADHD. But when you suggest prescribing these medications, typically parents have questions and concerns, says Caroline Fisher, PhD, MD, Chief of Child Psychiatry at Samaritan Health Systems in Corvallis, OR. In an article she wrote for the...

In a past article from The Carlat Psychiatry Report, Joshua Sonkiss, MD, Medical Director for Fairbanks Community Mental Health Services and Boys and Girls Home of Alaska in Fairbanks, reviewed and explained the different types of study designs. Case reports: Someone writes up an interesting case they’ve seen. Case reports are good...

When used appropriately, screen media can be useful rather than harmful. But with children, there must be limits, says Mary G. Burke, MD of the Sutter Pacific Medical Foundation in San Francisco, who covered the topic in a past Carlat Child Psychiatry Report article. Since screen time can be addictive for susceptible...

All behavior is a code that a child uses to communicate, says Jessica Minahan, a board-certified behavior analyst and special educator, who co-authored The Behavior Code Companion. “Bad behavior” is often cloaked anxiety, and we can support education professionals by offering ideas that help anxious children. In a past issue of The Carlat Child...

Over the past few years I wrote a couple of courses for Relias Learning.  I never looked them up since I didn’t have much reason to do so.But today I did to offer a resource to someone and, OMG, over 4500 positive reviews on the managing autism course and over...

Most of the research I review is flawed. It’s not so hard to build a decent design. So I made a 21 frame cartoon to help people. While it’s written for NFAR*, the ideas are universal. The link and a sample frame are below. Hope you like it! www.nfar.org/images/stories/uploads/2017/NFAR-Grant-Rants-Web.pdf  ...

In the April 2017 Journal of Developmental and Physical Disability, Mayes et. al, published an article entitled: Tantrums are Not Associated with Speech or Language. This research is important from clinical, research as well as advocacy perspectives. The authors investigated the common notion that children with autism tantrum because they...

The Affordable Care Act has it’s problems, but it does try to make things better.  One way it does this is by making sure that people who speak different languages don’t lose out on care. If you are like me, as a member of a bunch of professional societies, you...

Practical EncouragementYou know that look: anxiety on the verge of defiance.  Parents often ask me for ideas on how to help a child with his anxiety, how to get through the moment, maybe even build him up, rather than triggering something worse.  When children are already sensitized like this, the...

Today I had a chance to describe DIR/Floortime including what we do, research and advocacy today. Free audio download – hope it’s helpful. Let me know! https://www.voiceamerica.com/episode/91022/dirfloortime-what-it-is-how-it-can-help-individuals-with-developmental You can also check out the show on the network site at http://www.voiceamerica.com/show/2517/therapeutic-approach-to-growth

Let’s be famousWe don’t really want to be bothered by paparazzi. But as it turns out, if we want to leave something useful behind, we probably need to say something meaningful, do that well so that many people hear us, and, of course, still pay the bills.  Here’s my plan,...

Affect Regulation Theory: A Clinical Model (Norton Series on Interpersonal Neurobiology)A recent article argues that we thrive in a natural tension between things and don’t do so well when we fall into a more simplified but ossified state. Think of Tronick’s messy interactions, in which the ongoing tension of break...

My article, featured, and free, in The Carlat Child Psychiatry Report Getting meds just right is challenging in autism. Sometimes we succeed. For example, a woman with minimal verbal ability is extremely aggressive. She is on a number of medications including valproate 1000 mg extended release, paroxetine 40 mg, ziprasidone...

Mindful Education – Mainstream Practice?We hear it constantly: mindfulness, balance, breathe. To fight stress, to have better lives. And happiness. And recently we hear how important it is to learn these things in school,earlier and earlier. Sure – but how do we really do that and does it really work?...

One of the unfortunate aspects of playing video games is that they often lead to isolation and irritability, especially in kids with autism spectrum disorder (ASD). What if there was a game that combines the allure of gaming and leverages – without demanding – that the energy be directed towards...

Dana Walrath – Like Water on Stone Genocide is incomprehensible. Maus made the European Jewish Holocaust more accessible, using a graphic novel format. Walrath uses verse to tell of the Armenian Genocide, reminiscent of the book of Lamentations describing the desolation of Jerusalem after the Babylonian siege in 586 BCE. But...

KPBS did a recent article, for which I am grateful, mainly as they included my concerns about the problem of compliance training as a core aim of intervention creating more vulnerability in an already vulnerable population Hiding in plain sight: Autism research unmasks gender disparities

When things are already escalated: Pause – quietly observe Stay calm – use few words, simple and supportive: ‘We can figure this out’. Wait – allow time for the person to settle down; don’t touch if not needed. Empathize – try to nearly but not fully match the person’s level...

We all face daily challenges: caring for family members, working with colleagues, perhaps supervising others or responding to a boss.  Sometimes we know what to do, even if we have to bear some discomfort, as we respond to situations in a steady and kind manner. And yet, often enough, we are...

As many people know, my talks are big on repeated images: a (borrowed) ven diagram to explain how the elements of evidence based practice combine in true informed consent*; a heart to remind people that with all we do it is about ’empathy first’ ; a pause button to embed...

A Pause During Battle: Tech Play Engaged in a pitched battle, our rag tag DIR/Floortime Coaliton of California, fighting hard for the rights of families to have access to all evidence based approaches, including developmental ones, is pitted against an array of companies and organizations devoted to ensuring that only...

Evidence Based Practice – An Overview Defining Evidence Based Practice:Evidence Based Practice (EBP) is a process for making better clinical treatment decisions.  In EBP we consider relevant research about a condition and think about what might be useful based on clinical judgment and experience.  We then talk with families about...

It’s not uncommon: a patient or family member is in severe distress and we need to figure out what to do and find resources right away.  This week SAMHSA the Substance Abuse and Mental Health Services Administration, released an excellent free app that helps us during difficult moments when we...

You may have noticed that when we post, Barbara Kalmanson and I are giving you links to our own websites, sometimes with more links to click for added resources. There is usually a wait while the page loads and this dissuades people from clicking and reading.  Please don’t be annoyed! ...

Advocating for Evidence Based Practices in Autism Spectrum Disorder Our UCSD Autism Research Seminar this morning featured Connie Wong PhD, first author on the report Evidence Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorders.  It’s free to download at: http://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/2014-EBP-Report.pdf This is the most recent review...

I am deeply troubled by the problem of helping people understand the existence of hate and brutality of totalitarian regimes and intolerant despots.   The Orphan Master’s Son, a novel by Adam Johnson may help – it depicts the horrific human oppression enough to nearly traumatize readers, and in doing...

We just finished the Profectum conference in Pasadena, which was really great in so many ways including a big boost for advocacy for Parent Choice for Evidence Based Practices. The conference content itself included excellent talks about sensory, motor, and dynamic brain systems, care presentations in multiple settings (school, clinic,...

In this tip, excerpted from a past issue of the Carlat Child Psychiatry Report, Elizabeth Tien, MD, a child & adolescent psychiatrist at Maimonides Medical Center in Brooklyn, NY, offers off-label advice on prescribing medications for children with PTSD. Below are some general tips, but to get a handy table on which...