Blog Archive

'Preventing the 20 year old fighter in the 2 year old biter.' May 24th, 2019

‘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: Video Coding of Interactions to Support Social Comunication and Development Feb 4th, 2019

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 Nov 13th, 2018

Carlat Child Medication Fact Book for Child Psychiatrists  

Child Medication Fact Book for Psychiatric Practice Sep 23rd, 2018

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...

Carlat - Quick Take Issue Video – Depression in Children and Adolescents Sep 19th, 2018

  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.

Carlat - Antipsychotics and Aggressive Children With ADHD Jul 15th, 2018

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...

Carlat - Quick Take Issue Video – Autism in Children and Adolescents Jul 15th, 2018

  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

Carlat - Integrative Approach to Assessing ADHD Jun 30th, 2018

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...

Carlat - Managing Conflict Over Medication Consent Jun 20th, 2018

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...

Carlat - Calming Violent, Aggressive Patients May 23rd, 2018

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...

Carlat - Tips for Good Medication Practice May 6th, 2018

  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...

Autism and Medication with Dr. Joshua Feder Apr 21st, 2018

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...

Carlat - Managing Medications with Adolescents Apr 20th, 2018

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...

Helping Children To Tell Us About Their Experience Apr 8th, 2018

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...

The Blessings of a Bad Review Mar 24th, 2018

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...

Carlat - Treating Binge Eating Disorders Mar 12th, 2018

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,...

Carlat - Talking to Parents About Prescribing Stimulants Feb 23rd, 2018

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...

Carlat - Understanding Study Types and Methodology Feb 5th, 2018

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...

Carlat - Advice on Limiting Screen Time for Children Jan 28th, 2018

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...

Helping Kids with Problem Behaviors in School Dec 30th, 2017

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...

Effective Online Courses – Who Knew? Sep 24th, 2017

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...

Grant Rants: Building Better Research Aug 23rd, 2017

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  ...

Unpacking Tantrums Jul 16th, 2017

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...

Tech to Manage the ACA 1557 Non-Discrimination Notification Requirement Oct 11th, 2016

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 Encouragement Apr 22nd, 2016

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...

Connect with Autism Treatment – free audio file Mar 15th, 2016

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 famous Feb 14th, 2016

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,...

Pride vs Shame: tension needed for growth Feb 13th, 2016

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...

Medication Strategies for Helping People with Autism Spectrum Disorders Nov 30th, 2015

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? Oct 5th, 2015

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?...

Judo for Tech Isolation? Game for autism benefits social communication Aug 24th, 2015

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...

Exploring genocide in accessible verse Aug 23rd, 2015

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...

Girls on the Autism Spectrum Jul 15th, 2015

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

Quick Guide Emergency Services for First Responders for Persons with Autism and Related Disorders May 17th, 2015

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...

Spreading the word: Reflective Process – What it is and why it’s important May 16th, 2015

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...

Graphic Medicine : pictures for care and healing May 3rd, 2015

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 May 3rd, 2015

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 Apr 19th, 2015

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...

Quick help for mental health crises Apr 11th, 2015

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...

Click (& Meditate) to Advocate! Apr 9th, 2015

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 ASD Mar 24th, 2015

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...

Recognizing Hate Mar 21st, 2015

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...

Profectum Success! Mar 16th, 2015

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,...

Carlat - Off-Label Use of Medications for Children and Adolescents with PTSD May 29th, 1018

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...