Workshop Session: Thursday, March 9, 2017

Click here for session handouts.

11:00 a.m. - 12:30 p.m.

Global Adolescent Health Comes of Age: Beyond the Lancet Commission on Adolescent Health and Wellbeing

Nicola J. Gray, PhD1, George C. Patton, MD2, Susan M. Sawyer, MD2, John Santelli, MD, MPH3, Tamera Coyne-Beasley MD, MPH4
1Association for Young People's Health; 2University of Melbourne, 3Columbia University Mailman School of Public Health; 4University of North Carolina at Chapel Hill
Track: Public Health/Advocacy

Description: 2016 marked the launch of the Lancet Commission on Adolescent Health and Wellbeing, the culmination of 3 years of collaboration between 30 commissioners from 14 countries. The Commission report provides a new integrated narrative for adolescent health and wellbeing in a global context. Its recommendations address major challenges and areas for future work. The Lancet has committed to a Standing Commission for at least five years, through which the Commission’s recommendations will be advanced and monitored. The workshop will include SAHM members who had lead roles within the Commission. Facilitated by SAHM’s Board of Directors and the International Chapter, this forum will provide an opportunity for the broader SAHM membership to consider the implications of the Commission’s findings for their everyday clinical, research, policy and advocacy work, and the wider role that SAHM might play as an organisation as global interest in adolescent health increases.

Educational Objectives
  1. Reflect upon the drivers of global interest in adolescent health and development, including the shifting policy context.
  2. Summarize findings from the Lancet Commission on Adolescent Health and Wellbeing related to global epidemiology, the evidence base for action, social determinants of adolescent health, models of youth engagement and accountability in practice.
  3. Consider and evaluate the opportunities for SAHM members to contribute to the development of adolescent health in the international context.
Faculty Expertise: Professor Patton leads a research group that has conducted the first global studies of mortality, disease burden and health risks for AYA. This extended into his role as Chair of the Lancet Commission on Adolescent Health and Wellbeing between 2013 and 2016. Professor Sawyer was elected to the SAHM Board of Directors in 2014, is a vice-president of IAAH (Oceania Region), the current chair of WHO's Technical Steering Committee on Maternal, Newborn, Child and Adolescent Health, and was a Lancet Commissioner. Dr Gray is the President of the International Chapter of SAHM, and their representative on the SAHM Board of Directors. She has led the contribution of SAHM to two recent international consultations. Dr Coyne-Beasley is the President-Elect of SAHM. She has had a long-term interest in global health, providing service and health care to adolescents through missions and relief programs in Africa, Central America, South America and the Caribbean.

Adolescent Bone Health Clinical Cases: Evidence Based Evaluation and Management

Sarah Pitts, MD1, Amy DiVasta1, Catherine Gordon, MD, MSc2, Neville Golden, MD3
1Boston Children's Hospital, 2University of Cincinnati College of Medicine, 3Lucile Packard Children’s Hospital Stanford
Track: Clinical Advances

Description: This workshop will bring together basic bone health concepts reviewed in prior years during the Bone Health Special Interest Group sessions with current evidence and place them into a clinical context. Attendees will review cases with bone health experts; discussing an evidence based approach to care and management. Cases may include the bone health of adolescents with anorexia nervosa, those requiring hormonal replacement therapy, athletes with stress fractures, and adolescents with osteoporosis.

Educational Objectives
  1. Practice interpreting routine bone health labs and imaging.
  2. Translate current evidence regarding bone health science into practical clinical applications.
  3. Summarize evidence based treatment approaches for adolescents with impaired bone health.
Faculty Expertise: I am a clinician in the Boston Children's Hospital Bone Health Program and an educator in the Boston Children's Adolescent Medicine Fellowship. I see patients weekly with bone health concerns and and one of four clinicians who reads the DXAs for our hospital. I have spoken locally, nationally, and internationally on the topic of Adolescent Bone Health. This year I begin work with Dr. Catherine Gordon as a co-editor of a textbook on Adolescent Bone Health for primary care providers.

Suicide Risk and Assessment for Adolescents and Young Adults

Bridgid M. Conn, PhD, Sara Sherer, PhD, Terez Yonan, DO
Children's Hospital Los Angeles
Track: Clinical Foundations

Description: Suicide is the second leading cause of death among adolescents and is a major public health problem in the US. Recently, the American Academy of Pediatrics released a clinical report advocating for continued and updated training in the identification and management of suicide risk and behavior among adolescents. Suicidal risk is one of the most challenging things to ask about, particularly in primary care and community clinics. Due to the sensitive and critical nature of suicide risk, practitioners often report feeling under-prepared or uncomfortable following up on suicidal ideation. Prevention and intervention efforts with this specific population may be improved by increasing knowledge, skills, and confidence of adolescent healthcare providers. Using a developmental perspective, this workshop will provide an overview of warning signs, risk, and protective factors associated with suicidal behaviors among adolescents and young adults. In addition, attendees will participate in interactive training activities focused on screening, referral, and safety planning. The workshop will also address challenges in addressing suicide risk, particularly in outpatient/primary care settings. As recent studies have reported that youth may be at greater risk of suicidal behavior from media exposure, the workshop will increase attendees ability to tap into to community and digital resources for decreasing risk and increasing protective factors to promote strengths-based interventions. Implications for clinical practice and advocacy will be discussed, such as connecting youth with peer support networks and technological tools, and promoting dissemination of prevention/intervention efforts, particularly in under-served diverse communities.

Educational Objectives
  1. Identify risks and warning signs associated with suicidal behavior, focusing on the latest research on adolescents and young adults
  2. Summarize key steps in addressing suicide risk among adolescents and young adults in outpatient settings
  3. Evaluate potentially useful apps, local and national support programs, and crisis resources for adolescents and young adults
Faculty Expertise: The primary and additional authors together have many years of experience in the areas of adolescent medicine, suicidality, and suicide risk assessment, prevention, and intervention. More specifically, the authors have extensive experience in assessing and addressing suicide risk with adolescents across inpatient and outpatient settings, and providing suicide risk assessment training for health care professionals and other support staff. The primary author has expertise in the area of self-injurious behavior and suicide risk with adolescents and young adults, including consultation on assessment and intervention. The second author is a recognized expert in the area of suicidality and has served on the Suicide Prevention Task Force for Los Angeles County Department of Mental Health. The third author has expertise in the treatment of mental health disorders in an adolescent medicine setting.

Cultivating the Connection between Health and Education – Innovative Strategies in School-Based Health Care

Ryan H. Pasternak, MD, MPH1, Margaret Riley, MD2, Steve North, MD, MPH3, Venessa Shields, MA4
1LSU-Health School of Medicine, New Orleans; 2University of Michigan Medical School; 3Health-e-Schools School-Based Telemedicine Program, CRHI; 4LSU-Health School of Nursing, New Orleans
Track: Clinical Advances

Description: School-based health centers (SBHCs) are a distinctive healthcare setting in which health care professionals can cultivate the connection between health and education.  They can offer unparalleled access for patients, and play a particularly important role in reducing barriers to healthcare among adolescents who are medically underserved, low income, and often in high-risk situations.  They have been shown to improve both the health and the education of students who access the center.  Additionally, SBHCs provide a unique opportunity for public health as patients are a “captive audience” within the school.   There are almost 2000 SBHCs across the United States providing a growing network of physical and mental health services for adolescents, with expansion by over 30% planned over the next 4 years and increasing use of telehealth services. This session will describe innovations within school-based health in three states. From the UMHS Adolescent Health Initiative (AHI) the development, testing, and results of an Adolescent Centered Environment toolkit piloted in 8 SBHCs around the state which a goal of developing the sites into adolescent centered medical homes. The Health-e-Schools program will highlight the telehealth based comprehensive asthma program they have launched in conjunction with Mission Children’s Hospital. From LSU School of Medicine in New Orleans, a program will be described where the relationship between SBHCs, reproductive health advocates and health professions students and clincians aims to advance reproductive health advocacy, school sexual health education and sexual health services in school and school-based health settings as well as the community at large.

Educational Objectives
  1. Describe 3 innovative programs within school-based health that highlight the connection between health and education, including: The use of the Adolescent Centered Environment assessment and planning tool which helps SBHCs transform into adolescent medica
  2. Describe how telehealth can be used to improve access to specialists in school-based health centers
  3. Describe how innovative relationships between SBHCs/Students, Reproductive Health Advocates, and Clinicians can improve both education and clinical care around sexual health
Faculty Expertise: Dr. Riley is Medical Director for University of Michigan school-based clinics and Regional Alliance for Healthy Schools.  She presented nationally on innovations within SBHCs, and published “The Adolescent “Expanded Medical Home” SBHCs Partner with a PCP to Improve Population Health and Mitigate the Social Determinants of Health.” Dr. North a nationally recognized leader in school-based telemedicine is Medical Director at Mission Center for Telehealth, and founded Health-e-Schools school-based telemedicine, currently providing primary-care, cardiology, pulmonology and psychiatry for 14,000+ students at 33 schools in western NC. Dr. Pasternak is Medical Director for LSU Pediatrics’ SBHCs and Louisiana Public Health Institute’s School-Health Connection program, presents nationally on school-health; most recently working with Vanessa Shields, LSU Nursing Student, with experience as CDC National HIV Behavioral Surveillance Project interviewer to further innovative programs advancing evidence-based reproductive health education and STI screening for youth through partnership with health professions student organizations, schools, and SBHCs.

Beyond the Binary: Supporting Transgender and Gender Nonconforming Patients

Jennifer Leininger, MEd
Ann & Robert H. Lurie Children's Hospital of Chicago
Track: Education/Training

Description: In 2013, Ann & Robert H. Lurie Children’s Hospital of Chicago founded the Gender & Sex Development Program to provide comprehensive and affirming care to gender non-conforming and transgender youth. This workshop will outline the program as well as the institutional initiatives that were necessary to transform the care environment and fully support patients and families. The Gender Program at Lurie Children’s Hospital identified the need for institutional commitments beyond the original clinical scope of the program. In addition to reviewing the multidisciplinary care model of the Gender Program, the Program Manager will review three key initiatives that were institutionally implemented in support of gender inclusion within the organization. These include: 1. An institutional position statement in support of transgender and gender nonconforming people 2. A model policy to inform schools about how to meet the needs of gender non-conforming and transgender students 3. Changes to the physical plant to provide greater access to patients and facilities (conversion of single use restrooms to “all gender” restrooms).   Additionally, in order to support a holistic approach for addressing patient and family needs, Lurie’s commitment to gender inclusion continues to expand beyond the walls of the hospital.  External advocacy efforts include: schools, city agencies, state legislation, community centers, and other medical institutions.  Through the Gender program Lurie Children’s seeks to transform the delivery of the care system into one that is competent and comprehensive as well as welcoming and supportive.

Educational Objectives
  1. Discuss the importance of gender inclusion and gender diversity within a medical framework.
  2. Verbalize and demonstrate best practices and tactics for creating an an environment that is inclusive of transgender patients.
  3. Analyze the current state of gender support in education and medical fields.  Provide information for how to best support trans and gender expansive youth as practitioners and support staff.
Facutly Expertise: Jennifer Leininger, MEd, manages the Gender & Sex Development Program at Ann & Robert H. Lurie Children’s Hospital of Chicago. As Program Manager, Jennifer leads community, policy and advocacy initiatives. She specializes in working with schools, hospitals, and organizations to be more inclusive of gender diversity. Jennifer continues to develop and implement educational sessions to support the inclusion of gender expansive youth and their families in their schools and communities. Since 2008, Jennifer has provided family-centered, patient support while working in Lurie Children's Division of Adolescent Medicine. Jennifer holds a Master of Education degree from DePaul University in addition to a BS (Marketing) and a BA (Theatre) from Miami University. In addition to her work at Lurie Children's, Jennifer has worked on adolescent and children's programming with other nationally recognized organizations, including the Museum of Contemporary Art, Old Town School of Folk Music and About Face Youth Theatre.

Empowering Adolescents with Intellectual Disability: Enhancing Sexual Health Education through Community Collaboration

Laura K. Grubb, MD, MPH, Frinny R. Polanco-Walters, MD, Karen Saroca, MD
Floating Hospital for Children at Tufts Medical Center
Track: Public Health/Advocacy

Description: We aim to promote better access to sexual health education for adolescents and young adults with intellectual disability so they may better understand their sexuality and develop  skills to respond appropriately in sexual situations. It  has been erroneously assumed adolescents with intellectual disability do not experience sex feelings or engage in sexual behaviors which has led to lack of sexual health education in their schools, homes, and other settings. A lack of effective sexual education can lead to adolescents engaging in risky sexual activity resulting in teen pregnancy and sexually transmitted infections among students with intellectual disability. This is a problem that affects adolescents all over the world and one that sorely needs to be addressed through education.  At the Josiah Quincy Upper School in Boston, MA we developed a sexual health course for adolescents with intellectual impairments. By using interactive activities that match the level of understanding of the students we aimed to enhance social skills, foster positive attitudes about sexuality, and increase knowledge of appropriate behavior among local high school students with different levels of intellectual disability. During this workshop we will discuss the importance of fostering and facilitating working relationships between local school leaders and staff members to develop an effective sexual health education program. This year’s conference theme Cultivating Connections is relevant to our workshop content as it serves to emphasize the importance of fostering working relationships between medical providers and community members to prepare adolescents with intellectual disability to make healthy sexual decisions.

Educational Objectives
  1. Promote better access to sexual health education for adolescents and young adults with intellectual and developmental disabilities.
  2. Emphasize the importance of fostering relationships between adolescent specialists and local school staff members including nurses and teachers to develop an effective school-based sexual health education program for adolescents with intellectual and developmental disabilities.
  3. Demonstrate sexual health education course activities and information taught in targeted sexual health education classes.
Faculty Expertise: Dr. Laura Grubb is an adolescent medicine specialist, practicing in a diverse urban primary care adolescent clinic. She is faculty for the Boston Public School Sexual Health Initiative, a multi-disciplinary initiative to improve sexual health education and access within Boston Public Schools. She has partnered with Josiah Quincy School nursing and educational staff to improve adolescent health services, develop classroom based educational sessions, and partner students with health mentors. She collaborated on a Grand Rounds presentation, “Sexuality & Youth with Intellectual Disability.” Dr. Grubb serves on SAHM’s advocacy committee and the American Academy of Pediatrics Committee on Adolescence.

3:45 - 5:15 p.m. 

Addressing Chronic Absenteeism among Adolescent Students

Trina M. Anglin, MD, PhD1, Linda M. Grant, MD, MPH2
 1Health Resources and Services Administration/Maternal and Child Health Bureau; 2Boston Public Schools    
Track: Public Health/Advocacy

Description: Eighteen percent of high school students in the United States are chronically absent from school, missing more than 15 days each year. Rates, which vary by state, district and school, are mediated by poverty. Students who chronically miss school, regardless of reason, including chronic health conditions, housing instability, and anxiety about safety, are more likely to experience poor academic performance and to drop out. Many students who do not attend school regularly by choice are at risk for several additional issues, such as substance use, delinquency, and unprotected sexual activity. Adolescent health professionals are poised to play key roles in promoting student attendance. This workshop explores actions that adolescent health professionals can take at the clinical and community levels. At a clinical level, they can identify students who have erratic attendance patterns or who are not engaged with school, and help them find positive solutions. They can connect with their local schools and school districts to support the needs of individual patients as well as advocate for the implementation of evidence-based and promising practices that promote school attendance and enhance student engagement with learning and school. This workshop will describe several complementary approaches that successful schools and districts employ and will promote the use of data from national surveillance systems that participants can use to discern student attendance patterns. Workshop participants will apply their new knowledge to develop strategies and plans for boosting the school attendance of individual patients and the student bodies at their local high schools.

Educational Objectives
  1. Describe major causes of chronic school absenteeism and the effects that missing school have on academic progress and high school graduation
  2. Use three national surveillance systems that include a focus on student attendance
  3. Apply knowledge of promising clinical efforts and evidence-based school programs to develop strategies that local adolescent health clinicians and partnering schools, districts and communities can use to improve student attendance and engagement with learning
Faculty Expertise: The workshop’s two faculty members have expertise and experience in addressing student absenteeism. Dr. Trina Anglin, in her federal role at the Health Resources and Services Administration/Maternal and Child Health Bureau, is responsible for school health at program and policy levels. The intersection of physical and mental health with K-12 education has been the major focus of Dr. Linda Grant’s career, whether locally as medical director of Boston Public Schools and an adolescent medicine specialist at Boston University School of Medicine, or nationally with projects with the Council on School Health for the American Academy of Pediatrics and the American School Health Association. Both faculty members belong to committees and commissions that have examined student absenteeism. They have also made previous presentations on this topic and Dr. Anglin developed a federal meeting to address this topic as part of the National Coordinating Committee on School Health and Safety.

Reframing Trauma to Reduce Risk: Implementing a Trauma-Informed Approach to Teen Pregnancy Prevention

Denese Shervington, MD, MPH, Jakevia L. Green, MPH, Tracey Spinato, LMSW
Institute of Women and Ethnic Studies  
Track: Public Health/Advocacy

Description: "Reframing Trauma to Reduce Risk: Implementing a Trauma-Informed Approach to Teen Pregnancy Prevention" will reflect the SAHM conference theme by: 1) emphasizing the importance of helping youth recognize the linkage (i.e. "connection) between mental and emotional wellness and risk behavior, and 2) discussing how a trauma-informed approach to teen pregnancy requires the insight, expertise, and collaboration of community members and professionals to ensure that programming is responsive to the population served and advances much-needed access to education and resources for youth. This moderated panel discussion will feature multiple perspectives of youth-serving professionals: reflect the collaborative efforts made to develop, implement, and evaluate a trauma-informed approach to teen pregnancy; and provide strategies to integrate trauma-informed approaches to program delivery. Cultivating connections is an integral aspect of developing, implementing, and advancing trauma-informed approaches to teen pregnancy prevention and other forms of care. Panelists will share their experience with fostering connections to implement a trauma-informed teen pregnancy prevention program with over 2,500 youth from 2010-2015 and how now with funding through 2020, efforts will be scaled to reach over 16,000 youth. Panelists will identify 3 or more strategies to foster collaboration at community, state, and/or regional level. Dr. Shervington, who has longstanding professional experience and expertise in psychiatry and public mental health, will speak to the increased awareness and implementation of trauma-informed appraoches to impact risk behavior. Panelists will present statistical findings that provide context for increased risk behavior among teens as a means of coping with various sources of stress and trauma.

Educational Objectives
  1. Define and list key components of a "trauma-informed approach" and identify potential sources of trauma within their specific target populations.
  2. Formulate strategies to integrate mental and emotional wellness concepts and activities into their teen programming aimed to reduce risk behavior.
  3. Describe at least 3 strategies to foster collaboration with key stakeholders and community members in order to expand trauma-informed approaches to teen programming and other forms of care.
Faculty Expertise: Dr. Shervington has an intersectional career in psychiatry and public mental health. She is the President/CEO of The Institute of Women and Ethnic Studies (IWES), a community-based public health institute; and Clincial Professor of Psychiatry at Tulane University. At IWES, she directs the community-based post-disaster mental health recovery division that she created in the aftermath of Hurricane Katrina. At Tulane, she provides psychotherapy supervision for psychiatric residents. Dr. Shervington is a graduate of NYU School of Medicine. She completed her residency in Psychiatry at the University of California San Francisco, and is certified by the American Board of Psychiatry and Neurology. Dr. Shervington also received a Masters of Public Health in Population Studies and Family Planning from Tulane University School of Public Health and Tropical Medicine. In 2006, she received the Isaac Slaughter Leadership award by the Black Psychiatrists of America and the Jeanne Spurlock Minority Fellowship Award in 2012.

Managing Concussions, a partnership between the school and the primary care clinic

Dale M. Ahrendt, MD, FSAHM1, Katie E. Myhre, MD, MPH2, Joshua M. Smalley, DO1
1San Antonio Uniformed Services Health Education Consortium; 2Madigan Army Medical Center
Track: Clinical Advances

Description: Management of students who sustain concussions / mild traumatic brain injuries has become complicated in the last 10 years with recommendations for pre-season screening, acute injury evaluation, physical and cognitive rest, and return to activity protocols changing frequently as research helps to fine-tune management.  Studies have shown that over 80% of concussions are initially seen in the primary care setting and not emergency departments, making this a primary care issue. Working with school administrators, teachers, and sports trainers to develop plans for cognitive rest and how to manage their return to school and activities is an important part of managing these patients. For the 10% of patients that don’t recover within a month of injury,  being able to treat prolonged symptoms and collaborate with the schools to develop accommodations is even more challenging. Cultivating relationships with the student, parents, school and subspecialists to partner in their recovery is key to coordinating all of the pieces.  Through this workshop we will give providers the tools and confidence to be able to manage all aspects of concussion care. We will discuss options for pre-season testing, examinations that can be done in the primary care setting without expensive equipment that will help you discern residual deficits, guidelines for cognitive rest, and return to play and school protocols. We will also discuss how to manage patients with prolonged post-concussion symptoms that can be done within the primary care setting or in partnership with neurology, psychology, and physical therapy colleagues.

Educational Objectives
  1. Be able to perform an exam specific for concussion evaluation, to include vestibular and oculomotor testing and balance testing without expensive equipment.
  2. Be able to develop a plan for both physical and cognitive rest and return to school and sports
  3. Be able to develop a plan to manage patients with prolonged post-concussion symptoms
Faculty Expertise: All three presenters have experience working with school-based clinics. Dr. Ahrendt has spoken at local and state level conferences educating on concussion evaluation and management in the primary care setting. He is currently involved in concussion research with the Cleveland Clinic Concussion Center, validating new concussion management  tools for cognitive and balance assessment.  Prior to retiring he worked with the Air Force Basic Trainee clinic. Dr. Myhre is a subject matter expert to the Army Surgeon General in the field of sports medicine advising training bases on sports nutrition and has conducted research on the Air Force basic trainee population. Dr. Smalley has conducted workshops teaching utilization of concussion evaluation tools in the primary care setting. He is the current Adolescent Medicine physician working with the Air Force basic trainee population and technical school students, and is faculty with the military fellowship program.

Active learning to train medical students to Identify, Engage and Support Sexual Minority Youth and their Peer-Parental Relationships

Renata Arrington-Sanders, MD, MPH, Neha Yogesh Bakhai, BS, Errol Fields, MD, MPH, PhD, Michael Barone, MD, MPH
Johns Hopkins University School of Medicine
Track: Education/Training

Description: In 2014, the Association of American Medical Colleges released a report outlining formal comprehensive standards addressing the lack of medical education on health care for sexual and gender minorities (SGM). The Pre-Clerkship Educational Exercises (PRECEDE) curriculum at the Johns Hopkins School of Medicine occurs at the beginning of each clinical clerkship cycle, 5 times a year.  This curriculum focuses on building knowledge that medical student will utilize during their subsequent rotations.  As part of the Student-led LGBTQ Curriculum Team (SLCT), a curriculum for the pediatrics PRECEDE curriculum, was developed by a student-faculty collaboration. It was implemented with the aim to build student communications skills to affirm, validate and assess the mental health of SGM youth and support the development of peer-parent relationships. We used the approach of Kern et al. to develop the curriculum: first focusing on needs assessment and then matching active learning exercises to achieve the learning objectives. The student learning objectives for our successful workshop include: 1) List at least three ways to affirm/validate youth questioning their sexual orientation; 2) know key domains and questions for assessing the mental health status of a youth patient, related to social support and bullying; 3) describe ways to collaborate with a school counselor to support a patient’s health; and 4) explain at least two communication techniques for supporting parents adjusting to their children’s sexual orientation while providing relevant community resources.   The overall goal of this workshop is to assist other institutions in implementing similar strategies into their medical student curricula.

Educational Objectives
  1. Generate a needs assessment for one’s institution for student communications training to care for SGM youth and develop learning objectives based on needs assessments
  2. Use a curriculum development framework to match active learning methods to core objectives.
  3. Assess and plan how a successful curriculum model at one institution may be adapted to fit other various settings and groups (residents, providers, etc) and implementation strategies used to fit each institution.
Faculty Expertise: The Team has been developing and evaluating medical school curricula for many years and has extensive work with sexual and gender minority youth. Dr. Michael Barone has lead the PRECEDE curriculum for over 12 years. He is the director of medical student education in the Department of Pediatrics and the associate dean for faculty educational development and assistant dean for student affairs at the Johns Hopkins University School of Medicine. He has extensive publications in medical education techniques and development of curricula. Drs. Renata Arrington-Sanders and Fields have extensive experience caring for sexual and gender minority (SGM) youth and training medical school, resident and pediatric providers to gain skills to care for this population. Mrs. Bakhai help design the curriculum and spearheaded the medical student LGBTQ Curriculum Team (SLCT).

Are things the same as they ever were? Fostering social connection online and a new look at cyberbullying

Yolanda N. Evans, MD, MPH1, Ellen Selkie MD, MPH2, Megan Moreno, MD, MPH1
1Seattle Children's Hospital; 2University of Michigan

Track: Clinical Advances

Description: The internet and social media represent new forums where bullying can occur.  Providers may ask about cyberbullying in clinical visits, but may not have the knowledge or empowerment to offer patients interventions if it is occurring.  While most prevention efforts thus far have come from schools, health professionals who care for adolescents also have the opportunity to prevent cyberbullying.  Educating patients and parents about cyberbullying may aid in prevention, but providers working outside of schools may not have knowledge of effective methods for keeping teens from becoming perpetrators, remaining targets, or being bystanders who do not intervene. However, in the past year, the Institute of Medicine, new research studies, and a comprehensive National Academies of Sciences (NAS) report have moved the field forward in understanding overlap in cyberbullying and traditional bullying, as well as new directions for prevention and intervention. This workshop will introduce the NAS report’s content and recommendations as well as practical approaches for adolescent health providers to implement intervention and prevention strategies with individual adolescents.  Updates in the most current evidence based applications will be addressed for a variety of practice settings.

Educational Objectives
  1. Define the current evidence based options for addressing traditional and cyberbullying including updates from the Institute of Medicine and the National Academy of Sciences.
  2. Identify components of traditional bullying prevention that may be applicable to cyberbullying and those components that are not applicable including research finding from workshop leaders
  3. Strategize creative solutions, based on research findings and clinical expertise from workshop leaders, for how to address cyberbullying on an individual level, including all people involved (bystander, victim, and perpetrator).
Faculty Expertise: Yolanda Evans: Dr Evans is author and editor of the Seattle Children's Hospital sponsored blog, teenology101. Her research interest includes the use of social media for health education & physician blogging. Ellen Selkie: Dr. Selkie’s area of research focus is cyberbullying and social media use amongst adolescents. She has been an invited panelist on cyberbullying at a variety of conferences including the American Academy of Pediatrics. Megan Moreno: Dr. Moreno has is the PI for the Social Media and Health Research Team (SMAHRT) which focuses on how social media, digital health impact adolescents. She has spoken internationally on social media and has published extensively in the field.

Building Strong Clinical Connections With Youth Living with Autism Spectrum Disorders and Intellectual Disabilities

Mari Radzik, PhD, Sara Sherer, PhD, Sari Glassgold, PhD
USC/Children’s Hospital Los Angeles
Track: Education/Training
Description: Adolescents and young adults living with autism and intellectual disabilities (ASD and ID) are at increased risk for poor medical and psychological follow-up due to lack of developmentally appropriate and culturally sensitive services. Their communication deficits impede their ability to accurately report symptoms to their primary care and allied health providers.  These youth misread social cues, and unsuccessfully overcome and cope with these deficits. They experience difficulties building relationships and report more loneliness than their typically developing peers resulting in rejection, bullying and social isolation.  They are sensitive to changes in routine or the environment.  Unique sensitivities to touch, smell, taste and other senses further impede their ability to access necessary medical care. Communication is the essence of connectedness and particularly important to the adolescent and young adult trying to navigate the adult world. Deficits in communication make that transfer all the more complicated and impair the adolescent’s ability to become a fully functioning adult. Most youth with ASD and ID deeply desire connection with others and long to be understood. Since communication deficits an essential component of these disorders, this workshop will address the connectedness challenges they experience.  ASD and ID have become a world-wide phenomenon and require medical and psychological care that is culturally sensitive and attuned to the impact of the diagnoses on the youth and the family. Adolescent providers will continue to see a growing number of ASD and ID youth in clinical practice.  This workshop will help providers be better prepared to serve these youth.
Educational Objectives
1.     Identify the prevalence, co-morbidities and differential diagnoses among adolescents and young adults living with autism and intellectual disabilities.
2.     Better communicate with their adolescents and young adults diagnosed with autism and intellectual disabilities in the medical and psychological setting.
3.     Employ effective interventions useful in clinical settings and become aware of applicable linkages and community services.
Faculty Expertise: All three of the providers have extensive clinical experience in an out-patient behavioral health program working with adolescents and young adults living with autism spectrum disorders, developmental and intellectual disabilities. The presenters have provided out-patient individual, group, parent and family therapy with this population and have worked extensively to link families and patients to community resources and to help them with their educational needs.  The presenters are also currently writing up the results of research that investigates the impact on friendship building and loneliness on youth living with autism and intellectual disabilities. This research was presented at the APA Conference in Hawaii (Sherer, S., Glassgold, S., Radzik, M. Battling Loneliness, Developing Social Skills – A Group Model with PDD/ASD/ID Adolescents, American Psychological Association Annual Convention, Honolulu, Hawaii, 2013.

(Back to top)