Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Here’s why pediatricians ask about trauma and violence

Nerissa Bauer, MD, MPH
Conditions
February 28, 2019
Share
Tweet
Share

As a behavioral pediatrician, I see children with behavior problems. Kids with aggression, kids who have been kicked out of multiple daycares or schools and kids who are not doing well at home or school.

One of the things I always look for are clues as to why. Behaviors, while stressful, are not a diagnosis. They are symptoms of something else. For example: Just because a kiddo is not completing homework or cannot pay attention does not automatically mean the child has ADHD. This is what makes behavior and mental health in children so challenging.

There is no blood test or rapid swab test to perform that tells you with 100 percent certainty that a child has a specific behavioral/mental health diagnosis. And while some of these behaviors can run in families (such as ADHD, anxiety), we must always consider whether these behaviors reflect what is happening around the children. Sometimes it is just helping families tweak what they are doing when interacting and disciplining their children. However, sometimes it runs deeper than this. And the cause is not necessarily because the child is naturally choosing to behave this way.

Children look to their adults for comfort and security. They are always learning by watching and observing the words and actions their family members and friends do. They are sponges and take in everything. This is how we learn — through social interactions. It starts early with the social smile. The infant learns that when he or she smiles at his momma, she will respond in kind with a smile, a coo or a smooch. The infant squeals in delight and smiles again. This “serve and return” of social interactions between caregiver and infant lays the foundation for a healthy, nurturing and stable relationship and helps strengthen connections in the brain. We know that when caregivers are not able to muster the energy or are not sensitive to the child’s needs/cues, it can have negative effects on the brain connections that ultimately will impact a child’s physical, social and emotional health for their lifetime.

As parents, we are constantly role modeling behaviors to our children — the “good,” the “bad” and all the “in between.” In fact, teens who grew up in homes where their parents or older siblings smoked are more likely to take up smoking themselves. We also know that children exposed to domestic violence in the home and see parents who cannot resolve conflict peacefully are more likely to engage in bullying behavior. Not every child exposed to domestic violence will automatically become perpetrators, nor will every child who sees their parent smoke become a smoker. But it does raise the chances.

In pediatrics, we monitor the health and well-being of children. We check their growth. We support our families. We want to ensure parents feel competent and able to deal with those common issues that come up when raising children. To do this, we need to inquire about these other risk factors that can lead to behavioral problems and poor health. Just as we ask about allergies or how things are going, we also ask about how the parent is doing and feeling, how they are coping and if there have been recent changes to the family structure (for example, divorce or a death). We ask about domestic violence. And now given the tragic events happening in our world today, we must ask about exposure to virtual and real community violence.

This is why pediatricians may tell you to turn the TV off or not watch the news when children are around. Sure, we want our children to be citizens of the world, but exposure to the startling and horrific images can be unsettling. Parents can choose to talk with their child about current events after they have processed it first and have gotten over their own fears and made sense of it for themselves.

The “costs” of these exposures are not easily measured, but it can affect how our children grow and develop, how they behave and act. We know kids exposed to domestic violence have a higher likelihood of developmental delays. We know kids exposed to both domestic violence and parental depression may have higher risks of having a behavioral/mental health issue as early as in the preschool years.

Pediatricians, family physicians and pediatric nurse practitioners all care about one thing. They care about your child’s health and wellbeing.

We must ask those difficult questions because we want to know how to best support the entire family. When a risk factor, such as parental depression, domestic violence or poverty, is identified, we can provide help by connecting families to community resources.

So the next time your child’s doctor or provider asks about these sensitive issues, it is because we want to be able to help make sure your child thrives. We want to support you and your family. And what if your child’s doctor does not ask? If you feel comfortable bringing it up, please do. If a parent shares information that impacts the child or impacts the family — it will make them stop and listen.

Nerissa Bauer is a behavioral pediatrician. She can be reached at Let’s Talk Kids Health.org.

Image credit: Shutterstock.com

ADVERTISEMENT

Prev

This residency interview season: Be the rebel

February 28, 2019 Kevin 0
…
Next

A plastic surgeon explains the dangers of the Brazilian butt lift

February 28, 2019 Kevin 1
…

Tagged as: Pediatrics, Psychiatry

Post navigation

< Previous Post
This residency interview season: Be the rebel
Next Post >
A plastic surgeon explains the dangers of the Brazilian butt lift

ADVERTISEMENT

More by Nerissa Bauer, MD, MPH

  • It’s time to acknowledge the developmental behavioral pediatric workforce

    Nerissa Bauer, MD, MPH

Related Posts

  • Gun violence in America is a national emergency

    Hussain Lalani, MD and Justin Lowenthal 
  • Why is trauma activation so expensive?

    Skeptical Scalpel, MD
  • Fight gun violence with science

    Jamie Coleman, MD
  • It’s time to seriously study gun violence

    Michael B. Bagg
  • Let’s share our stories about gun violence

    Barbara Meyer, MD, MPH
  • Approach the gun violence epidemic like we do with coronavirus

    Charles Nozicka, DO

More in Conditions

  • Why timing, not surgery, determines patient survival

    Michael Karch, MD
  • Why psychotherapy works and why psychotherapy fails

    Peggy A. Rothbaum, PhD
  • How oral health silently affects your heart, brain, and body

    Charles Reinertsen, DMD
  • How President Biden’s cognitive health shapes political and legal trust

    Muhamad Aly Rifai, MD
  • The emotional first responders of aesthetic medicine

    Sarah White, APRN
  • Why testosterone matters more than you think in women’s health

    Andrea Caamano, MD
  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How medicine repurposing enables value-based pain management and insomnia therapy

      Olumuyiwa Bamgbade, MD | Meds
    • Finding balance and meaning in medical practice: a holistic approach to professional fulfillment

      Dr. Saad S. Alshohaib | Physician
    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How regulatory overreach is destroying innovation in U.S. health care

      Kayvan Haddadan, MD | Physician
    • Why the U.S. mental health care system is failing and how to fix it [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How medicine repurposing enables value-based pain management and insomnia therapy

      Olumuyiwa Bamgbade, MD | Meds
    • Finding balance and meaning in medical practice: a holistic approach to professional fulfillment

      Dr. Saad S. Alshohaib | Physician
    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How regulatory overreach is destroying innovation in U.S. health care

      Kayvan Haddadan, MD | Physician
    • Why the U.S. mental health care system is failing and how to fix it [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...