Claudia M. Gold is a pediatrician who blogs at Child in Mind and is the author of Keeping Your Child in Mind.

When family separations become a threat to existence

Conditions
July 25, 2018

The face of a 2-year-old Honduran girl, dwarfed by the adults who only appear as legs in the photo, communicates undeniable anguish. Used to represent the horror of children separated from their parents at the U.S.-Mexico border, the photo became a lightning rod for controversy when it turned out that this particular child was not actually separated from her mother. In an interview for CBS News the border patrol officer involved …

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When family separations become a threat to existence

Maybe mothers saved the Affordable Care Act

Policy
April 8, 2017

In striking contrast to the happenings in the U.S. Congress, Kate Middleton, future queen of England, spoke these words at London’s Royal College of Obstetricians and Gynecologists on the occasion of a launch of educational films dealing with maternal mental health:

Nothing can really prepare you for you the sheer overwhelming experience of what it means to become a mother, It is full of complex emotions …

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Maybe mothers saved the Affordable Care Act

The value of moving through grief to healing and growth

Physician
February 16, 2016

(The following story was told to me by a friend; details have been changed to protect privacy.)

An early winter snowstorm left Janet with an unexpected whole day alone with her 17-year-old daughter Ally. As was typical for the pair, they spent the morning in comfortable separateness. Janet took advantage of the opportunity to catch up on paperwork, while Ally stayed in her room working on college applications. In Janet’s view …

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The value of moving through grief to healing and growth

ADHD and early death: We often miss the story

Conditions
April 1, 2015

Alarming headlines, based on a recent study, declare that diagnosis with ADHD doubles the risk of early death. Psychiatrist Stephen Faraone, commenting on the original study published in the Lancet, concludes that: “for clinicians early diagnosis and treatment should become the rule rather than the exception.” This conclusion represents a false assumption that the deaths occurred in cases that were not treated.

The large cohort study in Denmark, that looked at records of …

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ADHD and early death: We often miss the story

The measles outbreak: Let’s look at the bigger picture

Conditions
February 21, 2015

As the measles outbreak gathers worrisome steam in parallel to the explosion of passionate rants both pro and anti-vaccination, I find myself wondering; what is this really about? Rather than get bogged down in the myriad of issues on either side- though at the outset I will say that as a pediatrician I unequivocally recommend vaccination; I will aim to look at the bigger picture.

Is this issue really about trying …

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The measles outbreak: Let’s look at the bigger picture

Postpartum depression may be a misnomer

Conditions
December 8, 2014

Postpartum depression may be a misnomer. A more accurate term might be postpartum neglect — not by mothers, but of mothers.

The human infant is uniquely helpless in the early weeks and months of life. His arms fly up over his head at random moments in a primitive “startle reflex.” His sleep patterns have no rhyme or reason. He eats and poops round the clock. Serving an evolutionary purpose, in part to achieve an upright …

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Postpartum depression may be a misnomer

The Shooting at Sandy Hook report: 4 things we can learn from it

Physician
December 4, 2014

The recently released report, Shooting at Sandy Hook Elementary School, from Connecticut’s Office of the Child Advocate offers a searing in-depth account of the holes in our mental health care system. The report is careful to point out that no causative link exists between their findings and the events at Sandy Hook. However, this in-depth investigation offers an opportunity, if we are able to hear and take action on its …

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The Shooting at Sandy Hook report: 4 things we can learn from it

Cognitive behavioral therapy: Why parents should be involved

Conditions
November 10, 2014

While studying for my recertification exam as required by the American Board of Pediatrics, I came across this question:

 A 7-year-old girl is having difficulty establishing relationships with other children despite repeated opportunities to do so. The girl prefers to stay near her mother or her teacher and will avoid other children. She sometimes cries and can be difficult to calm down after being dropped off at school, so her mother frequently remains …

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Cognitive behavioral therapy: Why parents should be involved

Should we use antipsychotics to treat ADHD?

Conditions
October 19, 2014

Polypharmacy, or use of multiple psychiatric drugs, for treatment of attention deficit hyperactivity disorder (ADHD) is on the rise. A recent study compared treatment with basic therapy (stimulants plus parent training) with augmented therapy (those two plus risperidone, an atypical antipsychotic). The study concluded that treatment with risperidone was superior.

When children show dramatic improvements in behavior on risperidone, now being prescribed with increasing frequency for ADHD and a range …

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Should we use antipsychotics to treat ADHD?

When medications devalue the opportunity to listen

Conditions
August 25, 2014

When I hear debate over the association between SSRIs (selective serotonin re-uptake inhibitors, a class of antidepressant medication) and suicidal behavior in children and adolescents, I am immediately brought back to a night in the early 2000s.  As the covering pediatrician I was called to the emergency room to see a young man, a patient of a pediatrician in a neighboring town, who had attempted suicide by taking a nearly …

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When medications devalue the opportunity to listen

Stop comparing depression to diabetes

Conditions
August 5, 2014

At the recent gubernatorial candidates forum on mental health, Martha Coakley repeated the oft-heard phrase that depression is like diabetes. Her motivation was good, the idea being to reduce the stigma of mental illness, and to offer “parity” or equal insurance coverage, for mental and physical illness. However, I am concerned that this phrase, and its companion, “ADHD is like diabetes,” will, in fact, have the exact opposite effect.

A recent New …

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Stop comparing depression to diabetes

Young children are silenced by psychiatric medication

Physician
June 26, 2014

Tom Insel, director of the National Institute of Mental Health (NIMH) in his recent blog post, “Are Children Overmedicated?” seems to suggest that perhaps more medication is in order. Comparing mental illness in children to food allergies, he dismisses the “usual” explanations given for the increase prescribing of medication.  In his view these explanations are; blaming psychiatrists who are too busy to provide therapy, parents who are too busy to provide …

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Young children are silenced by psychiatric medication

Kids in foster care end up on antipsychotic medication for ADHD

Conditions
April 25, 2014

A recent study, one that received relatively scant media attention (compared with a concurrent New York Times piece about a new psychiatric diagnosis termed “sluggish cognitive tempo” that may be the “new ADHD”) showed that antipsychotics are being prescribed to nearly one third of kids (age 2-17) in foster care who are diagnosed with attention deficit hyperactivity disorder (ADHD).

This disturbing statistic brought to mind a common complaint I hear from parents …

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Kids in foster care end up on antipsychotic medication for ADHD

The rise of ADHD diagnoses in young mothers

Conditions
April 1, 2014

“I know its my ADHD acting up,” a mother of three young children recently said to me as an explanation for her inability to recall a particular piece of information. My observation, in the setting of mybehavioral pediatrics practice, of increasing numbers of mothers of young children being diagnosed with ADHD is in keeping with a recent report from Express Scripts. This report, based on pharmacy claims data, showed a 53% rise in writing of prescriptions for ADHD in …

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The rise of ADHD diagnoses in young mothers

ADHD and the value of uncertainty

Conditions
March 4, 2014

A recent article in the New Republic, provocatively titled “ADHD Does Not Exist,” starts out well enough. The author, a psychiatrist with “over 50 years experience” points to the fact that ADHD describes a collection of symptoms, rather than their underlying cause. Using stimulants to control these symptoms, he argues, is analogous to prescribing pain medication for cardiac chest pain rather than addressing the underlying circulatory problem.

But my …

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ADHD and the value of uncertainty

Perhaps ADHD is a problem of not listening

Conditions
February 20, 2014

Recently I reviewed my son’s high school essay on To Kill A Mockingbird. I was surprised and pleased to rediscover, or perhaps discover for the first time now that I was viewing it from the perspective of over 50 years of life experience, the profound wisdom of the book.

In one of the novel’s most famous quotes, Atticus tell his daughter Scout, “you never really understand a person until you consider things …

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Perhaps ADHD is a problem of not listening

Rising ADHD rates is a symptom of our broken health system

Conditions
January 16, 2014

When the American Academy of Pediatrics came out with new guidelines a couple of years ago extending the age of diagnosis of ADHD (attention deficit hyperactivity disorder) down to age 4, it seemed as if Pfizer might have been waiting in the wings.  Soon after, a new preparation of ADHD medication in an oral suspension, for kids too young to swallow pills, became available.

I was a lone voice expressing opposition …

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Rising ADHD rates is a symptom of our broken health system

Mental, not behavioral, health care: Why it matters

Conditions
January 2, 2014

A colleague of mine recently pointed out a study by the Center for Health Care Strategies (CHCS) about mental health care for children. Among their findings was this: Almost 50 percent of children enrolled in Medicaid who are prescribed psychotropic medications receive no identifiable behavioral health treatment.

This is a disturbing, though not surprising, statistic given that these medications are commonly prescribed by primary care clinicians. Children living in poverty often experience greater environmental stress and may …

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Mental, not behavioral, health care: Why it matters

iPad on the potty: A violation of infants’ rights?

Physician
December 20, 2013

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I was contemplating writing a blog post about the movement by the Boston-based advocacy group Campaign for a Commercial Free Childhood urging Fisher-Price to recall the baby bouncy seat with an attachment for insertion of an iPad. When I then received an email from a colleague with a link for another product — a potty seat with an attachment for an iPad — there …

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iPad on the potty: A violation of infants’ rights?

We need a movement to deconstruct the ADHD diagnosis

Conditions
December 10, 2013

When the American Academy of Pediatrics changed the guidelines for ADHD to expand age of diagnosis to include children from age 4-18 (from 6-12), that number of cases would rise was, by definition, inevitable. The recent survey by the CDC, published in the current issue of the Journal of the American Academy of Child and Adolescent Psychiatry, indicating that one in 11 children in the US carry a diagnosis of ADHD, …

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We need a movement to deconstruct the ADHD diagnosis

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