The MCG Pediatric Podcast

• Early Language Developmental Delay

  Language delays are one of the most common concerns brought up in pediatric well visits. Dr. Jennifer Poon, a pediatric specialist in Development and Behavior, joins Dr. Sarah Straka and medical student Alisha Patel to discuss how to recognize and manage language delays. Specifically, they will: Define and understand language delay. Recognize the initial signs and symptoms of language delays. Identify and explain clinical pearls of potential etiologies of language delays. Recognize the developmental milestones for language based on age. Discuss the prevalence of language delays as well as identify the risk factors and patient demographics that have an increased susceptibility. Understand the initial diagnostic approach to the child with suspected language delay. Review the most common interventions when a child has language delay. Understand how to best discuss the prognosis for language delays and counsel the families and caregivers CME Credit (requires free sign up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19528 References: Karani NF, Sher J, Mophosho M. The influence of screen time on children's language development: A scoping review. S Afr J Commun Disord. 2022 Feb 9;69(1):e1-e7. doi: 10.4102/sajcd.v69i1.825. PMID: 35144436; PMCID: PMC8905397. Law, James et al. “Speech and language therapy interventions for children with primary speech and/or language disorders.” The Cochrane Database of Systematic Reviews 2017,1 CD012490. 9 Jan. 2017, doi:10.1002/14651858.CD012490 Sices, Laura, and Marilyn Augustyn. “Expressive Language Delay (‘Late Talking’) in Young Children.” Edited by Robert G Voigt and Mary Torchia, UptoDate, Wolters Kluwer, UpToDate, Inc., 25 Jan. 2022, https://www.uptodate.com/contents/expressive-language-delay-late-talking-in-young-children. Spratt, Eve G et al. “The Effects of Early Neglect on Cognitive, Language, and Behavioral Functioning in Childhood.” Psychology (Irvine, Calif.) 3,2 (2012): 175-182. doi:10.4236/psych.2012.32026 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652241/ Sunderajan, Trisha, and Sujata V Kanhere. “Speech and language delay in children: Prevalence and risk factors.” Journal of family medicine and primary care 8,5 (2019): 1642-1646. doi:10.4103/jfmpc.jfmpc_162_19 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559061/ Takahashi I, Obara T, Ishikuro M, et al. Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years. JAMA Pediatr.Published online August 21, 2023. doi:10.1001/jamapediatrics.2023.3057 Young, Allen. and Matthew Ng. “Genetic Hearing Loss.” StatPearls, StatPearls Publishing, 17 April 2023. https://www.ncbi.nlm.nih.gov/books/NBK580517/ Zuckerman B, Khandekar A. Reach Out and Read: evidence based approach to promoting early child development. Curr Opin Pediatr. 2010 Aug;22(4):539-44. doi: 10.1097/MOP.0b013e32833a4673. PMID: 20601887.

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  24:46
• Male Neonatal Circumcision

  To Snip or Not to Snip - prepare for a “Cut” above the rest. On this episode of the MCG Pediatric Podcast, Dr. Bradley Morganstern, a Pediatric Urology physician, joins General Pediatrician Dr. Lauren Smith and Pediatric Resident Dr. My Duyen Vo to discuss the procedure of routine neonatal male circumcision, including benefits, potential complications, and contraindications. In this podcast, they will: Review the basic procedure for routine neonatal circumcision Discuss the benefits and risks associated with circumcision Depict the potential complications from circumcision that may require further intervention from urology Present the current guidelines on male circumcision from the American Academy of Pediatrics (AAP) Explore the history and cultural traditions surrounding circumcision Special thanks to Dr. Rebecca Yang and Dr. Alice Little Caldwell for peer reviewing this episode CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19526 References: Aggleton, Peter (2007). “Just a Snip?”: A Social History of Male Circumcision, Reproductive Health Matters, 15:29, 15-21, DOI: 10.1016/S0968-8080(07)29303-6 Blank MD, S., Brady MD, M., Buerk MD, E., Carlo MD, W., Diekema MD, D., Freedman MD, A., Maxwell MD, L., Wegner MD, S. (2012). TASK FORCE ON CIRCUMCISION. Circumcision Policy Statement. Pediatrics, 130 (3): 585-586. https://doi.org/10.1542/peds.2012-1989 Blank MD, S., Brady MD, M., Buerk MD, E., Carlo MD, W., Diekema MD, D., Freedman MD, A., Maxwell MD, L., Wegner MD, S. (2012). TASK FORCE ON CIRCUMCISION. Male Circumcision Technical Report. Pediatrics, 130 (3): e756–e785. 10.1542/peds.2012-1990 Centers for Disease Control and Prevention (CDC). (2021). Protect Your Baby from Bleeds – Talk to Your Healthcare Provider about Vitamin K [Fact Sheet]. U.S. Department of Health & Human Services. https://www.cdc.gov/ncbddd/blooddisorders/documents/vitamin-k-p.pdf Kaweblum, Y. A., Press, S., Kogan, L., et al (1984). Circumcision using the Mogen clamp. Clin Pediatr (Phila.) 23:679-82. Morris, B. J., Bailis, S. A., Wiswell, T. E. (2014). Circumcision Rates in the United States: Rising or Falling? What Effect Might the New Affirmative Pediatric Policy Statement Have? Mayo Clinic Proceedings, 89 (5): 677-686. https://doi.org/10.1016/j.mayocp.2014.01.001 Owings M, Uddin S, Williams S. (2013). Trends in circumcision for male newborns in U.S. hospitals: 1979-2010. Atlanta, Georgia: Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/data/hestat/circumcision_2013/circumcision_2013.pdf Smith, L. The History of Male Infant Circumcision(Medical resident thesis).  WHO, UNAIDS (2010). Neonatal and child male circumcision: A global review. www.circlist.com/considering/neonatal_child_MC_UNAIDS.pdf

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  25:50
• Specific Learning Disorders

  Did you know that approximately 1 in 5 children experience learning and attention issues, but only a fraction of them receives an official diagnosis? In this episode of the MCG Pediatric Podcast, hosts Rishab Chawla and Dr. Jennifer Poon delve into the topic of Specific Learning Disorders (SLDs). They discuss the prevalence, diagnostic criteria, assessment methods, and treatment interventions for SLDs. The conversation aims to provide a comprehensive understanding of SLDs and highlight the importance of early intervention and support. CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19525 References: Barto, A. The State of Learning Disabilities: Understanding the 1 in 5. Available from: https://ldaamerica.org/lda_today/the-state-of-learning-disabilities-today/. Dominguez, O. and P. Carugno, Learning Disability, in StatPearls. 2024, StatPearls Publishing: Treasure Island (FL). About learning disorders and disabilities. Available from: https://www.childrenshospital.org/conditions/learning-disorders-and-disabilities. Learning Disabilities: Overview. Available from: https://www.nhs.uk/conditions/learning-disabilities/. Intellectual Developmental Disorder (Intellectual Disability). 2022, American Psychiatric Association. Developmental, A.S.o. and B. Pediatrics, AAP Developmental and Behavioral Pediatrics, ed. R.G. Voigt, et al.: American Academy of Pediatrics. Burns, M.K., et al., Toward a Unified Response-to-Intervention Model: Multi-Tiered Systems of Support, in Handbook of Response to Intervention: The Science and Practice of Multi-Tiered Systems of Support, S.R. Jimerson, M.K. Burns, and A.M. VanDerHeyden, Editors. 2016, Springer US: Boston, MA. p. 719-732. Health Issues & Treatments for Spina Bifida. 2023; Available from: https://www.cdc.gov/NCBDDD/spinabifida/treatment.html. Leonard, H., et al., A systematic review of the biological, social, and environmental determinants of intellectual disability in children and adolescents. Frontiers in Psychiatry, 2022. 13. Snowling, M.J., A. Gallagher, and U. Frith, Family risk of dyslexia is continuous: individual differences in the precursors of reading skill. Child Dev, 2003. 74(2): p. 358-73. Felitti, V.J., et al., Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 1998. 14(4): p. 245-258. Zarei, K., et al., Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children. Children (Basel), 2021. 8(9). CDC’s Developmental Milestones. 2023; Available from: https://www.cdc.gov/ncbddd/actearly/milestones/index.html. Lipkin, P.H., et al., Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020. 145(1). IEP and 504 plans. Available from: https://www.choa.org/-/media/Files/Childrens/patients/school-program/iep-504-resource-page.pdf?la=en&hash=BF719764C11B474F8659306C061E00FD938CE5D0. Individuals with Disabilities Education Act Sec. 300.8 Child with a disability. 2018. Affects focus, attention and behavior and can make learning challenging. Available from: https://ldaamerica.org/disabilities/adhd/. Sahoo, M.K., H. Biswas, and S.K. Padhy, Psychological Co-morbidity in Children with Specific Learning Disorders. Journal of Family Medicine and Primary Care, 2015. 4(1): p. 21-25. Ee, J., B. Stenfert Kroese, and J. Rose, A systematic review of the knowledge, attitudes and perceptions of health and social care professionals towards people with learning disabilities and mental health problems. British Journal of Learning Disabilities, 2022. 50(4): p. 467-483. From the Boston Globe: "How to Support your Dyslexic Child". 2021; Available from: https://dyslexia.yale.edu/boston-globe-support-dyslexic-child/. Resources https://ldaamerica.org/resources/ American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/learning-disabilities/Pages/default.aspx

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  25:28
• Common Pediatric Eye Emergencies

  Did you know that vision problems in children often go unnoticed until it's too late, potentially leading to irreversible vision loss? Dr. Steven Brooks, professor, and distinguished chair in ophthalmology at the Medical College of Georgia joins MCG students Emily Austin and Arjun Bhatt to uncover the hidden dangers of the 4 most common pediatric eye emergencies. Review four basic pediatric eye emergencies: amblyopia, strabismus, leukocoria, red eye emergencies Discuss causes, symptoms, treatment options, and the vital role pediatricians play in early detection and management. Review common case presentations of the emergent eye conditions in children Highlight the vital role pediatricians play in early detection and management. CME Credit (requires free sign up): Click Here for Link References: 1. Dr. Brooks' Presentation on Common Pediatric Eye Emergencies Brook, S. (2023). Presentation on Common Pediatric Eye Emergencies [Google Slides presentation]. Retrieved from https://docs.google.com/presentation/d/1zpxZZnH5NTTpSq57HUegz_mC5zGkGrhK/edit?usp=share_link&ouid=107180084657435193874&rtpof=true&sd=true   2. AAO Pediatric Eye Evaluation Preferred Practice Patterns (2023) American Academy of Ophthalmology. (2023). Pediatric Eye Evaluation Preferred Practice Patterns [PDF]. Retrieved from https://nam02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26source%3Dweb%26rct%3Dj%26opi%3D89978449%26url%3Dhttps%3A%2F%2Fwww.aao.org%2FAssets%2F0b507d20-f419-40ac-ac7c-99b11c95f58e%2F638070751054300000%2Fpediatric-eye-evaluations-ppp-pdf%26ved%3D2ahUKEwiv7P2E1NiFAxXZ4ckDHaPhBhsQFnoECBIQAQ%26usg%3DAOvVaw3ortok8vheUdG_OypWrm4N&data=05%7C02%7CARJBHATT%40augusta.edu%7C2d7137e07d264c7c962708dc6b0c56cb%7C8783ac6bd05b4292b483e65f1fdfee91%7C0%7C0%7C638502947937678385%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=IWSuIMyXuRbmeSh8riz7hbKZaSWRQLkcClHDexm7n58%3D&reserved=0   3. AAO Amblyopia Preferred Practice Pattern (2024) American Academy of Ophthalmology. (2024). Amblyopia Preferred Practice Pattern. Retrieved from https://www.aao.org/education/preferred-practice-pattern/amblyopia-ppp-2022   4. AAPOS Guidelines for Pediatric Eye Condition (2022) American Association for Pediatric Ophthalmology and Strabismus. (2022). Guidelines for Pediatric Eye Condition. Retrieved from https://www.jaapos.org/article/S1091-8531(22)00009-X/fulltext#:~:text=Astigmatism%2520%253E3.0%2520D%2520in%2520any,Δ%2520should%2520also%2520be%2520identified. 5. AAO Stepwise Approach to Leukocoria (2016) American Academy of Ophthalmology. (2016). Stepwise Approach to Leukocoria. Retrieved from https://www.aao.org/eyenet/article/stepwise-approach-to-leukocoria 6. First Aid (2023) Le, Tao; Bhushan, Vikas; Qiu, Connie; Chalise, Anup; and Kaparaliotis, Panagiotis. First Aid for the USMLE Step 1 2023. New York: McGraw Hill LLC, 2023.    

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  26:53
• LGBTQIA+ Health Care, Community Disparities and Closing the Knowledge Gap

  There has long since been a knowledge gap in medical education regarding care of LGBTQIA+ patients. This has manifested itself in health disparities that detrimentally affect the LGBTQIA+ population. This podcast serves as a way to start bridging the gap on order to mitigate the effects of bias, discrimination, and prejudice that queer patients often face in health care. Research has shown that consistent, early exposure in medical education to patients from the queer community has been beneficial in preparing future practitioners for gender inclusive care. We must also do our parts as pediatricians to make sure our queer youth grow into confident, thriving queer adults.  Join Dr. Farrah-Amoy Fullerton, a recent graduate of the pediatric residency program at MCG, and Professor of Pediatrics, Dr. Lisa Leggio, as they introduce LGBTQIA+ health care disparities and describe ways to bridge the gap for eager general practitioners who would like to know more. CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19523  References: Bonvicini, K. A. (2017). LGBT healthcare disparities: What progress have we made? Patient Education and Counseling, 100(12), 2357–2361. https://doi.org/10.1016/j.pec.2017.06.003 Fish, J. N. (2020). Future directions in understanding and addressing mental health among LGBTQ youth. Journal of Clinical Child & Adolescent Psychology, 49(6), 943–956. https://doi.org/10.1080/15374416.2020.1815207 Nowaskie, D. Z., & Patel, A. U. (2020). How much is needed? patient exposure and curricular education on medical students’ LGBT cultural competency. BMC Medical Education, 20(1). https://doi.org/10.1186/s12909-020-02381-1 Ormiston, C. K., & Williams, F. (2021). LGBTQ youth mental health during COVID-19: Unmet needs in public health and policy. The Lancet, 399(10324), 501–503. https://doi.org/10.1016/s0140-6736(21)02872-5 Reisman, T., & Goldstein, Z. (2018). Case report: Induced lactation in a transgender woman. Transgender Health, 3(1), 24–26. https://doi.org/10.1089/trgh.2017.0044 Reisner, S. L., Bradford, J., Hopwood, R., Gonzalez, A., Makadon, H., Todisco, D., Cavanaugh, T., VanDerwarker, R., Grasso, C., Zaslow, S., Boswell, S. L., & Mayer, K. (2015). Comprehensive Transgender Healthcare: The gender affirming clinical and public health model of Fenway Health. Journal of Urban Health, 92(3), 584–592. https://doi.org/10.1007/s11524-015-9947-2 Underman, K., Giffort, D., Hyderi, A., & Hirshfield, L. E. (2016). Transgender Health: A standardized patient case for advanced clerkship students. MedEdPORTAL. https://doi.org/10.15766/mep_2374-8265.10518 Wamboldt, R., Shuster, S., & Sidhu, B. S. (2021). Lactation induction in a transgender woman wanting to breastfeed: Case report. The Journal of Clinical Endocrinology & Metabolism, 106(5). https://doi.org/10.1210/clinem/dgaa976 Wylie, K., Knudson, G., Khan, S. I., Bonierbale, M., Watanyusakul, S., & Baral, S. (2016). Serving transgender people: Clinical Care Considerations and Service Delivery Models in transgender health. The Lancet, 388(10042), 401–411. https://doi.org/10.1016/s0140-6736(16)00682-6 The Williams Institute at UCLA School of Law. (2023, July 10). How many adults and youth identify as transgender in the United States? - Williams Institute. Williams Institute. https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/ https://implicit.harvard.edu/implicit/takeatest.html Coleman E, Radix AE, Bouman WP, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health. 2022;23(Suppl 1):S1-S259. Published 2022 Sep 6. doi:10.1080/26895269.2022.2100644 https://pflag.org/ thetrevorproject.org

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  21:44

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