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MNAAP Newsletter

Advocacy Begins with Listening

edwards-r-annebw150By MNAAP Policy Chair Anne Edwards, MD, FAAP

Child advocacy might be defined as speaking out on behalf of children. And yet, it might be said that advocacy really begins with listening. As pediatricians with varied backgrounds, advocacy is at the core of our work. We are privileged to partner with children and families to promote health and overall wellbeing. As we partner, we listen to the stories — successes and challenges — of children. This informs our initial (often individual) advocacy: communicating with a school, addressing food insecurity or completing a prior authorization form. This individual advocacy may lead to engaging more broadly on a community level by actively participating in coalitions to address issues such as childhood obesity.

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Screening for Adverse Childhood Experiences, Psychosocial Risk, and Resilience

AndyBarnesbw150TomScottBy Andrew J. Barnes, MD, MPH, Assistant Professor, Developmental-Behavioral Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota and Tom Scott, MD, Clinical Professor, Developmental-Behavioral Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota

Although there are normative challenges during childhood – for example, separating from parents for daycare – many children experience frequent or ongoing stress that is overwhelming. Such stress, including Adverse Childhood Experiences (ACEs) and extreme poverty, can lead to modified gene expression, problems with cognitive and social-emotional development, and chronic health conditions. These negative outcomes are less likely for children with ample protective factors, whether internal (such as self-regulation) or external (such as a consistent, nurturing adult caregiver). These factors improve children’s capacity to succeed and develop well in the context of threat or challenge – i.e., resilience.

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Social Emotional Screening in Early Childhood

CatherineWrightbw150Glenace-Edwallbw150TomScottBy Catherine L. Wright, PsyD, MS, LPCC, Glenace E. Edwall, PhD, PsyD, LP, MPP, and Tom Scott, MD

Social emotional screening in primary care identifies infants, toddlers, and preschoolers in need of referral for mental health services. This screening process is currently receiving increased clinical and public health attention because of concerns about low rates of detection and treatment of behavioral and emotional problems in the United States.

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Postpartum Depression Screening in Pediatrics made Meaningful, Simple and Reimbursable

HelenKimheadshot-tessaBy Helen Kim, MD, Director of the HCMC Mother-Baby Program, and Tessa Wetjen, Minnesota Department of Human Services

The AAP has clearly stated that pediatricians must lead efforts to reduce the impact of toxic stress on children given the lifelong impact of adverse childhood experiences on physical and mental health.

Postpartum depression occurs in 10 to 35 percent of mothers (Berkule, et al., 2014) and poses a significant risk for toxic stress in children by undermining a mother’s ability to provide the nurturing interactions children need for healthy development. Children of depressed mothers or fathers are more likely to perform lower on cognitive, emotional and behavioral assessment (Berkule, et al., 2014) and have increased risk of mental health issues later in life (Ferro & Boyle, 2015).

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MNAAP Member Profile: Marilyn Peitso, MD, FAAP

Dr. Peitso with daughter Hailey, a psychologist, on her wedding day in September of 2015. Dr. Peitso and her husband also have another daughter, Robyn who is a 4th year medical student, and a son, Matthew, who is a geologist.

Dr. Peitso with daughter Hailey, a psychologist, on her wedding day in September of 2015. Dr. Peitso and her husband also have another daughter, Robyn who is a 4th year medical student, and a son, Matthew, who is a geologist.


What does a typical day or week look like for you?

After a long career as a primary care pediatrician, last year I switched gears and became a pediatric hospitalist at St. Cloud Hospital. Shifts vary from 9-12 hours in length. I take care of sick children and also healthy newborns, in support of a very busy newborn service. I am fortunate to have NICU and PICU backup. I also have a 0.2 position as physician champion with the Care Transitions team within CentraCare, which allows me to continue my work advocating for families and robust care coordination.

What’s one pediatric issue you are particularly passionate about and why?
Addressing disparities in health care. With the help of a MNAAP grant from AAP Friends of the Children several years ago, my peds department had the opportunity to improve our developmental screening process for Somali children and bring on board a Somali community health worker. This experience has raised my awareness of all manner of barriers to equal health care access, and also the power of individual commitment and action.

You’re an active member of MNAAP. What benefits have you gained from your involvement?
When I was contemplating stepping up my involvement in MNAAP activities, Dr. Jeff Schiff told me that being active in MNAAP had a way of opening doors. I have gone through many doors, personal and professional, directly leading from my activities with MN AAP.

Which other organizations are you currently involved with?
I serve on the Board of Trustees of the Minnesota Medical Association and the Board of the Minnesota Medical Association Foundation. I am a member of AAP and the Section on Hospital Medicine and the Council for Children with Disabilities. I also sing in my church choir when able.

What’s one thing most people are surprised to learn about you?
I am a Boston Marathon finisher and am currently in a 12-step program for grieving ex-runners. It’s called “Yoga”.

What’s one of the best pieces of advice or funniest things a child has said?
Best advice category: “Hey mom, can we get a dog?”

Anything else you want to add?
There is a power and momentum created when pediatricians, passionate about advocating for children, work together with parents and other advocates, toward a common goal. I highly recommend it as both a professional and leisure time activity.