Massachusetts Child Psychiatry Access Project: MCPAP

USPSTF Recommends that Adolescents Aged 12 to 18 Be Screened for Depression

The US Preventative Services Task Force (USPSTF) has recommended that adolescents be screened for depression in primary care.  This recommendation is based on evidence on the benefits and harms of screening for depression in primary care.

Click here for the USPSTF recommendation published in the April 2009 issue of Pediatrics.

Click here for the USPSTF evidence review in Pediatrics.

Click here for the Associated Press story.

Click below to download a Primary Care Behavioral Health Screening Toolkit for the MassHealth  Children's Behavioral Health Initiative.  This toolkit includes guidelines on general implementation of behavioral health screenings in primary care settings and guidance on clinical issues related to screening and referral.  Implementation of four commonly used screening tools ---CHAT, PSC, PEDS and PHQ-9---is highlighted.  The PHQ-9 is recommended for adolescents aged 12 to 18.

Download PCCScreening Toolkit

CRAFFT Toolkit Now Available

The Massachusetts Department of Public Health, in conjunction with MBHP and the Center for Adolescent Substance Abuse Research (CeASAR), has published a toolkit for the CRAFFT( acronym for Car, Relax, Alone, Forget, Friends, Trouble) screen.  The CRAFFT screens for substance abuse in adolescents.

Click the download below for the CRAFFT screening toolkit:  ( The toolkit may take a few minutes to download.)

Download CRAFFT Screening Tool

Depression in the United States Household Population, 2005-2006

In September 2008, the Center for Disease Control (CDC) released key findings from the National Health Interview Study (NHIS) regarding depression in the US household population, 2005-2006.

Key findings include:

• In any 2-week period, 5.4% of Americans 12 years of age and older experienced depression.
• Rates of depression were higher among poor persons than among those with higher incomes.
• Approximately 80% of persons with depression reported some level of functional impairment because of their depression, and 27% reported serious difficulties in work and home life.
• Only 29% of all persons with depression reported contacting a mental health professional in the past year, and among the subset with severe depression, only 39% reported contact.

To view the entire report, please click here.

New M-CHAT Website

A new M-CHAT website at http://www2.gsu.edu/~psydlr includes downloads, instructions, translations, and articles related to the M-CHAT.  In addition to the English M-CHAT, you may download the M-CHAT in Arabic, Chinese, Dutch, German, Gujarati, Icelandic, Japanese, Portuguese, Sinhala, Spanish, Tamil, and Turkish.

New Joint Advisory from AAP and AHA on ADHD Stimulant Medications

The American Heart Association ( AHA) and the American Academy of Pediatrics ( AAP) issued a joint statement on May 16, 2008 clarifying the AHA's previous statement on April 21, 2008 regarding cardiovascular evaluation and treatment of children receiving stimulant medication for the management of ADHD.

The May 16th clarifying statement has been endorsed by the American Academy of Child and Adolescent Psychiatry (AACAP), the American College of Cardiology, Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), and the National Initiative for Children's Healthcare Quality (NICHQ).

The original April 21st statement issued by the AHA recommended that physicians obtain ECGs to identify children with possible heart problems before considering them for treatment with stimulant medication for ADHD.  The May 16th joint statement clarifies that while it is reasonable for a physician to consider obtaining an ECG as a part of an evaluation of a child being considered for stimulant medication, it is not mandatory to obtain one.

For the full text of the media advisory/joint statement, please click below.

Download adhd_advisoryfinal.DOC

Early Intervention and Autism

Earlier identification and early intervention of Autism Spectrum Disorders (ASD) may result in substantially better outcomes.^1,2, “Early intervention” includes children of age 3 and below.

According to the recently published AAP Guidelines for the Management of Children with Autism Spectrum Disorders, there is a growing consensus that important principles of effective early intervention for children with ASD includes entry into intervention as soon as an ASD diagnosis is seriously considered rather than deferring until a definitive diagnosis is reached.³

 

Positive Screening for Autism in Ex-preterm Infants

A new study published in the April issue of Pediatrics shows that 26% of ex-preterm infants with a birth weight of less than or equal to 1500 g at birth (n=91) had a positive result on an autism screen.  The study suggests that early screening may be especially important for this high risk population.

Click here for the abstract in the April issue of Pediatrics.

Click here for a related associated press article.

Click here for a link to the “AAP Guidelines for the Identification and Evaluation of Children with Autism”.

Click here for a link to the AAP Autism Surveillance and Screening Algorithm. (Click the diagram to make it larger.)

Click here for link to the Modified Checklist for Autism in Toddlers (M-CHAT). The M-CHAT is a MassHealth approved screening tool.

Click here for scoring instructions for the M-CHAT.

The Warning Signs Project

The REACH (The Resource for Advancing Children’s Health) Institute recently developed a toolkit for detecting warning signs of potentially serious educational, mental, or behavioral difficulty.  The toolkit includes warning signs of ADHD, bipolar, conduct disorder, depression, eating disorders, suicide, and substance abuse.  The toolkit provides a bibliography of books, a list of helpful websites, and listings of advocacy and professional organizations.  The toolkit also contains useful instructions geared toward patients who may be experiencing warning signs.

Click here for a link to the Warning Signs Project Toolkit.

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Revised Guidelines on Childhood Obesity

According to a December 2007 Pediatrics supplement, depression, an important comorbidity of obesity may precede or result from obesity.

The December 2007 Pediatrics supplement contains a summary report of expert recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity.

Click the link below to view the summary report:

http://pediatrics.aappublications.org/cgi/content/full/120/Supplement_4/S164

National Survey on Drug Use and Health Shows Misuse of Over the Counter Cough and Cold Medications among Persons 12-25

According to a 2006 national survey conducted by SAMHSA (Substance Abuse and Mental Health Services Administration) on drug use and health, approximately 3.1 million people aged 12-25 have used cough and cold medicines containing dextromethorphan (DXM) to get high.

Among those 12-25 year olds who abused cough and cold medicines, 82% had also used marijuana, 49% had also used inhalants, and 44% had used hallucinogens.

 Click below to visit the SAMHSA survey:

http://oas.samhsa.gov/2k8/cough/cough.htm

Click below to find information on the CRAFFT, a six question free MassHealth approved screening tool which can help primary care physicians screen their patients for substance abuse:

http://www.ceasar-boston.org/clinicians/crafft.php