Childrens Mental Health Awareness Free Event Day
Disclaimer:
Everything below is a mix of what I observed and heard during the event. The goal isn’t to pinpoint "who exactly said what," but to share (usually) an outsider's view and overall perspective on these industries. I’m not here to act as a definitive firsthand source—readers should do their own research. I hope this inspires you to attend events, explore new industries, and hear what leaders are presenting. These notes combine my observations with thoughts on how things could run smoother and how ideas connect (IMO). I’m not an expert, you know? Just hanging out in the room with them. Enjoy!Topics Include:
This is a topic I’m kinda on the fence about. I’m someone who (I semi-joke) ‘grew up in therapy’. Just for like 20 years, I feel like, I was always talking to therapists - so much!! Part of me is like, okay… if 10 years of therapy is so intense… should we keep doing it for 20? hahhaha. You know what finally got me to feel a lot better? A lot of stuff I didn’t even know how to do then (or have motivation/true influence to embrace) —- More self-confidence. Engaging in fun (slightly vulnerable but rewarding) hobbies. More time on my own. More learning. Healthy eating, taking vitamins + suppliments, setting more boundaries, more intentional exercise, nonstop nature, overall attention to natural things, finding more purpose, being brave, and removing chemicals as much as possible from my life. More sunshine. Good music (often in languages I can’t understand haha). I mean, I’m happier than ever these days - and it’s just been small moves and small habits (not chemicals! Not medicine, you know?!! I kinda think TOO MUCH THERAPY can make you a bit of a rambling person who overthinks a bit, overshares a bit, and is a little socially awkward hahahah. Right? Maybe. I’d have no idea. And dropping it entirely is often too much). But I do think we aren’t given enough advice and guidance as kids in how to believe in ourselves and trust ourselves. A lot of time our ‘madness’ feelings make sense because of our surroundings. Schools are often crappy places and families can be tough.
Why Attend? Kids are more depressed than ever these days, so how is the hospital industry trying to cheer them up? Let’s find out.
Overall Event Ratings: Venue (4/5), Food (4/5), Speaker Content (3/5), Networking (2/5), Likeliness to Return (4.5/5)… (more below)
Photo Collage and Commentary:
Notes from the Event:
And btw - minus tomorrow, I’m about to attend like 20 events over the next 8 days, so these next few blogs are going to be a bit more… idk? Realistic with that situation. Less elaborative and gorgeous hahaha.
(FORMATTING + MORE EDITS COMING SOON)
I arrived late and was told there were two rooms you could choose from. The first had snacks, the other was the presentation hall. When I walked into the snack room, I got confused cause there was a presenter on the screen, talking to kinda no-one except a few people on their laptops in this room. I was like, uh? Is this the 2nd list of speakers, awkardly talkign to no one? But then I realized, oh… they’re live-streaming the other room into here. Okay.
Plus this room had better closed captions than the main stage room. So weird - but good!! It was like the snack room was for neurodivergent people hahah. Who needed more help focusing - though the main stage room was awesome too. I liked both. Spoiler alert.
Then I realized I wanted to eat something and probably not eat it in the main room, so I started off in there. Just sat down and started taking notes. She was talking about autism.
It used to be thought that autism was passed down but now we realize that’s not the case.
Genetic behaviors affect the brain and we study how.
Genetic diagnosis is where we start with the families, then we assess all sorts of domains. Intellectual disability, psychiatric, a few different ways.
They look at the genes of kids, looking at many ranges of intellectual ability. Some have no intellectual disability at all, some with profound, everything in between.
They look at the history of the caregiver’s mental health.
ADHD and anxiety are most prominent for ADNP and CHD8 autism, not DYRK1A as much.
Few people have depression or those concerns.
Then they look at caregivers' standardized reporting. They say their current symptoms: depression, anxiety, ADD, and oppositional behavior.
OPPOSITIONAL BEHAVIOR???
Diffuse pattern of elevation.
Pastries are empty carbs. No true energy. Make you tired. Wild. And then attendees are furniture shopping during these meetings. And browsing social media. LOL.
Substantial proportion in each group are depressed, anxious, and ADHD (again, I think it’s the ENVIRONMENT not the PEOPLE).
What domains are elevated for these people? What tends to elevate together?
Many times caregivers don’t have depression, but their kids do. This is a missed opportunity… idk what she said.
Some of the parents weren’t concerned about depression, though maybe that’s missed?
Oh... so they’re saying that their kids aren’t depressed, but maybe they are and the parents don’t know??? Omg.
Concerns through standardized ratings are exceeding those that caregivers tell us historically, and this is maybe especially notable for depression.
These lead to several needs. First we need protocols for mental health screening that are part of routine child care with genetic conditions, because if we aren’t paying attention, we are missing things that are treatable.
We need better understanding of mental health changes in these groups over time. We have little data and evidence to base clinical recommendations.
Affected families need information to base their guidance.
We need to identify baseline meaningful areas for families and modify treatments.
See how the genes are influencing the behavioral development.
Understand the picture and leverage the information if we collect it.
Thank you to the many families who donated their time and experience to this.
NEW SPEAKER — local professor at a university and on some local boards:
We don’t know enough about pediatric brain function due to lack of advanced tech that can look into the brain of a child at the speeds of thinking.
To have such a tech would advance three fields:
Pediatric neuroscience: brain processes (cure)
Pediatric neurology: brain networks (action)
Pediatric neuropsychiatry: brain biomarkers (prediction)
This doctor says “um” like 100 times as he explains this stuff above.
They want more effective predictors of pediatric mental health disorders.
What methods are commonly used now in major medical centers? We want to get to a high frequency so we can measure at the depth of the brain.
Right now our imaging doesn’t measure the electrical activity, just the metabolic consequence. It is very slow. Measuring changes of metabolic activity about 1–3 times a second.
Exquisite depth resolution — we can see the brain at all depths.
EEG is another method from the 1930s. It measures the brain, voltage fluctuations on the cerebral cortex mostly. It samples brain waves at high speeds — a thousand times a second or more — but the depth resolution is far less.
Also has the advantage to measure different speeds of brain rhythms — 30 to 40 oscillations per second.
Brain oscillations between 40–150 cycles per second is what we want with magnetoencephalography that measures magnetic fields that leave the scalp. They are generated by the brain and reflect the underlying electrical activity with this method. We can actually sample very fast — a thousand cycles per second. We have both surface and deep resolution.
But this was designed for adults.
The user or patient has to sit underneath it and remain immobile for an extended period of time. That doesn’t work for children.
We want something like a hat that kids can wear and have social engagements. We’ve begun working with a group of physicists at universities that have made wearable apparatus that can be configured in a way to fit to any child’s head. It has a hundred or more magnetic sensors.
All of this I’m just like, omg. No comment.. I get it I guess - but, yeah. The whole industry I’m so skeptical of.
It measures the magnetic fields that leave the head — the results of electrical current flow that large groups of neurons create when they fire or become actively coherent at the same time.
And because these magnetic fields have a size to them, in their certain dimension, it depends on activity deep in the brain as well as on the surface of the brain.
We can measure these actives up to hundreds of cycles per second.
We can see activation when people hear sounds. Coherent activation in the brain — just 16 milliseconds. Then we see another activation in the other side of the brain.
We see the entire progression of auditory information through the brain of this person.
What can we do that would be helpful with this?
We can look at children with very low IQ and we can see how they understand how to listen. Sometimes they need to associate movement with sound. It’s like Pavlov’s method with conditioned reflexes.
Nonverbal children learn this slower than children with typical IQs or without disability.
But we are learning different brain circuits are active during learning at different frequencies. That’s what’s important here.
Some parts of your brain are busy during the learning process. Some parts move more quickly when you’re thinking. The “speed of thought.”
Theta oscillation and frequencies can be impaired with children with severe intellectual disability, which means we can possibly replace these missing oscillations in the brains of children to remediate the disability.
Wearable MEG can effectively locate the upper epileptic foci.
I got distracted looking at their signs in here. I’m in the coffee/lounge room watching the speeches on the projector (but I’ll go into the presentation room soon). There are three signs talking about “capital, footprints, access, innovation and research.”
One is a woman wearing a mask playing with a kid with autism and some toys.
The next is three tweenage kids hugging and smiling at the camera. They all have piercings all over, wearing lots of neon makeup and neon clothes, waving a rainbow flag behind them like it’s a cape for the three of them.
And the third image is a girl playing sports looking at the camera.
Ever since I learned about brain damage turning into anger, and how most doctors (who are honest) SEVERELY WARN against kids playing football, snowboarding… any sort of brain-injury high-risk situations…
Not interested.
I heard a doctor talking about how oftentimes you hit your head and it results in depression and anxiety, anger. A lot of the time brain damage turns into emotional damage — but the research is still vague.
So anyway, I just think people aren’t careful enough with their kid’s physical heads and brains and let them get hit all the time in various fun sports.
But it’s truly life-risking, ruining the quality and investment of your life and care for yourself and ability to think.
They said they’re about to have a break, now they’re letting people ask questions.
All of the past 4 presenters just came on the stage.
A woman who works at the university nearby in suicide prevention — she wants to know how to better market, promote, and get engagement from Asian families around suicide prevention.
The translation of suicide is stigmatized, so how do we reach that population?
Some words in Vietnamese are so stigmatized that we can’t even use them. We have to skirt around it and use other words.
We’ve partnered with community groups and agencies. I’ve communicated with a dozen or so who work in the community with various Asian groups — two that stand out (he lists one of his partners who only serve Asian and Pacific Islanders) and then also a referral service. They care for the Asian-American population in the state.
For immigrants, there is a lot of involvement in the health board.
What is going on with Seattle public schools in your project? As far as suicide? What is being done for kids with autism, disability, and genetic conditions?
One of the things we see when we’re working with youth who are immigrants is that they’re living in two worlds. Their family culture is one world they live in, but they’re also navigating the USA culture of teenagehood which has its own set of challenges and nuances. Trying to work with the youth to understand how they fit into both of these worlds and how they can draw strengths and resilience from both of these communities.
So there are a lot of partnerships the schools try to bring in from their communities, you know. It can be challenging. There are so many communities here in Seattle — we’re blessed with that diversity — and at the same time, sometimes finding the right referral isn’t an easy thing to do.
We need navigation. Some of the schools are working on things like navigation hubs, technologies to help you. We don’t know who is available.
We need seamless transitions so you’re not jumping and waiting weeks when the youth is really in crisis. We’re trying to get them connected sooner.
Well now we also have an extra layer of neurodiversity and neurodivergence that goes on top of cultural, linguistic, and other pieces of that intersection. I’m thinking about how mental health concerns relate to the population in particular. It’s really challenging.
We use screening tools which help with community comfort. We do programs like the autism center, suicide prevention screening, mental health days. Everyone needs a mental health day. (The audience laughs.)
A pediatric nurse speaks up, says she’s just here for some Ed Leave. She’s worked with a lot of patients and families and such. She has a lot of questions.
Wants to ask about schools and prevention coming to the hospital.
What have you seen in your research with social technology and that piece? I’m sure that really contributes to a lot of these mental health problems.
(Wow, sounds like she has a lot of suicidal kids come in. She looks like she’s about to cry as she speaks. Omg this poor girl. These poor nurses.)
Yes, it does contribute a lot. To work with the youth, we need to understand the whole picture of what’s going on. How do they use the phone? What is their cycle in the feeling of depression?
During COVID, those kids were making up going on their phones — on their phones all day and all night. Not ending in the real world. It was terribly depressing.
We’re in a different state now, we’re back to being in person, but social media is not going away. They’re bombarded with other people’s perfections. Always being liked or not liked. How many hearts you’re getting. I think we need to do a lot more work engaging young people themselves to work around this. We’re not getting rid of this. We’re not going back.
There are going to be cell phones — so what innovations can we work on to still have a fruitful life and take care of your mental health? That’s my thought. And then the schools have to deal with bullying, sexting, there’s a lot more at their fingertips.
Getting phones out of schools or turned off is something that... we need more research on it. There is a lot of speculation and options. It’d be valuable to get more data.
Seattle public schools are experimenting with different policies — being allowed to have phones, or not at all, or no rules. There are spaces we can look at data others are collecting right now. How local and family-based policies affect that.
Next person says: that was a great question. I was going to ask if kids have full access during school hours.
There are several states and countries that have blocked that, and many studies are showing kids with depression and anxiety who are using social media for a certain number of hours every day — when that is taken away, they do better.
There is a positive experiment of that.
THIS GUY ROCKS
A lady says I’m wondering if girls are shown to be more vulnerable to social media and more likely to be depressed?
We found the most vulnerable was youth identifying as trans or non-binary. They’re at elevated risks for mental health concerns.
But there is clear indication that girls tend to be more impacted.
Makes me think about the rats of research. I wonder if this is true or just a guess. Since the rats being researched are way more emotional than the women.
We learned that in the Aging seminar last week. Hahah. IDK if I trust these people’s conclusions anymore hahahah.
I mean, I studied “how to conduct research” in college. I think we need to revisit all this. Plus, half of the USA’s data comes from college students' work, right? Or more? hahhaah.
Okay the break is over and the Emcee is passive-aggressive as everyone is running a bit late.
OMG I love this girl here looking for a charger. She’s so fantastic just like “how is this a lecture hall without plugs?” I love her hahaha.
She’s so right. She’s grumbling to herself behind me. Can’t believe that she has to use this stupid plug outlet and share it with the camera guy.
Now she said she may move to the snack hall (where I just was) — I suggested that to her.
I’m sitting sorta near her friend and I told her friend, “charge your laptop,” sassily hahahahah.
She said she doesn’t want to handwrite notes so she’s writing on her laptop.
OHHHHHHH WOWWWWWWWW LOOK AT THIS!!!!!! Omg her speech is talking about concussions. SHE’S TALKING ABOUT WHAT I JUST WAS COMPLAINING ABOUT ABOVE!!!!!
Biking, skiing, motocross…
In total 1–2 million youth have concussions each year (maybe many don’t report it)
Up to 40% of concussed youth have prolonged recovery
She said many get 100% better (idk if this is true, but I’m not a doctor. I feel like they say a lot of emotional stuff never recovers — like your brain gets warped? But idk. Maybe she’s talking just about certain lists of symptoms)
She said she wants kids to play sports safely and it’s important to her.
In her timeline, she worked for many years in chronic pain.
Chronic dizziness, pain, learning, focus (okay. She’s tracking it a bit. I wonder “anger” etc.)
How is that person immune? How well do they recover?
It’s super scary to get this injury. You suddenly have all these problems, your brain can’t function well. You can’t do your sport. It’s the way everyone is responding to you. This injury is in the context of multiple spheres of influence.
How did they respond?
Did their parents have a history with pain that causes them to be more careful?
How did the school respond? The coaches?
Acute and chronic pain
With chronic concussion, their emotions and thoughts drive it (with the least tissue input)
Like, their thoughts and emotions tend to hold them back more than their bodies
Acute concussions are most held back by their bodies.
So they’re working on a project and should hopefully have some data in a few years.
Pain psychology perspective. They think about it with this perspective to figure out healing (okay. Okay. I’ll admit. These guys are doing this in a way I approve of I think.)
So they work with the local universities. They think about certain types of injuries and issues. They want a care manager to help link mental health to physical health.
A lot of symptoms overlap and if you’re not bringing them together, they can’t help.
Headache hurts your sleep. It hurts your mental health. They need organized care.
Studies that lead up to this include the collaborative care study. This was care management approach, CBT with medication added as needed. Managing physical and emotional needs.
Barriers to recover 1 month from injury are complex and often psychosocial (akin to chronic pain)
Only kids more than a month out of an injury — and the thoughts are more of the barriers to recovery. It’s mental barriers. :) okay.
The paper they did in 2020 showed some benefit from this. Funded by NIH and it looked at data. Measure of health-related quality of life — how are these kids functioning in the world? In school? In social interactions?
They were initially very impaired. But with this collaborative care, the gap widens and they’re doing much better at a year.
She asks the Emcee if she’s running out of time, the Emcee nods.
The entire audience laughs. I get the feeling they’re laughing because her speech is actually really interesting and so we’re all kinda like bummed it’s ending, but also laughing at the reality.
Her presentation has nice special effects btw hahaha.
She said it’s really complicated and she’s happy to talk about it more later. She is running out of time here. It’s a year-long study, they’re about 1/3 of the way through. They are very hopeful that funding will continue and they should have results in a few years.
Feel free to reach out to her. Thank you.
This girl just came and sat next to me for a second and she smells 100% like a banana hahahahaha. She left to throw something away, but now she’s back. Totally smells like a banana hahah, but I think she was eating seeds. So that’s why I’m a little confused:
Adolescent and Young Adult Cancer Survivors
Btw, as always, I truly think cancer’s cure is being withheld from the public/world. Many cures. Just a bigger issue going on and maybe there’s a bigger goal trying to be solved or something that we just don’t understand. But, yeah.
84,000 new cancer diagnoses / year
See. Huge industry. Why would they solve it? They’d lose all this money, funding, research? Idk. Just thinking it. I keep seeing rumors all over Twitter about stuff like this!!!! And its’s not the craziest idea.
Treated with surgery, radiation, immunotherapy, stem cell transplant
Many have to relocate
86% overall survival rate
Surviving is not the same as thriving
an audience member audibly agrees.
Many people with cancer go on to develop many health conditions after. There are also long-term cognitive issues — executive functioning, speed, memory, learning.
Over 50% of cancer patients will go on to have inability to put food on the table, afford housing… also not able to keep up with exercise and diet. Also psychosocial outcomes, compared to other younger counterparts and older adults.
Navigating an important development transition such as how to develop independence, independence from parents, being able to establish and maintain social relationships, romantic relationships, and many different cancer diagnoses/treatments. Maybe reoccurrence. Pain, fatigue, pain, anxiety, depression, sleep problems.
1/3 will have long-term problems with anxiety and depression.
85% will experience fear of cancer reoccurrence.
We have opportunities for digital health perspectives. There has been a big shift in digital healthcare since COVID and we’re not going back.
92% of survivors use the internet to seek help and information.
LOL Duh! That stat is kinda eyerolling to me. It’s ike, duh.
Digital health is appropriate for individuals with prolonged immunosuppression. Digital health promotion interventions help overcome access barriers.
A study from 2021 found that smartphone delivery of psychosocial care was universally appealing and appropriate. We found they were accustomed to smartphones and apps. Digital natives who grew up in the digital age.
They reported a reluctance to share information and personal problems in traditional face-to-face therapy.
They liked skills reminders, interactive guided exercises.
Two reviews found over 3,000 apps that are publicly available on platforms.
Almost all of them were designed as self-guided interventions.
4% for youth and young adults
2% supported by research
1% designed for those with medical conditions
Big market opportunity.
eHealth and mHealth psychological interventions for youth medical conditions:
Early evidence of positive treatment effects
mHealth not yet tested for efficiency
Research portfolio looks at cancer across the continuum. Only looking at AYA survivorship and attention bias modification and text messaging intervention. The study is ongoing.
Individuals with anxiety and depression tend to experience a negative attention bias. They have an automatic and unconscious response to hyperfixate on negative or threatening cues in the environment and have extreme difficulty removing or disengaging their attention from that negative cue. If you imagine someone with a phobia of spiders and they walk into the room, they will get hyperfixated on spiders and can’t focus on anything else going on.
This is evolutionary. We try to sense predators and this lurking sense has serious impacts on your mortality and your sense of physical safety.
Particularly in the context of cancer, the paradigm attention biases have been studied in adult breast cancer survivors.
Patients with cancer have internal and external threat stimuli.
Every year when AYA cancer patients go in for scans, they’re so worried. With so many scans, they are constantly reminded and have negative worry and fear with this affect. The presence of anxiety and depression during data maintenance has a negative effect.
We have developed an adaptive version of attention bias modification specifically for the fears of AYAAs with cancer. We developed these cancer-specific stimuli in collaboration with clinical psychologists.
We are training the brain to disengage from negative stimuli and engage in positive. We retrain away from negative threats and toward more positive things.
Remove from the fear of cancer emergence.
We do this over four weeks, eight sessions on this app.
Plus daily text messaging intervention with gratitude and positive interventions. Joyful moments, fun memories, bucket list, acts of kindness, favorite faces.
Our control trial is ongoing and compliance with attention bias modification and text messaging intervention. We are conducting exit interviews with AYAs who participate and with initial feedback from some of these exit interviews.
With regard to daily texts: “It was kind of fun. It felt like journaling, it gave me a chance to reflect on the day and I liked that.” (said the survivor’s review)
We want to connect survivors with providers. Digital health can serve as a foundation of a stepped care model in pediatric cancer towards universal care access, and “stepped up” care is delivered by psychosocial clinicians.
The tech landscape is fast-paced and ever-evolving. What are the other opportunities and what are the barriers?
There are opportunities and needs for psychosocial intervention.
There’s her contact info for questions or suggestions. Thanks to her team.
The emcee says she’s an anxiety-provoking instrument at this event, they’ll test it out. (LOL!! Good joke. She just slam dunked with that self-aware comment. It wiped away all of her previous awkwardness and kinda unlikeableness, cause now she even found a way to get what she wants and be happy/fun again. This is smart and funny.)
Next speaker: co-occurrence of mental health concerns and chronic pain
For those of you who don’t know what it’s like to receive and try to find help. Some quotes directly from parents:
“This has affected us as a family entirely in multiple ways. Either my wife or I have been with him to various hospitals throughout the US trying to find a diagnosis and treatment for his pain. There were times he was away from home for three weeks at a time so this has impacted our family life over the last two and a half years.” — father of a 13 y/o
“I think the longer I’ve had the pain it’s getting worse and worse. Last year I missed 99 days of school and I worry I will get to the point I’m constantly in pain and not able to enjoy life due to it.” — 16 y/o with chronic abdominal pain
20% of children have chronic pain (pain going on more than 8 months)
Most common is primary pain (pain that doesn’t have another cause — most commonly in the head, abdomen, or musculoskeletal systems)
Girls have more incidents than boys
Children and adolescents with chronic pain have 3x risk of developing mental health conditions
anxiety, depression
post-traumatic stress disorders
suicidality
substance use
I want to ask them how they use lighting and sound intentionally in their hospitals. How much time do they spend outside? Are they considering getting rooftop beds so kids can get natural light and fresh air? Lol. IDK.
30–70% of youth in their studies continue into adulthood with pain
lol what a HUGE range!! OMG. This data hahaha. It’s crazy and not specific at all.
They have strong evidence-based data to help kids with pain. Most is CBT — teaching kids pain coping skills and strategies to enhance daily function. Reintegration into school, and social and physical activities. This is the standard of care for children to treat chronic pain. But very few children and adolescents will receive this psychological intervention. This is primarily due to a shortage of psychologists.
Only 5% of children and adolescents with chronic pain will receive psychological intervention
shortage of dedicated interdisciplinary pediatric pain clinics and pain psychologists
geographic distance
stigma
Her research focuses on finding ways to get better access to treatment, more equity and access. Using the internet and mobile intervention.
In a variety of populations with chronic pain, we have found CBT helps them deal and cope with chronic pain and change for the child
Successful implementation in specialty clinics: high adoption and sustainability with provider training and promotion
So they start with kids with existing chronic pain.
They have a logo of a monster that I guess is their mascot or something? Gross I hate that.
They said they want to go earlier and intervene at the point of acute pain. All pain starts as acute. We have these windows to have the ability to prevent the transition of acute to chronic. One window is surreal interventions.
We have a better opportunity to think about targeted primary prevention. We’re interested in capturing parents who have their own chronic pain conditions (IBS), whose children are 4x more likely to have IBS too. We’re working to teach their kids to deal with everyday aches and pains.
So to make a difference, we need low-cost interventions available to children with chronic pain; implement and sustain these interventions in real-world settings
Design interventions that are personalized and address unique pain phenotypes, especially mental health comorbidities
Use ‘big data’ EHR to identify children earlier in their care journey (i.e. primary care) for elevated risk; implement screening and stratify to effective therapies
Focus on prevention and early intervention
Do you have to keep the workforce trained? How about the panel speaks on this (all the former speakers are up on stage btw). She asked if they want to start us off, and now a woman is having trouble with the microphone.
In my area, we don’t have enough trained workforce. We want to encourage people to get interested in chronic pain and become an expert in this population. But at the same time, that’s not going to solve all the problems. There is a unique integration that needs to occur. So how do we embed training for chronic pain within school-based mental health programs? For example, what we heard about this morning — pain isn’t in a lot of existing mental health screening spaces. I think there are some expert pain psychologists who do this exclusively, but that can’t be the only solution.
Whether it’s pain, dizziness… as a therapist, you need to give that continuing support. When your patient keeps getting new issues, have a model that supports that.
There are also workforce limitations where models within AYA — like things only an undergraduate student could do.
A woman speaks up saying since she works in the medication industry for adolescents, she is thankful for their words. She said let’s make sure it’s all evidence-based. ADHD is 6–11% of the population, versus peanut allergies at 2%. We have completely changed airplanes for 2%.
ADHD doubles the rate of early death. We don’t build environments for these kids.
YESSSS. There we go!! She’s saying what I’m always thinking.
She asks: Do you see any efforts to change the way we live? It’s not really conducive to the way we’re living.
Legit I tiny-bit clapped aloud and cheered a little but no one joined in, though my banana smelling neighbor agreed, just not too loud.
ADHD is on a normal curve, important to know that. There are folks with elevated ADHD risks. When they’re in good environments, they look good in daily life.
From a public health perspective, maybe we help those folks stay out of the clinical range. There are probably going to be bigger effect sizes from some of those lifestyle/environmental pieces.
We will just manage their impairments to not derail their life.
Is it interesting to think from a chronic continuum perspective? Like obesity? Instead of a fixed perspective. That is where our field is going.
The diagnosis - and then what suite of interventions is available?
Hm. Lame answers.
New woman studies brain injury and developmental measurements that could help. We bring across data from different places for brain injury, mental health. I loved all of your presentations. I’m left — you all touched on aspects of this. I’m curious from each of you.
We live in this world where everyone thinks there’s going to be an answer and machine learning for everything.
But those of us who know, know you need really good data for any of that to happen.
In each of your areas, where are we right now in respect to the accessibility issue to app-based assessments related to concussion? The sidelines of high school sports, added symptoms in middle school. You should give teachers the power to monitor, be paid for it, and see how kids are doing while going through protocols.
Are we there yet? Do we have tools?
If not, how can we take what you’re all doing and really be able to influence the right kinds of tools being developed with what you all have?
Concussion is particularly challenging in terms of diagnosis. It is clinical, and it means you had an injury that created functional problems with your brain that we can’t see on imaging. There are tools we use on the sideline, but it’s all symptom-based, which is problematic. Trying to use these tools is sort of the best that we’ve got. I don’t know of anyone using AI approaches in that regard. I think that could be interesting and I’d love to talk further.
Chronic pain’s diagnosis is complicated. You need a full medical workup that is appropriate - and what that means for each particular patient is slightly different. Where the gaps occur: there is a big gap from primary care to any specialized care, and that is often because diagnostic testing is negative. Doesn’t show any particular area to follow up on. Also just relates to access - if you’re in a rural area with no pediatric care.
AI is taking big data from health records and, with other data - maybe self-reported questionnaires. The things we know predict chronic pain are in deep mental health. So if you’ve been experiencing pain and you’re screening positive for mental health - these are the kids to be prioritized and given treatment. It is always okay to start treatment with a kid with chronic pain without full diagnoses.
It is a paradigm shift in pain. To think about how there are symptoms you can help with now, regardless of the ultimate diagnosis.
LUNCH: cut short. Then they wanna have another keynote. IDK if I’ll stay. Lemme see the other talks. This has already been so much and impressed me. Hahahaha.
Talk on suicide:
Suicide was the second leading cause of death for Black kids.
I took a picture but showed up late.
Individuals and individual families are what we’re looking at.
What’s happening inside these families with physiological and psychological responses that could be linked?
Their downstream explanation is why this may be happening. We’re thinking this is primarily something happening in the home environment.
It’s how we should be thoughtful about it. It causes emotional problems, brain injuries, mental health issues, unintended pregnancy and pregnancy complications, STDs, cancer, drug use and unsafe sex. Education, occupation, and income — all affected.
Discussions today about ways in which ADHD is linked at an 11-times more likely rate of kids not being employed, not having jobs, or completing school. We link it back to ACES. Toxic stress and toxic parenting practices.
They concur in context of historical trauma.
ACES can be transmitted across generations and in the brain function of the parent, how the parent parents. It’s filtered into the parent when the parent is pregnant. And then once the child is born, the postnatal factor or effects are seen once the child is born. It’s directly aligned to the ACES of the child that then impacts what we see as children are developing.
The parent’s alcohol and drug use was predictive of adolescent behavior or of the problem behavior. Ten years later, there was a reciprocal effect of the parent behavior affecting the child, the child behavior affecting the parent. The problem of one generation can lead to similar problems in the next generation through that kind of social interaction that can happen in families more importantly.
These historical stressors have to be captured transgenerationally. They are the cause. They are the transmission message of how we manage our lives and navigate social drivers that impact our lives. They increase vulnerabilities and promotive behaviors need to be expanded in the context of understanding this in a transitional perspective. Connecting that then to generation of ACES transition over time in families. So while we begin to think about why suicide may be increasing, what we do know is that these social determinants continue to influence what experiences that people have in their everyday life.
Do families have access to structures, systems, and institutes to make their lives livable, as your strategy mentioned earlier?
So all children can have optimal opportunities to live their best life.
We know that structurally and systemically imposed challenges breed behavioral and physical health problems.
So rather than looking only at people’s lifestyles, we should look at how these upstream social drivers are creating circumstances that explain the lifestyle that people live and how these systems explain the way in which people begin to perceive their life situations that then influences how they cognitively make meaning the way they do. The way they see their situation, which explains what they do and how they respond to it. So upstream systems and structures are an important part of the puzzle.
I started to study this several years ago, began to look at everyday life experiences of Black families in particular, noting ways we’re not supposed to talk about historical vestiges of enslavement and it creates social positions like marginalization and minoritization. It is a consequence of the structure.
These structures also create these what I call "mundane and extreme environmental stressors." These particular kinds of indicators really create hassles and other storm situations in families. And the way that families often navigate is through a process I call family protective equipment.
Increasing their vulnerability toward compromised families, relationships, compromised health, and compromised development and adjustment of them and their children. And Watson refers to these as ordinary magic. Many of us also refer to these as cultural assets.
Coping aspects of coping strategies. But it’s part of not only this generational and environmental and historical trauma — okay, she’s talking too fast.
How do adversities cascade through families to influence and compromise behavioral health?
What kinds of PE do families use to navigate waters created by upstream policies and practices? I’ve used this image that actually is one of my research person's idea. She said this illustration is how we navigate these toxic waters.
You have to encompass yourself in a rubber suit as a Black family to win in these toxic waters.
Many of this exists because of the enslavement and what has been transmitted across generations of how to navigate these under circumstances.
Learn optimism, kinship support, racial pride, community socialization, racial socialization.
Then the spirituality — that they put this rubber suit on them in order to navigate these lived experiences of raising their children and living in this toxic environment. And the paper is noted here on screen as well.
You can see that when mothers in particular are experiencing racial discrimination, it increases their anxiety, depression, and engagement in harsh punitive parenting. But on the other hand, kids are also impacted by racial discrimination.
Exposure to racial discrimination in early childhood, when kids are exposed, as mothers have these conversations about what they’re experiencing,
Kids begin to learn really early how to adapt to these kinds of circumstances.
Exposure to this in childhood didn’t continue to affect the internal working model. Emotional management and effort control of the children as they move from the early adolescents to the middle adolescents. And because it was not significant.
When kids are exposed to this during early stages, there is a sense of coping that can reach a threshold. For parents who are engaged in processes to help them navigate these racial discriminatory experiences, that is a process. That is a protective process that keeps it from housing on them and creating problems for them.
Continuous exposure to racial discrimination was linked to early onset of chronic disease.
Early diabetes, cardiovascular problems.
The protective process was the way parents prepare them for these experiences.
If your children experience any emotional problems, what would you prefer to do in order to seek care for your children?
The top vote was to go to a family member to seek advice. More than a professional.
Family, then school counselor, pastor, teacher, doctor, friend, psychiatrist, social worker, psychologist.
In the context of family protection equipment to navigate systemic and structural challenges. What I’ll share with you now are results from preventative intervention trials we have effectively been able to test and some findings from them. These two trials emerge from longitudinal studies that we conducted for over ten years.
Many were from raising kids in low-income families.
They started to look at students in middle school. Parent protective processes. Youth protective processes. Focusing on these intervention targets during middle school years would have approximate outcomes and effects as they entered into early adolescence with long-term effects as they enter into young adulthood.
This first model shows the testing of the PAST program and you can see the PAST program was effective in enhancing those parenting processes. Those processes resulted in a decrease in use and avoidance of risk opportunities.
The avoidance of risk opportunities then resulted in a result in risk behaviors along with a reduction in risk behaviors as kids...
Okay… so they want kids to be less risky.
They started testing if these processes seemed to be universal — so to what extent were they protecting for more than just risky behaviors, but were they enhancing parenting processes that were allowing parents to prepare their children to navigate schooling in racialized circumstances. Going to school in situations where kids have greater exposure to being marginalized or racialized in schools. And so you can see from this particular model here that the SAFE program increased what we call academic racialized socialization practices. And they were parenting processes specifically designed where parents were teaching their children how to monitor themselves in schools so that they would not get in trouble and would not compromise their academic — she’s talking too fast.
Racial pride buffered kids from any compromised school competence. Therefore, decreasing the likelihood of school failure and also decreasing the likelihood of school dropout. We found the process was important for males and females.
LOL WHAT ARE THE PROCESSES??? Hahaha. Tell us!!
They had attendants attend programs over the few weeks, but they had trouble getting families to attend them. So would a different platform change the way we were targeting? This was a three-arm study. An e-health, facilitator-led small group, and home-mailed literature.
Two arms were truly active, one self-led.
Are we going to review what it said??? Hahaha. No? I’m literally staying here to hear… I think a lot of people want to know!!
You can see how toxic waters are impacting families. You see the connection between parent exposure to discrimination and depression along with the way kids experience discrimination.
Would kids be protected against depression in the midst of kids experiencing racial discrimination? Would that hold from post-tests when they are twelve until they were fourteen years of age? You can see from this particular slide that the PAST did increase racialized equity-informed parenting.
The takeaway message is that these take-home groups are working.
The groups that directly focus on discrimination as the explicit issue are effective and scalable as interventions. It's necessary to protect both parents and adolescents, since both are experiencing toxic exposure to interpersonal and systemic racism. And then... I lost the thread. The speaker started talking too fast.
Historical messages of our past are still very present. So instead of using your energy to constantly navigate the historical context of how you’re raising your child and living your life, use that energy to draw on cultural assets. The goal is to elevate the promotion of good things within families so that children and their families can live productive lives.
How might that happen? It might need to happen through what she’s calling "transformative innovation policy." That means strategic shaping that aims to drive society in a direction that produces positive outcomes for all. It’s a way of creating a desirable future world. And now is the time to dream about how we build that.
This approach goes beyond traditional policy or practice transformation by focusing more specifically on the societal changes that need to happen for us to thrive.
They have a blueprint for a national prevention infrastructure for emotional and behavioral disorders.
Our climate — and our society overall — has shifted.
A girl just came up and started cleaning in front of the speaker mid-speech for no reason. Lol. Wait until the speech is over! I’m like, okay... would she have done that if the speaker was white? Haha. You know? Now I’m in that mindset from this speech. No joke though hahaha. I mean, maybe its passive? Or maybe it’s just time to clean up - in the middle of her speech while we’re (half of us) trying to listen and take notes.
The speaker is focusing specifically on recommendations for the summit that’s happening today.
The evidence program is focused on the need to continually evaluate well-disseminated programs — ones that are easily assessed with detailed data about their effectiveness, including generalizability across populations and clear implementation strategies.
These programs not only need to show they’ve created evidence but also define who they’re designed to serve and what’s required for that to work.
OMG, now this girl is breaking down a table! Lol. So disruptive. Wait until the end of the presentation, right? Not in the final five minutes. Or are they trying not to interrupt the start of the next one? BUT HELLO — there are so many breaks built into this event.
There’s a guy standing by the door, I think he’s thinking all of the exact same things as me about this food breakdown situation. Like ALL of the same. IDK.
Also, they have like 500 cookies... but no fruit. And they ran out of sandwiches.
Where are their priorities? So weird.
Why wouldn’t you serve healthy food at a cancer research center? Literally the best excuse to. Makes no sense.
Okay, I’m getting distracted. Let’s get back to it.
OMG, what the heck — she’s putting the cookies away? Oh no, they’re breaking down all the tables. So weird. Just do this later. Why now? Snacks after, please?
The speaker is ending with recommendations and caveats, saying that a lot of changes have occurred since these recommendations were written:
More funding is needed to research prevention of mental, emotional, and behavioral health disorders.
Interestingly, the total funding for this is still very low.
When these funding announcements come out, they should be co-created with communities.
Include community voices to ensure true representation.
A relevant agency should manage and maintain a centralized and dynamic evidence clearinghouse.
That clearinghouse needs a mechanism to evaluate implementation and track how new knowledge is being created.
There needs to be investment in frontline personnel across key settings.
OMG I just realized I have a personal thing I REALLY need to get to — so I’m leaving soon. Ahh!
They said we need data on integrity and privacy. Data sharing should support training and technical assistance, especially so community members can make use of the data being collected.
These girls are being so rude. Why are they packing up in the middle of the speech? Other people are noticing it too.
Final recommendation: we should use the best available evidence to sustain, restore, and develop policies that have both direct and indirect effects on behavior.
I hope they’re giving the nurses this food - not trashing it out of ‘rules’!!!!
Lastly, our stage should implement evidence-based policy to prevent firearm violence, which is a risk factor for all kinds of behavioral disorders. This includes, but is not limited to, finding effective ways to protect children and their families from community violence, as it is a legal means of safety counseling.
Investing early in prevention could mitigate both the suffering and the economic toll of... okay, I couldn’t type fast enough to finish that thought.
This woman seems to be going over time, but I think she’s the featured speaker for the whole thing, so they’re letting her do it.
There’s a girl near me working with ChatGPT on coding, I think. Haha. That must be awesome.
Okay, she finished her speech. She has a copy of the four-pager.
I’m gonna get going because I have some work to do. I need to run home and take care of things for my daughter before the end of the day. Work-life balance, baby! That’s how you do it. Hardest part is getting out of the house :)
I feel like this event was a LOT better than I thought it would be. Even had some sass and honesty. Good. Okay, go go!
Overall Event Reviews Elaborated:
Venue (5/5): Well, it was at a childrens’ hospital but their venue (for both the snacks and the presentations) were great.
Food (4/5): It was a free event - so lots of food was awesome. But HELLO!! We’re all going to get cancer if we eat their food!! It was so unhealthy hahah. Geeze. But plenty of it was delicious.
Speaker Content (3/5): Interesting, but the audience was even more interesting . I felt like it was a skeptical audience. The speeches were interesting though, but they didn’t give enough time for Q&A and being more ‘real’.
Networking (2/5): They had lots of time for networking, but I didn’t use any of it, except once by mistake. Talked to two people, but not much came out of it hahah. We just talked about abuse of student IEP’s and how chaotic middle schools are here in Seattle.
Likeliness to Return(4.5/5): Sure! I’d come to something like this again. I learned a lot and it was better than I expected, but I’m still skeptical of healthcare in general. I think we need to be leaning WAY more natural overall in the ‘health’ department. From our soil to our food to our air to our lifestyles.
Until next time, I wish you the motivation and success to search for opportunities around your area. Search and explore: Who is out there giving talks? There are new things happening all of the time
Find relatable or interesting topics you like and check them out! Maybe even something hosted at a cool venue, if there’s no other reason to go. Let’s see what you can learn and discover not too far from home. 😊
