Children with physical illness face all the medical challenges of their condition as well as the psychological trials that may arise as they cope with their illness. There may be emotional bumps during the child's many developmental stages for both the child and family.
Our Pediatric Behavioral Health Specialists are available to help children and families cope with the emotional and behavioral aspects of a child's physical illness.
Areas of Service:
- Psychiatric Testing & Evaluation
- Neuropsychological Evaluation
- Medication Management
- Individual Therapy
Examples of Care
Even in adults, it takes maturity, patience, and solid self-esteem to manage a physical illness or condition. Children with physical illness often develop these characteristics at amazingly young ages.
Every member of the family, however, may need help coping with challenges at times. Our specialists provide support during these times of adjustment for the child and the family during the child’s short or long-term illness.
Examples of support include:
- At what age is a child with diabetes or PKU old enough to understand what he can and can’t eat?
- How does a parent set boundaries and discipline a child who may not survive to be an adult?
- How does a teenager with an organ transplant cope with the round face and thick hair growth from steroids?
- How does the teen with diabetes balance medical compliance with peer pressure and the need to blend in?
- At what age does the parent begin to step back and allow the child to be responsible for his own health decisions and consequences?
- How can the child adjust emotionally to physical loss of a limb, of mobility, of mental capacity?
- How can a parent handle guilt that may arise from realizing the child’s problems are the result of the parent’s genes?
A change in behavior may be one of the first signs of illness in a newborn. It's normal for a baby's activity, appetite, and cries to vary from day to day, even hour to hour. But, a distinct change in any of these areas may signal illness.
Generally, if your baby is alert and active when awake, is feeding well, and can be comforted when crying, occasional differences in these areas are normal. Consult your baby's doctor if you are worried about your baby's behavior. Some changes may indicate an illness is present.
Listlessness or lethargy
Lethargic or listless babies appear to have little or no energy, are drowsy or sluggish. They may also sleep longer than usual. They may be hard to wake for feedings and even when awake, are not alert or attentive to sounds and visual cues. Sometimes, this can develop slowly and a parent may not notice the gradual change. Lethargy may be a sign of infection or other condition, such as low blood glucose (sugar). Consult your baby's doctor if your baby becomes lethargic or has a change in activity level.
Feeding difficulties due to a sucking problem may show up when a baby starts out at birth with a strong, vigorous suck and gradually become less effective at feedings over time. Or when a baby starts out with a weak suck and does not eat effectively. This is especially common if he or she was born prematurely. Babies with a weak suck may not pull strongly or have a good latch while breastfeeding. The mother may not hear the baby swallowing or gulping during feedings. A mother's breasts may not feel full right before a feeding or she may not notice her breasts getting softer (emptying) after a feeding. If' you notice your baby is unable to empty the breast effectively or suck at the bottle effectively, or if feeds take longer than 30 minutes, you should consult your baby's doctor.
After the first day or so, most newborns are ready to eat every 2 to 4 hours. They will show signs of hunger by sucking on fingers or a hand, crying, and making rooting motions. A sick baby may refuse feedings. A baby who sleeps continuously and shows little interest in feeding may be ill.
Spitting up and dribbling milk with burps or after feedings is fairly common in newborns. This is because the sphincter muscle between the stomach and the esophagus (the tube from the mouth to stomach) is weak and immature. However, forceful or projectile vomiting, or spitting up large amounts of milk after most feedings, can mean a problem. In formula-fed babies, vomiting may occur after overfeeding, or because of an intolerance to formula. In breastfed or formula-fed babies, a physical condition that prevents normal digestion may cause vomiting. Discolored or green-tinged vomit may mean the baby has a blocked intestine.
Weight loss up to about 10% of birthweight is normal in the first 2 to 3 days after birth. However, the baby should reach his or her birthweight by 10 or 11 days old. Signs a baby is not gaining weight may include a thin, drawn face, loose skin, and a decreased number of wet or soiled diapers. Newborns should have at least 3 wet diapers a day. By a week of age should have at least 5 wet diapers a day. Most doctors want to see a newborn in the office at the end of the first week to check his or her weight. Lack of weight gain or continued weight loss in a young baby may be a sign of illness or other conditions that need to be treated.
Feeding problems can be a sign of other conditions and may lead to serious illness if untreated. Consult your baby's doctor if your baby has any difficulties taking or digesting feedings.
Persistent crying or irritability
All babies cry. This is their only way of communicating their needs to you. Babies also develop different types of cries for different needs, including:
In need of a diaper change
At first, parents may not know how to interpret cries, but they usually can console a baby by meeting those needs. However, a baby who is continuously fretful and fussy, or cries for long periods, may be ill. Also, a baby may be very irritable if he or she is hurting. Jitteriness or trembling may also be signs of illness. Colic is crying that starts around 2 weeks of age, occurs in spells, lasts for a total of 2 to 3 or more hours daily, several times a week, and is difficult to stop. There are many theories and plenty of expert opinions, but no one is really sure about the causes of colic.
Examine your baby carefully to make sure there is not a physical problem, such as clothing pinching the baby, or a diaper pin sticking the baby. There may be a thread or even a hair tightly wound on a finger or toe. Look at the baby's abdomen for signs of swelling. Check to make sure your baby isn't too warm or cool. Consult your baby's doctor promptly if your baby is crying for longer than usual or has other signs of illness.
Behavior disorders (sometimes referred to as disruptive behavior disorders) are the most common reasons children are referred for mental health evaluations and treatment.
Many types of behavioral disorders require clinical care by a physician or other health care professional. Listed in the directory below are some, for which we have provided a brief overview.
Dr. Laura Murphy received her Ph.D. in Clinical Psychology from Duke University and completed a Pediatric Psychology fellowship at Ohio State University. She recently joined the Division of Pediatric Psychiatry and Behavioral Health and is an Associate Professor on the clinical track. Dr. Murphy’s primary clinical care focus is medically ill chil... Read More
Deirdre Caplin, MS, PhD received her Master’s Degree in Rehabilitation Counseling from Purdue University School of Science, her PhD in Clinical Child Psychology from Ohio University, and her clinical internship in Pediatric Psychology at the University of Louisville Medical Center. She has been with the Department of Pediatrics since 2001 and join... Read More
Lisa L. Giles, M.D. is an Assistant Professor of Pediatrics and Psychiatry at the University Of Utah School Of Medicine. Dr. Giles graduated from the University of Utah with a degree in chemistry and subsequently received her medical degree from the University Of Utah School Of Medicine. She completed a combined residency in Pediatrics, Adult Psy... Read More
D. Richard Martini, M.D. is Division Chief , Behavioral Health, Department of Pediatrics, University of Utah School of Medicine. He is also Director, Department of Psychiatry and Behavioral Health, Primary Children’s Medical Center. Dr. Martini graduated from John Hopkins University and received his medical degree from the University of Pittsburgh... Read More
Travis Mickelson, M.D. attended medical school at the University of Utah. He also completed both his residency in General Psychiatry and fellowship in Child and Adolescent Psychiatry at the University of Utah. Dr. Mickelson’s clinical interests include consult liaison psychiatry, outpatient psychiatry and teaching medical students and residents. ... Read More
Dr. Morstein graduated from Oral Roberts University with a B.S. in nursing and received her MS with an emphasis on child psychiatric nursing from the University Of Oklahoma School of Nursing and her PhD in nursing from Oregon Health Sciences University . Dr. Morstein currently works as a Psychiatric Advanced Practice Registered Nurse at Primary... Read More
Chris Rich, M.D. is an Associate Professor of Pediatrics at the University Of Utah School Of Medicine. Dr. Rich graduated from the University of Utah with a B.A. in German and received his medical degree from the University Of Utah School Of Medicine. He completed his adult psychiatric residency at UC San Diego and his Fellowship in Child and Ad... Read More
|Primary Children's Hospital|
Kyle M. Smith, M.D. is an Assistant Professor of Pediatrics at the University of Utah School of Medicine. Dr. Smith obtained a bachelor's degree in psychology from Northwestern University in Evanston, Illinois. He subsequently received his medical degree from the Creighton University School of Medicine in Omaha, Nebraska. He completed a combined r... Read More
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