In this Q&A episode, we wrap up our series on psychosis by exploring the important role of family, relationships, and support systems in caring for children and adolescents experiencing psychosis. Our host Paul Wirkus, MD, FAAP and guest Kristi Kleinschmit, MD discuss how household dynamics can influence recovery, including the importance of predictability, stability, and a supportive home environment. They also revisit the concept of low expressed emotion and whether it remains a recommended approach for families.

The conversation addresses support following a first episode of psychosis, including the importance of recognizing and treating symptoms early. We discuss how to approach medication when a patient has limited awareness of their illness and may not recognize the need for treatment. Building trust and identifying people the patient trusts to help them recognize and describe changes in their thoughts, behaviors, or experiences can be an important part of this process.

We also highlight NAMI as a resource for education, family support, and support specifically for siblings. For Utah pediatricians and primary care clinicians, the Utah Psychiatric Call-Up Line remains an additional resource for consultation and guidance when navigating psychiatric concerns.

The Virtual Curbside is a podcast of the American Academy of Pediatrics, Utah Chapter (UTAAP), connecting pediatricians and subspecialists through practical, accessible pediatric education. Learn more about UTAAP at aaputah.org.

ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.

AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This week, we take a brief detour from our series on psychosis for a special Book Club episode. Our host and guest discuss Stephen Covey’s classic The 7 Habits of Highly Effective People, exploring the seven habits and the ideas behind them.

The conversation also considers how some of Covey’s principles can apply to pediatric practice and the everyday work of caring for patients and families.

Next week, we’ll return to our series on psychosis with the Q&A episode.

The Virtual Curbside is a podcast of the American Academy of Pediatrics, Utah Chapter (UTAAP), connecting pediatricians and subspecialists through practical, accessible pediatric education. Learn more about UTAAP at aaputah.org.

This week on The Virtual Curbside, we take a closer look at hallucinations and delusions in children and adolescents. Our host Paul Wirkus, MD, FAAP and guest Kristi Kleinschmit, MD discuss how to approach the diagnosis while keeping safety at the forefront. A thorough history is essential, including the patient’s family history, recent illnesses or infections, travel, changes in function, confusion, and the nature and timing of delusions or hallucinations. The conversation emphasizes the importance of considering both psychiatric and medical causes when a child presents with new or concerning symptoms.

We also discuss the role of lab tests and imaging in the evaluation, including when additional medical workup is warranted and when symptoms require evaluation in the emergency department. The episode highlights the PREP program, a resource for young people experiencing a first episode of psychosis, and the Utah Psychiatric Call-Up Line, a publicly funded consultation resource available to primary care clinicians and pediatricians.

This episode provides a practical framework for recognizing concerning symptoms, evaluating possible causes, assessing safety, and knowing when to seek additional support or urgent care.

The Virtual Curbside is a podcast of the American Academy of Pediatrics, Utah Chapter (UTAAP), connecting pediatricians and subspecialists through practical, accessible pediatric education. Learn more about UTAAP at aaputah.org.

ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.

AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In Episode 2 of our series on psychosis, we take a closer look at schizophrenia in children and adolescents, including the typical onset of symptoms, the role of genetics, and the relationship between cannabis use and psychosis. Our host Paul Paul Wirkus, MD, FAAP and guest Kristi Kleinschmit, MD review the disorders and conditions that commonly overlap with schizophrenia or occur at higher rates, including autism, major depressive disorder, bipolar disorder, schizoaffective disorder, anxiety, and substance use disorders.

The conversation also explores how schizophrenia can progress over time and what clinicians can expect as the illness unfolds. We discuss the role of psychotherapy alongside other treatments and the important role pediatricians can play in supporting patients and families throughout the course of illness.

Finally, we highlight the Utah Psychiatric Call-Up Line, a publicly funded resource available to Utah primary care and pediatricians for consultation and support when navigating psychiatric concerns. The episode also addresses the pediatrician's role in helping adolescents and young adults transition from pediatric to adult mental health care.

Utah Call-Up Line: 801.587.3636 or https://healthcare.utah.edu/hmhi/programs/call-up.

Have a question for our hosts or guests? Email questions@vcurb.com. For more information, additional episodes, and available CME/MOC credit, visit vcurb.com.

The Virtual Curbside is a podcast of the American Academy of Pediatrics, Utah Chapter (UTAAP), connecting pediatricians and subspecialists through practical, accessible pediatric education. Learn more about UTAAP at aaputah.org.

ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.

AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This month we turn to psychiatric topics, beginning with an important clinical question: when a child or adolescent presents with unusual thoughts, perceptions, or behaviors, how do we distinguish psychosis from other psychiatric or medical conditions?

In this episode, our host Paul Wirkus, MD and guest Kristi Kleinschmit, MD discuss psychotic experiences and how they can occur in conditions including major depression, bipolar disorder, and OCD, as well as with substance use and trauma or PTSD. We explore how to think about experiences such as imaginary friends and vivid imagination, and when symptoms such as catatonia should prompt a closer evaluation.

The conversation also emphasizes the importance of looking beyond a psychiatric diagnosis. Infection, other medical illnesses, and genetic syndromes can all play a role in changes in behavior or perception, making a thoughtful history and appropriate medical evaluation essential. The episode offers pediatricians a framework for recognizing concerning symptoms, considering the broader differential diagnosis, and determining when additional evaluation or referral is needed.

Have a question for our hosts or guests? Email questions@vcurb.com. For more information, additional episodes, and available CME/MOC credit, visit vcurb.com.

The Virtual Curbside is a podcast of the American Academy of Pediatrics, Utah Chapter (UTAAP), connecting pediatricians and subspecialists through practical, accessible pediatric education. Learn more about UTAAP at aaputah.org.

ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.

AMA Credit Designation Statement
Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This week we wrap up our series on supporting children’s social, emotional, and relational health with a conversation focused on what pediatricians and other clinicians can take from the series and put into practice. Our host Paul Wirkus, MD and guests Neal Davis, MD and Quang-Tuyen "Q" Nguyen join us to reflect on the key messages from the previous episodes and explore how clinicians can incorporate relational health into everyday pediatric care, particularly when working with families facing additional challenges.

The discussion emphasizes that supporting children’s mental and relational health doesn’t always require a lengthy intervention. Sometimes, it happens in the small encounters - a pediatrician showing genuine care, listening to a family, noticing what they need, and helping parents feel supported. We also consider how clinical care can be strengthened when the policies and systems surrounding families are designed to work for them rather than create additional barriers.

Q shares practical insights into advancing relational health in pediatric practice and supporting vulnerable populations, while Neal offers a broader vision for the future of early childhood health care. The episode closes by looking at the role pediatricians, health systems, and communities can play in creating a healthier future for Utah’s children and families.

Book Club: Amazing Generation

Have a question? Email questions@vcurb.com.

For more information about available credit, visit vCurb.com, or for information about the UTAAP, visit aaputah.org.

ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.

AMA Credit Designation Statement

Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This week, we turn to one of the most common parenting questions in pediatric practice: screen time and digital wellness. Our host Paul Wirkus, MD, FAAP and guest Mark Witt, MD, discuss the unique role pediatricians have in helping families navigate technology use, while recognizing the challenge of addressing an increasingly complex topic within the limited time of a well-child visit.

Rather than focusing only on a specific number of screen-time hours, the conversation emphasizes an age-specific approach and encourages pediatricians to consider what screen use may be displacing. We explore how increased screen time can affect physical activity, family time, sleep, and even where children use screens within the home. The discussion also highlights the value of establishing screen-free spaces and creating healthy boundaries around technology.

Throughout the episode, our guest offers practical ways pediatricians can begin conversations about digital wellness and help families develop healthy, sustainable habits around screens.

AAP Statement on Screen Time
Book Club: Amazing Generation

Have a question? Email questions@vcurb.com.

For more information about available credit, visit vCurb.com, or for information about the UTAAP, visit aaputah.org.

ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.

AMA Credit Designation Statement

Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In Episode 2 of our quality improvement series on parenting advice in pediatric practice, we focus on the role pediatricians can play in supporting emotional resilience for both children and their parents. Host Paul Wirkus, MD, FAAP and guest Ryan Gottfredson, DO begin by discussing why quality improvement matters in clinical practice and how small, intentional changes can help pediatricians incorporate meaningful parenting guidance into routine care.

The conversation explores modern parenting challenges, including stress, toxic levels of stress, and strategies for building resilience. We discuss how parents can teach resilience by modeling healthy behaviors, while maintaining balanced boundaries that provide children with both structure and support. Additional topics include helping children navigate failure, fostering independence, and finding the balance between parental authority and recognizing the humanity of both parents and children.

Finally, we address a practical challenge familiar to every pediatrician: how to make space for these important conversations during a well-child visit when time is limited. The episode offers ideas for integrating parenting guidance into everyday clinical encounters without adding an unrealistic burden to already busy practices.

Have a question? Email questions@vcurb.com.

For more information about available credit, visit vCurb.com.

ACCME Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians.

AMA Credit Designation Statement

Kansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.