Child Mind Institute, Inc.

THURSDAY, April 6, 2023 -- Does it sometimes feel like your young picky eater is turning every meal and snack into an epic power battle — and you’re just not sure how to get them the nutrition they need? If so, you’re not alone. According to an article published recently in the journal Pediatrics , up to 50% of kids may be described as "picky eaters." And while there’s no one agreed-upon definition of picky eating, in general, if your child or adolescent is particular about the food they eat at least some of the time, you may have a picky eater on your hands. “I think all parents have said at one time, ‘My kid is such a picky eater!’” clinical psychologist Rachel Busman said in a recent Child Mind Institute article . “It’s very normal for kids to go through stages where they’re a little more picky, especially when they are trying to assert their autonomy.” Experts at the institute note that picky eating is one of the most “common complaints” of parents. Here, they and other child experts weigh in on the topic with five top tips for parents of picky eaters: Grocery shop and cook together Involving your child in grocery shopping can help extend their picky eater food list to include novel items, Busman explained. When they are shown a wide variety of food flavors and options, it can open their eyes to new tastes and textures they might enjoy. Similarly, if you scroll through recipe books or websites together and pick a new dish or dessert to create, it helps make eating different foods a fun adventure instead of a battle. Avoid forcing foods Cleveland Clinic registered dietician Jennifer Hyland notes that forcing kids to eat food they don't like can make them doubt their own body signals surrounding hunger, especially when they’re toddlers. “Forcing food can cause your child to distrust their own appetite and lead them to believe that they can’t regulate their own hunger cues,” she explained in an article . Instead, allow them to eat until they’re full — even if that means some vegetables are left on the plate. This also helps ensure that eating food doesn’t become associated with stress and anxiety. Have meals as a family Both Hyland and the pediatricians at Healthychildren.org recommend eating together as a family, to help create a positive vibe around food. They also suggest cooking the same meal for everyone at the table and including at least one food in each meal that your picky eater enjoys, if possible. “Try your best to cook the same meal for the whole family. The child may not eat all of it, but it’s important that you present it, and that you set an example of trying these foods yourself,” Hyland explained. Take food rejection calmly Teaching your child that unwanted food is still safe food is important, according to the Child Mind Institute. For instance, they may need to be shown that the tomato they are repulsed by isn’t actually full of bad germs just because they don’t like it. One way to demonstrate this is to teach your child to offer unwanted food to others at the table. When your picky eater sees other family members enjoying it, they’re more likely to understand that it’s safe to eat. Have fun with food You may have thought that a good meal presentation was only for formal restaurants, but as it turns out making foods into fun shapes and including a variety of colors in your meals can help make them appealing to kids. Hyland recommends offering your picky eater something they can shake onto their food if they don’t want it, to make it “more exciting.” Additions like herbs, seasonings or seeds can help turn an unwanted item into a winner. “Sprinkles also go a long way,” said Hyland. “Sometimes it really is as simple as that.” The Cleveland Clinic also notes that a child may try a food between 10 to 20 times, on average, before they like it. This means that your patience and persistence in re-offering previously rejected foods to your picky eater can really pay off. Hyland explained that, “The most important thing a parent can do with a choosy eater is to be consistent and not give up.” Posted April 2023

A new virtual mental health clinic for children launched on Wednesday. The startup, named Fort Health, links pediatric primary care to behavioral care. “The pediatrician is the first port of call for families looking to find any form of care for their child, including behavioral health care. However, pediatricians often have no place to send these families because of long waitlists and affordability issues. Most mental health providers are out of network — according to the National Alliance on Mental Illness, mental health providers are four times more likely to be out of network compared to other providers,” said Natalie Schneider, Fort’s CEO. To address these issues, her startup developed a telehealth-based mental health clinic that partners with pediatricians for referrals and health plans for coverage. Fort was created at Redesign Health, a New York City-based company that launches healthcare startups. It was built in partnership with the Child Mind Institute, a nonprofit focused on children’s mental health. Fort is designed to improve children’s access to mental health professionals, as many pediatricians currently don’t know to whom they should refer patients and families don’t know who to trust, Schneider declared. She said this has become an even bigger problem as more and more children are presenting mental health conditions at primary care visits. “Growing up in today’s world, kids are facing a social media obsessed society, substantial political and environmental volatility and a global pandemic. Combined with natural insecurities that come with growing up, kids are more likely to report mental health concerns — including stress and depression — than any other age group. And only about half of those who need mental health care are currently receiving it,” Schneider said. A family’s first point of contact with Fort is usually through a referral from a primary care provider referral, she declared. The startup gives families access to telehealth sessions with its clinical staff, which is made up of licensed child therapists and board-certified child and adolescent psychiatrists. Each patient sees a child therapist for their first session. After evaluating the patient’s unique needs, the therapist recommends a path forward using up to three options: individual therapy sessions, therapy sessions with their parents, and/or psychiatry services. If the selected path doesn’t seem like the right fit to the child and their family, they can choose a different path or change therapists. During the course of a patient’s treatment plan, Fort’s therapists and psychiatrists track the child’s progress with clinical assessments and share feedback with the family — and their pediatrician, pending permission. The startup offers its services using a fee-for-service model. It accepts patients covered by Aetna, Optum/UnitedHealthcare and Geisinger Health Plan, and there is also a cash-pay option. Fort currently only operates in New Jersey, but it has plans to expand into New York and additional states later this year. The company employs five therapists and three child and adolescent psychiatrists but is hiring additional therapists every week and plans to have more than 50 therapists by the end of the year, Schneider said. To help with this effort, the startup engaged in fundraising and was successful, securing a $4.5 million investment from Blue Venture Fund. So what makes Fort different from other virtual mental health clinics for children, like InStride Health or Brightline? Schneider pointed to a couple of factors: the model of direct partnership with pediatricians and the partnership with the Child Mind Institute. The latter includes the development of a proprietary four-week clinical training program for evidence-based care, she said. Overall, Schneider said the goal of her new startup is to help children receive the behavioral healthcare they need in a faster and more affordable fashion. “Nine out of 10 children visit their pediatrician once a year, and the average delay between symptom onset and getting mental healthcare is eight years. Connecting primary and mental health care lets Fort Health treat more children sooner,” she said.

EndeavorRx, the FDA De Novo-authorized video game digital therapeutic for children with ADHD, is getting a slew of new gameplay features, its developer Akili Interactive announced today. EndeavorRx takes the form of a game in which users navigate an alien avatar through a course while they respond to on-screen prompts. The app keeps track of movements, monitors the user’s behavior and quickly adapts to the player. The FDA indicates the treatment to improve attention function in children ages 8 to 12 years old with primarily inattentive or combined-type ADHD, who have a demonstrated attention issue. Akili says the new features give users more choices while they play. They can now select and unlock new characters and costumes, complete new quests and build their own universe. While the updates are designed to enhance the game playing experience of EndeavorRx, they were built without disrupting Akili’s Selective Stimulus Management Engine (SSME) core technology that targets attention focus, the company said. The Akili team took the latest trends in video game development paired with user feedback to create the updates. “Rapid product iteration is critical to creating amazing experiences for patients and delivering on the full promise of digital therapeutics,” Carl Gottlieb, senior vice president of engineering at Akili Interactive, said in a statement. “Since obtaining FDA clearance, we’ve been listening and learning, and are taking a dynamic patient-responsive approach to create an amazing experience -- from the product to the delivery process. Because EndeavorRx is uniquely delivered through a video game, we have nearly endless opportunities to enhance the product and evolve it based on user feedback and gaming trends to drive enjoyment and engagement.” WHY THIS MATTERS Between 2016 and 2018 about 11% of children aged 5 to 17 years old had been diagnosed with ADHD in the U.S., according to the CDC. Boys are more than twice as likely to be diagnosed with the condition than girls. Medication and behavioral therapy are the two most common forms of treatment for ADHD, yet medication is used more often. Among all children 2 to 17 years old with ADHD in 2016, 62% were on medication compared to 47% who received any behavioral treatment for their ADHD in the past year, according to the CDC. The prevalence of treating ADHD with medication poses problems as stimulants are associated with side effects including sleep problems, decreased appetite, delayed growth, headaches, nausea, irritability when the medication wears off, the development of tics, moodiness and cardiac risks, according to the Child Mind Institute. Further, studies show a link between ADHD and substance use disorder later in life. In fact, approximately one-fifth of adults with SUD have ADHD, according to the Journal of Clinical Psychology. These risk factors make ADHD a prime clinical candidate for non-invasive treatments like EndeavorRx. THE LARGER TREND Earlier this year, Akili scored $160 million in funding with eyes set on expanding EndeavorRx’s capabilities into other cognitive conditions, including depression and COVID-19-related brain fog. Boston Children’s Hospital spin-out Mightier also has a video game treatment for children with ADHD. It recently received a $2 million National Institute of Mental Health grant to study its effectiveness with Magellan Health. Outside of ADHD, gamification has been studied among people with diabetes and overweight veterans to help them increase their physical activity.