Jeffrey Shahidullah

University of Texas at Austin | UT · Psychiatry and Behavioral Sciences

Introduction: Attention-deficit/hyperactivity disorder (ADHD) in children and adolescents is commonly managed in primary care. Changes in United States health care have led to the integration of behavioral health services within a patient’s “medical home” to improve access to, engagement in, and continuity of quality health care. Despite proliferat...

Children and adolescents are increasingly being prescribed psychotropic medications to address mental health needs. With the difficulty in accessing child and adolescent psychiatrists, primary care providers are often tasked with initiating and managing these medication regimens. The standard of care around psychotropic prescribing in primary care...

Children with autism spectrum disorder (ASD) present with complex medical problems that are often exacerbated by a range of other intellectual and psychiatric comorbidities. These children receive care for their physical and mental health from a range of providers within numerous child-serving systems, including their primary care clinic, school, a...

Objective: To identify perceptions of behavioral health (BH) training in pediatric residency programs, the degree of involvement from behavioral health providers (BHPs), and opportunities for and barriers to innovation in training. Method: A tailored design methodology was used to target all pediatric residency program directors in the United St...

Given the prevalence of school-age children and adolescents who are prescribed with and are taking psychotropic medications, a critical issue that school psychologists may likely encounter in contemporary practice is providing both quality and continuity of care to these students in the context of relevant legal and ethical parameters.With a thorou...

Introduced in 2013 as a new diagnosis in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), disruptive mood dysregulation disorder (DMDD) recategorized chronic and recurrent irritability from bipolar disorders to depressive disorders. Not only did this transition affect diagnostic nomenclature, but it also changed pharma...

Objective: To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes. Methods: We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integ...

Despite robust evidence supporting exposure‐based interventions for anxiety disorders in youth, these treatments are often underutilized, implemented with low fidelity, and delivered in an unnecessarily cautious manner. Few studies have examined important implementation variables (e.g., knowledge, training, perceptions) related to using exposures i...

The goal of the current study was to conduct a substantive validity review of four autism knowledge assessments with prior psychometric support (Gillespie-Lynch in J Autism and Dev Disord 45(8):2553–2566, 2015; Harrison in J Autism and Dev Disord 47(10):3281–3295, 2017; McClain in J Autism and Dev Disord 50(3):998–1006, 2020; McMahon in Res Autism...

Animal-assisted therapies have been increasingly used as part of treatment for a range of emotional-behavioral conditions and have more recently been incorporated into treatment for children with symptoms associated with autism spectrum disorder. Autism spectrum disorder affects one in 36 children and early interventions can be very effective. The...

Autism evaluation processes are often fragmented and lead to delays in accurate identification and services. These inefficient processes also lead to substantial burden on families when navigating the autism diagnostic odyssey that often requires information-sharing across providers and settings. Collaboration across schools, clinical settings, and...

Objective: We (a) describe the development of a hospital–school–community telepartnership (HSCT) program targeting suicidality crisis response implemented in the immediate aftermath of the COVID-19 pandemic, (b) report on service utilization outcomes from the first year and half of program implementation, and (c) share early lessons learned and imp...

Psychotropic medications are commonly prescribed to school-aged youth for the management of mental health concerns. This paper describes the current state of evidence for psychotropic medications in school-aged youth. More specifically, the following sections summarize relevant medication research trials and practice parameters pertaining to psycho...

Given existing barriers to a timely autism diagnosis, this study compares the efficiency and equity of diagnoses conducted in-person vs. telehealth in a developmental behavioral pediatrics setting. The transition to telehealth was prompted by the COVID-19 pandemic. Eleven months of clinic data in electronic medical records were retrospectively anal...

Attention-deficit/hyperactivity disorder (ADHD) is a common presenting concern in primary care. This study examined the relationship between pediatric residency training program characteristics and residents' ADHD knowledge, attitudes, and comfort in providing ADHD services. Given the familiarity that pediatric chief residents have with the trainin...

Objective: Minimal guidance is available in the literature to develop protocols for training non-clinician raters to administer semi-structured psychiatric interviews in large, multi-site studies. Previous work has not produced standardized methods for maintaining rater quality control or estimating interrater reliability (IRR) in such studies. Our...

Child health disparities in terms of access to high-quality physical and behavioral health services and social needs supports are rampant and pernicious in the United States. These disparities reflect larger societal health inequities (social injustice in health) and lead to preventable population-specific differences in wellness outcomes with marg...

CASE Sam is an 11-year-old young boy with autism spectrum disorder (ASD), unspecified anxiety disorder, and attention-deficit/hyperactivity disorder, combined presentation. He was initially diagnosed with ASD at 6 years of age after evaluation by a developmental-behavioral (DB) pediatrician. He presents to the DB pediatrics clinic to reestablish ca...

Providing high-quality services to autistic students and their caregivers requires interprofessional collaboration. This paper highlights the importance of collaboration between clinical and school settings to promote integrated and comprehensive care for autistic students and their caregivers. First, we present how autistic students are identified...

This paper describes the (Sin Exclusión) Transdisciplinary Autism Assessment and Resources ([S]TAAR) model and presents early metrics tracking efficiency and equity in access to high-quality comprehensive autism evaluations for young children. Retrospective chart reviews over one year (08/2018-08/2019) with n = 173 children were reviewed. Through c...

Autism spectrum disorder (ASD) is a neurodevelopmental disability affecting 1 in 44 children nationally. Timely referral to intervention and support services for ASD has consistently demonstrated significant long‐term positive effects on symptoms and subsequent skills and family outcomes. This paper highlights a novel and innovative approach of sho...

Introduction: Despite increased prevalence and identification of pediatric behavioral health concerns, families face many barriers when attempting to access behavioral health services. System navigators, or individuals experienced in navigating the health system, help to engage families in services by helping individuals overcome barriers for acces...

The increasingly diverse and complex student population school psychologists serve necessitates a reconceptualization of the field with explicit emphasis on interprofessional, interagency collaborations (IIC) to promote equitable and high-quality services for all students. School psychologists are positioned to play a central role in IIC with speci...

Introduction: Despite increasing evidence that use of the "common factors" and "common elements" approaches are effective in improving patient outcomes, and calls for pediatricians to address patient behavioral health concerns, little is known about pediatrician knowledge, perceptions, and use of these approaches. Method: Pediatric chief residen...

This guide helps primary care pediatricians, family doctors, nurse practitioners, and other professionals identify, treat, and prevent mental health problems as well as promote good mental health in their patients. Clinicians will gain insight into effective methods for helping patients and families share mental health concerns, learn about mental...

The autism diagnostic process in the United States has been described as inaccessible, stressful, and fragmented 1. To improve these services within Central Texas, an interdisciplinary diagnostic team was developed through Dell Children's Comprehensive Autism Program. The team was interested in monitoring family-centered outcomes to inform service...

The transition to virtual and hybrid schooling given the COVID-19 pandemic in the United States has upended the education system and may be widening gaps in service disparities, particularly for children with disabilities. Schools often function as "de facto" service systems for most children with disabilities, particularly those from racially and...

Background: Interagency collaboration between community and school settings is one mechanism to serve the complex needs of pediatric patients with autism spectrum disorder (ASD). Purpose: We surveyed a national sample of community-based providers to examine their perspectives on interagency collaboration with school-based providers when serving ped...

Objective: Anxiety disorders are the most prevalent mental health conditions among school-aged children (Merikangas et al., 2010) and have negative consequences for youth in schools (Ingul et al., 2019; Langley et al., 2004). The school setting is an ideal venue for the provision of mental health services and presents opportunities for free and equ...

Objective: Evidence-based treatments for mental health concerns include psychopharmacological and psychosocial approaches. Pediatrics organizations indicate psychopharmacology needs to be a component of training. This study investigated the status of training in psychotropic medication prescribing through a national survey of pediatric chief resid...

Many youth with autism spectrum disorder (ASD) may benefit from interdisciplinary care coordination. Communication and collaboration between the school and clinic settings is particularly important when youth with ASD are receiving both special education and clinic-based services. The responsibility of initiating coordinated care has historically b...

This book addresses the importance and relevance of interprofessional care coordination for children and youth with autism spectrum disorder (ASD). It covers the role of interprofessional collaborations across various settings for multiple service provision purposes. The volume examines interprofessional collaboration among professionals across suc...

Children with chronic illness who are hospitalized have numerous social, emotional, cognitive, and behavioral needs that necessitate care across service systems. Coordinating care with school-based delivery systems offers opportunities to address these needs and to minimize academic disruptions caused by time spent out of school. Most hospitalized...

Introduction: Although primary care clinicians often refer children and families to community-based mental health services, a sizable number of patients do not make it to their 1st appointment. Engagement interventions delivered in primary care that focus on reducing structural and perceptual barriers to accessing care hold promise to improve this...

Youth with autism spectrum disorder (ASD) have many and varied social, emotional, behavioral, and academic needs. In many cases, these children also have medical needs, adding to the level of care they require. Medical conditions commonly co-occur in children with ASD; some of the most common include epilepsy, gastrointestinal issues, sleep problem...

This chapter introduces this book and its central purpose. Autism spectrum disorderAutism spectrum disorder, its associated symptoms, and rising prevalence warrant service provision from several disciplines and professions. The rationale and benefits of interprofessional care coordinationCare coordination are discussed. The following chapters in th...

While developmental and behavioral interventions are the primary treatment methods for youth with ASD, psychotropic medications are often prescribed by psychiatrists, developmental-behavioral pediatricians, and sometimes primary care clinicians (PCCs) to manage co-occurring disorders and symptoms. To maximize the effectiveness of these medications,...

In the concluding chapter of the book, a brief review of preceding chapters is provided. The purpose of this chapter is to reflect on common themes throughout the chapters, and to highlight some key areas for future work in interprofessional care coordination (ICC) for autism spectrum disorder. Specifically, some current and future priorities may i...

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting 1 in 59 children in the United States. The benefits of early detection and intervention for ASD have been clearly documented. However, significant delays exist in access to early screening, diagnosis, and service provision. Despite the American Academy of Pediatrics’ guidelin...

A systemic issue in traditional health service delivery models to children and adolescents is the difficulty in accessing quality developmental/behavioral health (D/BH) care. Contributors to this problem include the lack of available specialty D/BH specialists (e.g., child and adolescent psychiatrists and psychologists, developmental-behavioral ped...

Introduction: Primary care is a common access point for children and adolescents with depression and suicidality concerns. In this setting, pediatricians typically function as front-line providers given barriers that patients face in accessing mental health clinicians. Method: This study surveyed chief residents from all pediatric residency prog...

Optimal service delivery for students with autism spectrum disorder (ASD) often involves interdisciplinary care coordination between primary care clinicians, community-based providers, and school personnel such as school psychologists. Interdisciplinary care coordination includes communication and collaboration from multiple providers to facilitate...

School-clinic care coordination is the interprofessional communication and collaboration between providers in the educational (i.e., schools) and medical (i.e., primary/specialty care clinics) homes to promote streamlined and integrated care for individuals with special health care needs, such as autism spectrum disorder (ASD). Current Knowledge AS...

This study used an experimental vignette design to examine whether school psychology students’ attitudes toward a teenager in a case vignette varied based on whether or not they believed the teen to be transgender. Transgender status was conveyed indirectly through names (e.g., by indicating that the student with the legal name “Anthony” had reques...

In the United States, ethnic minority status and low socioeconomic status both confer greater risk of premature birth. These sociodemographic factors also contribute to a greater risk of postpartum depression, as does giving birth prematurely. Considering the known adverse effects of postpartum depression on children’s development, NICU-based menta...

Early identification of young children at developmental risk is important for linkage to needed services. Yet, despite guidelines for developmental screening, many pediatricians do not systematically use screening tools. Because many young children spend time in childcare settings, conducting screening in these settings may improve rates of early i...

Improving behavioral health and communication skills of pediatrics residents remains an important focus in medical education. This poster presents a preliminary evaluation of two novel standardized patient (SP) training experiences in which PGY-1 residents observed and practiced behavioral health/communication skills within a group format, and faci...

Children and adolescents are increasingly being prescribed with psychotropic medications to address mental health needs. With the difficulty in accessing child and adolescent psychiatrists, primary care providers are often tasked with initiating and managing these medication regimens. The standard of care around psychotropic prescribing in primary...

This presentation was part of a symposium at the 2019 APA Annual Convention titled: Collaboration between the Educational and Medical Homes in Service Provision for Students with ASD

Due to the multiple etiological pathways of chronic pain that implicate biological, psychological and sociocultural factors, interdisciplinary teambased treatment is recommended (Kerns et al., 2011). Cognitive behavioral therapy (CBT) is an evidence-based component of a comprehensive approach to the treatment of chronic pain (Ehde et al., 2014). In...

There is a high prevalence of child and adolescent behavioral health needsthat present in primary care, and these issues are commonly addressed using psycho-tropic medications. Although several collaborative and integrated psychotropic medi-cation models have been proposed, there has been limited discussion of the complexethical considerations rela...

Objective: This commentary describes the current state of pediatric resident training in behavioral health and highlights specific pediatric residency training modalities that may be facilitated or enhanced by involvement of pediatric psychologists. Method: Several calls to action have been made recently by pediatrics organizations around the need...

Research continues to elucidate the finding that children's functioning is composed of numerous interdependent influences such as physical and psychological health, and ecological contexts which are inextricably linked. However, our nation's healthcare delivery system has not traditionally followed this framework in adequately addressing whole-pers...

The American Academy of Pediatrics recommends that pediatricians be trained to collaborate with school personnel and has stated that inadequate collaboration across systems is a contributor to suboptimal health care. Mail-based surveys were used to target chief residents of all pediatric residency programs in the United States (N = 214). Participan...

Primary care physicians often prescribe psychotropic medications for pediatric patients, but training, time, and reimbursement issues can hamper best practice. Psychiatrists available by telehealth and psychologists embedded in the medical home have been described to enhance care via collaborative medication-related roles (e.g., Shahidullah et al....

This handbook addresses the delivery of high quality pediatric behavioral healthcare services that are multitiered, evidence-based, and integrated, involving interprofessional collaboration across child serving systems, such as pediatrician offices and schools. The book sets forth a contemporary, leading edge approach that reflects the relationship...

Pediatric primary care providers such as pediatricians and pediatric residents tend to be the most accessible professionals to manage behavioral health concerns such as social-emotional, behavioral, and developmental issues. However, pediatricians report they do not feel comfortable managing common behavioral health issues. Many in the field have a...

Training delivered to medical students and residents in behavioral health is widely acknowledged to be inadequate. While the use of standardized patients is common in medical training and education for physical health conditions via the adherence to clinical protocols for evaluation and treatment, this approach is infrequently used for behavioral h...

This paper describes an empirical approach to assessing pediatric residents' attitudes, knowledge and skills in primary care behavioral health. Outcomes from that assessment approach are presented from two pediatric residency training programs in the northeastern United States. Thirty-six pediatric residents completed attitudes, knowledge and skill...

Attention-deficit/hyperactivity disorder (ADHD) in children and adolescents is commonly managed in primary care. Changes in United States healthcare have led to the integration of behavioral health services within a patient’s “medical home” to improve access to, engagement in, and continuity of quality health care. Despite proliferation of these int...

The three evidence-based treatments for use with children demonstrating externalizing ADHD symptoms, such as hyperactivity-impulsivity, are (1) stimulant medication, (2) behavioral treatment implemented across home and school, and (3) a combination of the two. Despite the compelling research support for each of these treatments, there remains varia...

Psychotropic medication effectively reduces ADHD core symptomatology, yet often fails to facilitate the academic and/or behavioral skill development needed for a student to succeed in school. School psychologists are in the unique position of facilitating the implementation of school-based adjunctive treatments for those students with ADHD who are...

A randomly selected group of Nationally Certified School Psychologists (NCSPs; n = 817) were mailed the 42-item School Psychopharmacology Roles and Training Evaluation (SPRTE) which inquired about their caseloads, practice roles as proposed by DuPaul and Carlson (2005), and prior training in psychopharmacology. A modified Tailored Design Methodolog...

The purpose of this study was to empirically investigate Nationally Certified School Psychologists' (NCSP) training in and use of evidence-based interventions (EBIs) for child behavior concerns as well as their reported implementation barriers. A modified Tailored Design Method (TDM; Dillman, Smyth, & Christian, 2009) using up to four mail-based pa...