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Introduction
Skills and Expertise
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Publications
Publications (171)
Background: Canada lacks an approach to early childhood mental health prevention aimed at decreasing barriers to care among highest-needs families. In this Canadian randomized controlled trial, we aimed to evaluate whether participation in the Family Check-Up® (FCU) would be associated with lower severity of child behavior problems (primary outcome...
Canada lacks an approach to early childhood mental health prevention aimed at decreasing barriers to care among highest-needs families. In this Canadian randomized controlled trial, we aimed to evaluate whether participation in the Family Check-Up® (FCU®) would be associated with lower severity of child behavior problems (primary outcome) and careg...
Determining if where a child lives (country in the case of this study) is explanatory for exposure to physical punishments is often complicated by confounders. This study determined the odds of exposure to physical punishment for children living in the Dominican Republic (DR) and Haiti, the two countries that share the island of Hispaniola, after a...
Background:
Religious affiliation may account for some variance in parenting behaviors used for disciplinary intent. However, most reported studies of this relationship are limited to high-income countries focused on Christianity.
Objective:
This study aimed to determine whether parenting behaviors vary by religion in a low- and middle-income co...
Children with Down syndrome require services from different sectors over time to optimize health and development, however, there is little information on longitudinal, cross-sector service use. Parents of children with Down syndrome attending a Canadian children's hospital participated in semistructured interviews covering life-time multiple sector...
Exclusive breastfeeding (EBF) is infrequent and decreasing over time in the Dominican Republic. This study aimed to identify patterns of, and women's rationale for, early complementary feeding. Mothers of children under 12 months of age living in a low-resource peri-urban community had three opportunities to contribute: (i) responding to feeding qu...
Child and adolescent psychiatrists and their associations are grappling with the idea of restructuring their subspecialty to including transitional age youth (TAY), sometimes operationalized as persons 18-25 years of age. This consideration is currently before the Canadian Academy of Child and Adolescent Psychiatry (CACAP). This essay identifies se...
This study aimed to determine whether better hematological outcomes were attained in young anemic (hemoglobin <11.0g/dl) children following a quality improvements initiative (QII) of a basic anemia screening and iron treatment approach in a low-income community. Pre-post changes in two anemic cohorts, one before (cohort A, n=115) and one after (Coh...
There is limited use of empirically supported mental health interventions in schools. Leveraging technology may reduce some barriers, however, use may still be limited. To further understand variable intervention use, this study investigated the challenges experienced by teachers invited to implement a daily report card (DRC) intervention aided by...
Background
There is a lack of information about cross‐sector service use by children with developmental disabilities despite their need for services from multiple sectors.
Methods
Responses to service use questions from a parent‐completed survey on school‐aged children who attended clinics specific for those with developmental disabilities at a Ca...
Objective:
Primary care practitioners determine access to care for many preschool children with mental health (MH) problems. This study examined rates of mental health (MH) problem identification in preschoolers within primary healthcare settings, related service use, and MH status at follow-up. The findings may inform evidence-based policy and pr...
Objective
Although Haiti and the Dominican Republic (DR) share the same island of Hispaniola, exclusive breastfeeding is much higher in Haiti. As prelacteal feeding also differs between the two countries, it was hypothesize that prelacteal feeding would account for the subsequent differences in breastfeeding exclusivity between the two countries, w...
Teachers’ use of evidence-informed classroom management and behavioral health strategies may improve student behavior and classroom function. However, little is known about the extent to which teachers employ various strategies and whether strategy use varies across grades. This study aimed to determine the frequency distribution of reported use of...
Deciding whether to screen for adverse childhood experiences (ACEs), like screening for any risk factor or health condition, should be informed by a systematic approach. The following questions, derived from key principles of health screening, are used to systematically evaluate the recommendation for ACEs screening: (1) Does an evidence-based inte...
Adverse childhood experiences (ACEs) are increasingly recognized as important predictors of poor health outcomes. In response, there is increasing application of ACEs questionnaires in clinical practice and population health surveys. Such efforts are often justified as approaches to identify ACEs, components of trauma-informed care, and/or measures...
Historically, teachers’ uptake and implementation of empirically supported classroom interventions have involved substantial face-to-face consultation. However, most schools do not have the resources to provide this intensive level of support and many teachers may not need it. Thus, evaluation of alternative supports is warranted. In this pilot stu...
Vlad, not his real name, a 15 year old boy with an autism spectrum disorder and intellectual disability, was referred for psychiatric consultation due to aggression and other behavioural problems. He presented for initial psychiatric consultation on five psychotropic medications with associated severe obesity. A systematic deprescribing and cross-t...
Thanks to the Journal for extending the opportunity for discussion about the topic of adverse childhood experiences (ACEs) screening and to Dr. Watson for her response to our letter (1,2). It is important to highlight that we are NOT contesting the need for health care providers to be aware of, and knowledgeable about, ACEs. Rather, our concern is...
Background
Adolescence is a high-risk period for the onset of suicidal thoughts and behaviors. Identification of preceding patterns of internalizing and externalizing symptoms that are associated with subsequent suicidal thoughts may offer a better understanding of how to prevent adolescent suicide.
Methods
Data from the National Longitudinal Surv...
An increasing number of stakeholders are calling for the implementation of universal screening for adverse childhood experiences (ACEs). While there is little doubt that ACEs increase the likelihood of negative sequelae, this does not automatically translate to benefits from universal ACEs screening. This is the situation for other proposed univers...
Objectives:
Despite frequent use of antipsychotic medications to target severe behavioral problems among children with intellectual disabilities (ID), there is little information as to the extent to which adverse effect monitoring is in place for this population. The aim of this pilot study was to determine the extent to which monitoring for adver...
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been cautiously restrictive in incorporating etiological variables into diagnostic criteria. This etiologically agnostic approach seems appropriate given the lack of evidence for single dominant causal factors for most mental disorders. Moving toward an etiologically based diagnost...
Objectives: Teachers’ use of evidence-informed classroom management and behavioral health strategies may improve student mental health and function. However, little is known about the extent to which teachers employ such strategies and whether the frequency of use varies across grades. The few small studies that have been conducted suggest a reduct...
The term dual diagnosis can refer to the co-occurrence of an intellectual disability and a mental disorder. While such a term may have some advocacy rationale aimed at facilitating improved mental health care for those with intellectual disabilities, it is proposed that the construct has flawed underpinnings, and its application may problematize me...
Objective:
Telehealth to schools may be a strategic approach to expand child mental health service delivery, however, there are only a few published examples. This report describes video-conferencing telehealth linkage attempts to schools to facilitate mental health consultation.
Methods:
A series of synchronous video-conferencing linkage strate...
Introduction
The quality of clinical practice guidelines (PGs) has not been evaluated in child and youth mental health (CYMH). To address this gap, we will: (1) conduct a systematic review (SR) to answer the question ‘among eligible PGs relevant to the prevention or treatment of CYMH conditions, which PGs meet criteria for minimum and high quality?...
Objective:
To present a case series of children retrialed on stimulants after initial poor stimulant responses given the paucity of information on the usefulness of this strategy.
Methods:
Health records from an ADHD medication service were obtained for six children who: (i) were medication naïve at service entry; (ii) had trials of at least one...
Chez les enfants d’âge préscolaire, les comportements perturbateurs sont d’importants facteurs de risque et des éléments potentiels de troubles du neurodéveloppement et de la santé mentale. Entre l’âge de deux et cinq ans, il est normal d’observer des comportements transitoires comme un certain défaut de se conformer, des crises de colère et de l’a...
Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some noncompliance, temper tantrums and aggression between 2 and 5 years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when accompanie...
A new Fetal Alcohol Spectrum Disorder (FASD) guideline was published in the Canadian Medical Association Journal in 2016. This is relevant to the mental health field as mental health symptoms and psychiatric disorders are often identified as associated with and/or part of FASD presentations. Unfortunately, the new guideline has not advanced underst...
Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some non-compliance, temper tantrums and aggression between two and five years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when acco...
Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some non-compliance, temper tantrums and aggression between two and five years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when acco...
Objective:
To describe and contrast early complementary feeding (ECF) over time in breastfed infants in the Dominican Republic (DR) and Haiti, the two countries that share the island of Hispaniola.
Methods:
Secondary data analysis was conducted on cross-sectional data from Demographic and Health Surveys administered at four different time-points...
Objective:
To review research findings that consider whether attention deficit hyperactivity disorder (ADHD) is a discrete entity or whether it is more consistent with an extreme end-of-trait distribution in the population and to then grapple with the potential clinical implications.
Quality of evidence:
Peer-reviewed publications in the past 5...
Background
Family physicians and other primary care practitioners are encouraged or expected to screen for an expanding array of concerns and problems including intimate partner violence (IPV). While there is no debate about the deleterious impact of violence and other adverse psychosocial exposures on health status, the key question raised here is...
Objective
The relationship between caesarean sections (C-sections) and infant feeding varies between different samples and indicators of feeding. The current study aimed to determine the relationship between C-sections and five indicators of infant milk feeding (breast-feeding within 1 h after delivery, at the time of the survey (current) and ever;...
Objective:
Point-of-use (POU) strategies to improve drinking water, particularly chlorination, are promoted within cholera epidemics when centrally delivered safe drinking water is lacking. Most studies examining POU practices during cholera epidemics have relied on single cross-sectional studies which are limited for assessing behavioural changes...
Iron is often initiated for children with low hemoglobin values in the absence of other indicators of iron deficiency in low-resource
settings. Unfortunately, there are few reports describing outcomes from such an approach outside of clinical trials. This
study examined outcomes of an anemia screening and treatment service in a low-resource communi...
Objective:
The Multimodal Treatment Study for Attention-Deficit/Hyperactivity Disorder Swanson, Nolan, and Pelham, Version IV (MTA-SNAP-IV) is a common rating scale to measure attention-deficit/hyperactivity disorder (ADHD) symptoms during medication treatment. Relying on the traditional scoring approach for this instrument to identify symptom rem...
Gaps in the receipt of micronutrients and anthelmintic medications by children in low-and middle-income countries undermine efforts to reduce the burden of vitamin A and iron deficiencies, and soil transmitted helminthiases. This study aimed to identify the extent of equitable receipt of these interventions in the Dominican Republic (DR) using indi...
We conducted an expedited knowledge synthesis (EKS) to facilitate evidence-informed decision making concerning youth suicide prevention, specifically school-based strategies and nonschool-based interventions designed to prevent repeat attempts.
Systematic review of review methods were applied. Inclusion criteria were as follows: systematic review o...
While not designated as an improved drinking water source, bottled water is increasingly used by households in low- and middle-income countries as families strive to obtain perceived safer drinking water. The Dominican Republic has high levels of bottled water use despite high levels of piped water access. This study aimed to identify household cha...
Response to anemia in low-resource settings may entail presumptive iron treatment for those with Hemoglobin (Hb) levels falling below certain cut points. This study aimed to inform an anemia screening and treatment service in a low-income community in the Dominican Republic by determining (i) the prevalence of anemia in young children attending thi...
Objective:
Little is known about the pattern of service receipt and outcomes from clinics implementing best practice guidelines in child mental health. This study aimed to determine these variables for a clinic that implemented an attention-deficit/hyperactivity disorder (ADHD) treatment guideline proposed by the Children's Medication Algorithm Pr...
Background
The extent of behavioural treatment recommendations described in attention-deficit/hyperactivity disorder (ADHD) practice guidelines has not been examined.MethodA scoping review identified eight agency-based ADHD practice guidelines. Key components of behavioural treatment recommendations were summarized.ResultsAll guidelines mentioned b...
The current study aimed to determine the extent of association between mental health symptoms and impairment in children using teacher ratings. Strengths and Difficulties Questionnaires (SDQ) data were extracted from an administrative database for consecutively referred children to a school mental health service between 2004 and 2009 (n = 480). Inc...
