John McLennan

John McLennan
The University of Calgary | HBI · Department of Community Health Sciences

Doctor of Medicine

About

147
Publications
9,073
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
3,127
Citations
Introduction

Publications

Publications (147)
Article
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Chapter
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...
Article
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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?...
Article
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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;...
Article
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...
Article
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
(1) To describe the strategies employed by child mental health agencies to manage service demands; (2) to determine whether the types of strategies used are related to meeting Canadian Psychiatric Association (CPA) benchmarks and wait times; and, (3) to determine whether the types of strategies used are related to agency characteristics. An online...
Article
The objectives of this study were to examine changes in stress among parents of children with special needs in a respite service and consider parental experience of the service. Families who were enrolled in a ten-month centre-based respite program were invited to participate in the evaluation. Change in parent stress, indexed by the Parent Stress...
Conference Paper
Background: Delivery of key micronutrients and anthelminthic medications to children in low-and middle-income countries has reduced the burden of vitamin A and iron deficiencies, and soil-transmitted helminthic infections. However, there may be significant gaps in delivery of these interventions and there is some mixed evidence for inequitable dist...
Article
BACKGROUND: The use of antipsychotics, especially second-generation antipsychotics (SGAs), for children with mental health disorders in Canada has increased dramatically over the past five years. These medications have the potential to cause major metabolic and neurological complications with chronic use. OBJECTIVE: To synthesize the evidence for s...
Article
BACKGROUND: Second-generation antipsychotics are commonly associated with metabolic complications. These medications are being used more frequently for the treatment of mental health disorders in children, which has stimulated the need for creating formal guidelines on monitoring their safety and effectiveness. Previous guidelines have been develop...
Article
Full-text available
OBJECTIVE: This study aimed to determine the extent of exposure to community violence among delinquent Brazilian youth in the 12-month period prior to their incarceration and to identify factors associated with this exposure. METHOD: With an oversampling of girls, a cross-section of youth under 18 years of age from juvenile detention units in the c...
Article
The goal of this study was to examine social skills deficits among children with and without prenatal alcohol exposure (PAE) who were both referred to a respite programme. Thirty-seven children with PAE and 23 non-exposed children (aged 3 to 8 years) were evaluated on the Social Skills Rating System (SSRS) by their caregivers and respite workers. A...
Article
Full-text available
This study aimed to determine the extent of exposure to community violence among delinquent Brazilian youth in the 12-month period prior to their incarceration and to identify factors associated with this exposure. With an oversampling of girls, a cross-section of youth under 18 years of age from juvenile detention units in the city of São Paulo, B...
Article
Full-text available
THE OBJECTIVES OF THIS STUDY WERE TO: 1) describe wait times at agencies providing child and adolescent mental health services (CAMHS) in Canada; and 2) determine whether agency and waiting list characteristics are associated with wait times for different clinical priority levels. A web-based survey was distributed to 379 agencies providing CAMHS i...
Article
The objective of this study was to determine the extent of changes in mental health status of children in a respite service as little has been reported on this aspect of respite care. All families enrolled in a new centre-based respite program in a moderately large urban center in Canada were invited to participate. The child's primary caregiver co...
Chapter
Brazil is the fifth largest country in the world and the largest in the southern hemisphere. With a current population of about 186 million, of whom 33 percent are under 18 years of age (Instituto Brasileiro de Geografia e Estatística [IBGE], 2006b), it is the fifth most populated country in the world (IBGE, 2006a). Despite being a regional economi...
Article
This study aimed to determine changes in service receipt and mental health status of children referred to a school-mental health partnership program in Alberta, Canada. Participants were caregivers of children formally evaluated by a psychiatrist and/or pediatrician within the program. Caregivers were interviewed about service use and child mental...
Chapter
IntroductionThe Development of a Rational Service System for At-Risk ChildrenFactors Supporting the Development of Separate Specialized Services for Subgroups of At-Risk ChildrenShould Separate Specialized Services Be Developed for Children with FASD?Policy Considerations: Strengthening the Service System for a Broader Range of Children At-RiskAckn...
Article
Care givers may engage in a variety of strategies to try and improve drinking water for children. However, the pattern of these efforts is not well known, particularly for young children in high-risk situations. The objective of this study was to determine care giver-reported strategies for young children with (1) undernutrition and (2) living in a...
Article
Intrinsic and institutional spirituality or religiosity may each provide unique protective effects against the negative impacts of stress on mental health. Whether this extends to adolescents exposed to high levels of community violence is unknown. Three hundred twenty-five incarcerated adolescents from São Paulo City, Brazil responded to questions...
Article
Delivering mental health services to children and their families through schools has many potential advantages. However, little is known about the characteristics of children referred to such services. This study aimed to determine the pattern of mental health and learning difficulties of children referred to one school mental health service. An id...