Attention-deficit/hyperactivity disorder (ADHD) is a treatable pediatric condition, but children with racial-ethnic minority backgrounds often do not receive timely or consistent treatment. Understanding how systemic racism impacts care and learning from families of color about their experiences can provide critical insights for improving clinical practice and engaging patients equitably in ADHD care. We interweave a mother's experience navigating ADHD care for her son with commentary from an interprofessional team about what clinicians can do for families to reduce the impact of systemic racism on care. .

Clinicians caring for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) must be prepared to answer questions about the disorder and its treatment from parents who are unfamiliar with ADHD, as well as those who have been exposed to information and misinformation about it. In this article, we provide evidence-based responses to common questions and concerns that parents and guardians have about their child's ADHD diagnosis and treatment options. .

Pediatricians are often the first providers to assess and treat attention-deficit/hyper-activity disorder (ADHD) in youth. While a variety of pharmacological and psychosocial interventions exist for ADHD, stimulants remain the first-line medication treatment. Many stimulant formulations now exist, providing the pediatric prescriber with a diverse repertoire of treatment options. This article is tailored to the pediatric prescriber in the primary care setting and discusses stimulant management, with emphasis on dosing equivalencies, common stimulant-dosing strategies, and newer stimulants. .

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric psychiatric disorders and is frequently diagnosed and treated by pediatricians. Stimulant medications are the first-line treatment for ADHD but may not be a good fit for many patients due to side effects, inadequate treatment response, or family preference. Non-stimulant ADHD medications provide a useful alternative for patients that cannot tolerate stimulants, have an incomplete treatment response to stimulants, are at risk for stimulant diversion, or whose family prefers to avoid stimulants. Nonstimulant ADHD medications can be used as monotherapy or added to a stimulant as an augmentation strategy. The recommended nonstimulant ADHD medications include alpha agonists (eg, guanfacine extended-release [ER], clonidine ER) and norepinephrine reuptake inhibitors (eg, atomoxetine, viloxazine). Other nonstimulant medications (eg, buproprion, tricyclic antidepressants, polyunsaturated fatty acids) have been used off-label for ADHD but are not recommended and should only be considered as a third-line option. .

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that often presents in early childhood and, for most people, persists into adulthood. The symptom presentation and impact on functioning often evolve over time as children reach the developmental stages of childhood, adolescence, and adulthood. Children with ADHD are at risk of comorbid disorders, as well as potential cumulative adverse outcomes, if their ADHD is not adequately or appropriately treated in a timely manner. Pediatricians play a unique and critical role in educating, guiding, treating, and empowering children with ADHD and their families across the pediatric lifespan. Their role extends beyond pharmacological treatment of ADHD to ensuring favorable outcomes in social, academic, emotional, and behavioral functioning by providing anticipatory guidance and facilitating conversations that promote understanding of their child's condition. .

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that typically presents in childhood and can cause significant impairment from youth into adulthood across multiple settings (eg, school, home). Pediatricians are the most likely health professionals to identify and treat ADHD. However, ADHD symptoms often overlap with other common mental health disorders, making accurate identification challenging. The diagnosis of ADHD relies on a combination of history gathering, screening tools, and clinical judgment. In this article, we review tools and strategies for ADHD identification, assessment, and treatment monitoring in primary care pediatrics. .

Coronavirus disease 2019 (COVID-19), which is now known to be caused by severe acute respiratory syndrome coronavirus 2, has been a public health threat since early 2020 and has affected millions of people worldwide. Many studies have now shown that this virus exhibits a milder infection in children compared to adults. Acute COVID-19 infection, multisystem inflammatory syndrome in children (MIS-C), and long COVID have been recently well-established in the pediatric population with a myriad of systemic manifestations. This section of the review will focus on the following systems-neurology, psychiatry, endocrinology, hematology, and oncology-under three broad lenses, such as acute COVID-19, MIS-C, and long COVID. .

While the importance of medical professionalism is widely recognized, strategies for incentivizing positive professionalism have not been formally reviewed. We reviewed available literature on interventions to promote professionalism in training and practice to identify common themes and differentiate extrinsic vs intrinsic motivators. Among 24 relevant articles identified for review, 4 programmatic themes emerged: recognition and rewards (extrinsic motivators), and review of performance and reflection (intrinsic motivators). Most incentive programs were geared toward medical students or faculty, and few studies included outcomes data, although the reported findings suggested a positive impact. Incentive programs, such as awards programs, recognition of role models, feedback, coaching, and reflection, appear to promote positive professional behaviors, though further study is needed to facilitate optimal integration of best practices across training and practice. .

Pediatric advocacy is an effort to champion the well-being of children and adolescents, ensuring access to quality health care and addressing socioeconomic issues linked to adverse health. This article explores pediatricians' responsibilities in advocating for their patients within the health care system and in broader societal contexts. Models of physician advocacy and the concept of advocacy as a fundamental professionalism responsibility, grounded in ethical principles and societal obligations, are introduced. As providers for patients who lack the capacity to advocate for themselves, the unique role of the pediatrician is examined. The improving landscape of advocacy education in undergraduate and graduate medical training programs is presented, and the concept that engaging in advocacy can help physicians battle burnout is raised. Barriers to advocacy for pediatricians are addressed. Pediatricians should leverage their expertise and influence to advance the health and rights of patients and their families. .

The school building provides a unique opportunity to prevent, identify, and treat illness in children. School staff must be prepared to care for children with acute and chronic health care needs and pediatricians should be aware of the health resources available in local schools for their patients. This article provides an overview of multiple school-based health topics including the roles of various school health professionals, medication administration in the school setting, the legal protections around health information, school-based health centers, and the rise of telehealth. Most importantly, this article reminds providers that school-based health resources are all unique to each school and school district; all parents of children with health needs should meet with their school's administration to understand what resources are available. .

Electronic health records (EHRs) have become integral to modern health care, facilitating documentation, billing, and care coordination. However, their increasing use introduces potential challenges to professionalism in the patient-physician relationship. This article explores both the positive and negative impacts of EHRs on professional behaviors, including empathy, communication, and efficiency. We discuss strategies to enhance professionalism in EHR use, with a focus on training and education for medical professionals. We also highlight the importance of patient engagement and shared decision-making in navigating the evolving digital landscape of health care. .

Fueled by the coronavirus disease 2019 pandemic, vaccine hesitancy has become more pronounced and challenging given the increased distrust of science, pervasiveness of misinformation, and polarization of ideas. As such, pediatric providers are increasingly on the frontline of vaccine conversations with their patients, families, colleagues, and communities. To respond effectively to vaccine hesitancy, providers should employ professionalism in all aspects of their practice, including commitment to learning and growth, cultural awareness and humility, ethical responsibility to self and others, oral communication, reliability and dependability, teamwork, critical thinking and quantitative reasoning, and the engagement in public discourse around vaccines. By ensuring excellence in each professionalism domain, pediatric providers will have the best chance of enhancing vaccine positivity and minimizing vaccine hesitancy. .

The coronavirus disease 2019 (COVID-19) originated in Wuhan, China, in late 2019. Within a span of a few months, it was deemed a global pandemic by the World Health Organization. It was first thought to affect the adult population, but soon after, cases of COVID-19 in children started emerging. As more and more pediatric cases started unveiling, an entity called multisystem inflammatory syndrome in children (MIS-C) that replicated Kawasaki disease was established. More recently, it has been noted that children have persistent symptoms for weeks or months after acute COVID-19 infection, and the term coined for these symptoms is "long COVID." This section of the review will summarize the respiratory, cardiovascular, dermatological, and gastroenterological manifestations noted in infants in three broad categories: acute COVID, MIS-C, and long COVID. .

From the 12th Century, when the word referred to taking religious vows, to its present meaning as a constellation of organized practices requiring special training, legal liability, and covenants with individual patients and society, professionalism has played an important role in the practice of medicine. Until relatively recently, the concepts of professionalism and professional behavior were rooted in timeless ideals that individual physicians were expected to achieve in training and practice. As an ideal type, professionalism was seen as a quality or characteristic residing in the individual physician. By the same measure, the period of rapid technological and social change that marked the early to mid-20th Century made clear that timelessness, as it applied to professionalism, had its limitations. Where once sharing bad or sad news with patients was viewed as harmful, the right to know one's diagnosis is now enshrined in law and taken for granted in education and practice. Moreover, research shows that knowing one's diagnosis is often beneficial, not harmful, to individuals and families. In response to changing norms and technological advances, medical educators have introduced new models of professionalism that stress the role of social context and relationships in training and practice. One innovative approach is based on the concept of professional identity formation, the moment-by-moment process of becoming and being a physician. Identity formation occurs primarily through story-telling and other forms of self-expression in the context of a community of peers who learn to practice medicine with technical proficiency, kindness, and self-awareness together. .

Health care educators may enhance learning with thoughtful incorporation of game elements. Gamification has shown success across various fields in medical education. It has demonstrated deeper engagement by leveraging both intrinsic and extrinsic motivational factors. While beneficial, gamification requires thoughtful implementation to increase active learning and avoid potential negative effects, such as unhealthy competition. Serious games integrate learning objectives directly within their framework, making the educational experience an intrinsic part of gameplay. These games are specifically designed to enhance knowledge and skills while promoting decision making, teamwork, and communication. The immersive nature of serious games requires players to actively engage and apply their knowledge to solve complex problems. Serious games and simulation represent transformative educational approaches that not only enhance learning and retention but also develop essential competencies crucial for health care professionals. These strategies, when combined with effective debriefing, provide a robust framework to enrich education and training in health care. .

As we better understand how to deliver the most effective medical simulation, the applications and indications are growing. One way to extend the impact of these tools and methods is for community education and empowerment. Developing mobile simulation units with the intent to reach health care and community settings is a way to add value to a costly but worthy endeavor. Here we focus on developing bundles of medical simulation for pediatric populations and their families, including curricular objectives, considerations for psychological safety, and operations. .

Bacterial meningitis is a devastating disease with significant morbidity and mortality, especially in neonates and young infants. The overall incidence of meningitis has decreased with focused screening, public health interventions, and vaccination, but the disease remains a significant concern in high-risk groups. In this review, we provide an update on bacterial meningitis in children younger than age 60 days, including epidemiology, clinical presentation, diagnostic approaches, treatment, and prognosis. .