May 16, 2019

Identifying Behavioral Health Concerns in Children

Show Notes

On this episode, Chuck Gaidica is joined by Grace Derocha, a certified health educator, health coach, and dietitian as well as Dr. Jann Caison-Sorey, a senior medical director at Blue Cross Blue Shield of Michigan. Together, they discuss children’s mental health and its link to behavioral problems.

“One of the reasons behavioral health disorders don’t get picked up right away is… defense of parents and the defense of the caregivers that take care of them is sometimes a little hard to distinguish between. Is this just normal childhood behavior? Bouncing around? Or is this a problem?” – Dr. Jann Caison-Sorey

In this episode of A Healthier Michigan Podcast, we explore:

  • The importance of observation
  • Understanding your child’s personality
  • Identifying triggers (words or actions) and coping skills
  • How parental behavior influences children’s behavior
  • The physical effects of mental and emotional problems
  • Most common behavioral disorders affecting children
  • Finding a supportive physician

Transcript

Chuck: This is A Healthier Michigan Podcast, episode 28. Coming up, we discuss how do identify behavioral health concerns in our children.

Chuck: Welcome to A Healthier Michigan Podcast, the podcast dedicated to navigating how we can improve our health and well-being through small healthy habits we can start implementing right now. I’m your host, Chuck Gadica. Every other week we’re going to sit down with a certified health expert or two from Blue Cross Blue Shield of Michigan, do a deep dive into topics covering nutrition and fitness and a whole lot more.

Chuck: In this episode, we’re talking about childhood health and we’re joined by two ladies who have lots of experience on the doctor side as well as being parents. Grace Derocha is here. She’s a certified health educator and health coach and a dietitian. Good to see you.

Grace: Thank you so much for having me.

Chuck: And you’ve got how many kids now? 20?

Grace: It feels like it some times. Two.

Chuck: Two. Oh my gosh, so you’re an expert.

Grace: I don’t know about that.

Chuck: Because a lot of what we’re going to talk about today is family related, right? Observational in our kid’s life. And we also have somebody here and I’ve got to drop the mic as soon as I get done introducing Dr. Jann Caison-Sorey. She’s the senior medical director. Does that make you the boss of all of us?

Dr.Caison-Sorey: Not at all.

Chuck: No? She’s at Blue Cross Blue Shield of Michigan. She’s in quality management. She’s a pediatrician. She’s obviously a physician, so when we talk about all kinds of issues in children, some of them are psychological, some can be behavioral, some can be physical. How do we go about getting into this notion of helping our children? Is it just that as good parents, we start to watch what’s going on?

Dr.Caison-Sorey: I think that’s the key, Chuck. I really think that that is the key. For me as a pediatrician, adolescent medicine doc, I think probably the greatest advice we can offer parents is to have good observation, just kind of keep a good eye on what your child is like.

Dr.Caison-Sorey: One of the important things is, I always say this and I don’t know whether people pay attention enough to it, is know your child. And if you’ve got more than one child, just realize they’re not cookie cutters. One child may be vastly different than the other, so the power of observation is critical. So you really need to know your child. You need to know, just observe and just really kind of make sure you take the time to process what you’re seeing and what’s happening.

Chuck: And you’ve got one child.

Dr.Caison-Sorey: Correct. I do.

Chuck: And you have two, I’ve got five, which is like, seven Canadian.

Grace: You just won.

Chuck: Yeah, well. But you know, they are so different. You see that in your kids too, right? it’s just one.

Grace: As soon as you were saying that Dr. Caison-Sorey, Kahlea and Tommy are completely different. Not just because one’s a girl and one’s a boy. They’re just different. The way they look at things, the way they say things, the way they think. It’s so interesting.

Dr.Caison-Sorey: In your family, you have to realize children process things differently so you can have the exact same experience, same parents, same neighborhood school, the whole thing, and you’ll have children that’ll come away with two entirely different observations or sense of what just happened or even as they grow up, why are they so different? Because they’re different people.

Chuck: And you know, in a previous episode, maybe more than one, we’ve talked about good stress and bad stress. So having more than one child in a household or even self-imposed stress can indicate behavioral changes, right? But we know a lot of outside influences helped that as well. Can you talk to that idea of stress?

Dr.Caison-Sorey: Absolutely. Some kids can handle it. So just to come away with that notion that some kids can handle significant stress and be who they are and not necessarily change or have behavioral outcomes that reflect that there’s something wrong, whereas other kids can’t do that. They may not have the capacity to do that. So that’s where the notion of observing your children, understanding how much they can deal with or how much they can’t deal with, if there’s stress going on in the family and it can’t be helped, making sure that you change that focus and the force of that stress for each child so that they can understand it a little bit better. You almost may need to separate them, explain what’s happened.

Dr.Caison-Sorey: Financial problems, let’s say. Some kids understand, okay, I can’t have the new toy, I want to have. I can’t have that. Whereas, the other child doesn’t understand that and thinks that you are picking on them. So you as a parent, knowing that child, knowing their personalities, you need to moderate how you deliver that stress, if it can’t be modified.

Chuck: And you know what I found in my own life, I am a person who can get stressed but it sort of rolls off my back like a duck. I mean, literally like rain hitting a duck, it just rolls right off. And in my family, I saw other members of the family where they’re internalizing it. So, it’s the same stress.

Dr.Caison-Sorey: Absolutely.

Chuck: Just we’re dealing with it differently. Do you see that difference in your kids too?

Grace: Oh yeah, definitely. My daughter is like me, I’m sorry Kahlea. But she will hold some, we do affirmations, so she affirms herself like, in front of me.

Grace: And actually she helps me a lot. And Tommy’s like, whatever

Dr.Caison-Sorey: But you know, what you just described as very interesting. There’s psychological stages that kids go through. Girls are a little bit more advanced than boys.

Chuck: Hey, hey.

Dr.Caison-Sorey: I don’t mean that to sound negatively, but as a physician, we know that there’s psychological stages. Boys will physiologically lag behind girls, just because the biology of a boy is different. So, the girls are a little bit more advanced than just than the boys in terms of just the biology and how we were made by God, you know, how we are created. So the bottom line is when you describe how a female say accepts stress or accepts a adverse situation and the boy’s like, eh, whatever you’re reflecting where their heads are in terms of those psychological stages, where the boy may not be picking up all of the nuances, the girl seems to have a little bit more of a handle of what does this mean for me of a thing.

Dr.Caison-Sorey: And it doesn’t mean that the boy is any less cognitively intact, but it just reflects sometimes those different stages that they’re in. So you have to realize that. The difference between boys and girls.

Chuck: So what signs are we looking for? What should we really have our antennas up for when it comes to one kid, two, five, doesn’t matter. What are we looking for?

Dr.Caison-Sorey: Okay, just to reiterate this again. Know your child. Know your child. I don’t care if you have 10 kids, you have 10 different personalities. So know your child. Some kids are going to be easier than others, but sometimes the easier child is the one that you need to pay a little bit more attention to because they can slip under the radar. You may not pick it up. It’s the child that screams and yells is the one that gets your attention. But know your child. So power of observation.

Dr.Caison-Sorey: And the one thing I’m going to say to parents is look for change. Whatever that child has shown you for four, five, six, seven years old. Remember you have sort of a baseline sense of what your child is like. Look for change, subtle change. Some changes are subtle and some changes are abrupt. So you know, let’s say if it’s a child who was bed-wetting, stops bed-wetting and now bed-wetting again, that’s a change. So the question-

Chuck: So you mean, something could be a trigger.

Dr.Caison-Sorey: Something could be a trigger. Exactly. To restart what we call an earlier behavior. The child that then learns to speak, or maybe that says a few words that now doesn’t speak, or a child who was outgoing, fun, loving, goes to school, loves school now hates school. Has a phobia about, “I don’t want to walk on the sidewalk. I don’t want to walk on the cracks. I don’t want to walk by.”

Dr.Caison-Sorey: You have to pay attention to that. And you might discount it as a parent. Like, oh my God, that’s really, I mean, what is wrong with you? Why are you like that? Understand there’s a reason. So you use the word trigger, there’s a trigger. So the question becomes backtracking, being observant, asking questions, talking to the child one on one.

Chuck: Maybe even making notes for yourself to see what’s out of line with what’s typical?

Dr.Caison-Sorey: Keep a list.

Chuck: Yeah.

Dr.Caison-Sorey: And definitely utilizing that to say, do I need to get some help with this or do I need to observe more and validate? So one of the other things we do is validate. So you’re seeing this behavior that’s this change that you haven’t seen before.

Dr.Caison-Sorey: So you might want to go to school and ask you daughter or son’s teacher, “Do you see something different in my child?” You know, is there something different? And so once they say, “You know what? About a month ago I noticed that Johnny or Susie or Mary is now different. They used to play with the kids all the time. Now, they don’t.” Now, they cry all the time or they’re standing in the corners, you know, very, very self-isolated, don’t want to be around the other children kind of thing.

Dr.Caison-Sorey: So that’s the key. Just absolutely observing, making sure you recognize a trigger that might have produced a behavior change and then validating.

Chuck: And we know that life changes can have a super impact, right? And it can be really good, which includes dad got a promotion, we’re moving to a bigger house, but it’s going to be in a different city.

Chuck: Behavioral change. Or when mom and dad passes away or, or, or, but now we’ve got social media, so we know that there are these significant life changes. But oh my gosh. I mean, I was bullied as a kid. Again, I worked it out. It’s okay. Except for the twitch, I’m all right.

Chuck: But you know, I look back and I think if there were social media, and I don’t know how this plays out today for young girls, the bullying that can go on, I don’t know how … you couldn’t expect one of your kids to have an issue with it.

Grace: Yeah, it is hard. And I feel like my daughter is six, so she’s still younger. But there’s still things that I know I have to watch what I say about how I might be feeling about myself so that she’s not learning that kind of behavior, you know?

Dr.Caison-Sorey: And that transfers. You know, stress transfers as a kid and you have to realize what may be a little ripple to you is an earthquake to a child emotionally. So, the social media issue is hugely concerning. That’s one of the reasons why the American Academy of Pediatrics recommends limiting screen time. So when I say screen time, I’m not just talking about TVs, I’m talking about phones, any kind of-

Grace: Tablets.

Dr.Caison-Sorey: Anything. You have to do that. And the other thing that you want to teach is you want to counter-balance that emotional sort of stream that happens and the maybe negative that happens to your child, you have to teach self confidence. You have to teach self esteem. Those old adages that grandparents taught us as we were growing up is that make up your own mind. You know? Don’t let someone else make up your mind for you. You analyze, make up your own mind and have your own thoughts about what something is and know yourself.

Grace: That communication in and of itself is amazing, not only for the child, but even as a parent.

Grace: I feel like when I talk to Kahlea and Tommy, Kahlea is I feel like I’m bragging about my child.

Chuck: Go ahead.

Grace: But she’s profound. She’ll tell me. She’s like, “I know why I’m beautiful, because it’s from the inside out.” Like, my mind is blown.

Chuck: Well, yeah, but good job mom and dad, really.

Dr.Caison-Sorey: Absolutely.

Chuck: That’s really great.

Grace: Or like, she picked this up from a Cinderella movie. In the movie, the mom said to Cinderella, the newer one, “Have courage and be kind.” And so she says that all the time and she picked it up from that. I mean, courage and kindness are two pretty great things. I’ll take it.

Dr.Caison-Sorey: And it’s wonderful. But imagine the opposite of that.

Dr.Caison-Sorey: When you have a child where nothing is ever validated, you don’t ever tell them they’re beautiful or your son, you know, you’re a handsome young man. You’re tall, you’re strong, you’re so smart. Even if they’re not.

Grace: You’re powerful. You’re a hard worker.

Dr.Caison-Sorey: You build that. So even if I may not have the capacity to do, and I think I can do, I kind of think I can. So, I’m going to get as close to that as I can. But if you never ever give that validating, self esteem talk, strengthening talk, then you have a child that sways with the wind and that’s where the social media kind of has a little bit more of an in-road, because now you didn’t build that fortress. You didn’t put that there. You know?

Chuck: And you know, I’ve seen in my own life, my family’s life and then extended family’s life, sometimes I wrestle with this, your birth order, what your parents were like. And we were talking about this off mic a few minutes ago, how much our behavior can influence a child.

Chuck: So if I’m prone to depression and anxiety, how does that reflect on a child? So what we’re talking about, about all these positive ways for us as parents, some days we have to dig deep ourselves to find ways to motor past our problems, to help our kids because maybe we were not told that we were good enough or that we’re pretty or handsome enough. You know what I mean?

Dr.Caison-Sorey: Absolutely. And that’s critical. I mean, that is absolutely critical. Your children are always watching you. They’re always watching you when you don’t think they’re watching you, they’re watching you.

Dr.Caison-Sorey: So your episodes where you don’t deal well with something, you’re yelling and screaming, you’re using language in front of the child that you shouldn’t use, you’re putting someone down. It may be an older sib or a younger sib, so they do something wrong. And so rather than dealing with it as it’s just a child issue, “You made the wrong choice, so maybe next time you want to make the right choice.” You smack the kid, you knock them down. That kind of behavior starts to create a change in the child. So little subtle things like that trigger these chemical changes that then later manifest. So you really have to be careful.

Dr.Caison-Sorey: And in particular what’s really hard is if you yourself have a behavioral health disorder. Let’s say there’s schizophrenia or you have a mood disorder, you’re bipolar. Those are extremely challenging for a child.

Grace: I think it’s interesting, too.

Grace: So I’m going to be a dietitian for a second and I know Dr. Caison-Sorey and I have talked about this before. I worked as a pediatric dietitian and we had kids come in that would show different signs and symptoms of stomach aches or headaches or always having a stomach ache, not wanting to go to school because of it.

Grace: And it’s one thing to come see the dietitian and then the pediatric GI. But is there more going on? And many times, there was.

Chuck: And what would you say was more, it wasn’t just a diet issue or was it because they were eating the wrong thing? What do you mean?

Grace: So the stress of their life and some of their emotions impacted them physically. I had a patient before, he was a really good hockey player, but was feeling the pressure of that.

Chuck: To this day, my wife Susan, even as an adult, if there is a test involved, she immediately flashes back to being a young 12 to 15 year old girl who couldn’t take it when her mom let her out of the car in the morning for school and she knew she had a test. She’s just got this thing.

Chuck: So we’ve talked about behavioral things. We’re trying to know our children. We’re trying to watch for change. It could be dramatic change. It could become an eating disorder. Could be, I’ve got stomach aches all the time. I’m wetting the bed. When do we as parents decide we need to call in reinforcements, we need to go to a doctor. What is that level? Is it just our gut instinct or are things we should be thinking about?

Dr.Caison-Sorey: And it’s an excellent point. And Grace, I really appreciate what you say, because those are somaticizing signs that kids have. They come in, we think it’s some kind of a dietary issue, but it’s a signal. These are these subtle triggers that become somatic complaints. “Oh, my stomach is hurting.” It must be the food. It may be this, that, or the other, but it’s really not. Well, I have this horrible headache and it may be stress. It’s not. These are these signs and symptoms in children, because they can’t articulate everything that they feel. They change it or the body sort of switches the order of it so it presents as a symptom that the whole idea is calling for help. But how do you call for help when you’re six or seven or eight years old? You don’t know how to do that. So stomach ache, you know, mom, dad, you know, that gets somebody attention. So, that brings you in.

Dr.Caison-Sorey: The key here is that you really want to just figure out, okay, if this is persistent, this is not just a one day, this happened at 2:00 in the afternoon, Thursday, and then, okay, now it’s gone. Persistence. School phobia. The kid who had fun, loves kids, loved the sandbox. Then, all of a sudden there’s this withdrawal or this change. There’s this subtle something or this constant stomach ache that happens everyday. Persistence.

Dr.Caison-Sorey: So when there’s persistence and you’ve gone out and you’ve validated, you’ve talked to the teacher, you said, listen, I’m seeing this in my son/daughter, do you see this? Or, you’ve talked to the babysitters. Like, grandparents are often babysitters and they’re great validators. Do you see what I’m seeing? And they say oh yeah, I noticed.

Chuck: So even the other spouse in the house, because sometimes boys or girls relate to mom or dad differently.

Dr.Caison-Sorey: Absolutely. I’m sorry I missed that point. You’re absolutely right. Talk to the other spouse. Have you noticed, you know? Because that other spouse is going to pick it up. They may not be everyday doing every little thing. But the bottom line is they’re going to say, you know, I did see that. I did see that difference. So persistence and then validation, which means, okay, I’m not the only person seeing this. So, let’s maybe get an expert in here. Let’s go to the primary care doctor. Let’s see if there’s something that we need to do.

Chuck: Because the stomach ache could literally be a GI issue.

Grace: Right, it could be a stomach ache.

Chuck: We’re kind of saying it’s maybe induced by something else, but if you rule that out with your doc.

Grace: Yeah, and with persistence, I think that that is definitely the key. They’re constantly coming in. My stomach still hurts. We made changes. We took out dairy, you know. You had something bad. Maybe you didn’t cook that all the way. Maybe there was food poisoning, but like, you’re coming in all the time now and telling me your stomach’s hurting.

Chuck: But you know, I’m not a doctor, I just play one on podcasts. But we have other podcasts that we’ve done. I mean, we’re up to episode 28 right, where we’ve talked about breathing exercises and I think we’re targeting obviously people, adults, but I think a lot of that applies to our children.

Chuck: If a child is getting nervous and that’s turned into upset stomach ergo, I can’t go to school, you know, for five days a week in a row, maybe there’s something that even our podcast could help with that we can all learn from, because we can express that to our kids as well.

Chuck: But okay, so we’ve gone to our primary. Maybe we’ve even ruled out a physical problem. When do we start to look at this as a mental health issue? Behavioral issue?

Dr.Caison-Sorey: There are going to be some signs and symptoms that really distinguish themselves, so this is not going to be the little aberrant behavior that happens periodically. As Grace was saying, persistence, persistence, persistence. I’m seeing this all the time. It’s even probably getting a little worse, so I need to kind of figure this out because you have to realize kids get the same problems as adults, so a child, you know, usually we say in pediatrics, we don’t really diagnose these major behavioral health disorders under the age of Eight, but kids can exhibit that.

Dr.Caison-Sorey: The condition that sort of supersedes that is autism. Different story. You picked that up earlier on. But for your depression, your anxiety disorders, those are kind of the most common childhood issues, you’re going to see those sort of start to creep into that child’s life and their behavior is going to change kind of reflecting that. Things like bipolar illness, you can see that, if you’re paying attention.

Chuck: When they’re younger? You mean, under eight?

Dr.Caison-Sorey: Yes. ADD. Attention deficit disorder. ADHD, attention deficit hyperactivity disorder. Those are gonna flag early. The mother, father, caregivers are going to know, okay this child is like somebody turns a motor on in the morning and it doesn’t go off. So, you are going to pick those things up but you have to kind of be very mindful that this is not childhood behavior.

Dr.Caison-Sorey: One of the reasons why behavioral health disorders don’t get picked up right away is just in defense of parents and the defense of the caregivers that take care of them is sometimes a little hard to distinguish between, is this just normal childhood behavior? Bouncing around? Or is this a problem?

Grace: That’s exactly what I was just thinking. When do you set, like what is their normal range? You know? As a parent even observing and talking to your kids all the time, trying to figure that out, it’s not always easy.

Dr.Caison-Sorey: It isn’t.

Chuck: And life has changed. I guess it’s related to the screens that we’re all exposing ourselves and our kids to. But just to be honest, when I was a kid, A.) There weren’t that kind of screen choices that we had. And more importantly, my mom and dad would say, “Get out of the house and don’t come back until the streetlights come on.” I mean, in other words, even if I had a lot of energy, I wasn’t locked into a home where that’s all I’m doing is trying to find the next screen. I was out working it off somehow. I don’t even know what I was doing.

Grace: We played in the neighborhood. Literally, my parents had a bell for dinner. Like, come. Come eat.

Dr.Caison-Sorey: But you know, kids nowadays don’t have recess. I had recess, so by the time was time to take that test, I had already burned off all my energy so now I could do what I needed to do.

Grace: Focus.

Dr.Caison-Sorey: You don’t have that anymore. So in children, when are you looking for learning disabilities? There are children who can’t master certain topics and we kind of know that. Usually if there’s a learning disability, the pediatrician is going to pick that up early on. We do something called developmental assessment. There’s a Denver developmental assessment and there are more developmental studies or surveys that you can do on kids as you see them. So you’re going to pick up those subtle, let’s say cognitive delay. Child has a cognitive delay. That gets picked up earlier on. You’re gonna pick up some of your autistic behavior, ritualistic behavior, the child who rocks back and forth, and it’s more of a typical behavior or the child who has these ritualistic things that they do with their hands, those will get picked up early.

Dr.Caison-Sorey: Those are not going to be a surprise to the parent because you know those are progressive over time. But these classical disorders that mirror adulthood, the depression, you’re going to see a child that say, goes from, and remember in adulthood, depression is usually sadness. But in a child, what you may see is a child who’s anxious, that’s moody, that can’t kind of control, they can’t express what’s going on. You see that.

Dr.Caison-Sorey: Kids who have bipolar or start to exhibit bipolar illness, they’re going to move from a mannequin or wildly excitable. And then all of a sudden they’re sitting on the couch curled up. So you’ll see that’s not something you should miss as a parent. You shouldn’t miss those.

Chuck: And I think we can do this with grace. Grace and Dr., but I think we can approach our children and our caregivers and doctors if necessary with the empowerment that we are the parent.

Grace: Yes.

Chuck: And when we bring in our list, we can say, “No, no, no. Let me just bring you back here. This is what I’m talking about. I’m observing this,” because oftentimes somebody wants to take us maybe down a different path and I want to kind of bring this all together.

Chuck: I am learning more in this episode that the power of observation is really what’s critical, which means we have got to practice being in the moment with our children, right? We’ve got to take our own screen, our own phone, turn it upside down, put it away, turn it off, because we’ve got to get in the zone with our own kids.

Dr.Caison-Sorey: We absolutely do.

Grace: Yeah. We have rules in our house about that. We’re not always following them perfectly, but we do have a drawer where when we get home from work, we put our phones away.

Grace: But I have been called out.

Dr.Caison-Sorey: That is great.

Grace: I’ve been called out before when I’ve been working, when it was like dinner time and Kahlea is like, oh, can you shut that? She’s like, didn’t you already work today?

Chuck: So, everybody looks for a hack. I’m not sure we have a hack, but is it really the power of observation, keeping a list? Because if we try to confine it to memory, I think that can get a little fuzzy in this busy world, too.

Dr.Caison-Sorey: I think you’re absolutely right. You know, something that’s aberrant that happened and you thought, oh. You know? It’s easy to dismiss it. And then when someone asks, when’s the last time that happened? You don’t know whether it was six months ago, four months ago, you don’t know.

Dr.Caison-Sorey: So I absolutely agree. Putting down a list of the things that you observed in child A, B, C or whatever it is, and they just seemed like out of character, different than what you’re used to.

Dr.Caison-Sorey: The other thing that I say to parents, you know, you can always sort of engage other parents of children about your age to say, what have you noticed? You want to validate, you want to just see am I the one that’s kind of the only one noticing this, but write a list.

Dr.Caison-Sorey: The thing I want to really make sure that parents are comfortable with is you’ve got to have a physician that believes in you. When you go to that position and you say to the physician, “My child is acting fuzzy and I’m worried,” you don’t want to have a dismissive “Ah, it’s okay. It’ll go away.”

Chuck: “He’s a kid.” Yeah.

Dr.Caison-Sorey: You really want to have somebody that believes that you as a parent knows that child better than they do. And there’s something there.

Grace: It’s so interesting that you said that because when I was pregnant with my first, I didn’t know this was a thing. To interview different pediatrician offices.

Dr.Caison-Sorey: Yes. Exactly.

Grace: And we did that and I actually liked a few of them. They were all so great.

Chuck: What did they think of you? No, I’m kidding.

Grace: Oh, I don’t know.

Chuck: Because we love you.

Grace: I’m not sure. But it was interesting. I had never heard that before because you always just … I mean, I love doctors. My dad was a doctor and you know they’re the experts, so you just go to whoever you go to.

Grace: But you want to make sure that there’s a relationship there.

Dr.Caison-Sorey: You do. You need one.

Grace: And that was eye opening, you know? So any parents out there, if you are about to have kids or if you feel like maybe you’re at the wrong place for you, it’s not anything personal, it’s just what’s going to work best for you and your family.

Chuck: All right, good stuff. Dr. Caison-Sorey, good to see you.

Dr.Caison-Sorey: Thank you.

Chuck: Thanks so much for your time.

Dr.Caison-Sorey: Thanks for inviting me here.

Chuck: Grace Derocha, good to have you here.

Grace: Thanks for letting me be the mom.

Chuck: No, it’s good. You’re both moms.

Dr.Caison-Sorey: Yeah, we are.

Chuck: I mean, it really starts to trigger things that I think about with my own kids and still to this day and now it’s onto grandkids.

Chuck: So we talked about childhood health in this podcast episode, behavioral health concerns and of course stressors that can maybe put your child one way or another. And as both Grace and the doctor have pointed out, this idea of the power of observation, how important that is.

Chuck: So we want to thank you for this episode, allowing us to be in your ears. Remember you can pass this on, right? You can pass this on. If you’re a grandparent, pass it onto your kids. Sometimes it’s tough to tell your children how they should help with their children. Maybe a podcast would be the way to do that, by forwarding this. This is called A Healthier Michigan Podcast. It’s brought to you by Blue Cross Blue Shield of Michigan. If you want the show, you want to know more about it, check it out. Here comes the website: AHealthierMichigan.org/podcast, or you can leave us a review or rating on iTunes and Stitcher to get new episodes. You can go to your smartphone or tablet and be sure to subscribe to us on Apple Podcasts. We’re there. Spotify or your favorite podcast app. I’m Chuck Gadica. Thanks for being with us. Have a great rest of the day.