Dr. Jennifer Lachman is a pediatrician, not a psychologist. But like many doctors who treat children, a significant proportion of her patients are parents looking for help with kids throwing temper tantrums, being aggressive or not following rules.

“They’re very common issues that parents come across as part of natural child development and boundary issues and transitions kids go through as they grow up,” said Lachman, who works at Central Oregon Pediatric Associates. “We definitely see a fair amount of behavioral and mental health issues, partially because of resource availability in the community.”

What that means is that a significant proportion of pediatricians’ time ends up being spent teaching parents to work through their kids’ common behavioral issues — and these are doctors with a lot of other things to worry about.

“Talking about these things and giving parents tools to deal with them just takes a lot of time, and it’s time they don’t often have,” said Andrew Riley, an assistant professor of pediatrics in Oregon Health & Science University’s Institute on Development and Disability.

So Riley and his team at OHSU are working with doctors at COPA to develop a tool they think will save both doctors and patients time, make appointments more meaningful and help patients learn more outside the office. Beginning in July, the researchers will embark on a pilot project that will have patients watch videos that show effective behavioral interventions for kids and later report whether they used the strategies on their kids and whether they worked.

The videos — a total of seven will be produced through the initial pilot project — will feature OHSU staff members and their kids acting out common situations and evidence-based methods of dealing with them.

In a 5-minute-long example video, which is unedited and not yet available to the public, a woman teaches the viewer how to handle a situation in which her daughter is loudly trying to get her attention as she makes a phone call. First, the video shows how not to handle the situation. Next, it shows the appropriate method: Ignore the child’s unwanted behavior and then praise the child when she behaves appropriately.

“Kids are hungry for your attention as a parent,” a narrator coaches in the video. “That means behaviors you like should get lots of attention. Behaviors you don’t like and want to happen less should get little or no attention.”

Parents will watch the 3- to 5-minute videos on electronic tablets during the downtime that inevitably comes up during their pediatric appointments — either while they’re waiting for the doctor or if the doctor has to run out to provide urgent care to another patient. They’ll either choose a video or their nurse may suggest a video based on their specific concerns.

Then, about a month later, the researchers will call those parents and find out whether they used the tactics demonstrated in the videos and whether they found them to be effective.

The videos will also be posted on COPA’s website, where anybody with Internet access will be able to watch them. Ultimately, the videos will help make the increasingly short time patients spend with their doctors more meaningful, said Sondra Marshall, a licensed psychologist with St. Charles Health System who works at COPA three days a week helping patients with behavioral issues.

“Maybe the providers now don’t have to tell a parent how to do planned ignoring, they can follow up and say, ‘What questions do you have?’ ‘Is this what you’re doing?’” she said. “They can get more into the meat of it.”

And any parent can find information online, but not everything on Google is evidence based, Marshall said. These videos, by contrast, will provide empirical examples of good parenting practices, she said.

The project is being supported by a more than $62,000 grant from Cambia Health Foundation, the charitable arm of health insurance giant Cambia Health Solutions, which works with subsidiary companies such as Regence BlueCross BlueShield of Oregon.

Kathleen Pitcher Tobey, Cambia Health Foundation’s program officer, said she hopes the project ultimately provides for a better patient experience, improves the quality of care for children and ultimately saves money.

“There is also the potential for cost savings if these concerns can be addressed in primary care rather than in specialty care settings,” she said.

At COPA, Marshall often gets pulled into physical health appointments when families start presenting what the doctor believes are mental health issues. Last week, for example, she saw a child who was having abdominal pain. Lab tests, however, found no medical cause.

“The issues really are from mental health, a lot of anxiety — that was really driving the abdominal pain,” she said. “Sometimes you’ll get a medical presentation, but the patient wasn’t wanting to go to school — just really, really sad, and they came right to their pediatrician.”

In most cases, patients just have strong connections with their pediatricians, Marshall said.

“These are their go-to people,” she said.

— Reporter: 541-383-0304,

tbannow@bendbulletin.com

Topics the videos will cover

• How to use attention effectively

• How to give effective instructions

• How to provide effective praise

• How to do timeouts correctly

• The best ways to use rewards

• Enhancing play with kids

• Helping kids deal with frustration/difficult emotions

Source: Andrew Riley, OHSU