There has been increasing alarm over psychotropic medication use for children and youth in foster care across the country. Given the rates of psychotropic drug use among children in foster care, there is a growing concern that these medications may be taking the role of an easy fix in managing care, and the results can be tragic. Trends in psychotropic medication usage that are of serious concern include the practice of numerous drugs being prescribed in combination, as well as these powerful medications being prescribed for very young children. Medications properly administered and thoughtfully prescribed as part of an evidence-based, appropriate overall treatment program can certainly be helpful to a child or youth in need. Children who have experienced abuse and neglect require a variety of support—including medical and behavioral health care. This activity will discuss the appropriate and inappropriate use of psychotropic medication and the safety and efficacy of these medications among children and youth in foster care.

Learning Objectives
At the end of this educational activity, participants should be able to

• Review criteria for the appropriate use of psychotropic medication in children and youth in foster care, as well as nonmedication alternatives
• State factors that contribute to inappropriate psychotropic prescribing practices
• Discuss concerns surrounding the usage, safety and efficacy of psychotropic medications prescribed to children and youth in foster children and the recommended monitoring guidelines for improved well-being
• Examine the use of prescription psychotropic drugs in children in the foster care system 
• Review psychotropic medication use in children as it relates to behavioral health and child welfare

Presenter
Ron J. Steingard, MD
Associate Medical Director
Senior Pediatric Psychopharmacologist
Child Mind Institute
New York, New York

About the Presenter
Ron J. Steingard, MD is a nationally known and respected child psychiatrist, a service innovator and an ardent and steadfast advocate for children. He has been a leader in the field with over 30 years of experience in child psychiatry. Dr. Steingard is an expert in the diagnosis and treatment of children and teens with behavioral and psychiatric problems. He has worked with, written about, and conducted research regarding children with a variety of behavioral and psychiatric problems. The focus of his research has been on attention deficit hyperactivity disorder and depression in children, but he has also done extensive work with children and adolescents with bipolar disorder, autism spectrum disorders, obsessive-compulsive disorder, anxiety disorders and eating disorders.

During 25 years at Harvard Medical School, Dr. Steingard served as the Associate Director of the Pediatric Psychopharmacology Unit at Massachusetts General Hospital from 1988 to 1991 before establishing the Pediatric Psychopharmacology Unit at Children's Hospital Boston. In 1997, he became the Director of the Division of Child and Adolescent Psychiatry at Cambridge Hospital and he later served as interim chair of the Department of Psychiatry at Cambridge Hospital. In 2001, he was recruited to become the Vice Chair for Child and Adolescent Psychiatry at the University of Massachusetts Medical School and serve as a professor of Psychiatry and Pediatrics. By 2011, Dr. Steingard was the Associate Vice Chancellor and Chief Medical Officer for Commonwealth Medicine, the school's public healthcare consulting arm.

In addition to providing direct care to children and adolescents, Dr. Steingard has a strong interest in creating initiatives that promote public health. He developed a program called the Massachusetts Child Psychiatry Access Project (MCPAP), which dramatically increased the availability of care and currently serves over 95% of children in the state. He has served as the president of the New England Council of Child and Adolescent Psychiatry, was a member of the Council on Child and Adolescent Psychiatry at the American Psychiatric Association and served as an advisor to the US Department of Health and Human Services on issues concerning children and scientific research.  He has also served on the Editorial Board of the Archives of General Psychiatry, one of the most prestigious journals in the field.

Dr. Steingard earned his medical degree from Pennsylvania State University.  Following an internship in general psychiatry at the University of Michigan, he completed an adult psychiatric residency and a child psychiatry fellowship at Cambridge Hospital, Harvard Medical School.

Disclosures of Relevant Financial Relationships
In accordance with the ACCME Standards for Commercial Support^SM, OptumHealth Education requires all those involved in the development of activity content to disclose their relevant financial relationships. An individual has a relevant financial relationship if such person (or their spouse/partner) has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the activity content over which the individual has control.
OptumHealth Education ensures that the content is independent of commercial bias.

Presenter Disclosure
Ron J. Steingard, MD has indicated that he has no relevant financial relationships.

Activity Planners
Sarah Chart, RN
Senior Director
OptumHealth Education

Rebecca Gleason, RN, CCM
Activity Manager
OptumHealth Education

V. Silverstein, MD
Eagle Creek Medical Communications
Durham, North Carolina

Activity Planner Disclosures
Sarah Chart and Rebecca Gleason reported that they are employees of and own stock in UnitedHealth Group.
V. Silverstein, MD has indicated that she has no relevant financial relationships.

Method of Participation
There are no fees for participating in or receiving credit for this activity.
For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

Participants will receive a certificate upon successful completion of the activity, which includes the following:

• Completing the entire activity
• Completing the Pre- and Post-Activity Assessments, Activity Evaluation, and Application for Certificate of Credit forms

You must be logged into your account to participate in this activity. Get started by clicking “Begin” and viewing the “CE Info”; then follow the prompts at the bottom of the screen. At the end of the activity, you will be able to view, save, or print your certificate of participation. The Area of Practice you indicated in your profile corresponds with your certificate type. A complete listing of all of your activities can be found under “My Account”, “My Activities.”

Method for Calculating CE Credit
CE credit was calculated by the complexity of content.

Accreditation Statement
This activity has been planned and implemented by OptumHealth Education and UnitedHealthcare – Community & State. OptumHealth Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Credit Designation Statements
Physicians
OptumHealth Education designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)^™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants
The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.

Nurses
The participant will be awarded up to 1.00 contact hour(s) of credit for attendance and completion of supplemental materials.

Nurse Practitioners
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.

Attendance
A certificate of attendance will be provided to learners upon completion of activity requirements, enabling participants to register with licensing boards or associations that have not been pre-approved for credits. To apply for credit types not listed above, participants should use the procedure established by the specific organization to which you wish you apply credit.

Provided By
This activity is jointly provided by OptumHealth Education and UnitedHealthcare – Community Plan.

Commercial Support
There was no commercial support received for this activity.

Hardware/Software Requirements
To view this activity you will need Internet Explorer 7.0+ or Firefox 3.0+ with Windows Media Player 9+, RealPlayer 12+, or Adobe Flash Player 9+. Be sure to disable your pop-up blocking software prior to the beginning of this activity.