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March 7, 2019

A bill to promote the benefits of immunization will be heard in the House Health and Human Services Policy Committee on Friday, March 8.

Please take 1 minute to contact your House member and urge them to support this effort to increase immunization rates. Our voice needs to be louder than those contacting legislators with anti-vaccine rhetoric.

In short, HF 1182 would provide funding to the Minnesota Department of Health and community-based organizations to promote the benefits of immunization for those communities most at risk. The education efforts would be focused upon geographic areas or populations experiencing or at risk of experiencing an outbreak of a vaccine-preventable disease.

Talking points:
  • Vaccines prevent serious illness and save lives. Yet misinformation about vaccines is all too common, leading many parents to opt out of vaccines and put children and others at risk.
  • States with more permissive vaccination laws, such as Minnesota, are at increased risk for outbreaks of vaccine-preventable disease.
  • Data from the Minnesota Department of Health shows that several communities and schools have high rates of non-medical exemptions. In Wadena County, for example, 13 percent of Kindergartners are entering school without required vaccinations.
  • Targeted education is needed to counter myths and falsehoods about vaccination, especially in communities with high rates of non-medical exemptions.

Please take 1 minute to contact your House member and urge him or her to support HF 1182. 

1. Enter your home address to find your MN House member:

2. Send him or her a brief email using the language above. Feel free to personalize or modify. Copy so we can track outreach.

Another option is a quick call saying, “I’m a constituent in your district and pediatrician calling to convey my support for HF 1182, a bill to help provide education to communities with low vaccination rates.”



June 30, 2020

If you have questions about the process to apply for financial relief funds through the CARES Act Provider Relief Fund from the U.S. Department of Health and Human Services (HHS), visit the AAP’s FAQ page about this process. There you can learn more about eligibility requirements, how to apply, and more.

According to AAP, pediatric practices can expect to receive a payment equal to at least 2 percent of reported gross revenues from patient care. Additional payments may be allocated to account for considerations like greater loss of revenue, greater volume of Medicaid patients, or other factors.

The MNAAP Pediatric Mental Health work group is hosting a virtual learning collaborative to help pediatricians statewide improve clinic rates for adolescent/young adult depression screening/referral.

This MOC4 has been approved by the ABP for 25 points that can be completed in four months by Dec. 15, 2020. This project is being done in partnership with the Minnesota Department of Health and the Minnesota Department of Human Services and there is no charge for this MOC4.

If you want to sign up for this MOC4, please complete this online sign-up. For more information or questions email

Board elections are held each spring for open positions on the boards of the Minnesota Chapter of the American Academy of Pediatrics (MNAAP) and the Minnesota Academy of Pediatrics Foundation (MAPF).

This year, there were five openings on the board of directors and all were for member-at-large positions beginning July 1, 2020 through June 30, 2023.

MNAAP members who voted confirmed Nathan Chomilo, MD, FAAP; Madeleine Gagnon, MD, FAAP; Kathy Kulus, MD, FAAP; Hannah Lichtsinn, MD, FAAP; and Andrea Singh, MD, FAAP to serve on the MNAAP Board of Directors. Also confirmed through the 2020 election were a new president-elect: Eileen Crespo, MD, FAAP, and a new treasurer, Janna Gewirtz O’Brien, MD, FAAP.

Congratulations to our new board members!

Thank you to our board members whose terms have expired or are rotating off of their positions on the board: Nusheen Ameenuddin, MD, MPH, FAAP; Andrew Kiragu, MD, FAAP; Joe Neglia, MD; Deb Smith-Wright, MD, FAAP; and Lindsey Yock, MD, JD, FAAP. We appreciate your hard work and dedication!

June 16, 2020

By Sam Marzouk, Ph.D., L.P.

Pediatric attention-deficit/hyperactivity disorder (ADHD) is one of the most heterogeneous behavioral health diagnoses. In the current iteration of the diagnostic and statistical manual of mental disorders (DSM-5), ADHD is conceptualized by two broad dimensions of inattention and hyperactivity/impulsivity, each comprising an array of symptoms. Given the numerous possible symptom combinations and diagnostic profiles, individualizing the treatment approach of ADHD is a clinically necessary yet challenging task. Emerging signs and symptoms of pediatric ADHD are often first identified in a primary care setting. This makes pediatric primary care providers well-positioned to make important treatment planning decisions. It is therefore helpful for pediatric providers to not only identify core symptomatology but also key associated features of pediatric ADHD that correlate with a higher risk of associated functional impairment and more longitudinally adverse outcomes. 

One such feature that appears to uniquely contribute to heightened functional impairment in children with ADHD is emotional impulsivity (EI). Emotional impulsivity (also referred to as “emotional lability” or “emotional dysregulation” throughout the literature) refers to a diminished ability to modulate an emotional state precipitated by an environmental stressor. Not surprisingly, EI typically leads to subsequent maladaptive behavioral choices (e.g., fights, destruction of property, verbal aggression, etc.). While impulsivity in and of itself is typically understood in behavioral terms, the preceding emotional impulsivity is often overlooked. As a general clinical feature, EI cuts across numerous behavioral health diagnoses and is by no means specific to pediatric ADHD. What is important, however, is the relationship between EI and pediatric ADHD. Epidemiological research suggests that between 24 and 50 percent of children with ADHD also have clinically significant EI. What’s more, research has shown that children with ADHD and co-occurring EI often have greater core symptom severity, a higher risk for comorbid psychopathology, and poorer long-term outcomes. As a more specific empirical example, Russel Barkley (2010), one of the more prolific pediatric ADHD researchers, longitudinally followed a group of children with ADHD into early adulthood. Barkley found that those with comorbid EI at childhood evidenced greater functional impairment in adulthood across multiple domains (e.g., occupational, social, financial, etc.). Taken together, EI may represent the proverbial “tipping point” of pediatric ADHD in terms of functional impairment and adverse long-term outcomes.    

Emotional impulsivity appears to be a particularly important yet overlooked associated feature of ADHD. Given that EI is not identified as a core symptom of ADHD in the DSM-5, providers are more prone to underestimate its importance to the overall clinical picture and may, therefore, fail to assess for its presence. Pediatric providers play an important role in formulating and often coordinating an ADHD treatment plan. The evidence-base surrounding best practices for treating pediatric ADHD suggests that pharmacological and/or psychosocial treatment modalities have the highest efficacy. When EI enters the clinical picture, a more integrated approach inclusive of psychopharmacological interventions, psychotherapeutic interventions, and even occupational therapy may be indicated. 

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