Nonprofit gives Wyoming failing grade for early mental health screenings

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By Chrissy Suttles Wyoming Tribune Eagle Via Wyoming News Exchange

CHEYENNE - Former Cheyenne resident Anna Hershire noticed her daughter, Autumn, consistently missing academic marks as early as third grade. She was dismissive and distracted from her schoolwork, often seeming more despondent than anyone her age.
"She fell behind in basic arithmetic and language comprehension really early," Hershire said. "We tried everything from computer-assisted learning programs to after-school tutoring, but nothing helped. She was also just mentally spacing out. Doctors thought it was possibly ADHD, but couldn't establish the root of her problems."
As 9-year-old Autumn continued through elementary school in 2013, her emotional and academic provocations escalated, and Hershire considered a special education program.
During the process of identifying alternative programs, Hershire and Autumn visited a walk-in clinic for a cold when the physician noted something irregular about Autumn's demeanor. He recommended a local child psychiatrist.
"After a few evaluations, the doctor suggested she be tested for a mood disorder, which no one had considered because she was so young," she said.
Autumn, they realized after weeks of therapy, was experiencing a mild form of childhood-onset schizophrenia, a rare and controversial diagnosis in children.
Early-onset schizophrenia is estimated to affect 1 in 30,000-40,000 American children, according to the American Journal of Psychiatry.
With a combination of psychotherapy and medication, Autumn's condition and disposition visibly improved in a matter of months. Mother and daughter then moved to Rapid City, South Dakota, to be closer to family and find a "fresh start." Autumn's symptoms are still under control, and her grades have drastically improved, Hershire said.
While Autumn's particular challenges are atypical in school-age children, her late diagnosis is not.
A recent study released by the Children's Health Fund, a national nonprofit, suggests that states could be doing more to mandate mental and physical health screenings for K-12 students. The study's author determined that 29 states are performing at an unsatisfactory level in screening for vision, hearing, asthma, dental, nutrition, lead and behavioral issues.
Wyoming was among eight states earning a failing grade.
The investigation explored connections between health and academia, identifying what researchers call "health barriers to learning," or undertreated medical conditions proven to affect learning in schools.
"Teachers will see a child sleeping at a desk thinking that he or she is not paying attention when there is actually a health condition behind it," Irwin Redlener, co-founder of Children's Health Fund, said.
Researchers analyzed state requirements for recommended yearly health screenings in schools and concluded that Wyoming failed to produce any state-mandated health screenings outside of pre-K immunizations and middle school sports physicals.
States are able to create screening requirements for schools, but are not required to do so under any particular statute.
While most pediatricians in Wyoming do full wellness checks when students receive their immunizations, Collin Prince, a pediatrician at Cheyenne Regional Medical Center's Children's Clinic, said it is common for more than half of children to miss their check-ups for six or more years.
"This is a harder world for kids to navigate," Prince said. "There are a lot more distractions, and a lot pulling families apart. Children have more stress and emotional problems than seem to be there on the surface. I think it is very important that we see them regularly."
Prince said anyone with insurance can receive a free screening, but those without insurance can pay up to $200 for complete care.
Still, Prince thinks mandated health screenings would eliminate a lot of learning barriers for students in Cheyenne and Wyoming. He said asthma-related and mental health issues are some of the most common conditions of children in his practice.
Pediatricians generally screen development from infancy to 5 years old, ensuring there are no cognitive or physical delays, but once a child begins school, those screenings are up to the parent.
"It can have profound consequences on children academically," Redlener said. "It is not to say many children are not getting checkups from their local doctors, but it becomes very random."
Redlener said a collaborative effort can be made among parents, teachers and local health professionals to guarantee kids are getting the best care.
"Parents need to see themselves as their child's advocate," Redlener said. "There is a role for schools, a role for parents and a role for government. It doesn't have to be intrusive, but it sends a message that we have to get this done."
Janet Farmer, president of the Wyoming School Nurses Association and head nurse for Laramie County School District 1, said she believes doctors are already providing proper health screenings.
"States are hoping that parents are doing regular follow-ups on their own with their providers," Farmer said. "Kids are already going to the doctor, and I would hope that providers are including that whole physical as part of that immunization check. I don't know that I would say, initially, that it should be mandated because I think it is already happening."
She said, while she cannot speak to all district protocols, Cheyenne's schools are working with health providers and students to provide assistance.
There is a process in Laramie County for teachers to express concerns about a student. A committee called the Building Intervention Team, which is comprised of various officials in each school, will regularly gather to discuss the best course of action for a student struggling academically. The committee processes referrals from parents, staff or other concerned parties of students and develops appropriate intervention.
"I think it is in the national interest for every child to have the opportunity to be successful," Redlener said. "They have to grow up healthy and educated. Wherever you stand on the political spectrum, every state can make something happen."

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