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Pediatric Notes | Fall 2025
Thanks for reading the Fall edition of Pediatric Notes. Use the links below or scroll to view each article
- Bradley Hospital’s Access Center: Keeping Kids Safe and Supported
- Inside the CNDC: Integrated Care for Neurodevelopmental Disorders
- Teen-Focused Pilonidal Program Offers Relief for Patients and Surgeons
- Dr. Giulia Righi Connects Research and Clinical Care
- Register for the Sixth Annual Pediatric Healthcare Summit
- New Staff Joins Hasbro Children's and Bradley Hospital
Bradley Hospital’s Access Center: Keeping Kids Safe and Supported
Bradley Hospital’s Access Center is a key entry point for families, pediatricians, schools, and community providers seeking psychiatric help for children and adolescents. Its clinicians act as expert consultants with a network of resources to connect patients to the most appropriate care, whether that means outpatient visits, day treatment, care within the home, or inpatient admission. The center also includes Kids’LinkRI, a 24/7 statewide consultation line run in partnership with Gateway Healthcare.
Avoiding Hospitalization
The priority of the Access Center and Kids’LinkRI is to keep young people safe while helping them remain in their homes, schools, and communities whenever possible.
“Our goal is to keep children safe while keeping them out of the hospital,” said Kathleen Donise, MD, director of pediatric behavioral health emergency services at Brown University Health. “Hospitalization really is the last resort to keep a child safe, and we believe that wholeheartedly. We want to keep the child within the support of their family, school, and community as much as possible because that's what's best for them.”
Pediatricians with urgent concerns are encouraged to call Kids’ Link RI (1-855-543-5465) first, since the line offers immediate consultation, safety screening, and referrals. The Access Center becomes involved if a scheduled evaluation or intake is needed.
Dr. Donise has shaped the integration of emergency psychiatric services across Bradley and Hasbro Children’s. Early in her career at Brown Health, she became the first full-time emergency department psychiatrist at Hasbro Children’s. After several years working in college mental health at Princeton University, she returned to Rhode Island to unify and strengthen pediatric emergency psychiatry services. “I really loved emergency work,” she said. “I guess that's just what I'm meant to be doing.”
Under Dr. Donise’s leadership, Bradley and Hasbro Children’s emergency psychiatric services have been integrated into a single system. This includes the Bradley Access Center, Kids’LinkRI, the Psychiatry Emergency Service (PES) at Hasbro’s emergency department, and the Hasbro PACE (Psychiatry Access, Continuity, and Evaluation) Clinic. The goal is to streamline care and draw on varied expertise.
Partnering with Our Communities
Education for community partners has been central to the Access Center’s mission. Schools have been trained to call before sending students to the emergency department, and similar outreach has occurred to pediatricians, with the ability to expand that training further. She also encourages pediatricians to use the Pediatric Psychiatry Resource Network (PediPRN) for consultation when safety concerns are not acute but additional psychiatric guidance may be needed, particularly around medication questions.
Demand for pediatric psychiatric services continues to rise. To better meet this need, in December Hasbro Children’s will open a new, specially designed eight-bed area within the emergency department, for children arriving with behavioral health concerns.
“This space is designed to better meet the needs of our kids and their families,” said Dr. Donise. “It’s going to be an amazing addition.”
Together, the Access Center, Kids’LinkRI, Hasbro PACE Clinic, and Hasbro PES represent a growing network of services designed to meet children where they are and provide the right level of care at the right time. By focusing on safety, connection to community support, and avoiding unnecessary hospitalization, Bradley Hospital and Hasbro Children’s are working to give young patients and their families the best chance for stability and healing.
Inside the CNDC: Integrated Care for Neurodevelopmental Disorders
According to the Centers for Disease Control and Prevention, one in six children between the ages of three and 17 has been diagnosed with a developmental disability such as autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD). The Children’s Neurodevelopment Center (CNDC) at Hasbro Children’s is designed to meet the growing need for early diagnosis and coordinated care for these and other complex conditions.
Meeting Growing Demand with Compassionate Care
The CNDC provides diagnostic and ongoing care for children with neurological, developmental, metabolic, and behavioral disorders. Its multidisciplinary model includes pediatric neurology, urology, orthopedics, neurosurgery, and craniofacial services—all in one coordinated setting.
“To meet the growing need for autism and ADHD evaluations, we are working collaboratively with ancillary services such as psychology and social work to provide a more comprehensive and timely review of each child,” said Miranda Davis, MOT, OTR/L, the senior clinical administrator of the CNDC. “This model not only ensures a more complete understanding of the child’s needs but also helps reduce overall wait times.”
The team works closely with Hasbro’s rehabilitation services, including occupational and speech therapy, to ensure wraparound support for families. Many patients are seen through joint or coordinated visits across specialties to streamline care and reduce the burden on families navigating multiple appointments.
“Our multidisciplinary model allows us to evaluate and treat the whole child, rather than isolated symptoms,” said Davis. “Many of our patients have overlapping medical and behavioral needs, and by bringing different specialties to the same table, we can develop a more accurate, comprehensive plan. This leads to earlier diagnoses, reduced duplication of services, and better long-term outcomes, while also significantly easing the burden on families.”
Referrals to the CNDC are reviewed quickly—often the same day or within one to three business days. To reduce delays in care, developmental behavioral pediatricians reserve weekly appointment slots for new patients. Currently, most new patients are seen within two months, with urgent needs accommodated within one to three days.
The CNDC continues to expand its capacity to meet demand while maintaining close coordination with referring providers. With a team-based approach and improved access for new and urgent patients, the center is positioned to support children and families with complex needs across Rhode Island and southeastern New England.
Looking ahead, the CNDC team is focused on continuing to expand access and reduce wait times, particularly for children in need of early developmental evaluations. “We’re always working to refine our processes so we can see more patients, more quickly—without compromising the quality of care,” Davis said.
Referrals to the Children’s Neurodevelopment Center can be submitted through Epic or by calling the center directly. Referring providers are encouraged to contact the team with questions, requests for consultation, or follow-up needs by calling the center directly at 401-444-5685.
Contact the Children's Neurodevelopment Center (CNDC)
For more information or for an appointment, please call us at 401-444-5685.
Teen-Focused Pilonidal Program Offers Streamlined Care
Being a teenager is tough. It’s even tougher with pilonidal disease, a painful condition where a cyst or tunnel develops near the tailbone and can cause swelling, drainage, bleeding, and discomfort. The location of the cyst and the symptoms often make adolescents feel too embarrassed to tell their parents or pediatricians, delaying care and worsening symptoms.
At Hasbro Children’s, nurse practitioner Andrew McCarthy, CPNP, is working to change that. A member of the pediatric surgery team since 2012, McCarthy has developed a structured approach to help adolescents get faster access to care, earlier intervention, and ongoing support—both clinical and emotional.
Streamlined Treatment for Pilonidal Care
The PEACH Program (Pilonidal Education, Awareness, and Care at Hasbro) is a two-pronged initiative that combines a hygiene campaign with a streamlined procedural pathway. The hygiene campaign includes education, pre- and post-op counseling, and care kits of donated supplies such as wipes and soaps. The procedural pathway gives patients earlier access to minimally invasive treatment, often without requiring a trip to the operating room.
What began informally during the COVID-19 pandemic—when physician schedules were strained—has grown into a reliable pathway of care for adolescent pilonidal patients. McCarthy evaluates and treats pilonidal disease in a variety of settings, including the clinic and pediatric sedation, and works closely with the surgical team to determine which patients may still need operative management. As a result, most patients now receive care sooner—often before their symptoms escalate to the point of needing emergency treatment or surgery.
“I can do a procedure safely, appropriately, with no high risk of recurrence versus the operating room,” he said. “That allows our surgeons to be able to do more challenging cases in the operating room and offload that patient from the ER.”
Pilonidal disease is most common in adolescence, often triggered by hormonal changes during puberty. Even with treatment, recurrence is common. “For anyone that has had a procedure for pilonidal disease, there is a 30 to 40% chance it comes back,” said McCarthy. “That’s where it can be very frustrating or annoying for these patients. They’re doing everything from hair maintenance to hygiene, and it comes back.”
To support ongoing care, McCarthy has partnered with vendors to provide donated hygiene products like Dude Wipes and Rusted Acre soaps, which he assembles into care kits for patients.
He also sends patients home with wound care products such as MediHoney and offers individual coaching around habits that can help reduce recurrence.
On average, the pediatric surgery team sees 125 to150 patients with pilonidal disease annually. The PEACH Program now accounts for roughly 50 of those cases each year, a number that continues to grow.
The program has also had a noticeable impact on surgical workflow. Over the last two years, McCarthy has absorbed approximately one-third of pilonidal visits that would previously have gone directly to a surgeon. Pediatric sedation has been a key partner in making outpatient care more accessible and less disruptive for patients.
Balancing Expert Care with Compassionate Communication
PEACH’s strength lies in how it balances clinical care with communication. McCarthy adjusts how he speaks with each patient—some are comfortable joking, others need a more reserved approach. McCarthy encourages pediatricians to raise the topic during routine visits. Symptoms like itching, drainage, or spotting on toilet paper may be early signs. “Sometimes parents only discover the issue while doing their teen’s laundry,” he said.
For many adolescents, the benefits of the program are simple and meaningful: shorter waits, quicker relief, and a chance to get back to being a kid.
“Our group helps patients sit for their SATs, for band concerts, to go back to track meets,” said McCarthy. “We help teenagers be teenagers.”
To learn more about pediatric surgical services and related programs, visit the Pediatric Surgical Services website.
Dr. Giulia Righi Connects Research and Clinical Care
What began as a passion for neuroscience research evolved into a desire to work directly with patients for Giulia Ricciarelli Righi, PhD While completing her Ph.D. in cognitive neuroscience at Brown University, she discovered the satisfaction of clinical work—shaping the path she follows today as lead psychologist for Bradley Hospital’s inpatient unit at the Center for Autism and Developmental Disabilities (CADD) and staff psychologist at the Pediatric Anxiety Research Center (PARC).
“Early in my career, I was really drawn to the research because I found it very stimulating and exciting,” said Dr. Righi. “As I matured as a scientist and a person, the clinical piece also started to feel appealing and important because the research, on some level, is so many steps removed from having an impact on something actionable.”
At PARC, Dr. Righi provides individualized exposure-based cognitive behavioral therapy to select patients with anxiety and obsessive-compulsive disorder (OCD), often including the whole family. At CADD, she treats children with complex psychiatric and neurodevelopmental needs, in addition to managing the administrative duties of the center.
Her multidimensional positions touch on inpatient care, research, practice management, and psychotherapy, and she values that variety in her work.
“Over the years I have learned that combining some admin responsibilities with clinical work and research is the best recipe for me to stay engaged and enjoy what I do,” explained Dr. Righi.
Her research interests lie at the intersection of psychiatry and neurodevelopment. She focuses on psychiatric presentations in neurodiverse populations and is currently exploring how sleep patterns may influence treatment response—work she hopes to expand through future studies.
Pediatricians are on the frontline of identifying symptoms in children and adolescents who may need help from Bradley Hospital and Dr. Righi’s team. She encourages pediatricians to refer patients when there are questions about complex psychiatric or developmental presentations, even if symptoms are subtle.
“Pediatricians are doing a fantastic job identifying concerns, especially in younger children,” she said. “As kids grow older and presentations become more nuanced, we’re here to help clarify what’s going on and support families with next steps.”
Dr. Righi finds deep meaning and motivation in her work. “Working with kids is the best part of my job,” she said. “It keeps me interested, engaged, and inspired every day.”
To learn more about the Center for Autism and Developmental Disabilities and the Pediatric Anxiety Research Center, visit their websites.
Register for the Sixth Annual Pediatric Healthcare Summit
Join colleagues from across New England for the Sixth Annual Pediatric Healthcare Summit, presented by Bradley Hospital, Hasbro Children’s, and Boston Children’s Hospital. The virtual program will be held on Wednesday, December 3.
This continuing education course offers the latest updates and innovations in pediatric care, with expert-led lectures and interactive Q&A sessions. Topics include:
- The New Newborn Screen
- New Insights about Adolescent Substance Use and Treatments that Work: Bridging Research and Clinical Practice
- Common Lower Extremity Musculoskeletal Injuries in the Adolescent Athlete
- In Defense of Vaccines: From Correction to Connection
- Making Rash Decisions: A Primary Care Approach to Diagnosing and Treating Skin Lesions
Pediatric Healthcare Summit
Register now to secure the early bird rate, which is $125.00 for clinicians and free for students and trainees. Starting November 5, the cost for clinicians will be $150 but will remain free for students and trainees.
