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Background Learners developing competency-based skills, attitudes, and knowledge through the achievement of defined milestones is a core feature of competency-based medical education. In 2017, a special interest study group of the American Academy of Child and Adolescent Psychiatry convened a panel of specialists to describe pediatric consultation-liaison psychiatry (CLP) best educational practices during child and adolescent psychiatry fellowship. Objective The objective of this project was to develop a national consensus on pediatric CLP competencies to help guide training in this specialty. Methods An expert working group developed a list of candidate competences based on previously established educational outcomes for CLP (formerly Psychosomatic Medicine), child and adolescent psychiatry, and general psychiatry. A survey was distributed to members of the American Academy of Child and Adolescent Psychiatry Physically Ill Child Committee to determine child and adolescent psychiatry fellowship educational needs on pediatric CLP services and generate consensus regarding pediatric CLP competencies. Results Most survey respondents were supportive of the need for a national consensus on core competencies for pediatric CLP. Consensus from a panel of experts in the field of pediatric CLP generated a list of proposed core competencies that track the Accreditation Council for Graduate Medical Education's six core competencies. Conclusions Consistent learning outcomes provide the foundation for further development of tools to support training in pediatric CLP. There is a need to develop further tools including outcome assessment instruments and self-directed learning materials that can be used to support lifelong learning.

Callous-unemotional (CU) traits in children and adolescents are an important risk factor for forensic behaviors in youth and in adulthood. There is a strong biologic basis in CU traits, offering the possibility to design biological interventions to address this risk factor. This paper advances the hypothesis that the administration of exogenous oxytocin is a biological intervention worthy of further investigation to address CU traits and moderate future risk factors for forensic behaviors. The evidence for this assertion rests in the empiric evidence that social cognitive deficits play a major role in child and adolescent CU traits and psychopathy. Simultaneously, emerging evidence suggests that youth with CU traits have defined neuroendocrinological correlates within the oxytocin system. A review of the normal neurohormonal physiology of this system is presented to provide a groundwork for the delineation of these correlates. That deficits in this system are found in alternate psychopathologies that present with deficits in social cognition serves as the basis for the hypothesis that these deficits may play a key role in the development and manifestation of CU traits. Their correction through psychopharmacologic and alternate means may provide a future route to addressing a central area of adolescent forensic psychiatry.