Jornal de pediatria最新文献_第2页

Neonatal mortality trends in the 21st century: findings from the Global Burden of Disease Study 2021 21世纪新生儿死亡率趋势：2021年全球疾病负担研究结果

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2026-02-17 DOI: 10.1016/j.jped.2026.101519

Dongqing Gu , Xiaofei Zheng , Yan Zhou , Fengjie Tan , Rui Gui , Linna Wei , Lubin Liu

{"title":"Neonatal mortality trends in the 21st century: findings from the Global Burden of Disease Study 2021","authors":"Dongqing Gu , Xiaofei Zheng , Yan Zhou , Fengjie Tan , Rui Gui , Linna Wei , Lubin Liu","doi":"10.1016/j.jped.2026.101519","DOIUrl":"10.1016/j.jped.2026.101519","url":null,"abstract":"<div><h3>Objective</h3><div>Neonatal mortality remains a significant global health challenge, particularly in low- and middle-income countries. This study aimed to analyze the trends and causes of neonatal mortality from 2000 to 2021.</div></div><div><h3>Methods</h3><div>Data on all-cause and cause-specific mortality were obtained from the Global Burden of Disease Study 2021. Joinpoint regressions were employed to calculate the annual percentage change and the average annual percentage change. Pearson's correlation was utilized to estimate the relationships between mortality rates and the Human Development Index.</div></div><div><h3>Results</h3><div>The global all-cause neonatal mortality rate has declined by an average of 2.1% per year since 2000, while the absolute number of neonatal deaths remained at 2.19 million globally in 2021. Neonatal disorders continued to be the leading cause of death among neonates in 2021, followed by congenital birth defects, lower respiratory infections, sexually transmitted infections excluding HIV, diarrheal diseases, and malaria. The neonatal mortality rate varied significantly across different countries and territories, ranging from 0.61 per 1000 livebirths in Andorra to 55.35 per 1000 livebirths in South Sudan. By 2021, 120 countries (58.8%) had achieved the Sustainable Development Goal 3.2 target. Additionally, strong negative correlations were found between mortality rates and Human Development Index (<em>r</em> = -0.867, <em>P</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Despite significant progress, regional disparities persist; only half of the countries achieved the Sustainable Development Goal 3.2 target by 2021. These findings emphasize prioritized interventions for neonatal disorders in low/middle-income countries and highlight socioeconomic development as critical to equitable mortality reduction within public health frameworks.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 2","pages":"Article 101519"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unraveling ADHD for the pediatrician 为儿科医生解读多动症。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2025-11-01 DOI: 10.1016/j.jped.2025.101464

Erasmo Barbante Casella, Beatriz Borba Casella

{"title":"Unraveling ADHD for the pediatrician","authors":"Erasmo Barbante Casella, Beatriz Borba Casella","doi":"10.1016/j.jped.2025.101464","DOIUrl":"10.1016/j.jped.2025.101464","url":null,"abstract":"<div><h3>Objective</h3><div>To review current evidence on the pathophysiology, clinical features, differential diagnosis, and therapeutic management of Attention-Deficit/Hyperactivity Disorder (ADHD), emphasizing the pediatrician’s role in diagnostic recognition and coordination of multidisciplinary care.</div></div><div><h3>Data sources</h3><div>Narrative synthesis of the contemporary literature addressing genetic and neurobiological underpinnings, diagnostic criteria, comorbidities, and treatment strategies relevant to pediatric practice.</div></div><div><h3>Summary of findings</h3><div>ADHD is a multifactorial neurodevelopmental disorder involving genetic predisposition and neurobiological alterations, particularly in cortico-subcortical circuits related to dopaminergic and noradrenergic modulation. Clinical presentation varies with age and context and may be accompanied by comorbidities such as learning disorders, anxiety, and depression. Diagnosis is clinical, based on standardized criteria and assessment across multiple settings, and requires exclusion of conditions that mimic ADHD. Management is multimodal, encompassing psychosocial interventions, school-based support, and, when indicated, pharmacological therapy. Pediatricians serve as the first point of contact and play a central role in early identification, family guidance, and integration of healthcare and educational teams.</div></div><div><h3>Conclusion</h3><div>Proactive pediatrician involvement is essential for early diagnosis and effective management of ADHD, supporting better prognosis and the child’s overall development.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101464"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Warning signs for identifying neurodevelopmental disorders: a systematic literature review 识别神经发育障碍的警告信号：系统的文献综述。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI: 10.1016/j.jped.2025.101478

Liubiana Arantes de Araújo

{"title":"Warning signs for identifying neurodevelopmental disorders: a systematic literature review","authors":"Liubiana Arantes de Araújo","doi":"10.1016/j.jped.2025.101478","DOIUrl":"10.1016/j.jped.2025.101478","url":null,"abstract":"<div><h3>Objective</h3><div>To synthesize the most consistent warning signs (“red flags”) for NDDs: autism spectrum disorder, cerebral palsy, intellectual disability, language development disorder, coordination developmental disorder, attention deficit hyperactivity disorder, and global developmental delay.</div></div><div><h3>Data source</h3><div>Review in PubMed/Medline, Cochrane Library, SciELO, CAPES, and BVS, 2003-2025. Methodological quality was assessed with NOS, CASP, and AMSTAR.</div></div><div><h3>Data summary</h3><div>54 studies were included. The most consistent early signs were grouped by NPMD domains: Motor: delay to sit ≥ 9 m, absence of independent walking 18 m, absence of pincer grasp 10 m, and asymmetrical motor patterns 12 m; Language: absence of babbling at 9–12 m, lack of words until 15–18 m, and absence of two-word combination 24 m; Social: absence of social smile, poor eye contact, deficits in shared attention and communicative gestures; Cognitive and behavioral: regression of skills, repetitive behaviors, absence of symbolic play, and irritability or inattention; Others: atypical sensory responses, sleep disturbances, and feeding difficulties. Instruments such as M-CHAT-R/F, ASQ, Bayley, and HINE increased the accuracy of screening and reduced referral delays.</div></div><div><h3>Conclusion</h3><div>Early recognition of warning signs for NPMD disorder associated with complementary examinations and formal assessment should be integrated into routine pediatric care.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101478"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the editor regarding “Development of a machine learning-based predictive model for long-term adverse outcomes in neonatal bacterial meningitis” 关于“开发基于机器学习的新生儿细菌性脑膜炎长期不良后果预测模型”的致编辑的信。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2026-03-13 DOI: 10.1016/j.jped.2026.101523

Rafael Gomes de Melo D’Elia, Angélica Saiuri de Aurélio Penteado

引用次数: 0

The impact of adenoid hypertrophy across pediatric age groups on maxillomandibular development and position 儿童各年龄组腺样体肥大对上颌骨发育和位置的影响。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.jped.2026.101524

Xue-Ru Zhang, Jian-Ya Zhang

{"title":"The impact of adenoid hypertrophy across pediatric age groups on maxillomandibular development and position","authors":"Xue-Ru Zhang, Jian-Ya Zhang","doi":"10.1016/j.jped.2026.101524","DOIUrl":"10.1016/j.jped.2026.101524","url":null,"abstract":"<div><h3>Objective</h3><div>Although adenoid hypertrophy (AH) is associated with malocclusion, its age-specific impact on craniofacial development across different dentition stages remains unclear. This study aimed to assess AH-related craniofacial changes across distinct phases of dental development.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 180 children divided into three age groups: 3–5, 5–8, and 8–11 years. Lateral cephalometric radiographs were used to evaluate sagittal skeletal relationships (SNA, SNB, ANB), dentoalveolar position (NA-Apo), occlusal plane inclination (NPo–FH), jaw lengths (ANS-Ptm, Co-Gn), and overjet. Comparisons were made between the AH and control groups within each age cohort.</div></div><div><h3>Results</h3><div>In the 3–5 year group, no significant craniofacial differences were found between AH and control subjects. Between 5–8 years, AH was linked to a significantly lower SNB angle and higher NA-Apo angle (p < 0.05). By 8–11 years, AH patients showed significantly reduced SNA, SNB, and NPo–FH angles, along with increased ANB, NA-Apo, and overjet values compared to controls (p < 0.05).</div></div><div><h3>Conclusion</h3><div>AH was associated with age-dependent craniofacial changes—such as mandibular retrusion, dental protrusion, posterior occlusal tilt, and increased overjet—without altering jaw length. Early diagnosis and timely intervention during key growth stages are crucial to prevent long-term facial abnormalities. Given the retrospective, 2D cephalometric design, causality could not be inferred, and longitudinal or treatment effects could not be assessed.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 2","pages":"Article 101524"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hyperbilirubinemia monitoring program in infants ≥ 35 weeks: a Brazilian quality improvement study ≥35周婴儿高胆红素血症监测项目：巴西质量改善研究

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI: 10.1016/j.jped.2026.101502

Ana Luiza Y. Grillo , Sérgio T.M. Marba , Jamil P.S. Caldas

{"title":"Hyperbilirubinemia monitoring program in infants ≥ 35 weeks: a Brazilian quality improvement study","authors":"Ana Luiza Y. Grillo , Sérgio T.M. Marba , Jamil P.S. Caldas","doi":"10.1016/j.jped.2026.101502","DOIUrl":"10.1016/j.jped.2026.101502","url":null,"abstract":"<div><h3>Objective</h3><div>To implement a systematic monitoring program for hyperbilirubinemia in the first week of life in newborns ≥ 35 weeks of gestational age.</div></div><div><h3>Methods</h3><div>A quality assessment study was conducted with an estimated sample size of 385 newborns using a phototherapy utilization rate of 10 %. All newborns with a gestational age of ≥ 35 weeks admitted to a secondary general hospital well-baby nursery were included. Transcutaneous bilirubin (TcB) was systematically measured, and total serum bilirubin (TsB) was measured as needed. Patients with TcB levels above the 75th percentile according to the nomogram by Bhutani et al. (2021) were followed up after discharge from a specific outpatient clinic. The rates of outpatient follow-up clinic utilization, incidence of total bilirubin ≥ 15 mg/dL at discharge, readmission for phototherapy, and exchange transfusion were evaluated.</div></div><div><h3>Results</h3><div>Of the 432 newborns analyzed, 53 (12.3 %) were referred for follow-up, with a return rate of 83 % (44). Twelve newborns (27.2 % of those who attended the return visit and 2.7 % of the total sample) were readmitted for phototherapy for a median duration of 36 (30–48) hours. Three infants had bilirubin values ≥ 15.0 mg/dL at discharge and did not require readmission. None of the patients required an exchange transfusion.</div></div><div><h3>Conclusions</h3><div>The outpatient follow-up program for jaundice demonstrated high adherence, safety, and effectiveness, and reduced the rate of phototherapy use threefold.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 2","pages":"Article 101502"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Myths and facts in the treatment of neurodevelopmental disorders – other therapies 治疗神经发育障碍的神话和事实-其他疗法。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2025-10-29 DOI: 10.1016/j.jped.2025.101452

Chaves Livio Francisco S. , Pessoa Fabio Borges , Marques Pedro Henrique Resende

{"title":"Myths and facts in the treatment of neurodevelopmental disorders – other therapies","authors":"Chaves Livio Francisco S. , Pessoa Fabio Borges , Marques Pedro Henrique Resende","doi":"10.1016/j.jped.2025.101452","DOIUrl":"10.1016/j.jped.2025.101452","url":null,"abstract":"<div><h3>Objective</h3><div>To critically examine the effectiveness of complementary and alternative therapies (CATs) in the treatment of neurodevelopmental disorders, distinguishing myths from evidence-based practices and supporting informed therapeutic decision-making for healthcare professionals, educators, and families.</div></div><div><h3>Data sources</h3><div>Evidence was collected from PubMed, Scopus, and Web of Science up to August 2025. Systematic reviews, meta-analyses, and international consensus statements addressing attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), specific learning disorders, communication and language disorders, intellectual disability, and developmental coordination disorder were included.</div></div><div><h3>Summary of findings</h3><div>Interest in interventions such as neurofeedback, transcranial direct current stimulation, music therapy, equine-assisted therapy, virtual reality, and gamification has grown substantially. However, most of these approaches lack methodological standardization and robust evidence to justify their use as primary treatments. Some demonstrate modest benefits as adjunctive strategies, especially when integrated into structured programs and supervised by multidisciplinary teams. Conversely, therapies including acupuncture, ozone therapy, and hyperbaric oxygen therapy present insufficient scientific support and should not be considered substitutes for validated methods.</div></div><div><h3>Conclusion</h3><div>Complementary and alternative therapies remain a topic of significant debate in the management of neurodevelopmental disorders. While certain approaches may offer limited adjunctive benefits, their clinical use should be carefully evaluated within evidence-based frameworks. The development of rigorous evaluations, standardized protocols, and the safe integration of innovative technologies is essential to optimize therapeutic outcomes without compromising access to scientifically validated interventions.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101452"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to identify depression and anxiety in children and adolescents 如何识别儿童和青少年的抑郁和焦虑。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2025-11-09 DOI: 10.1016/j.jped.2025.101462

Coraima A. Linan, Gibsi MP Rocha, Marta K. Lucion

{"title":"How to identify depression and anxiety in children and adolescents","authors":"Coraima A. Linan, Gibsi MP Rocha, Marta K. Lucion","doi":"10.1016/j.jped.2025.101462","DOIUrl":"10.1016/j.jped.2025.101462","url":null,"abstract":"<div><h3>Objective</h3><div>To review the epidemiology, diagnostic criteria, and therapeutic options for the most prevalent anxiety and depressive disorders in childhood and adolescence.</div></div><div><h3>Sources of data</h3><div>A non-systematic review was conducted in the PubMed, SciELO, and Google Scholar databases. Diagnostic criteria were defined according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and updated textbooks on child and adolescent psychiatry.</div></div><div><h3>Summary of the data</h3><div>Diagnosis requires a comprehensive clinical assessment, considering age-specific manifestations and differentiating expected developmental emotional responses from pathological conditions.</div></div><div><h3>Conclusions</h3><div>Management relies on psychoeducation and psychotherapeutic interventions—particularly cognitive-behavioral therapy—and, in moderate to severe cases, pharmacotherapy with selective serotonin reuptake inhibitors, preferably combined with psychotherapy. Early identification, especially at the pediatric care level, is essential to reduce morbidity, prevent recurrence, and promote healthy development.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101462"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dietary and nutritional interventions in the treatment of childhood neuropsychiatric disorders: evidence and myths 饮食和营养干预治疗儿童神经精神疾病：证据和神话。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2025-10-30 DOI: 10.1016/j.jped.2025.101465

Regina Torres Duarte Kostenko , Nathalia Ferreira Antunes de Almeida , Juliana Fernandez Santana e Meneses

{"title":"Dietary and nutritional interventions in the treatment of childhood neuropsychiatric disorders: evidence and myths","authors":"Regina Torres Duarte Kostenko , Nathalia Ferreira Antunes de Almeida , Juliana Fernandez Santana e Meneses","doi":"10.1016/j.jped.2025.101465","DOIUrl":"10.1016/j.jped.2025.101465","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the current scientific literature on the main dietary and nutritional interventions proposed for children and adolescents with neuropsychiatric disorders and describe their efficacy and safety, differentiating evidence-based practices from common myths.</div></div><div><h3>Data source</h3><div>The search was conducted using PubMed, SciELO, Cochrane, and Web of Science databases (2019–2025). The specific terms used in the search were formulated to encompass dietary interventions in children and adolescents with neuropsychiatric disorders and their outcomes.</div></div><div><h3>Data synthesis</h3><div>Gluten-free and casein-free (GFCF) diets did not reduce ASD symptoms and should be reserved for confirmed allergy or intolerance. Probiotics have shown inconsistent results for core ASD/ADHD symptoms, although they may alleviate gastrointestinal complaints in subgroups. Omega-3 s have shown modest and heterogeneous effects; In ADHD, high-dose EPA may improve attention when baseline levels are low, without consistent benefit in other domains. N-acetylcysteine reduced irritability in some trials, with no consistent effect on core symptoms. Folinic acid showed benefits in subgroups defined by biomarkers (folate receptor autoantibodies) and in ASD with language impairment, but this needs to be confirmed in larger studies. For vitamin D, high rates of insufficiency and possible modest gains in sub-outcomes were observed, with methodological heterogeneity.</div></div><div><h3>Conclusions</h3><div>This literature review showed that there is no scientific support for generalized dietary interventions, such as restrictive diets or nutritional supplementation, in the treatment of childhood neuropsychiatric disorders. Current evidence suggests the need for individualization and continuous monitoring. Specific interventions are justified only in the case of documented nutritional deficiencies.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101465"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Behavioral approach to autism spectrum disorder: quality versus quantity in interventions 自闭症谱系障碍的行为方法：干预的质量与数量。

IF 2.5 4区医学

Jornal de pediatria Pub Date : 2026-03-01 Epub Date: 2025-10-07 DOI: 10.1016/j.jped.2025.101451

Jaime Lin , Júlio César Claudino dos Santos , Cinara Ludvig Gonçalves

{"title":"Behavioral approach to autism spectrum disorder: quality versus quantity in interventions","authors":"Jaime Lin , Júlio César Claudino dos Santos , Cinara Ludvig Gonçalves","doi":"10.1016/j.jped.2025.101451","DOIUrl":"10.1016/j.jped.2025.101451","url":null,"abstract":"<div><h3>Objective</h3><div>To discuss the importance of balancing quality versus quantity in behavioral interventions for individuals with Autism Spectrum Disorder (ASD), highlighting evidence-based approaches and the role of therapist training.</div></div><div><h3>Data sources</h3><div>Narrative review of the literature examining evidence-based behavioral approaches for ASD, the tension between intervention intensity and quality, factors influencing individualized treatment planning, and the importance of professional qualification.</div></div><div><h3>Summary of findings</h3><div>Evidence indicates that more hours of therapy do not necessarily result in better outcomes, with studies showing no consistent dose–response relationship. Individual learning rates, comorbid conditions, and quality of implementation significantly influence results. High-quality, individualized planning, consistent execution, family engagement, and well-trained professionals are essential. Lack of regulation and standardized training, particularly in contexts without professional certification systems, poses challenges to delivering effective, evidence-based care.</div></div><div><h3>Conclusion</h3><div>Behavioral interventions for ASD must prioritize quality over quantity, ensuring evidence-based, individualized, and well-supervised treatment plans delivered by qualified professionals to achieve meaningful outcomes.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101451"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0