Jornal de pediatria最新文献

{"title":"Behavioral approach to autism spectrum disorder: quality versus quantity in interventions","authors":"Jaime Lin ,&nbsp;Júlio César Claudino dos Santos ,&nbsp;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}

{"title":"Determinants and spatial distribution of early newborn care in Somalia: evidence from the 2020 Somalia health and demographic survey","authors":"Abdirahman Omer Ali ,&nbsp;Awo Mohamed Kahie ,&nbsp;Nura Mohamed Omer ,&nbsp;Muhyadin Yusuf Dahir ,&nbsp;Abdisalam Mahdi Hassan ,&nbsp;Hodo Abdi Abdillahi ,&nbsp;Md. Moyazzem Hossain","doi":"10.1016/j.jped.2025.101496","DOIUrl":"10.1016/j.jped.2025.101496","url":null,"abstract":"<div><h3>Objective</h3><div>Early newborn care (ENC) is important for reducing neonatal mortality; however, the rate of receiving adequate newborn care is low in Somalia. Therefore, this study aimed to identify the individual, household, and community-level determinants and map the spatial patterns of ENC in Somalia to take the required actions and policies.</div></div><div><h3>Methods</h3><div>This study considered a weighted sample of 15,024 mother-newborn pairs extracted from a countrywide cross-sectional survey, the 2020 Somali Health and Demographic Survey (SHDS). Multilevel logistic regression was employed to identify factors associated with receiving adequate ENC within two days of birth. Global Moran’s I and Getis-Ord Gi* statistics were used for spatial analysis.</div></div><div><h3>Results</h3><div>The prevalence of adequate ENC was critically low (5.23%). Findings revealed that delivery in a health facility (vs. home: Adjusted Odds Ratio (AOR) = 0.22, 95% CI: 0.18-0.26), higher household wealth (richest vs. poorest: AOR = 2.02, 95% CI: 1.59-2.57), and higher birth order were influential predictors of receiving ENC. However, having multiple or a higher number of living children was associated with significantly lower odds of receiving ENC. Spatial analysis identified a statistically significant hot spot of higher ENC coverage in the northwestern regions and cold spots of extremely low coverage in the south.</div></div><div><h3>Conclusion</h3><div>In Somalia, early neonatal care is shockingly insufficient, and significant social and regional disparities. To achieve Sustainable Development Goal 3, interventions must be implemented based on identified cold spots, prioritizing the strengthening of access to skilled care at birth, and addressing the economic vulnerabilities of families.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 2","pages":"Article 101496"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843818","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}

{"title":"Effects of hydrotherapy and hammock positioning on pain reduction in preterm neonates","authors":"Ana Talita Vasconcelos Arcanjo Ribeiro da Silva,&nbsp;Francisco Plácido Nogueira Arcanjo,&nbsp;Jeferson de Sousa Justino,&nbsp;Lizandro de Andrade Teles,&nbsp;Ana Kelly Melo de Aquino","doi":"10.1016/j.jped.2026.101503","DOIUrl":"10.1016/j.jped.2026.101503","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of hydrotherapy and hammock positioning, applied individually or in combination, on pain reduction in preterm neonates.</div></div><div><h3>Methods</h3><div>This randomized clinical trial included 45 preterm neonates under 37 weeks of gestation and weighing less than 2,500g, admitted to the neonatal intensive care unit or intermediate care unit at Santa Casa Hospital in Sobral, Brazil. Palliative interventions were performed during routine invasive and painful procedures, specifically heel lances and handling of the orogastric tube during feeding. Neonates were randomized into three groups: hydrotherapy, hammock positioning, or a combined intervention, with 15 participants per group. Interventions were applied once daily for 15 consecutive days. Pain was assessed using the Neonatal Facial Coding System before and after each session, totaling 1,350 evaluations. Continuous variables were analyzed using Student’s t-test, and categorical variables were analyzed using Fisher’s exact test. The study was registered in the Brazilian Registry of Clinical Trials.</div></div><div><h3>Results</h3><div>The sample consisted of 53.3% male neonates, with a mean gestational age of 32.4±2.1 weeks. Hydrotherapy significantly reduced pain scores and pain prevalence. Hammock positioning also produced significant reductions in pain scores and prevalence. The combined intervention resulted in the greatest reduction in pain scores and pain prevalence. All within-group comparisons showed statistically significant improvements. No statistically significant differences were observed when the three intervention groups were compared directly.</div></div><div><h3>Conclusion</h3><div>Hydrotherapy and hammock positioning, applied individually or in combination, are effective, safe, and feasible strategies for reducing pain in preterm neonates and may complement standard neonatal care in NICUs.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 2","pages":"Article 101503"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063601","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}

{"title":"Autism spectrum disorder: overdiagnosis or a new pandemic?","authors":"Kamila Castro ,&nbsp;Rudimar Riesgo ,&nbsp;Carlos Gadia","doi":"10.1016/j.jped.2025.101439","DOIUrl":"10.1016/j.jped.2025.101439","url":null,"abstract":"<div><h3>Objective</h3><div>To critically analyze the factors influencing prevalence estimates of Autism Spectrum Disorder (ASD), considering methodological, clinical, etiological, and sociocultural determinants that shape epidemiological data and diagnostic practices.</div></div><div><h3>Data synthesis</h3><div>In recent decades, a substantial increase in ASD prevalence has been observed globally. This phenomenon is shaped by a combination of factors, including changes in diagnostic criteria, improved detection methods, expanded access to health services, and greater public awareness. However, it also raises concerns about possible overdiagnosis, particularly in complex clinical contexts. The interpretation of prevalence data is influenced by methodological designs, population characteristics, and sociocultural dynamics.</div></div><div><h3>Summary of the findings</h3><div>The absence of biological markers, the high rate of psychiatric comorbidities, and disparities in access to qualified professionals further complicate the diagnostic process. These elements highlight the need for caution when comparing data across studies, time periods, or geographic regions.</div></div><div><h3>Conclusion</h3><div>The ASD prevalence reflects a multifaceted process that demands careful and comprehensive interpretation. A deeper understanding of this scenario requires critical reflection on how diagnoses are established, interpreted, and applied. Strengthening diagnostic practices and epidemiological approaches is essential for ensure more accurate data and support informed decision-making in health policies.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101439"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954973","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}

{"title":"Sleep disorder assessment in children and adolescents with neurodevelopmental disorders","authors":"Camila dos Santos El Halal ,&nbsp;Magda Lahorgue Nunes","doi":"10.1016/j.jped.2025.101441","DOIUrl":"10.1016/j.jped.2025.101441","url":null,"abstract":"<div><h3>Objective</h3><div>To review the associations between various neurodevelopmental disorders and the most prevalent sleep disorders in children and adolescents, focusing on clinical characteristics and diagnostic approaches.</div></div><div><h3>Data sources</h3><div>A literature review was conducted using the PubMed database, employing the search terms “neurodevelopmental disorders” and “sleep disorders,” including “insomnia,” “sleep-related breathing disorders,” “circadian rhythm sleep-wake disorders,” “sleep-related movement disorders,” “parasomnias,” and “central disorders of hypersomnolence.” Specific diagnostic terms related to neurodevelopmental and sleep disorders were also utilized. Additionally, the reference lists of selected manuscripts were manually reviewed to identify further relevant publications.</div></div><div><h3>Data synthesis</h3><div>Sleep disorders are frequently associated with neurodevelopmental disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder, and intellectual disability, as well as genetic syndromes known to predispose individuals to sleep disturbances, including Down syndrome, Smith-Magenis syndrome, Prader-Willi syndrome, and mucopolysaccharidosis type II. These associations are mediated by anatomical, biological, and behavioral mechanisms. Diagnostic evaluation should be guided by clinical suspicion and typically involves a comprehensive clinical history, sleep diaries, standardized questionnaires, and, when indicated, additional diagnostic procedures.</div></div><div><h3>Conclusions</h3><div>Sleep disorders are more prevalent in children and adolescents with neurodevelopmental disorders. A thorough understanding of the most commonly associated sleep disturbances and the implementation of targeted diagnostic strategies are essential for appropriate clinical management and for improving long-term outcomes in this population.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101441"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000663","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}

{"title":"The effects of submission and exposure to real-world and virtual violence during childhood and adolescence","authors":"Luci Pfeiffer","doi":"10.1016/j.jped.2025.101494","DOIUrl":"10.1016/j.jped.2025.101494","url":null,"abstract":"<div><h3>Objective</h3><div>This text proposes a discussion and analysis of the effects of exposure to real-world and virtual violence in childhood and adolescence, and its repercussions on development.</div></div><div><h3>Data sources</h3><div>literature review on the topic of children's and adolescents' exposure to real-world and virtual violence, and observations from case studies of children and adolescents who were victims of serious and very serious violence, assisted by the DEDICA Program – Defense of the Rights of Children and Adolescents in Curitiba in the first semester of 2025.</div></div><div><h3>Summary of findings</h3><div>It is observed that a significant number of children and adolescents, regardless of their origins, ethnicities, beliefs, cultures, and the sociocultural condition of their guardians, are being exposed to various forms of violence, whether intrafamilial, domestic, institutional, or from their surroundings, through what they observe, witness, and experience in the real or virtual world.</div></div><div><h3>Conclusions</h3><div>It is concluded that exposure to situations of violence through direct aggression, witnessing, cohabitation, and/or participation can promote desensitization and the normalization of causing harm to others. Without protection or contestation of violent acts, whatever their source, those who are learning their own value and the value of others, and how to fight for life, come to accept them as an inevitable part of life, either suffering them or perpetrating them. The need for pediatric consultations to include guidance for caregivers and patients on preventing exposure to any form of violence, as well as the adoption of protective measures, including legal ones, against the harm to which they may be subjected, is evident.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101494"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781265","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}

{"title":"The role of neuropsychological assessment in the investigation of neurodevelopmental disorders","authors":"Danielle Irigoyen da Costa ,&nbsp;Rosana Vieira de Souza ,&nbsp;Thaís Cecília Fiamoncini","doi":"10.1016/j.jped.2025.101470","DOIUrl":"10.1016/j.jped.2025.101470","url":null,"abstract":"<div><h3>Objective</h3><div>The present study aims to present and discuss the role of neuropsychological assessment (NA) in the investigation of neurodevelopmental disorders (NDDs), with an emphasis on early diagnosis, on the steps that make up the evaluation process, and on the resources that complement clinical evaluation. Furthermore, the discussion is expanded to specific conditions, such as Attention Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Specific Learning Disorders (SLD), considering that they represent frequent assessment demands.</div></div><div><h3>Data sources</h3><div>A critical review of the national and international literature on neuropsychological assessment in NDDs was carried out, highlighting standardized instruments for the Brazilian context, complementary clinical tasks, and main cognitive and behavioral domains. References to essential books and manuals were included, with analysis enriched by the authors' clinical and teaching experience.</div></div><div><h3>Data synthesis</h3><div>NA constitutes a central tool for the early identification of alterations in neurodevelopment, with contributions to diagnosis and to the definition of intervention strategies. The process involves systematic steps, such as detailed anamnesis, application of standardized tests, and behavior analysis, covering different domains. The feedback, the final stage of the process, is essential for the understanding of the results and for adhering to the suggested procedures, and it should guide parents on practical implications, therapeutic and educational recommendations, and necessary referrals.</div></div><div><h3>Conclusions</h3><div>NA represents an essential resource in pediatric practice, both for diagnostic support and for directing interventions and monitoring the progress of children with NDDs. Its early use can modify the prognosis and promote better functional, academic, and socioemotional outcomes.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101470"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482057","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}

{"title":"The pediatrician’s role in the follow-up of children/adolescents with mental and/or neurodevelopmental disorders","authors":"Magda Lahorgue Nunes","doi":"10.1016/j.jped.2025.101492","DOIUrl":"10.1016/j.jped.2025.101492","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101492"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781312","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}

{"title":"Response of the authors to the letter to the editor regarding “Development of a machine learning-based predictive model for long-term adverse outcomes in neonatal bacterial meningitis”","authors":"Ying Chen ,&nbsp;Shengpei Wang ,&nbsp;Jing Wu ,&nbsp;Chi Wang ,&nbsp;Ying Li ,&nbsp;Peicen Zou ,&nbsp;Ruiqi Xiao ,&nbsp;Na Zhang ,&nbsp;Huiguang He ,&nbsp;Yajuan Wang","doi":"10.1016/j.jped.2026.101525","DOIUrl":"10.1016/j.jped.2026.101525","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 2","pages":"Article 101525"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343649","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}

{"title":"Transdiagnostic irritability in youth: a clinical review","authors":"Luiza Magalhaes de Oliveira,&nbsp;Guilherme V. Polanczyk,&nbsp;Luisa Shiguemi Sugaya","doi":"10.1016/j.jped.2025.101457","DOIUrl":"10.1016/j.jped.2025.101457","url":null,"abstract":"<div><h3>Objective</h3><div>Irritability is one of the most frequent concerns in pediatric mental health and a predictor of long-term psychopathology and burden. This article aims to provide a comprehensive review of non-episodic irritability along with evidence-based clinical recommendations for pediatric care professionals.</div></div><div><h3>Sources</h3><div>A narrative review was conducted based on the literature from the last 10 years and additional key studies. Observational studies, randomized controlled trials, systematic reviews, and meta-analyses were considered.</div></div><div><h3>Summary of the findings</h3><div>Non-episodic irritability is a transdiagnostic construct associated with several mental disorders. Research on etiological pathways suggests that irritability may involve distinct mechanisms, moderate heritability, and genetic associations with attention-deficit/hyperactivity disorder (ADHD), and depression. Clinical manifestations vary across different developmental stages, and distinguishing pathological from normative irritability may be challenging. Although there is no gold-standard measure, validated instruments are available. Despite recent advances, evidence-based treatment remains limited. Evidence supports psychosocial interventions that integrate parent- and child-focused components, as well as the use of stimulants for patients with comorbid ADHD. Antipsychotics are effective in reducing irritability in children with autism spectrum disorder. However, its use requires caution in non-autistic youth with irritability without a diagnosable disorder or with oppositional defiant disorder due to inconclusive efficacy and potential adverse effects.</div></div><div><h3>Conclusions</h3><div>Although publications on non-episodic irritability have increased, the evidence remains relatively nascent. Further research is needed to advance the knowledge on underlying mechanisms, enhance clinical recognition, identify effective interventions, and support the development of new treatments, ensuring that irritability is adequately addressed in clinical practice.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"102 ","pages":"Article 101457"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292213","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}