Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"Determining the Needs of Spanish-speaking Families That Receive Ambulatory Services in the Division of Developmental-Behavioral Pediatrics (DDBP): The Family Viewpoint.","authors":"Simon Abimosleh, Elodie Betances, Maria Beltran Quintero, Paola Amaya de Lopez, Olivia Deeb, Teresa Smith, Emily Sutthoff, Abbey Rubenacker, Andrea Vargas, Tanya Froehlich, Kelly Kamimura-Nishimura","doi":"10.1097/DBP.0000000000001530","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001530","url":null,"abstract":"<p><strong>Background: </strong>Previous satisfaction surveys in a Midwestern developmental-behavioral pediatrics clinic showed suboptimal experiences among Spanish-speaking caregivers, particularly regarding visit length and feeling unsafe during encounters. This study sought to gather detailed information about Spanish-speaking families' experiences with ambulatory developmental-behavioral services and to address a gap in the literature on inequitable health care experiences among caregivers of children with developmental-behavioral disorders.</p><p><strong>Methods: </strong>We collected descriptive, qualitative data on Spanish-speaking families' experiences with developmental-behavioral ambulatory care using Group Level Assessment (GLA) and Participatory Action Research (PAR) methods.</p><p><strong>Results: </strong>Fifteen Spanish-speaking caregivers participated. Although interpreter services were consistently available and often described as excellent, families reported concerns about interpretation accuracy and consistency. Caregivers also noted that providers sometimes appeared rushed, particularly when language barriers led to delays or shortened encounters with non‑Spanish-speaking clinicians. Families proposed several improvements, including expanding bilingual staffing to enhance comfort and communication, strengthening oversight and training for interpreter services-especially in telehealth-and ensuring interpreters actively engage children during therapeutic sessions.</p><p><strong>Discussion: </strong>Addressing these concerns through expanded bilingual staffing, improved interpreter quality, and more culturally responsive communication practices may substantially enhance the care experience for Spanish-speaking families and promote more equitable developmental-behavioral services.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Pediatric Primary Care Providers' Knowledge of Developmental Behavioral Pediatrics Through a Phone Consultation Line.","authors":"Duygu Unkaracalar, Rhonda Eppelsheimer, Randall A Phelps","doi":"10.1097/DBP.0000000000001520","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001520","url":null,"abstract":"<p><strong>Objectives: </strong>Developmental behavioral concerns comprise a large proportion of referrals in primary care. Access to Developmental Behavioral Pediatrics' (DBP) expertise is limited, with long wait-times to access care. We describe usage of a new DBP phone consult line, regarding diagnostic questions, recommended resources, and to assess contribution to pediatric primary care providers' (PCPs) knowledge and confidence in managing developmental and behavioral issues.</p><p><strong>Methods: </strong>This study has 2 components: (1) A retrospective review of consultation call-records between July 2023 to December 2025, describing utilization of DBP call line, including demographics, diagnostic questions, types of recommendations, and contribution to expediting appropriate interventions. (2) A prospective PCP survey to determine PCP satisfaction with recommendations and perceived learning of new information and skills for the management of DBP concerns.</p><p><strong>Results: </strong>A total of 362 consultations were completed. The average wait time for consultation was 10.7 days, significantly shorter than typical in-person DBP assessment wait times (averaging a year or more). Consultations addressed a broad range of developmental and behavioral concerns, and provided guidance on diagnosis, management, and care coordination. Most patients (85.7%) accessed appropriate interventions without or before referral. PCPs reported high satisfaction (89.7%) and learning new information applicable to future patients (79.3%).</p><p><strong>Conclusion: </strong>A new DBP phone consultation line improves timely access to DBP expertise. It facilitates collaborations between PCPs and DBPs to support PCP clinical decision-making. In addition to decreasing delays in accessing interventions, this model aligns with adult learning principles, to yield high provider satisfaction, enabling PCPs to apply newly acquired knowledge to future patient care.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149247262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Conditions and Early Development in Toddlers With Down Syndrome.","authors":"Miranda E Pinks, Noemi A Spinazzi, Mark A Prince, Carol L Wilkinson, Katherine Pawlowski, Lina R Patel, Kaylyn Van Deusen, Nancy Sullivan, Madison M Walsh, Somer L Bishop, Deborah J Fidler, Nicole T Baumer","doi":"10.1097/DBP.0000000000001516","DOIUrl":"10.1097/DBP.0000000000001516","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations between medical conditions and early developmental skills in young children with Down syndrome (DS).</p><p><strong>Method: </strong>Data were drawn from the first timepoint of a longitudinal study of children with DS (n = 114; mean age = 20.6 months). Caregivers completed a comprehensive medical history questionnaire, followed by a structured interview and review by a medical doctor to clarify endorsed conditions. Cognitive, expressive, and receptive communication, and fine and gross motor developments were assessed using the Bayley Scales of Infant and Toddler Development, Fourth edition. Associations between medical condition categories and developmental skills across domains were examined using partial correlations adjusting for age. Dominance analyses assessed the unique contributions of significant medical categories.</p><p><strong>Results: </strong>Vision conditions were associated with lower developmental scores across cognitive, communication, and gross motor domains. Seizure/epilepsy was associated with lower cognitive, expressive communication, and motor domain scores. Length of neonatal intensive care unit stay was associated with lower cognitive and communication scores. Additional factors, including premature birth, structural gastrointestinal conditions, dysphagia, eczema, and thyroid disease, were associated with lower scores in specific developmental domains. Dominance analyses revealed overlapping contributions across significant predictors with each developmental domain.</p><p><strong>Conclusion: </strong>Findings highlight the associations between co-occurring medical conditions and developmental heterogeneity among young children with DS. Results underscore the need for further work, including longitudinal research studies, to clarify the role of medical conditions in shaping neurodevelopment in DS.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and Assessment of a Tiered Autism Assessment Model.","authors":"Patricia K Zemantic, M Alice Shillingsburg, Christian Courson, Tiffany Harris, Denise Blank","doi":"10.1097/DBP.0000000000001527","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001527","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated a tiered autism assessment model (TAAM) designed to integrate caregiver and provider confidence ratings with an FDA-cleared eye-tracking-based diagnostic device for toddlers (16-30 months) within a specialty autism diagnostic clinic. Despite the availability and purported efficacy of the device, no published research to date has examined its integration into clinical practice.</p><p><strong>Method: </strong>We used a type I hybrid effectiveness-implementation design and the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to pilot TAAM. TAAM used caregiver and provider confidence ratings on ASD symptoms alongside device eligibility to triage patients to a shortened appointment (75 minutes or 2 hours) or a standard 4-hour appointment. Low caregiver- and/or provider-rated ASD confidence resulted in a 4-hour appointment. Patients with non-ASD device results received further testing. Caregivers and providers completed acceptability surveys. We describe key phases, including identifying barriers, preparing resources, and implementation.</p><p><strong>Results: </strong>Data from the first 7 months of TAAM indicate that most toddlers were device-eligible (87.80%). Notably, 77.78% of device-eligible toddlers met confidence rating criteria to qualify for a shortened appointment, supporting clinic efficiency. Caregiver and provider acceptability ratings of aspects of TAAM, and of the device specifically, were high.</p><p><strong>Conclusion: </strong>Preliminary findings suggest that TAAM and the device were acceptable to caregivers and providers. By optimizing triage decisions through ASD confidence ratings, this approach holds potential to improve clinical efficiency.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver-reported Family Impact of Congenital Cytomegalovirus Across Early and Middle Childhood.","authors":"Megan Pesch, Emily Santos, Andrea Ciaranello, Kay Leopold, Katherine L Rosenblum, Gail Demmler-Harrison","doi":"10.1097/DBP.0000000000001524","DOIUrl":"10.1097/DBP.0000000000001524","url":null,"abstract":"<p><strong>Objectives: </strong>To examine caregiver-reported family impact of congenital cytomegalovirus (cCMV).</p><p><strong>Methods: </strong>Caregivers of children with cCMV recruited by social media and nonprofit channels stratified by age: toddlers aged 1 to <4 years and school-aged children aged ≥4 to <11 years, completed online questionnaires. Outcomes among toddlers were assessed using the Infant Toddler Quality of Life Questionnaire and school-aged children using the Child Health Questionnaire. Multivariable linear regression models were specified a priori using a block-wise approach, with early-life clinical characteristics, followed by current medical and neurodevelopmental conditions. Standardized beta coefficients were used to compare effect sizes.</p><p><strong>Results: </strong>Of the children with cCMV (N = 181), early-life clinical characteristics were not independently associated with caregiver-reported outcomes after adjustment for current morbidity. Among toddlers, seizure disorder and cerebral palsy were most strongly associated with greater caregiver time burden, whereas autism and seizures were most strongly associated with more negative caregiver emotional impact. Among school-aged children, seizure disorder was strongly associated with greater caregiver time burden and reduced family activities, and both seizure disorder and autism were associated with a less negative caregiver emotional impact. Family cohesion was not independently associated with clinical characteristics in either age group.</p><p><strong>Conclusion: </strong>Caregiver-reported family impact outcomes in cCMV are driven more by current functional morbidity than by markers of disease severity at birth. Distinct, domain-specific patterns emerged across developmental stages, underscoring the importance of ongoing functional assessment and family-centered support for children with cCMV and their families.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Parent-mediated Intervention Versus Standard Therapist-based Intervention in Indian Children With Autism Spectrum Disorder: A Randomized Controlled Trial.","authors":"Praveen Suman, Jasnavdeep Kaur, Sonika Pal, Ashima Mehta, Jyoti Prajapati","doi":"10.1097/DBP.0000000000001518","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001518","url":null,"abstract":"<p><strong>Objective: </strong>The global prevalence of autism spectrum disorder (ASD) has increased substantially in recent decades. In India, prevalence estimates range from 0.74% to 1.68% among children aged 2 to 6 years. Therapist-based interventions are resource-intensive and impractical in low- and middle-income countries. Parent-mediated interventions (PMIs) offer an alternative; however, Indian comparative data are limited. This RCT compared the effectiveness of the Value-based, Quality interaction, Unique for the child, Responsive and Adapted for family (VQURA), a PMI, with standard Therapist-Based Intervention in young children with ASD.</p><p><strong>Methods: </strong>This prospective RCT included 24 to 36-month-old children fulfilling DSM-5 criteria for ASD. Participants were randomized to either the Parent-Mediated Intervention group, involving parent-delivered intervention with therapist guidance, or the Therapist-Based Intervention group, involving therapist-led sessions. Outcomes were assessed at baseline and 6 months using the Bayley Scales of Infant Development, Vineland Social Maturity Scale (VSMS), and Childhood Autism Rating Scale (CARS).</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Both interventions resulted in significant within-group improvements across developmental domains. The PMI group demonstrated significantly greater reductions in autism symptom severity (CARS score mean change -4.40 vs -2.60; p = 0.005) and larger gains in social and adaptive functioning (VSMS Social Quotient +17.22 vs +11.18; p = 0.015). Longitudinal analysis confirmed superior improvement trajectories for PMI in autism severity (p = 0.005) and social functioning (p = 0.009).</p><p><strong>Conclusion: </strong>The VQURA Parent-Mediated Intervention was more effective than therapist-based intervention in improving autism severity and social functioning, supporting its use as a scalable early intervention model in resource limited settings.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autism Diagnostic E-Consults After PCP Training: A Practice-integrated Model to Expand Diagnostic Capacity.","authors":"Jeffrey F Hine, Tori Foster, Ryan Coleman, Holly Miller, Laleh Bahrami, Anna Kathleen Spitler, Meng Xu, Zachary E Warren","doi":"10.1097/DBP.0000000000001522","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001522","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and clinical performance of an autism diagnostic e-consult model that embeds asynchronous psychologist review within primary care workflows to support diagnostic decision-making and triage by primary care providers (PCPs).</p><p><strong>Methods: </strong>Eight autism-trained PCPs across 4 clinics recorded brief diagnostic visits for children referred for autism evaluations. They submitted videos plus structured e-consult orders through a secure platform. Psychologists reviewed cases asynchronously and returned structured electronic health record (EHR) documentation indicating whether PCP impressions were supported and whether specialist follow-up was warranted. Diagnostic outcomes, triage decisions, child and visit characteristics, and observational scores were summarized using descriptive statistics, Wilcoxon rank sum tests, and χ2 tests.</p><p><strong>Results: </strong>Across 81 e-consults over 21 months, children had a median age of 2.3 years; the median interval from initial concern to completed e-consult was 73 days, and all reviews were completed within 7 days. Follow-up testing was recommended for 31%. Concordance between PCP global impressions and psychologist review was high, with 74% of diagnosed children rated \"obviously consistent with autism\" by their PCP. Children diagnosed with autism had higher ASD-PEDS scores on both psychologist and PCP ratings than those not diagnosed. Children referred for specialist follow-up had lower ASD-PEDS scores, and were more likely to have PCP-endorsed medical/social complexity and phrase speech.</p><p><strong>Conclusion: </strong>Pairing PCP training with EHR-integrated e-consults may offer a pragmatic pathway compatible with emerging billing and implementation models for autism assessment in primary care. In this sample, the process was associated with high concordance between PCP and psychologist determinations and appeared to route more complex cases to appropriate specialist follow-up.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiological Diagnoses Versus Descriptive Developmental Diagnoses.","authors":"Elisa J Moran, Sophia Kelsey, Shahad Salman, Robert G Voigt","doi":"10.1097/DBP.0000000000001523","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001523","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Case: &lt;/strong&gt;Jane is a 7-year-old girl who presented for a developmental-behavioral pediatrics (DBP) evaluation because of parental concern about developmental delays and atypical behavior. Jane is a former term infant who was small for gestational age. She experienced some initial feeding difficulties and was discharged home from the nursery at 5 days of age. As a toddler, Jane was mildly delayed in acquiring gross motor developmental milestones, but she was more significantly delayed in acquiring fine motor and adaptive developmental milestones. She began receiving private occupational therapy (OT) services at 18 months of age. Jane's mother reported persistent current concerns about Jane's fine motor and adaptive development, reporting that she is unable to unbutton, button, or tie her shoes. She reported that at school, Jane has difficulty with handwriting and drawing, and she has had a particular academic difficulty in math. She also reported that despite not exhibiting delays in her acquisition of speech and language developmental milestones, having a large vocabulary, and being able to relate experiences verbally, Jane has trouble with back-and-forth conversation. She reported that Jane frequently makes tangential comments, and she tends to have one-sided conversations, where she will repetitively list facts about her restricted interest in insects, without acknowledging whether others are listening or paying attention to her. She reported that Jane also tends to take things very literally, and she has difficulty recognizing humor and sarcasm. Jane's mother reported that Jane exhibits behavioral rigidity, with a strict need for routine and an overfocus on rules, and she often tattles on other children for breaking the rules. She reported that Jane prefers to play by herself, and she does not have any friends at school or in her neighborhood. She reported that Jane has no difficulties with inattention, impulsivity, or hyperactivity at home or at school. On physical examination, Jane was found to have short stature, webbing of her neck, and a low posterior hairline.During the DBP evaluation, Jane was observed to exhibit poor eye contact, to have difficulty modulating the volume of her voice, and to engage in one-sided conversations. On developmental testing, Jane received a standard score of 72 (age equivalent of 4 years, 6 months) in visual-motor integration on the Beery-Buktenica Developmental Test of Visual Motor Integration. On the Kaufman Brief Intelligence Test-2, she received a verbal standard score of 121 and a nonverbal standard score of 88. On the Wide Range Achievement Test-5, she received a Word Reading standard score of 129, a Spelling standard score of 126, and a Math Computation standard score of 74. Based on the history provided by her mother and direct observations of her behavior during the DBP evaluation, on the Childhood Autism Rating Scale, Second Edition, High Functioning Version, Jane received a score of 3","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal Article Reviews.","authors":"Ronald E Becker, Fiorella B Castillo, Audrey Christiansen, Beth B Emrick, Amber Wright","doi":"10.1097/DBP.0000000000001517","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001517","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilingual Exposure Does not Delay Language Development in Preterm Toddlers: Findings From 24 to 30 Months.","authors":"Kelly A Vaughn, Cathy Guttentag, Tricia Zucker, Marina Vannucci, Adolfo Berlanga, Diana Tobon, Gia Valles, Kimberli Izaguirre, Emely Herrera, Dana M DeMaster","doi":"10.1097/DBP.0000000000001515","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001515","url":null,"abstract":"<p><strong>Objective: </strong>The goal of this research was to compare language growth from 24 to 30 months of age among English monolingual toddlers, Spanish monolingual toddlers, and Spanish-English bilingual toddlers who were born preterm. Previous research has led to inconsistent findings about the relationship between bilingual exposure and language development for children born preterm. Based on research from other populations of children at-risk for language difficulties, we hypothesized that bilingual exposure would not worsen language difficulties among children born preterm.</p><p><strong>Methods: </strong>Between August 2023 and March 2025, we collected measures of parent-reported vocabulary and experimenter-administered language assessments from 37 toddlers (54% female) across 3 language groups (n = 16 English monolingual toddlers; n = 16 Spanish-English bilingual toddlers; and n = 5 Spanish monolingual toddlers). We compared the 3 language groups using a Bayesian approach, which allowed us to quantify the strength of the evidence for and against our hypothesis.</p><p><strong>Results: </strong>We found substantial evidence that Spanish-English bilingual children's language skills were comparable with those of English monolingual toddlers at 24, 27, and 30 months of age.</p><p><strong>Conclusion: </strong>This study adds to a growing body of evidence across multiple populations of children at-risk for language difficulties showing that when language skills are measured appropriately, there is no evidence that bilingual exposure worsens language outcomes relative to monolingual exposure. We strongly encourage clinicians to support families' decisions about their child's language exposure without fear that bilingual exposure will worsen language outcomes, even for children at-risk for language difficulties.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}