Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"Maternal Parenting Behavior and Preschoolers' Sleep Problems: The Mediating Role of Effortful Control in a Korean Population.","authors":"Jae Eun Jeong, Bomi Lee, Hyeon Chung Hong, Nana Shin","doi":"10.1097/DBP.0000000000001391","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001391","url":null,"abstract":"<p><strong>Objective: </strong>Sleep quality and quantity are critical for preschoolers' physical, cognitive, social, and emotional development. This study examined the individual and environmental factors associated with preschoolers' sleep problems. Specifically, we investigated the direct effects of maternal parenting behavior and the indirect effects mediated by preschoolers' effortful control.</p><p><strong>Method: </strong>A total of 774 mothers with preschool-aged children (aged 3-6 years) participated in this study. They completed a questionnaire assessing their parenting behavior, as well as their children's effortful control and sleep problems.</p><p><strong>Results: </strong>Our analysis yielded 3 major findings. First, we found that rejecting and chaotic maternal parenting behaviors were directly associated with sleep problems in preschoolers. Second, preschoolers' effortful control mediated the relationship between positive maternal parenting behavior and preschoolers' sleep problems. Third, among the 3 dimensions of negative maternal parenting behavior, the mediating effect of effortful control was observed only in the context of chaotic parenting.</p><p><strong>Conclusion: </strong>These results suggest that maternal negative and positive parenting behaviors may be differentially related to preschoolers' sleep problems, with the former exhibiting a more proximal association and the latter potentially linked through mediated processes. Furthermore, when home environments are unpredictable or inconsistent, preschoolers may struggle to develop appropriate behavioral regulation, which can contribute to sleep problems.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651023","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":"Experiences of Children With Down Syndrome and Caregivers Using Contactless Sleep Monitoring as Polysomnography Alternative.","authors":"Kiara Sclip, Andrew Collaro, Jasneek Chawla","doi":"10.1097/DBP.0000000000001396","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001396","url":null,"abstract":"<p><strong>Background: </strong>Sleep disordered breathing (SDB) is more prevalent in children with Down syndrome (DS), and polysomnography (PSG) is routinely performed by 4 years of age. However, application of sensors to the scalp and midface is often poorly tolerated in this population because of behavioral and sensory sensitivities, resulting in failed studies and incomplete data.</p><p><strong>Objective: </strong>This study aimed to explore caregiver experiences and perspectives of contactless sleep monitoring using Sonomat as an alternative to PSG.</p><p><strong>Methods: </strong>This was a cohort study of children with DS undergoing PSG for evaluation of SDB. Caregivers completed study-specific questionnaires on their child's experiences with PSG and Sonomat (in-hospital, home). Descriptive statistics of responses are reported.</p><p><strong>Results: </strong>Fifty-six children underwent simultaneous Sonomat and PSG monitoring, with 28 continuing home monitoring. Airflow sensors were poorly tolerated during PSG, with 30% of children unable to tolerate both nasal prongs and oronasal thermistor. All caregivers who used the Sonomat at home rated the experience positively; however, only 56% preferred it over in-lab PSG, indicating mixed preferences. Most caregivers found Sonomat easy to use, and a majority reported typical sleep patterns during home monitoring.</p><p><strong>Conclusion: </strong>The Sonomat represents a promising contactless tool for screening sleep disordered breathing in children with Down syndrome, particularly in cases where standard PSG is not tolerated. Its ease of use and acceptability suggest value in complementing traditional diagnostics, especially in home settings.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651022","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":"Food Insecurity Before and During the COVID-19 Pandemic and Early Childhood Development.","authors":"Jennifer O Lambert, Eliana M Perrin, Raymond Sturner, Barbara J Howard, Sara B Johnson","doi":"10.1097/DBP.0000000000001393","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001393","url":null,"abstract":"<p><strong>Objective: </strong>To describe changes in household food security status among families with young children before and during the COVID-19 pandemic, when many families experienced changes in food security status because of pandemic disruptions and relief programs, and to investigate the association between household food insecurity (FI) before and/or during the pandemic and developmental milestone attainment.</p><p><strong>Method: </strong>We used an interrupted time series design to evaluate the association between household FI and developmental milestone attainment before and during the pandemic. Our sample included US children 0 to 5 years with FI and developmental screenings prepandemic (June 2017 to February 2020) and intrapandemic (May 2020 to May 2022) in the Comprehensive Health and Decision Information System. Children with no food insecurity were compared to children with only intrapandemic (new), only prepandemic (resolved), or both intrapandemic and prepandemic (persistent) FI.</p><p><strong>Results: </strong>We found lower developmental milestone attainment only in the persistent FI group, with significantly lower communication (adjusted difference = -0.17; 95% CI, -0.33 to -0.01) and personal-social (adjusted difference = -0.15; 95% CI, -0.30 to -0.01) scores, versus children with no FI. There were no differences in developmental milestone attainment in any domains for children with new or resolved FI compared to children with no FI.</p><p><strong>Conclusion: </strong>Using the pandemic as a natural experiment to study how changes in household food security status are associated with development, we found that persistent, but not transient, household FI is associated with suboptimal early childhood development. To promote healthy development, pediatricians should promptly intervene to address FI and advocate for governmental programs that promote food security.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602068","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":"The Coexistence of Adverse Childhood Experiences, Positive Childhood Experiences, and Parent-Reported Attention-Deficit/Hyperactivity Disorder Severity: National Survey of Children's Health.","authors":"Suk-Joon Hong, My H Vu, Douglas Vanderbilt, Larry Yin, Karen Kay Imagawa, Alexis Deavenport-Saman","doi":"10.1097/DBP.0000000000001395","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001395","url":null,"abstract":"<p><strong>Objective: </strong>Children with higher adverse childhood experiences (ACEs) experience more severe parent-reported attention-deficit/hyperactivity disorder (ADHD). Positive childhood experiences (PCEs) help to build resilience and mitigate the impact of ACEs on ADHD. Prior studies have measured the 2 constructs as independent factors, but no research has examined their combined influence on children with ADHD. The first aim was to categorize children with different levels of parent-reported ADHD severity into classes based on shared characteristics of ACE and PCE promoters. The second aim was to examine the relationship between the classes and ADHD severity.</p><p><strong>Methods: </strong>Participants included children 6 to 17 years with data on the 2019 National Survey of Children's Health ADHD severity questionnaire (n = 19,715; weighted n = 49,149,269). Latent class analysis (LCA) identified subgroups of children experiencing patterns among PCE promoters and ACEs, which were measured as independent variables in an adjusted ordinal regression model to estimate their composite effects on ADHD severity.</p><p><strong>Results: </strong>Using LCA, one class belonging to children with low ACEs and high PCE promoters (class 1) and another belonging to children with high ACEs and low PCE promoters (class 2) were identified. Class 2 was 2.2 times more likely to have more severe ADHD (aOR 2.2; 95% confidence interval, 1.8-2.6).</p><p><strong>Conclusion: </strong>Findings suggest ACEs and PCE promoters do not operate independently; children with high ACEs had low PCE promoters and had more severe parent-reported ADHD. Clinicians should consider actively screening for the presence of ACEs and PCEs in all children, especially those with high ADHD severity, and build strong alliances with families.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602069","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":"Discussing Race With Families With Young Children: Pediatric Clinician Attitudes and Practice.","authors":"Grace S Lee, Melissa C Nguyen, Mariana Glusman, Alyssa Cohen, Nikki Shearman, Ashaunta Anderson, Clare Crosh, Tracy Truong, Teandra Ramos, Elizabeth Erickson","doi":"10.1097/DBP.0000000000001380","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001380","url":null,"abstract":"<p><strong>Objective: </strong>To describe clinician attitudes and practices regarding discussions about race-related topics with families of children aged 0 to 5 years.</p><p><strong>Methods: </strong>The authors distributed a survey to the Reach Out and Read (ROR) medical provider network to assess clinicians' prior education, attitudes and clinical practice discussing the impact of racism on child health, racial identity formation, and development of ethnic-racial pride. The authors report item response frequencies with a sub-analysis of respondent race, ethnicity, level of training, and practice region and setting.</p><p><strong>Results: </strong>Six hundred fifty-two surveys with 80% or more completion rate were analyzed. Over 90% of respondents agreed that racism affects child health. Although most agreed that clinicians have a role in discussing the impact of racism on a child's health, racial identity formation, and development of ethnic-racial pride with families, the majority did not regularly do so. Barriers included lack of time and education, clinician discomfort, and fear of damaging the therapeutic relationship. Many agreed that receiving education about these topics was very important, but fewer than 25% had prior education or knew of resources. Nearly 90% agreed that books and ROR can support these discussions; 79% were interested in additional ROR training.</p><p><strong>Conclusion: </strong>Although surveyed clinicians agree that they have a role in discussing race-related topics with families with infants and young children, they do not feel equipped to have these discussions. Pediatricians are interested in incorporating culturally diverse, developmentally appropriate books, and ROR to discuss issues related to race.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592825","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":"The Effectiveness of the Integrated Caregiver Language Intervention Program via Telepractice for Toddlers and Caregivers.","authors":"Hale Hancer, Suna Tokgoz-Yilmaz","doi":"10.1097/DBP.0000000000001390","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001390","url":null,"abstract":"<p><strong>Objective: </strong>Although active involvement of the caregiver is crucial in early intervention for toddlers at risk for developmental language disorders (DLD), challenges in accessing and participating in these programs often exist. Telepractice offers a potential solution to address this issue. This study aims to examine the effectiveness of an Integrated Caregiver Language Intervention Program via Telepractice (ICLIP-T).</p><p><strong>Methods: </strong>A quasi-experimental model with a pretest-posttest format and matched control groups was used. The ICLIP-T, comprising basic language modelling strategies and environmental arrangements, was developed. The session protocol included a video analysis of strategies from previous sessions, a discussion of new strategies, and a question-answer segment. The ICLIP-T intervention was conducted with 21 dyads (study group) over a 12-week period, with each session lasting 45 minutes. The outcomes were analyzed for both caregivers and toddlers and compared with those of the 21 dyads in the control group.</p><p><strong>Results: </strong>Significant differences were observed between the pretest and posttest language scores of toddlers in the study group, and in comparison with those of the control group. Furthermore, the study group revealed significant differences in caregivers' strategies between the pretest and posttest assessments.</p><p><strong>Conclusion: </strong>These results suggest that the language scores of toddlers at risk for DLD improved after the implementation of ICLIP-T by caregivers. Therefore, ICLIP-T should be conducted with larger cohorts and in toddlers with varying severities of DLD to confirm its utility.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585480","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":"Engagement With Recommended Developmental Follow-up and Supports Among Infants With Intrauterine Opioid Exposure.","authors":"Margarida Mascarenhas, Elizabeth Peacock-Chambers, Yarden S Fraiman, Leslie S Kerzner, Davida M Schiff","doi":"10.1097/DBP.0000000000001372","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001372","url":null,"abstract":"<p><strong>Objective: </strong>Describe the engagement of opioid-exposed infants (OEI) with recommended developmental surveillance and supports in the first year of life.</p><p><strong>Methods: </strong>We conducted a single-site retrospective cohort study of OEI delivered between 2016 and 2021, linking birth hospitalization, developmental follow-up (DFU) clinic, and early intervention (EI) records. Primary outcomes were attendance at DFU clinic and evaluation by EI. We used multivariable modified Poisson regression to examine how birthing parent-, infant-, and clinic-level factors are associated with service engagement.</p><p><strong>Results: </strong>Of 256 OEI, 75% engaged in at least 1 developmental service. Referral and attendance rates at the DFU clinic were 69% and 33%, respectively. Ninety-three percent were referred to EI, 73% evaluated and 58% enrolled in services. EI evaluation was positively associated with prolonged infant hospitalization (adjusted risk ratio [aRR] 1.01; CI, 1.002-1.01) and exposure to antidepressants (aRR 1.23; CI, 1.02-1.49) and cocaine (aRR 1.28; CI, 1.09-1.50). Probability of attendance at DFU was higher for infants born to parents receiving care at an integrated perinatal substance use clinic (aRR 2.13; CI, 1.07-4.24) and exposed to antipsychotics (aRR 1.73; CI, 1.12-2.67), whereas those remaining in parental custody had lower probability of engagement (aRR 0.62; CI, 0.39-0.97).</p><p><strong>Conclusion: </strong>Three-quarters of the OEI engaged in developmental surveillance services in the first year of life. Factors relating to disease severity, location of birthing parent care, birthing parent co-exposures, and parental custody were associated with engagement. Efforts to improve engagement in recommended follow-up should elicit the perspectives of caregivers to better understand the mechanisms that drive these differences.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555595","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":"Prenatal Substance Exposure and Positive Developmental Delay Screening Among Patients in Foster Care.","authors":"Lauren Q Malthaner, Jill D McLeigh, Gregory Knell, Katelyn K Jetelina, Folefac Atem, Sarah E Messiah","doi":"10.1097/DBP.0000000000001383","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001383","url":null,"abstract":"<p><strong>Objective: </strong>Prenatal substance exposure (PSE) is a known risk factor for negative birth outcomes and long-term health outcomes like neurodevelopmental problems. Children in foster care have increased exposure to PSE and higher proportions of developmental delay compared with the general population. It is unclear whether differences still exist among developmental delay screening among children in foster care with and without PSE.</p><p><strong>Methods: </strong>Data were extracted from patient medical records of a primary care clinic for children in foster care between January 1, 2018, and December 31, 2021. Cox proportional hazards regression generated hazard of positive developmental delay screening using the Ages and Stages Questionnaire-3 among those who with and without PSE controlling for sex, race, ethnicity, prematurity, caregiver type, as well as interaction between PSE and prematurity and PSE and race.</p><p><strong>Results: </strong>The sample included 975 patients. 60.4% had PSE, and 62.6% had a positive developmental delay screening at least once. 52.9% were male, and 45.5% were White. Those who had PSE but were nonpremature had 1.14 (95% confidence interval, 1.01-1.29) times the hazard of positive developmental delay screening compared with those without PSE and prematurity. However, those with PSE and prematurity had 2.01 times the hazard of positive developmental delay screening than those without either condition.</p><p><strong>Conclusion: </strong>Children in foster care with PSE are at risk for positive developmental delay screening compared with those without; however, those with both PSE and prematurity are at extra risk. This interaction should be considered when making inferences regarding developmental delay screening in this population.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530809","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":"In Their Own Words: Qualitative Study of Parenting During the COVID-19 Pandemic.","authors":"Quinn Tucker, Robert Sege, Allison Stephens, Twinkle Suthar, Eliza Loren Purdue, Charlyn Harper Browne, Dina Burstein","doi":"10.1097/DBP.0000000000001363","DOIUrl":"10.1097/DBP.0000000000001363","url":null,"abstract":"<p><strong>Objective: </strong>The authors aimed to understand the experience of parents and caregivers during COVID-19, including the challenges they faced and what helped them cope using the Strengthening Families (SF) Approach and Protective Factors Framework's five factors: parental resilience, social connections, knowledge of parenting and child development, concrete support in times of need, and social and emotional competence of children.</p><p><strong>Methods: </strong>The Family Snapshot Survey was developed to assess the impact of COVID-19 on family life, including items for quantitative analysis and 2 open-ended responses. This national survey of 9000 parents recruited from an opt-in internet panel was conducted in 3 waves of 3000 in November 2020, February 2021, and July 2021 using the online YouGov platform. The 2 open-ended responses are analyzed here using qualitative thematic analysis based on the SF Approach and Protective Factors Framework for caregivers with children aged 0 to 5 years.</p><p><strong>Results: </strong>The SF factors were used to classify 770 responses, with many responses identified as containing multiple factors, representing their interrelated nature. A lack of concrete support was the most frequent challenge, and parental resilience was the most frequent support.</p><p><strong>Conclusion: </strong>Access or lack of access to concrete support in times of need underscored many of the strengths and challenges, respectively. Participants described interactions between individual protective factors that allowed for safety, stability, or positive experiences. In future community policy creation, policymakers may look at how programs interact and allow families to access multiple protective factors at once, with a critical need for providing these concrete supports.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"46 3","pages":"e292-e299"},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenging Case January 2025: An Autistic Youth With ARFID During the COVID Pandemic.","authors":"Tammy Lim, Alison Cheng, Elana Bern, Marion Aw, Marilyn Augustyn","doi":"10.1097/DBP.0000000000001386","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001386","url":null,"abstract":"<p><strong>Case: </strong>Andrew is a 12-year-old boy living in Southeast Asia with autism spectrum disorder (minimally verbal), who first presented with new symptoms of low mood and anhedonia during the COVID pandemic. This was associated with loss of appetite, which culminated in him eventually refusing to eat any food or swallow any liquids (including saliva). He would hold his saliva in his mouth in the daytime and refused to swallow. He would spit out the saliva when instructed to do so. Because of his worries about swallowing his saliva involuntarily during sleep, he also experienced insomnia. If he managed to fall asleep, he would involuntarily swallow his saliva.Three months from his initial symptoms, he was relocated by his family, to another southeast Asian country for specialty care. At this time, he also refused to speak. He went from intermittently accepting some foods, to being completely averse to any food or fluid intake. He was diagnosed with avoidant restrictive food intake disorder. Because of his acute refusal to eat or drink, a nasogastric tube was inserted and subsequently a gastrostomy tube for enteral nutrition. With this intervention, he was able to maintain good weight and nutrition.Simultaneously, he began treatment in a multidisciplinary feeding and nutrition program. Genetic testing done for concerns of neurological regression yielded a variant of unknown significance. He also began an anti-depressant and sleep medication.During this period, he returned to his country of origin and was no longer able to receive direct in-person specialty feeding support, but did have a dedicated caregiver. He was seen once every few months either in-person or by telehealth by the multidisciplinary feeding and nutrition clinic in the second country. His caregiver was taught to implement behavior strategies with a goal of him resuming oral food intake eventually.What factors should be considered when evaluating a child with co-existing neurodevelopmental and psychiatric conditions, who completely stops eating or drinking in the midst of a global pandemic? What feeding approach would be helpful in managing a complex case like this? What feeding interventions can be actualized at home to reintroduce solids? How did the pandemic impact access to services?</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318549","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}