Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"Trends in Pediatric Attention-Deficit Hyperactive Disorder Diagnoses and Prescription Utilization: 2016 to 2019.","authors":"Christina Kazarov, Samuel K Peasah, Erin McConnell, Kavita K Fischer, Chester B Good","doi":"10.1097/DBP.0000000000001296","DOIUrl":"10.1097/DBP.0000000000001296","url":null,"abstract":"<p><strong>Objective: </strong>Attention-deficit hyperactive disorder (ADHD) is one of the most common psychiatric disorders among children, with estimated prevalence of 7% to 15% worldwide. The aim of this analysis was to update and summarize trends in diagnosis, demographics, and drug utilization of pediatric patients with ADHD.</p><p><strong>Methods: </strong>We used the Agency for Health care Research and Quality Medical Expenditure Panel Survey (MEPS), a survey of US individuals, families, their medical providers, and employers, using datasets from 2016 to 2019. The data sources from the MEPS database included the full-year consolidated files, medical conditions files, prescribed-medicines files, and condition-event link files for each year. We summarized trends in the proportion of children, ages 17 years and younger, with a diagnosis of ADHD, demographic information and a prescription for medication known to treat ADHD. In addition, we further stratified ADHD medication use by stimulant/nonstimulant categories.</p><p><strong>Results: </strong>There was a 1.6% and 4.7% absolute increase in children with an ADHD diagnosis and those prescribed ADHD medications, respectively, from 2016 to 2019. Most of these children were male, non-Hispanic, and on public insurance. Of the children prescribed an ADHD medication and concomitant behavioral medications, stimulants-only use was the highest (60%-67%), followed by stimulants/nonstimulants (13%-15%), stimulant/antidepressants (6%-9%), and nonstimulants only (5%-9%). The proportion of patients with ADHD in the high-income and near-poor categories increased by 4% from 2016 to 2019.</p><p><strong>Conclusion: </strong>Diagnosis of ADHD among children is trending upward in the United States. Central nervous system stimulants, especially methylphenidate formulations, are the most prescribed ADHD medications for children 17 years and younger.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e397-e405"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433264","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":"Behavioral Intervention that Extends Sleep Duration Leads to Greater Self-Control in School-Aged Children.","authors":"Andrea M Spaeth, Nicola L Hawley, Mary A Carskadon, Hollie A Raynor, Elissa Jelalian, Judith A Owens, Rena R Wing, Chantelle N Hart","doi":"10.1097/DBP.0000000000001303","DOIUrl":"10.1097/DBP.0000000000001303","url":null,"abstract":"<p><strong>Objective: </strong>Short sleep and evening phase preference associate with impaired self-control, yet few studies have assessed the efficacy of sleep extension for improving this behavioral domain. Thus, this secondary analysis of a behavioral sleep intervention measured whether an intervention that enhanced children's sleep also affected self-control. Differences by chronotype were also explored.</p><p><strong>Methods: </strong>Sixty-seven children (8-11 yr), who reportedly slept <9.5 hr/d, were randomized to either a control or sleep intervention condition (i.e., 4-session behavioral intervention to enhance sleep by 1-1.5 hr/night). Chronotype was assessed using the Child Chronotype Questionnaire at baseline, and self-control was assessed using the Self-Control Rating Scale (SCRS, a caregiver report) at baseline and 8 weeks postrandomization. Total sleep time (TST) was measured using wrist actigraphy for 1 week at both baseline and 8 weeks postrandomization. Partial correlations and mixed-model ANOVAs were used for statistical analyses, with age as a covariate.</p><p><strong>Results: </strong>At baseline, children with shorter TST (r = -0.29, p = 0.02) and an evening preference (r = 0.26, p = 0.049) were perceived as having lower self-control by their caregivers. Significant condition*time interaction effects were found for TST ( p < 0.001) and SCRS score ( p = 0.046): From baseline to follow-up, children randomized to the sleep intervention exhibited a significant increase in TST and were perceived as having greater self-control by their caregiver; children randomized to the control condition exhibited no change in TST or in SCRS score. The condition*chronotype*time interaction effect was not significant.</p><p><strong>Conclusion: </strong>A brief sleep intervention that enhanced TST also resulted in enhanced caregiver reported self-control in school-age children. Results add to the growing evidence for the importance of sleep health in children.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e463-e469"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581426","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":"Evaluation of Virtual Enhanced Child Adult Relationship Enhancement in Primary Care Intervention.","authors":"Jenna Kiely, Emily DePaul, Stefany Rojas, SolRubi Cortes, Samantha Schilling, Susan Dougherty, Joanne N Wood","doi":"10.1097/DBP.0000000000001292","DOIUrl":"10.1097/DBP.0000000000001292","url":null,"abstract":"<p><strong>Objective: </strong>Because of COVID-19 pandemic social distancing requirements, the in-person Child Adult Relationship Enhancement in Primary Care (PriCARE) positive parenting intervention was adapted for virtual delivery. Objective was to evaluate the efficacy of the virtual PriCARE program to improve parenting capacity, decrease child behavioral problems, and decrease child maltreatment risk.</p><p><strong>Methods: </strong>Caregivers of children 2 to 6 years old recruited from pediatric primary care were randomized to PriCARE (n = 92) or waitlist control (n = 90). Dysfunctional parenting, positive parenting skills, child behaviors, and child maltreatment risk were measured at baseline and 2 to 3 months after intervention using the Parenting Scale (PS), Dyadic Parent-Child Interaction Coding System (DPICS), Eyberg Child Behavior Inventory (ECBI), and Child Abuse Potential Inventory (CAPI). Kruskal-Wallis test compared median change scores from baseline to follow-up by treatment arm.</p><p><strong>Results: </strong>Of 182 enrolled caregivers, 92% (168) were mothers and 67% (122) completed study measures at baseline and follow-up. The median decrease (improvement) in total PS score was greater in the PriCARE group compared with the control group (-0.3 [IQR 0.69] vs -0.1 [IQR 0.56], p = 0.028) as was the median decrease (improvement) in ECBI problem score (-3 [IQR 9] vs -1 [IQR 7], p = 0.045) and ECBI intensity score (-9 [IQR 21] vs 0 [IQR 25], p = 0.006). Improvements in 4 positive parenting skills measured by DPICS were greater in the PriCARE group compared with the control group (all p< 0.003). Median decrease in CAPI abuse score did not differ significantly by study arm ( p = 0.055).</p><p><strong>Conclusion: </strong>The PriCARE virtual adaptation demonstrated promise in promoting positive parenting and decreasing child behavior problems.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"45 5","pages":"e439-e447"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479554","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":"Examining How National Levels of Life Expectancy, Education, and Income Influence Early Childhood Development: The Mediating Role of the Child's Nurturing Context.","authors":"W Andrew Rothenberg, Marc H Bornstein, Diane L Putnick, Jennifer E Lansford","doi":"10.1097/DBP.0000000000001305","DOIUrl":"10.1097/DBP.0000000000001305","url":null,"abstract":"<p><strong>Objective: </strong>Forty-three percent of children younger than 5 years in low- and middle-income countries (LMICs) are at risk of not meeting their developmental potential. This study investigated how 3 aspects of national development (national life expectancy, education, and income levels) are associated with early childhood development by influencing 5 domains of nurturing care (caregiving, the learning environment, safety and security, nutrition, and the health of the home environment).</p><p><strong>Methods: </strong>In total, 159,959 families with children aged 36 to 59 months living in 51 LMICs provided data. National development was measured using 3 indicators (national life expectancy, education, and income levels), and nurturing care was measured using 10 indicators that collectively captured the 5 nurturing care domains. Path analyses examined how nurturing care indicators mediated the effects of national development on early childhood development.</p><p><strong>Results: </strong>Higher national life expectancy was directly associated with more advanced childhood development. Higher national levels of education and income were indirectly associated with more advanced childhood development through aspects of nurturing care, such as reduced caregiver psychological aggression or physical violence, increased learning materials and wired appliances in the home environment, and greater caregiver education and child height-for-age. Greater caregiver cognitive caregiving practices promoted childhood development, regardless of levels of national development.</p><p><strong>Conclusion: </strong>Intervening to promote caregiver education, appropriate discipline strategies, cognitive caregiving practices, and family access to wired appliances, learning materials, and adequate nutrition is key to promoting childhood development in nations with lower levels of national development.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e448-e455"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977061","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":"Educational Values of Latino Families Participating in a School Readiness Intervention: Hopes and Implications for Pediatrics.","authors":"Jaime W Peterson, Alejandro Robles, Veronica Ilene Underwood Carrasco, Julia Zavala, Nicole Almanzar, Katharine E Zuckerman, Janine Bruce","doi":"10.1097/DBP.0000000000001295","DOIUrl":"10.1097/DBP.0000000000001295","url":null,"abstract":"<p><strong>Objective: </strong>To explore Latino parents' educational values and hopes for their preschool-aged children after a clinic school readiness (SR) intervention.</p><p><strong>Methods: </strong>Qualitative analysis of semi-structured interviews of Latino parents regarding their perceptions of a novel SR coaching intervention (2016-2017). Parents who received the intervention were approached for interview (n = 74); 59 postintervention interviews were completed in English or Spanish, audio recorded, transcribed, and translated into English. Iterative team-based coding and inductive thematic analysis of 47 interviews were conducted by 3 team members using Dedoose.</p><p><strong>Results: </strong>Children were on average 4.5 years old, with the majority speaking Spanish at home (57%), and having preschool experience (81%). Mothers mostly had no paid employment (53%) and limited formal education. Four domains emerged: 1) education is valued and seen as a pathway to a successful life for children, and 2) while structural and cultural barriers exist, 3) Latino families are motivated and 4) trust providers to offer SR support. Parents suggested pediatricians could provide more SR knowledge to families and offer programs within primary care. Integration of findings are summarized in a framework for clinical practice.</p><p><strong>Conclusion: </strong>Latino parents' trust in their pediatric providers, combined with their strong educational aspirations for their children, offers the pediatric clinic an opportunity to partner with families to reduce systemic SR barriers. Pediatric providers can support Latino parents in preparing their children for school through culturally responsive, strengths-based approaches that build on their educational aspirations, value existing SR efforts, offer SR knowledge around early literacy and math, and build connections to early childhood programs.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e431-e438"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433262","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":"A Comparison of Parent-Reported Severe Autism With Mild/Moderate Autism Among US Children.","authors":"Paul S Carbone, Carole H Stipelman, Michele E Villalobos, Allison Ellzey, Ashley Stuart, Gregory J Stoddard, Kathleen Campbell","doi":"10.1097/DBP.0000000000001306","DOIUrl":"10.1097/DBP.0000000000001306","url":null,"abstract":"<p><strong>Objective: </strong>An expert commission has proposed the term \"profound\" autism for children on the spectrum who are minimally verbal or nonverbal and have intellectual disability (ID), behavioral challenges, and co-occurring conditions. It is unknown whether parents' rating of \"severe\" autism aligns with the definition of \"profound\" autism. Using the National Survey of Children's Health, we sought to (1) estimate the prevalence of parent-reported severe autism, (2) identify child characteristics that are associated with severe autism, (3) compare health care utilization, and (4) compare caregiver stress and resilience between families of children with severe versus mild/moderate autism.</p><p><strong>Methods: </strong>Parent responses on the 2018 to 2019 NSCH were used to compare school-age children with parent-reported severe autism and those with mild/moderate autism. Descriptive statistics, χ2 tests, and logistic regression were used for statistical analysis.</p><p><strong>Results: </strong>Among parents of 1,368 US children with autism, 10.1% characterized their child's autism as severe, a prevalence of 1 in 333. Parents of children with severe autism were more likely to report ID (45% vs 12.1%, p < 0.001), language delay (88% vs 58.7%, p < 0.001), and difficulties in dressing and bathing (67% vs 19.2%, p < 0.001). Children with severe autism had more behavioral problems and co-occurring conditions but were no more likely to see specialists or receive autism-specific behavioral therapy. Their caregivers reported more stress and less resilience.</p><p><strong>Conclusion: </strong>The characteristics of \"profound\" autism and parent-reported \"severe\" autism significantly overlap, allowing the use of the NSCH for studies of this vulnerable population. Children with profound/severe autism could benefit from more behavioral therapy, specialty care, and family support.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983746","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":"Child Age at Time of First Maternal Concern and Time to Services Among Children with Autism Spectrum Disorder.","authors":"Julia Van Dyke, Steven A Rosenberg, Tessa Crume, Nuri Reyes, Aimee Anido Alexander, Brian Barger, Robert Fitzgerald, Kristina Hightshoe, Eric J Moody, Karen Pazol, Cordelia R Rosenberg, Eric Rubenstein, Lisa Wiggins, Carolyn DiGuiseppi","doi":"10.1097/DBP.0000000000001283","DOIUrl":"10.1097/DBP.0000000000001283","url":null,"abstract":"<p><strong>Objective: </strong>Early treatment of autism spectrum disorder (ASD) can improve developmental outcomes. Children with ASD from minority families often receive services later. We explored factors related to child's age at time of mother's first concerns about child's development and subsequent time to service initiation among children with ASD.</p><p><strong>Methods: </strong>Analysis included 759 preschool-age children classified with ASD based on comprehensive evaluations. Factors associated with retrospectively reported child age at time of first maternal concern and subsequent time to service initiation were investigated using multiple linear regression and Cox proportional hazards.</p><p><strong>Results: </strong>Earlier maternal concern was associated with multiparity, ≥1 child chronic condition, externalizing behaviors, and younger gestational age, but not race/ethnicity. Time to service initiation was longer for children of non-Latino Black or other than Black or White race and higher developmental level and shorter for children with ≥1 chronic condition and older child age at first maternal concern.</p><p><strong>Conclusion: </strong>Parity, gestational age, and child health and behavior were associated with child age at first maternal concern. Knowledge of child development in multiparous mothers may allow them to recognize potential concerns earlier, suggesting that first time parents may benefit from enhanced education about normal development. Race/ethnicity was not associated with child's age when mothers recognized potential developmental problems; hence, it is unlikely that awareness of ASD symptoms causes racial/ethnic disparities in initiation of services. Delays in time to service initiation among children from racial/ethnic minority groups highlight the need to improve their access to services as soon as developmental concerns are recognized.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e293-e301"},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428188","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":"Partnering With a Purpose: Promoting Equity and Justice for Black Children With Autism Spectrum Disorder.","authors":"Stephanie Castelin, Josselyn Okorodudu, Teresa Smith","doi":"10.1097/DBP.0000000000001276","DOIUrl":"10.1097/DBP.0000000000001276","url":null,"abstract":"<p><strong>Objective: </strong>Black children with autism and their families face disparities within clinical care and services, leading to inequitable health outcomes. However, there is limited research centering the voices of the Black autism community in understanding how to address these inequities. In this study, researchers explored the perspectives of caregivers of Black children with autism regarding barriers to equitable care and recommendations for improved services.</p><p><strong>Methods: </strong>Community leaders from an autism advocacy group and researchers from a large academic medical center partnered to conduct a Group Level Assessment with 31 Black families of children with autism. During a three-hour research event, participants discussed their experiences within community, school, and clinical services, collectively coded and interpreted the data, and generated action steps to improve services.</p><p><strong>Results: </strong>The findings revealed 6 areas of need regarding the services Black children with autism and their caregivers receive. Black caregivers recommended that systems of care improve access to culturally responsive care, integrate caregiver priorities within their care, and engage in collaborative decision-making with caregivers. Providers should also equip caregivers with an accessible roadmap for navigating their child's services and connect them to care management professionals and resources for mental health support.</p><p><strong>Conclusion: </strong>The findings of this study address a critical gap in the literature by partnering with the Black autism community to identify solutions to address their needs; these recommendations can be used as a foundation for service providers to reduce disparities and improve outcomes for Black children with autism and their families.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e302-e308"},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635579","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":"Reducing Stimulant Prescribing Error: A Quality Improvement Initiative in Pediatric Outpatient Setting.","authors":"Natthaphon Watthanathiraphapwong, Pathrada Traipidok, Pattra Charleowsak, Nattaporn Tassanakijpanich, Therdpong Thongseiratch","doi":"10.1097/DBP.0000000000001291","DOIUrl":"10.1097/DBP.0000000000001291","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of the Songklanagarind ADHD Multidisciplinary Assessment and Care Team for Quality Improvement (SAMATI) initiative on reducing stimulant prescribing errors in a pediatric outpatient setting.</p><p><strong>Methods: </strong>A retrospective study examined attention deficit hyperactivity disorder (ADHD) registry data from January 2017 to June 2023 to assess the impact of the SAMATI initiative, implemented in early 2020. This initiative, integrating multiple components such as audit and feedback, clinical pharmacist involvement, and Electronic Medical Record utilization, aimed to enhance ADHD medication management. Using interrupted time series and control chart analyses, the study evaluated the initiative's effect on reducing stimulant prescribing errors. Additionally, parental satisfaction was measured to gauge the initiative's overall success.</p><p><strong>Results: </strong>Out of 282 patients enrolled, 267 were included in the final analysis after exclusions. Post-intervention analysis showed significant reductions in various prescribing errors per thousand prescriptions: prescribing without concern drug-condition interaction (443 to 145, p < 0.001), prescribing without adequate monitoring (115 to 14, p < 0.001), lack of regular office visits (98 to 21, p = 0.007), and inappropriate dosage (66 to 14, p = 0.05). Medication errors severity classification also showed significant changes, with notable decreases in classes C and D errors. Parental satisfaction improved from 84% to 95%.</p><p><strong>Conclusion: </strong>The SAMATI initiative significantly reduced stimulant prescribing errors and enhanced parental satisfaction in ADHD care management. This study demonstrates the potential of comprehensive quality improvement strategies in improving medication management in pediatric healthcare. Further research in diverse settings is warranted to confirm these findings.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e283-e292"},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428113","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":"Co-occurring Epilepsy and Attention-Deficit/Hyperactivity Disorder in a 6-Year-Old Boy.","authors":"Beth A Jerskey, Alexis A Reid, Karen Spencer, Elizabeth Diekroger, Jason Fogler","doi":"10.1097/DBP.0000000000001284","DOIUrl":"10.1097/DBP.0000000000001284","url":null,"abstract":"<p><strong>Case: </strong>\"Andrew\" is a 6-year-old, right-handed, cisgender boy who presents for neuropsychological testing to determine whether he meets criteria for attention-deficit/hyperactivity disorder (ADHD). Andrew's parents report that he is easily distracted, has poor concentration, and is unable to sustain attention for discrete periods of time. Andrew is the product of an uncomplicated pregnancy and delivery, and there were no reported concerns in the postnatal period. Andrew met all of his language and motor milestones on time. He was described as having an \"easy\" temperament in his infancy and toddler years. Difficulties with attention started in preschool in that Andrew was described as frequently \"getting lost\" in his play or the task he was working on. He was easy to redirect and responded to cues and reminders. Socially, Andrew was described as friendly but not always \"picking up on social cues.\" Andrew's kindergarten teachers first noted that sometimes Andrew would \"blank out\" and appear to stare off, which was attributed to inattention. His teachers brought their concerns to Andrew's parents, and his parents began to observe Andrew more carefully and noted that these episodes also occurred at home daily. When queried, his parents reported that these episodes would last 4 to 5 seconds and Andrew would not respond to his name being called or to being physically touched. Andrew's medical history, and that of his immediate and extended family, is unremarkable. Routine hearing and vision screenings are also unremarkable. There are no reports of head injuries or concussions. Andrew's gait is stable, and there are no signs of motor weakness. There are no reports of sensory seeking or avoiding behaviors. There are no reports of witnessing or experiencing trauma; motor or vocal tics; or compulsions, ritualized behaviors, or restricted interests.Testing revealed high average verbal comprehension skills, average perceptual and fluid reasoning, and lower end of average working memory and processing speed. During testing, the examiner noted a rapid eye flutter, which Andrew did not see to recognize himself but did ask the examiner to repeat the previous question. Parent and teacher rating scales of emotional and behavioral functioning showed elevations in the areas of inattention and adaptability and 1 scale of executive functioning noted elevations in task monitoring but no other difficulties. Socially, Andrew is well liked by his peers, although he can present as \"silly.\" He has many same-aged friends and enjoys group activities. His parents have been hesitant to get him involved in sports because he has been known to have these staring episodes right after competing in sporting events. He also tends to have them more often during the school week when he has less sleep, which his parents attribute to having a difficult time falling asleep at night. What would you do next?</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e387-e389"},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428189","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}