Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"Reducing Excessive Screen Time Among Primary School-Aged Children Through Caregivers' Parenting Behaviors: A Feasibility Pilot Study in China.","authors":"Qian-Wen Xie, Xu Li Fan, Roujia Chen, Lingyi Chen","doi":"10.1097/DBP.0000000000001351","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001351","url":null,"abstract":"<p><strong>Objective: </strong>Given the well-documented associations between excessive screen time (ST) and adverse health outcomes, this pilot study aimed to examine the applicability and effectiveness of a multicomponent intervention that combined strategies to enhance caregivers' screen-related parenting practices with efforts to create a supportive community environment to reduce children's ST in a county in China.</p><p><strong>Methods: </strong>A 2-arm, cluster-randomized, wait-list controlled design was used. Eight communities and 336 caregivers of primary school-aged children were randomly assigned to intervention and control groups. Wilcoxon signed-rank tests and McNemar's χ2 tests were applied to evaluate within-group changes over time. A linear mixed model was used to assess intervention effects.</p><p><strong>Results: </strong>The intervention significantly reduced children's daily average total ST and entertainment ST on weekends (β = -43.81; p < 0.05; β = -22.29, p < 0.05) and on a weekly basis (β = -30.32; p < 0.05; β = -14.40, p < 0.05). Moreover, it significantly reduced the odds of excessive entertainment ST on weekdays (β = -2.32, p < 0.05) weekly (β = -2.34, p < 0.05) and excessive academic ST weekly (β = -1.71, p < 0.05). No significant treatment effect was found for parenting practices and children's physical activities.</p><p><strong>Conclusion: </strong>This study supports the feasibility of a multicomponent intervention and its effectiveness in reducing children's excessive ST, particularly in addressing entertainment ST.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804693","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":"Examination of Driving Performance across Autistic Drivers: AMeta-Analysis.","authors":"Alecia Mercier, Gabriela Sherrod, Robin Ennis, Olivio J Clay, Caroline G Richter, Despina Stavrinos","doi":"10.1097/DBP.0000000000001360","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001360","url":null,"abstract":"<p><strong>Objective: </strong>It is becoming evident that the unique challenges faced by autistic drivers are contingent on the driving context and specific skills required. This meta-analysis examined the driving performance of both autistic and nonautistic drivers, aiming to clarify the reasons behind inconsistencies in published findings and identify the relative strengths and challenges faced by autistic drivers.</p><p><strong>Method: </strong>This study was performed within a theoretical model of driving skills to break down the complex process of driving and identify specific strengths and challenges displayed by autistic drivers. Data were extracted from included studies, and a meta-analysis using random-effects models was conducted. Risk of bias was assessed, and sensitivity analyses were also conducted.</p><p><strong>Results: </strong>The results from 16 studies suggested that autistic drivers show a small yet significant deficit in their overall driving performance compared with nonautistic drivers. Autistic drivers showed significant challenges and variation in performance at the operational level of driving compared with the tactical level of driving. Variation across driving performance was found to be related to licensure status but not age.</p><p><strong>Conclusion: </strong>This paper was able to build upon prior work by clarifying strengths and challenges that are evident in autistic drivers and their driving performance. Notable differences were found to be most related to operational driving skills. These differences may subside with driving experience compared to nonautistic peers. Future studies should further assess potential reasonings for the variation seen across driving performance by examining the interplay of related factors.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804650","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":"Self-talk in a Patient With Down Syndrome: When is it a Concern?","authors":"Kerry K Prout, Jacqueline Kitchen, Lindsay Tobler, Sarah S Nyp","doi":"10.1097/DBP.0000000000001359","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001359","url":null,"abstract":"<p><strong>Case: </strong>Thomas is a 12-year-old boy with Trisomy 21, hypothyroidism, and hearing loss. During a recent follow-up visit to the multidisciplinary Down syndrome clinic, his parents expressed concern regarding changes related to Thomas's overall functioning and increasing problematic self-talk behavior. Thomas's parents report that he has talked to \"imaginary friends\" (e.g., \"no, don't do that\" or \"that's not nice\") since he was in preschool. Previously, parents have been reassured that this behavior is likely externalized self-talk and have been advised to not be concerned by the behavior as it is fairly common in youth with Down syndrome.His parents shared that he has always been \"in his own world,\" but over the past 6 months, the frequency of self-talk behavior has increased, and the content of self-talk has focused more on \"bad men\" (e.g., \"bad men do bad things\"). Thomas's parents have also noticed that it has become difficult to engage him in conversation or other tasks, including preferred activities, because of his preoccupation with \"talking to imaginary friends.\" In addition, Thomas has begun picking at his skin to the point of bleeding, his artwork/drawings have become more rudimentary (now drawing stick figures), his sleep onset and maintenance have reduced, and he refuses to go into his bedroom because of \"whispers in the walls.\"At school, Thomas's teachers have reported that his speech has become more difficult to understand, and he has been increasingly distracted by \"talking to imaginary friends,\" including in the middle of class time. Classroom behavioral interventions (e.g., positive reinforcement program) have not been helpful.When asked about recent stressors, Thomas's parents shared that there was a string of car break-ins in the neighborhood around 7 months ago and have wondered if overhearing about this event could have affected Thomas in some way.Given this history, what would you consider in development of a differential diagnosis and what would be your next steps in providing care for Thomas?</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804694","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 Hidden Academic Curriculum and Inequality in Early Education: How Class, Race, Teacher Interactions, and Friendship Influence Student Success, 1st Edition.","authors":"Megan Lane, Irene Koolwijk","doi":"10.1097/DBP.0000000000001366","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001366","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804695","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":"Internet-Delivered Parent-Child Interaction Therapy and Sleep Quality in Children With Developmental Delay: Examining the Mediating Role of Bedtime Resistance Behaviors.","authors":"Morganne Warner, Caroline J Gillenson, Justin Parent, Jonathan S Comer, Daniel M Bagner","doi":"10.1097/DBP.0000000000001361","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001361","url":null,"abstract":"<p><strong>Objective: </strong>Sleep problems are frequently reported and associated with externalizing behavior problems in young children, especially those with developmental delay (DD). Parent-child interaction therapy (PCIT) led to improved sleep in young children with DD, but research has not examined the effect of internet-delivered PCIT (iPCIT) on sleep quality or changes in bedtime resistance behaviors as a mediator. This study examined iPCIT's effect on sleep quality in young children with DD through its impact on bedtime resistance behaviors.</p><p><strong>Method: </strong>Participants were from a previously completed randomized controlled trial and included 150 children with DD (M age = 36.2 months, SD = 1.0 months) and their caregivers who were randomized to iPCIT or referrals as usual (RAU). Path analyses examined links between treatment condition, post-treatment bedtime resistance, and sleep quality reported at 6-month follow-up.</p><p><strong>Results: </strong>Treatment condition significantly influenced bedtime resistance behaviors (β = 0.17, 90% CI, [0.04, 0.29], p = 0.01), and these changes, in turn, significantly affected sleep quality reported at 6-month follow-up (β = 0.18, 90% CI, [0.03, 0.33], p = 0.02). Caregivers receiving iPCIT reported fewer bedtime resistance behaviors after treatment and improved child sleep quality at 6-month follow-up than caregivers receiving RAU.</p><p><strong>Conclusion: </strong>Although effects were smaller than in other studies examining PCIT's effect on sleep, these results highlight how iPCIT led to improved sleep quality in children with DD through changes in bedtime resistance. Further research is needed to explore differences in the effectiveness of in-person versus iPCIT, as well as other mechanisms (such as parenting behaviors) through which iPCIT affects child sleep quality.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804691","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":"Mental Health and Quality of Life of Adolescents with Physical, Intellectual and Developmental Disabilities: Perspectives of Parents and Children.","authors":"Suma Kolla Veer, Pamela Williams-Arya","doi":"10.1097/DBP.0000000000001365","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001365","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804692","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":"Integrated Behavioral Health and Implementation of the Safe Environment for Every Kid Approach in Pediatric Primary Care: A Mixed Methods Study.","authors":"Lawrence A Palinkas, Rosemarie Belanger, Lisa Saldana, Laurence Magder, John Landsverk, Holle Schaper, Howard Dubowitz","doi":"10.1097/DBP.0000000000001362","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001362","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the presence of integrated behavioral health care (IBH) in a pediatric practice is associated with improved implementation of Safe Environment for Every Kid (SEEK), an evidence-based approach to prevention of child maltreatment.</p><p><strong>Methods: </strong>Pediatric primary care practices across the United States (n = 44) expressed interest in participating in a longitudinal multisite trial. Half of the practices included IBH. Semi-structured interviews were conducted at different points in time with 49 practice leaders, primary care professionals, behavioral health professionals, and nursing and administrative staff. Quantitative data on implementation stage and phase, proportion of activities completed at each stage, and length of time to complete each stage were collected by the Stages of Implementation Completion measure.</p><p><strong>Results: </strong>Qualitative data revealed several instances in which IBH facilitated the adoption and implementation of SEEK and where SEEK supported IBH. However, apart from a longer duration devoted to program startup among IBH practices, none of the quantitative differences in rate of program startup, better completion of implementation activities, more tasks completed within each stage, and greater competency were statistically significant.</p><p><strong>Conclusion: </strong>Integrated behavioral health care in pediatric primary care settings may help to facilitate the implementation of interventions like SEEK designed to address social determinants of health and reduce the risk of child maltreatment. However, the current study did not find evidence, based on quantitative analyses, that IBH significantly affected the uptake of Project SEEK and that more research may be warranted.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804690","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 Value of ECHO Autism to Primary Care Providers: Building Community and Capacity.","authors":"Jennifer D Smith, Lisa M Vaughn, Erica Page, Terry Mitchell, Julia S Anixt","doi":"10.1097/DBP.0000000000001347","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001347","url":null,"abstract":"<p><strong>Objectives: </strong>The Extension for Community Healthcare Outcomes (ECHO) model has been shown to increase primary care providers' (PCPs) knowledge and self-efficacy in caring for patients with autism spectrum disorder (ASD). Benefits of ECHO Autism participation may not be fully captured in studies measuring only quantitative outcomes. Qualitative methodology was used to explore the perceptions, meaning, and impact of ECHO Autism from the perspective of participating PCPs.</p><p><strong>Methods: </strong>We used group level assessment, a large-group participatory, qualitative research method modified to a virtual format to explore the perceptions, meaning, and impact of the ECHO Autism program from the perspective of 6 participating PCPs, 1 family member, and 5 hub team members. Individual, semi-structured interviews were conducted with 4 ECHO Autism participants to further explore the identified themes.</p><p><strong>Results: </strong>Participants identified 6 primary themes corroborated by interview participants: (1) direct benefits to PCPs, (2) appreciation of the \"all teach, all learn\" approach, (3) sense of community, (4) value of the multidisciplinary conceptualization of care for children with ASD, (5) demystification of care for children with ASD, and (6) benefits to the PCPs' patients and their families. Feedback about ways to enhance the ECHO Autism program was categorized into 5 areas for improvement.</p><p><strong>Conclusion: </strong>ECHO Autism builds a community for providers who may otherwise feel isolated and hesitant to manage complex needs of children with ASD. ECHO Autism is an innovative approach to build capacity for PCPs to provide high-quality evidence-based care to these children within their own communities.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"46 2","pages":"e162-e168"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030583","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":"Social, Emotional, and Behavioral Functioning in Adolescents With Klinefelter Syndrome.","authors":"Anja L Jünger, Meagan Lasecke, Lara C Foland-Ross, Tracy L Jordan, Jamie L Sundstrom, Vanessa Lozano Wun, Gregory A Witkin, Chijioke Ikomi, Judith Ross, Allan L Reiss","doi":"10.1097/DBP.0000000000001335","DOIUrl":"10.1097/DBP.0000000000001335","url":null,"abstract":"<p><strong>Objective: </strong>Klinefelter syndrome (KS) is a common genetic condition in males associated with an extra X chromosome (i.e., 47,XXY). Individuals with KS often experience androgen insufficiency and tall stature and are at increased risk for depression, anxiety, and social challenges. This cross-sectional study investigates social and emotional functions in 52 boys with KS and 62 typically developing (TD) boys, aged 8 to 13 years.</p><p><strong>Methods: </strong>Self-report measures of anxiety, depression, and behavior and parent-report measures of social functioning and behavior were completed. In primary analyses, linear regression was used to test the effect of group (KS, TD) on standardized scores derived from widely used rating scales. In secondary analyses, we explored the influence of pubertal status on these scores and concordance between self- and parent ratings.</p><p><strong>Results: </strong>Our results indicate that boys with KS exhibit significantly increased anxiety, depression, and social difficulties relative to TD peers. Among participants with KS, peripubertal boys generally experienced more difficulties in aspects of social and emotional functioning as compared to prepubertal boys. Concordance analyses revealed differences between parent- and child-reports.</p><p><strong>Conclusion: </strong>These findings indicate that alterations in social, emotional, and behavioral functions are present in boys and adolescents with KS and may be influenced by puberty.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e216-e222"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014867","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":"Health Care Providers' Attitudes and Knowledge Related to Tic Disorder Identification and Treatment.","authors":"Kim Newsome, Helena J Hutchins, Rebecca H Bitsko, Lara R Robinson, Samuel M Katz, Nneoma Uba, Karyl T Rattay","doi":"10.1097/DBP.0000000000001345","DOIUrl":"10.1097/DBP.0000000000001345","url":null,"abstract":"<p><strong>Objective: </strong>Our study assessed child-serving health care providers' attitudes and knowledge related to identification and treatment of tic disorders including Tourette syndrome (TS), among children.</p><p><strong>Methods: </strong>We analyzed cross-sectional data from the 2022 Fall DocStyles, a web-based survey of health care providers. The analytic sample included 1058 child-serving providers (403 family practitioners, 232 internists, 251 pediatricians, and 172 nurse practitioners or physician assistants). We calculated point prevalence estimates and 95% confidence intervals and used χ 2 tests to statistically test differences by provider type and metro status of practice setting.</p><p><strong>Results: </strong>Less than two-thirds of providers (62.4%) considered evaluation of tics as their role, less than half (40.8%) considered diagnosis of tic disorders their role, and around one-fourth considered treatment of patients with tic disorders to be their role (27.3%). Lack of knowledge of tics/TS and lack of comfort evaluating patients for tics and tic disorders were the most often reported barriers to identification and diagnosis for most provider types, and across practice metro status categories. Online training was the most preferred source of information about tics and tic disorders overall and for each provider type.</p><p><strong>Conclusion: </strong>These findings support previous reports indicating challenges in health care provider comfort and knowledge in identifying and diagnosing tic disorders, and the need for more education opportunities around evaluation and diagnosis. Communication and training to support the needs of child-serving providers could improve the access to care for children with tics and tic disorders.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e175-e182"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015420","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}