Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"Boosting Autism Screening and Referrals with EHR-Integrated Tools at Well-Child Visits.","authors":"Shravani Vundavalli, Courtney M Brown, Juan D Chaparro, Aarti Chandawarkar, Stefanie Bester, Amy Newmeyer, Elizabeth W Barnhardt","doi":"10.1097/DBP.0000000000001325","DOIUrl":"10.1097/DBP.0000000000001325","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512159","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 Cannabis Use and Offspring Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Retrospective Cohort Study.","authors":"Kelly C Young-Wolff, Kevin Kong, Stacey E Alexeeff, Lisa A Croen, Nina Oberman, Harshal Kirane, Deborah Ansley, Meghan Davignon, Sara R Adams, Lyndsay A Avalos","doi":"10.1097/DBP.0000000000001323","DOIUrl":"10.1097/DBP.0000000000001323","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether maternal cannabis use during early pregnancy is associated with offspring attention deficit hyperactivity disorder (ADHD) and disruptive behavior disorders (DBD).</p><p><strong>Methods: </strong>We conducted a population-based retrospective birth cohort study of children (N = 141,570) born between 2011 and 2018 to pregnant individuals (N = 117,130) in Kaiser Permanente Northern California universally screened for any prenatal cannabis use at the entrance to prenatal care (at ∼8-10 wk gestation). Prenatal cannabis use was defined as (1) self-reported use and/or a positive toxicology test, (2) self-reported use, (3) a positive toxicology test, and (4) self-reported use frequency. Cox proportional hazards regression models adjusting for maternal characteristics (sociodemographics, other substance use and substance use disorders, prenatal care initiation, comorbidities) examined associations between prenatal cannabis use and offspring ADHD and DBD diagnosed by age 11 years.</p><p><strong>Results: </strong>The sample of pregnant individuals was 27.2% Asian/Pacific Islander, 5.7% Black, 24.5% Hispanic, and 38.8% non-Hispanic White, with a mean (SD) age of 30.9 (5.2) years; 4.6% screened positive for any cannabis use (0.4% daily, 0.5% weekly, 1.1% monthly or less, 2.7% unknown frequency); 3.92% had a positive toxicology test and 1.8% self-reported use; 7.7% of offspring had ADHD and 6.8% had DBD. Maternal prenatal cannabis use was not associated with ADHD (adjusted hazard ratio [aHR]: 0.84, 95% CI, 0.70-1.01), and there was an inverse association with DBD (aHR: 0.83, 95% CI, 0.71-0.97), which remained when cannabis was defined by toxicology testing but not by self-report. Frequency of use was not associated with outcomes.</p><p><strong>Conclusion: </strong>Maternal prenatal cannabis use was not associated with an increased risk of offspring ADHD or DBD.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479552","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":"Association Between Positive Childhood Experiences and Caregiver-Reported ADHD Diagnosis and Severity.","authors":"Elizabeth Crouch, Elizabeth Radcliff, Emma Boswell, Monique J Brown, Peiyin Hung","doi":"10.1097/DBP.0000000000001315","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001315","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the prevalence of positive childhood experiences (PCEs), a counter to adverse childhood experiences, in children with an attention-deficit hyperactivity disorder (ADHD) diagnosis. The purpose of this study was to examine the relationship between PCEs and ADHD diagnosis and severity, adjusting for child, family, and household characteristics, using a nationally representative data set.</p><p><strong>Methods: </strong>Using the 2020 to 2021 National Survey of Children's Health, our sample included children 6 years of age or older, as this is the age at which PCE questions are asked (n = 56,224). Multivariable logistic regression was used to examine the association between PCE type and ADHD diagnosis and severity, controlling for child and household characteristics.</p><p><strong>Results: </strong>In multivariable regression analyses, children who had volunteered in their community had lower odds of a reported ADHD diagnosis than children who had not volunteered in their community (adjusted odds ratio [aOR] 0.83; 95% confidence interval [CI], 0.73-0.95). Children with a connected caregiver had a lower likelihood of ADHD diagnosis than children without a connected caregiver (aOR 0.66; 95% CI, 0.58-0.74). Children reporting moderate to severe ADHD were less likely to report exposure to any of the 7 PCEs examined, when compared with children reporting mild ADHD.</p><p><strong>Conclusion: </strong>The findings from this study can be important for clinicians and families to mitigate the negative social and academic outcomes that children with ADHD may face.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394858","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":"Maternal Mobile Device Use and Mealtime Interactions With Children.","authors":"Jenny S Radesky, Heidi M Weeks, Harlan McCaffery, Niko Kaciroti, Julie C Lumeng, Alison L Miller","doi":"10.1097/DBP.0000000000001317","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001317","url":null,"abstract":"<p><strong>Objective: </strong>This study examined (1) whether different types of mobile device use are associated with quantity/quality of parent-child interactions and (2) moment-to-moment changes in quantity/quality of parent-child interactions when devices are used.</p><p><strong>Method: </strong>In 47 videorecorded home mealtimes conducted in 2011 to 2013, we conducted detailed coding of maternal device use (talking, texting/scrolling, having device on table), frequency of mother and child verbalizations, child bids for attention, and maternal response to bids (contingent, no response, negative response) in 5-second intervals. We examined between-mother differences in parent-child interaction variables for a 10-percentage point increase in each type of device use comparisons using negative binomial or logistic regression. We then compared intervals when there was active mobile device use to nonuse intervals using generalized estimating equation logistic regression, predicting the odds of each parent-child interaction variable.</p><p><strong>Results: </strong>Mothers averaged 29.8 years (SD 6.10), child age 5.97 years (SD 0.56), and 55% had completed at least some college. Higher percentage of time spent texting/scrolling was associated with a lower rate of maternal verbalization (adjusted rate ratio 0.89 [95% confidence interval, 0.84-0.95]) and contingent response (adjusted rate ratio 0.92 [0.84-1.00]) and higher odds of nonresponse (adjusted odds ratio 1.13 [1.04-1.22]). In each 5-second interval of active device use, there was decreased odds of maternal verbalizations (adjusted odds ratio 0.48 [0.34-0.69]), child verbalizations (0.62 [0.44-0.88]), contingent response (0.45 [0.28-0.74]), and higher odds of maternal nonresponse (2.36 [1.40-4.00]).</p><p><strong>Conclusion: </strong>These results demonstrate decreased parent-child verbal interaction and lower parent responsiveness during mobile device use, particularly with texting and scrolling.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394859","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":"Associations Among Race, Ethnicity, and Clinical Profiles of Young Children Evaluated for Autism in the Primary Care Setting.","authors":"Ann Marie Martin, Brandon Keehn, Angela Paxton, Mary R Ciccarelli, Rebecca McNally Keehn","doi":"10.1097/DBP.0000000000001298","DOIUrl":"10.1097/DBP.0000000000001298","url":null,"abstract":"<p><strong>Objective: </strong>Despite long-standing racial and ethnic disparities in autism spectrum (AS) diagnosis, recent research suggests that overall, greater numbers of Black and Latine children are now diagnosed with AS as compared with non-Latine White (NLW) children in some US regions. However, gaps remain in the equitable detection of Black and Latine children with AS without significant developmental impairment. The objective of this study was to determine whether the clinical profiles of young children evaluated for AS across a statewide system of early autism diagnosis in Indiana vary by race and ethnicity.</p><p><strong>Methods: </strong>We examined racial and ethnic differences in: (1) AS symptom severity, (2) developmental functioning, (3) adaptive functioning, and (4) behavior problems in a sample of 147 children, aged 14 to 48 months (M = 2.6 years), referred for AS evaluation.</p><p><strong>Results: </strong>Clinical profiles of young children evaluated differed significantly by race and ethnicity, with Black and Latine children exhibiting lower developmental ( p = 0.008) and adaptive abilities ( p = 0.01) and higher AS symptoms ( p = 0.03) as compared with NLW children.</p><p><strong>Conclusion: </strong>Potential explanations for findings include racial and ethnic differences in family and community awareness and knowledge about AS and follow-through on evaluation referral, both driven by social determinants of health (SDOH) affecting minoritized children. Bias in screening and assessment instruments and clinician surveillance, screening, and referral practices may also underlie differences in clinical profiles of children evaluated. Future research is needed to understand the SDOH that influence AS detection and diagnosis to improve equitable access to early diagnosis and intervention.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e414-e421"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635577","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":"Considerations and Actionable Steps to Promote Scaling of Early Autism Diagnosis in Community Primary Care Practice.","authors":"Rebecca McNally Keehn, Melanie Penner, Jennifer Shannon, Kristin Sohl, Carol Weitzman, Katharine E Zuckerman","doi":"10.1097/DBP.0000000000001297","DOIUrl":"10.1097/DBP.0000000000001297","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e492-e496"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602070","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":"Hearing Loss and Autism Spectrum Disorder.","authors":"Sarah A Pollick, Megan Honor Pesch, Arielle Spellun, Elodie M Betances, Susan Wiley, Leah C Geer, Kerry K Prout, Michelle Hu, Sarah S Nyp","doi":"10.1097/DBP.0000000000001308","DOIUrl":"10.1097/DBP.0000000000001308","url":null,"abstract":"<p><strong>Case: </strong>Gretta is a 3.5-year-old girl with a history of congenital cytomegalovirus, congenital bilateral profound sensorineural hearing loss (SNHL), and bilateral vestibular dysfunction, resulting in frequent falls. She underwent cochlear implantation at 12 months of age and was diagnosed with autism spectrum disorder at 2.5 years of age.On presentation for follow-up in the developmental-behavioral pediatrics (DBP) clinic, Gretta's mother reports that Gretta has refused to wear her cochlear implants for the past 5 months. Before that, she seemed to enjoy having access to sound and like dancing to music, and her receptive and expressive language skills, including speech, were progressing. Initially, the rejection of her devices occurred only at preschool. When frustrated or overwhelmed, she would close her eyes and remove her devices for up to 5 minutes before allowing them to be reapplied. Over time, this progressed to a complete refusal to wear her devices at school and then at home, rendering her without access to sound and spoken language.Gretta's mood has become sullen, and she is now having tantrums at school. She physically startles when attempts are made to reintroduce her devices. Her ability to participate in classroom learning or interact with her classmates is limited, as she attends a spoken-language-focused preschool program. A board-certified behavioral analyst, hired by the family, recommended that Gretta not be allowed to participate in classroom activities unless she wears her devices. She now becomes visibly anxious even when in the same room as her devices and repetitively states \"no implant, no implant.\" Her mother is worried about her inability to communicate and has \"no idea\" what may have changed or sparked her initial refusal to wear the devices.What factors would you consider when determining the cause and function of Gretta's refusal to wear the cochlear implants? How would you guide her parents, teachers, and clinicians to ensure the best developmental and behavioral outcomes for her?</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e497-e500"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977062","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":"Perceptions of Individuals with Autism Spectrum Disorder on How Health Care Providers Address Sexual Health.","authors":"Aanchal Sharma, David W Pantalone, Brooke Kohn, Erin T Pereida, Nicole Nadwodny, Susan Faja","doi":"10.1097/DBP.0000000000001293","DOIUrl":"10.1097/DBP.0000000000001293","url":null,"abstract":"<p><strong>Objective: </strong>Medical providers report barriers that prevent them from discussing sexual health with patients with autism spectrum disorder (ASD). No investigations have examined the perspectives of adults with ASD about their sexual health care experiences.</p><p><strong>Methods: </strong>Twenty-five verbal young adults diagnosed with ASD and 40 young adults without ASD participated. An 8-item self-report survey assessed frequency of health care visits, age when sexual health was first discussed, and frequency/content of discussions with providers.</p><p><strong>Results: </strong>The likelihood of discussing sexual health topics did not differ by group, χ 2 s < 3.25; p s > 0.07, except sexual victimization, which the ASD group reported having discussed less than the non-ASD group (32% vs 9%), χ 2 (1, N = 57) = 4.36, p = 0.04. Groups did not differ in their reported comfort level discussing sex/sexual health, having a primary care provider, or frequency of visits. The non-ASD group was significantly more likely to have received sexual health counseling (81%) than ASD group (52%), χ 2 (1, N = 58) = 5.33, p = 0.02. Participants in both groups reported having received sexual health information from similar sources except the ASD group was more likely to receive information from parents than the non-ASD group (68% vs 30%), χ 2 (1, N = 65) = 8.99, p = 0.003.</p><p><strong>Conclusion: </strong>Participants in the ASD and non-ASD groups reported similar comfort levels with sexual health discussions and access to health providers. Yet, the ASD group received less counseling related to sexual health-particularly sexual victimization screening-suggesting that critical information may be missing. Future studies should determine how to help providers overcome barriers to providing young adults with ASD sexual health aligned with their needs.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e406-e413"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433263","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":"Social Determinants in COVID-19 Experiences of Children With Disabilities Receiving School-Based Services in Chicago: Mixed-Methods Study of Parent/Guardian Perspectives.","authors":"Catherine Y Luo, Monica E Kowalczyk, Michael E Msall, Anna Volerman","doi":"10.1097/DBP.0000000000001294","DOIUrl":"10.1097/DBP.0000000000001294","url":null,"abstract":"<p><strong>Objective: </strong>To identify the impact of social determinants on the experiences of children with disabilities and their families during the COVID-19 pandemic from the perspective of parents/guardians.</p><p><strong>Methods: </strong>A mixed-methods study engaged parents/guardians of children with Individualized Education Programs (IEPs) in July to August 2021 at a developmental/behavioral pediatrics clinic in 1 urban academic medical center. All parents/guardians completed study-specific surveys on experiences and impact of COVID-19. A subset completed semi-structured interviews. Analysis included descriptive statistics and Fisher exact tests for survey questions and thematic analysis to code interviews and identify themes. Results were corroborated by experts in developmental/behavioral pediatrics and special education.</p><p><strong>Results: </strong>Participants included 24 parents/guardians representing 27 children (mean = 7.37 years). A majority attended public school (78%) and identified as non-White (78%). Most commonly, the children's disabilities were autism (52%), attention-deficit hyperactivity disorder (37%), and speech/language impairment (33%). The services received by children most commonly were speech/language (89%) and physical/occupational (70%) therapies. Five themes emerged about the impact of social determinants on experiences during COVID-19 related to: adapting to disruption of routines, attendance/engagement in learning, interruption of IEP services, support for children and families, and challenges with technology.</p><p><strong>Conclusion: </strong>Social determinants, such as housing, income, insurance, and quality of education, affected the experiences of families and their ability to adapt to the needs of children with disabilities in the setting of COVID-19 pandemic-related changes.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"45 5","pages":"e483-e491"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479555","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":"Experts' Views on Children's Access to Community-Based Therapeutic and Education Services After Genomic Sequencing Results.","authors":"Simon M Outram, Julia E H Brown, Matthew Norstad, Astrid N Zamora, Sara L Ackerman","doi":"10.1097/DBP.0000000000001299","DOIUrl":"10.1097/DBP.0000000000001299","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate how community-based experts respond to families seeking therapeutic and educational support services after pediatric genomic sequencing for rare conditions.</p><p><strong>Methods: </strong>We interviewed 15 experts in the provision of community-based services for children with intellectual differences, developmental differences, or both, as part of a large study examining the utility of exome sequencing.</p><p><strong>Results: </strong>Interviewees highlighted the complexity of the overall referral and assessment system for therapeutic or educational needs, that genetic diagnoses are secondary to behavioral observations in respect to eligibility for the provision of services, and that social capital drives service acquisition. Although emphasizing that genetic results do not currently provide sufficient information for determining service eligibility, interviewees also highlighted their hopes that genetics would be increasingly relevant in the future.</p><p><strong>Conclusion: </strong>Genomic results do not usually provide information that directly impacts service provision. However, a positive genomic test result can strengthen evidence for behavioral diagnoses and the future trajectory of a child's condition and support needs. Interviewees' comments suggest a need to combine emerging genetic knowledge with existing forms of therapeutic and educational needs assessment, and for additional supports for families struggling to navigate social and therapeutic services.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e456-e462"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581429","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}