Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"Engaging Spanish-Speaking Families From Low-Income Households With Children With Language Delays: Recruitment Strategies and Costs.","authors":"Tatiana Nogueira Peredo, Kelley L Durkin, Ann P Kaiser","doi":"10.1097/DBP.0000000000001514","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001514","url":null,"abstract":"<p><strong>Objective: </strong>This study describes recruitment approaches and costs of engaging Spanish-speaking and Latino families and their young children with language delays in a randomized clinical trial of a naturalistic language intervention approach.</p><p><strong>Method: </strong>A total of 214 families were initially screened, and ultimately, 81 families were determined to be eligible and were enrolled in a randomized clinical trial. Families found out about the study via passive recruitment strategies (social media or word of mouth) and active recruitment strategies (referral by experts in early bilingual language development or referral by nonexperts in early bilingual language development). Differences in eligibility based on recruitment strategy type were examined, and a participant acquisition cost for each recruitment source was estimated.</p><p><strong>Results: </strong>There were significant differences in eligibility based on how families were referred. Families who were referred to the study by experts were significantly more likely to qualify and enroll. Referrals from an early intervention provider were the most cost-effective way to recruit families.</p><p><strong>Conclusion: </strong>Active recruitment strategies were essential to recruiting Spanish-speaking and Latino families into a randomized clinical trial. Studies that use primarily or exclusively passive recruitment approaches may result in biased samples. Establishing relationships with community experts may be especially important for research targeting children with disabilities.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889214","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 Distress Due to the COVID-19 Pandemic and Changes in Young Children's Behavior.","authors":"Anne Martin, Rachel S Gross, Elizabeth B Miller, Pamela A Morris-Perez, Daniel S Shaw, Alan L Mendelsohn","doi":"10.1097/DBP.0000000000001488","DOIUrl":"10.1097/DBP.0000000000001488","url":null,"abstract":"<p><strong>Objectives: </strong>Given the known link between maternal and child mental health, it is likely that children whose mothers experienced more distress because of the COVID-19 pandemic were at greater risk for increased behavior problems. Yet research to date has not tested this hypothesis among families who were hit hardest by the pandemic-those with low incomes and from Black and Hispanic backgrounds. Research is also needed that focuses on young children and uses a longitudinal design.</p><p><strong>Design: </strong>We harmonized data from 4 cohorts originally designed to study pediatric parenting interventions with underresourced families in 2 US cities. We examined, first, whether maternal distress because of the pandemic was associated with change over the next 1 to 2 years in preschool-aged children's anxiety/depression and aggression, and second, whether such associations were moderated by maternal depression.</p><p><strong>Results: </strong>Maternal pandemic-related distress predicted a small increase in child aggression but no change in anxiety/depression. There was no moderation by maternal depression.</p><p><strong>Conclusion: </strong>Among families at risk of the most severe health and financial hardships because of the pandemic, maternal pandemic-related distress was associated with increases in child aggression 1 to 2 years later. Maternal mental health must be made a priority in the future disasters not only in its own right but also because of possible spillover effects on young children.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e527-e531"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822945","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":"Exploring the Relationship of Sleep, Screen Time, and Physical Activity With Deficient Emotional Self-regulation in Children With and Without ADHD.","authors":"David Laux, Natalie Deux, Johanna Schoppmann, Martin Holtmann, Tanja Legenbauer","doi":"10.1097/DBP.0000000000001505","DOIUrl":"10.1097/DBP.0000000000001505","url":null,"abstract":"<p><strong>Objective: </strong>This study examines associations between sleep problems, screen time, physical activity, and deficient emotional self-regulation (DESR) in children with and without attention-deficit hyperactivity disorder (ADHD).</p><p><strong>Methods: </strong>A total of 74 children aged 6 to 10 years participated in this cross-sectional study, including 43 inpatients diagnosed with ADHD and 31 control participants. DESR was assessed using a composite derived from Child Behavior Checklist subscales. Parents provided information on children's sleep, screen time, and physical activity using questionnaire measures. Hierarchical regression and group comparisons were conducted to examine associations between lifestyle factors and DESR.</p><p><strong>Results: </strong>Children with ADHD exhibited more sleep problems and higher screen time than controls. Sleep problems were strongly associated with DESR after adjusting for ADHD diagnosis. Screen time was positively correlated with DESR but was not independently associated with DESR in multivariate models. Physical activity was not associated with DESR, and no group differences in physical activity were observed.</p><p><strong>Conclusion: </strong>In this inpatient sample, sleep problems showed the most robust association with DESR, particularly among children with ADHD. These findings highlight sleep as a potentially important clinical target. Future studies should use longitudinal designs and objective measures to clarify directionality and mechanisms.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e494-e499"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671222","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":"Impact of Neonatal Intensive Care Units Experience on Child and Parent: A Developing Country Perspective.","authors":"Halise Metin Baz, Umut Durak, Mehmet Fatih Deveci, Mehmet Akif Buyukavcı, Gulsah Seydaoglu, Ramazan Ozdemir","doi":"10.1097/DBP.0000000000001483","DOIUrl":"10.1097/DBP.0000000000001483","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations of maternal psychological distress and neonatal medical risk during Neonatal Intensive Care Unit (NICU) hospitalization with child developmental outcomes, parental burnout, and perceived family impact at 18 to 24 months corrected age in a middle-income country setting with limited perinatal mental health infrastructure.</p><p><strong>Methods: </strong>This prospective, observational study included 175 mother-infant dyads admitted to a tertiary NICU transitional unit. Maternal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Perinatal Anxiety Screening Scale-Turkish Version (PASS-TR), respectively. Neonatal medical complexity was quantified using a composite Neonatal Risk Score (NRS). At 18 to 24 months corrected age, 112 infants and 96 mothers completed follow-up assessments including the Ages and Stages Questionnaire (ASQ-3), the Parental Burnout Assessment, and the Impact on Family Scale.</p><p><strong>Results: </strong>Maternal depressive (39.9%) and anxiety (75.8%) symptoms were common during the NICU stay but not linked to sociodemographic factors. Higher EPDS and PASS-TR scores were associated with developmental delays in communication, problem-solving, and personal-social domains. Parental burnout correlated with maternal depression, poorer child communication and motor outcomes, and higher NRS. Mothers of infants with hydrocephalus reported the highest distress and burnout.</p><p><strong>Conclusion: </strong>Maternal mental health and neonatal medical risk during NICU hospitalization were important correlates of later child and family outcomes. Routine psychosocial screening and risk stratification in NICU settings may facilitate early identification of at-risk dyads. In low-resource settings, integrated perinatal mental health support may be essential to improving long-term developmental and psychosocial outcomes.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e538-e545"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787906","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":"Time to Medication Initiation in School-age Children With ADHD in Developmental-Behavioral Pediatrics.","authors":"Sushma S Kasinathan, Lynne C Huffman, Ingrid Luo, Yair Bannett","doi":"10.1097/DBP.0000000000001480","DOIUrl":"10.1097/DBP.0000000000001480","url":null,"abstract":"<p><strong>Objective: </strong>To assess the timing of attention-deficit hyperactivity disorder (ADHD) medication prescriptions in relation to the ADHD diagnostic visit in school-aged children seen in Developmental-Behavioral Pediatrics (DBP) clinics and to investigate which clinical and sociodemographic factors affect the timing of medication prescription.</p><p><strong>Method: </strong>We retrospectively analyzed electronic health records of children 6 to 12 years old seen between 2016 and 2024 in 6 DBP clinics at Stanford Medicine Children's Health. ADHD cohort included patients with ICD-10 ADHD diagnosis and ≥1 month follow-up. Andersen Health Care Utilization model informed selection of predisposing (age, sex, race/ethnicity), enabling (insurance, clinician type), and need (ADHD subtype, co-occurring conditions) factors. Primary outcome included: time from first ADHD diagnosis to first ADHD medication prescription within 1 year of diagnosis. Cox regression model assessed associations between clinical and sociodemographic factors and study outcome.</p><p><strong>Results: </strong>Of 823 patients with ADHD, 623 (75.7%) were male; average age at first ADHD diagnosis was 8.2 years (SD = 1.5). Of 823 patients, 484 (58.8%) were prescribed medications within 1 year of diagnosis. The average number of days from ADHD diagnosis to first prescription was 51 days (median = 4). Longer time to medication prescription was associated with Asian race/ethnicity, psychologist clinician, and presence of 1 to 2 co-occurring conditions (most commonly anxiety). Shorter time to prescription was associated with older age, and ADHD combined and hyperactive/impulsive subtypes.</p><p><strong>Conclusion: </strong>Clinical and sociodemographic factors, including patient race/ethnicity, were associated with timing of medication initiation in school-aged children diagnosed with ADHD in DBP clinics. Future mixed-methods studies are needed to understand factors that influence medication initiation in DBP practice.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e487-e493"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634706","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":"Long-term Impact of Participation in ECHO Autism for Allied Health Professionals for Treating Pediatric Autism Spectrum Disorder.","authors":"Suma K Veer, Jennifer D Smith, Kelly Kamimura-Nishimura, Annahita D Modirrousta, Felicia Bernhard, Tanya Froehlich, Julia S Anixt","doi":"10.1097/DBP.0000000000001509","DOIUrl":"10.1097/DBP.0000000000001509","url":null,"abstract":"<p><strong>Objectives: </strong>Extension for community health care outcomes (ECHO) Autism is a successful tele-education program that improves primary care clinicians' knowledge, skills, and self-efficacy in providing medical care to children with autism spectrum disorder (ASD). However, less is known about the effectiveness of the ECHO Autism model for allied health professionals (AHPs). The study objective was to determine if ECHO Autism participation has long-lasting effects (>6 months postparticipation) on AHPs' care practices.</p><p><strong>Methods: </strong>Participants from 3 cohorts of the ECHO Autism for AHPs (EAA) program were invited to participate in qualitative interviews to provide perspectives on barriers to treating children with ASD, reflections on their learnings from EAA, and suggestions for program improvement. Interview recordings were transcribed, and thematic analysis was conducted.</p><p><strong>Results: </strong>Participants included 9 AHPs (4 occupational therapists, 4 speech language pathologists, and 1 physical therapist). AHPs reported that EAA participation reinforced and updated their existing knowledge when treating patients with ASD, affirmed their clinical practice, improved patient and family rapport, advanced professional development, and built interdisciplinary learning. The EAA's free virtual format was convenient; however, participation barriers included time away from clinical visits and inexperience with giving case presentations. Barriers to providing care to children with ASD included limited resources and managing challenging behaviors.</p><p><strong>Conclusion: </strong>EAA provided a flexible format for AHPs to increase their ASD-related knowledge, build interdisciplinary learning, and gain confidence in working with children with ASD. Study findings have the potential to improve the EAA program experience and enhance the autism-related clinical care practices of AHPs.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e506-e513"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680818","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":"Game-based Cognitive Training for School-age Children Living With or Exposed to HIV: A Randomized Controlled Trial in Uganda and Malawi.","authors":"Itziar Familiar-Lopez, Alla Sikorskii, Brian Winn, Lillian Wambuzi, Sufia Dadabhai, Mary G Fowler, Bruno Giordani, Sebastian P Vargas, Michael Boivin","doi":"10.1097/DBP.0000000000001499","DOIUrl":"10.1097/DBP.0000000000001499","url":null,"abstract":"<p><strong>Objective: </strong>Children with perinatally acquired HIV (PHIV) and those exposed to HIV but uninfected (HEU) are at increased risk for adverse cognitive and behavioral outcomes, particularly in sub-Saharan Africa. This study evaluated the efficacy of brain powered games (BPG), a mobile computerized cognitive rehabilitation intervention, on neurocognitive outcomes among children with PHIV, HEU, and HIV unexposed uninfected children (HUU) in Uganda and Malawi.</p><p><strong>Methods: </strong>We conducted a randomized controlled trial in Uganda and Malawi enrolling 599 children aged 5 to 12 years (PHIV = 120, HEU = 239, HUU = 240). Participants were randomized to a 12-week BPG intervention or a waitlist. Neuropsychological outcomes were assessed at baseline, postintervention, and 6-month follow-up using the Kaufman Assessment Battery for Children Second Edition (KABC-II), test of variables of attention, and Cogstate. Linear mixed-effects models estimated intervention effects, separately by country.</p><p><strong>Results: </strong>In Uganda, children receiving BPG demonstrated higher Learning composite scores (3.34; 95% CI, 1.03-5.65), Mental Processing Index scores (2.39; 95% CI, 0.78-4.01), and Nonverbal Index scores in KABC-II (2.28; 95% CI, 0.27-4.28) immediately postintervention compared with waitlist. Cogstate Maze Learning was higher postintervention (0.02; 95% CI, 0.004-0.043) and at 6 months (0.02; 95% CI, 0.003-0.040). In Malawi, Planning scores (-2.22; 95% CI, -4.39 to -0.05) and Delayed Recall scores (-2.87; 95% CI, -5.22 to -0.51) in KABC-II were lower in the intervention arm postintervention, whereas Cogstate Identification scores were higher (-0.03; 95% CI, -0.05 to -0.004).</p><p><strong>Conclusion: </strong>Mobile cognitive training produced modest, domain-specific cognitive benefits, with effects varying by context and HIV exposure status.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e554-e563"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406768","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":"Advancing Physician Skills in Discussing Development in Primary Care: A Brief Intervention for Pediatric Residents.","authors":"Kathleen Kastner, Carolyn Sleeth, Brittany Tayler, Crystal Cederna","doi":"10.1097/DBP.0000000000001487","DOIUrl":"10.1097/DBP.0000000000001487","url":null,"abstract":"<p><strong>Background: </strong>General pediatricians are often the first to discuss developmental differences with caregivers. Unlike when sharing a definitive developmental diagnosis, there is often diagnostic uncertainty during these initial discussions and caregivers may not be prepared to hear the information. Research examining pediatric resident training to discuss developmental differences is lacking.</p><p><strong>Objective: </strong>Study aims included the following: (1) Understand pediatric residents' experience and comfort sharing information about developmental differences. (2) Evaluate the impact of a brief educational intervention on residents' comfort, confidence, and perceived readiness.</p><p><strong>Methods: </strong>In 2023, Pediatric residents (N = 48) from 2 Midwestern programs completed a pre-intervention survey regarding experience, comfort, and confidence discussing developmental differences. After a 90-minute skill-building educational intervention that included an adaptation of the SPIKES framework to fit discussions of development, residents completed postsession surveys. Matched responses were compared to evaluate changes in comfort and confidence (N = 22, 45%). Descriptive statistics, Wilcoxon signed rank tests, χ 2 test, and McNemar analysis were used to analyze data.</p><p><strong>Results: </strong>Despite prior communication training, many residents lacked experience, comfort, and confidence in discussing developmental differences with caregivers pre-intervention. Post-intervention, residents reported significantly improved comfort and confidence with components of developmental conversations, and with the use of a consistent framework for discussing developmental differences.</p><p><strong>Conclusion: </strong>Findings suggest that a one-time, brief, multimethod educational intervention using an adapted SPIKES framework can improve resident readiness to discuss developmental differences.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e514-e517"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787920","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":"A Systematic Review of Caregiver-focused Interventions for Children With Cerebral Palsy in Low- and Middle-income Countries.","authors":"Courtney Allen, Geneva Baumberger, Melissa R Thomas, Kristen Cunningham, Anjali Rao, Reshma Shah, Megan S McHenry","doi":"10.1097/DBP.0000000000001510","DOIUrl":"10.1097/DBP.0000000000001510","url":null,"abstract":"<p><strong>Objective: </strong>In many global settings, children with cerebral palsy (CP) and their families face challenges in routinely accessing specialist-delivered care. This systematic review aimed to summarize caregiver-focused interventions for children with CP in low- and middle-income countries (LMIC).</p><p><strong>Method: </strong>Following Preferred Reporting Items for Systematic review and Meta-Analysis guidelines, we searched 8 electronic databases, most recently in February 2024. Eligible studies described caregiver-focused interventions for children aged 18 years or younger with CP, performed in LMICs (by World Bank criteria), reported outcomes in children or caregivers, and met standards for observational research design. Two reviewers independently extracted data, assessed risk of bias using the NIH Study Quality Assessment Tool, and qualitatively synthesized findings.</p><p><strong>Results: </strong>From 16,485 titles screened, 293 full texts were reviewed, and 16 studies met inclusion criteria. These studies were conducted in 10 LMICs, primarily in South Asia. Most interventions (n = 8) were group-based, with 8 interventions lasting longer than 12 weeks, considered long term. Outcomes focused on caregivers (n = 4), children (n = 4), or both (n = 8). Child motor function (n = 5) and caregiver mental health or well-being (n = 6) were the most common measures, with mostly positive impacts on motor function and little or negative effects on caregiver mental health. Caregivers reported benefits such as improved adaptability and knowledge, alongside enhanced child physical function and communication. Study quality was rated fair (n = 9) or good (n = 7).</p><p><strong>Conclusion: </strong>Caregiver-focused interventions in LMICs can positively impact caregiver well-being and child outcomes. Group-based delivery appears feasible and effective. Future work should explore sustainable implementation strategies to broaden reach and impact.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e564-e572"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875539","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":"Early Intervention Enrollment Among Substance-exposed Infants in Massachusetts: A Population-level Analysis.","authors":"Elizabeth Peacock-Chambers, Katie Q Gu, Emma Miller, Meng Shiou Shieh, Briana L Jurkowski, Sarah Palmer, Hafsatou Diop, Rachana Singh, Jonathan S Litt, JoAnna K Leyenaar","doi":"10.1097/DBP.0000000000001486","DOIUrl":"10.1097/DBP.0000000000001486","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess EI referral and enrollment rates among substance-exposed newborns (SENs) with and without a diagnosis of NAS in MA and to compare rates to infants and toddlers without known substance exposure.</p><p><strong>Methods: </strong>We analyzed the 2013-2020 Pregnancy to Early Life Longitudinal dataset, which includes maternal-infant birth hospitalization records linked with EI data. SEN and NAS were identified using ICD-9/10 codes. We conducted descriptive statistics and bivariate analysis to compare EI referral and enrollment between (1) SENs with and without NAS diagnoses and (2) SENs and the unexposed population.</p><p><strong>Results: </strong>Among 6565 SENs, 85.3% (n = 5602) were referred to EI, and of those referred, 49.5% (n = 2775) enrolled. Compared with SENs without an NAS diagnosis, SENs with an NAS diagnosis were more likely to be referred to (87.6%, n = 4242 vs 79.0%, n = 1360) and enroll in (53.2%, n = 2255 vs 38.2%, n = 520) EI. Among infants and toddlers without identified substance exposure, referral rates were lower (34.6%), but enrollment rates were higher among those referred (56.7%).</p><p><strong>Conclusion: </strong>Substance-exposed newborns in MA had relatively high rates of EI referral but lower rates of enrollment compared with the general population, particularly among SENs without a diagnosis of NAS, suggesting a referral-to-enrollment gap.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e532-e537"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822999","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}