Journal of Developmental and Behavioral Pediatrics最新文献

{"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}

{"title":"Maternal Responsiveness, Parenting Self-efficacy, and Economic Empowerment: Determinants of Infant Development in Pakistan.","authors":"Deepika Khanna, Marika Toscano, Soim Park, Atif Rahman, Najia Atif, Lauren M Osborne, Abid Malik, Pamela J Surkan","doi":"10.1097/DBP.0000000000001481","DOIUrl":"10.1097/DBP.0000000000001481","url":null,"abstract":"<p><strong>Objective: </strong>Maternal responsiveness and parenting self-efficacy may be constrained by a woman's ability to make household decisions. We evaluated if maternal responsiveness and parenting self-efficacy were associated with infant development. We further examined economic empowerment as a potential effect modifier of these relationships.</p><p><strong>Method: </strong>Data for this cross-sectional substudy included 400 participants of the 1,200 total participants included in the Happy Mother-Healthy Baby study investigating a cognitive behavioral therapy-based intervention among Pakistani women with anxiety symptoms conducted from 2019 to 2022. We examined the relationships between maternal responsiveness and parenting self-efficacy with 5 domains of child development at 6 weeks postpartum. We performed logistic regression analyses to assess these relationships and used interaction terms to examine economic empowerment as an effect modifier.</p><p><strong>Results: </strong>A 10-point increase in responsiveness score was associated with a 40%, 36%, and 32% reduction in the odds of developmental delay in communication (aOR = 0.60, 95% confidence interval [CI]: 0.42-0.85), problem-solving (aOR = 0.64, 95% CI: 0.46-0.88), and personal-social skills (aOR = 0.68, 95% CI: 0.47-0.98). A 4-point increase in the score for self-efficacy was related to a 30%, 45%, and 37% decrease in the odds of developmental delay in gross motor (aOR = 0.70, 95% CI: 0.51-0.96), problem-solving (aOR = 0.55, 95% CI: 0.40-0.74), and personal-social skills (aOR = 0.63, 95% CI: 0.45-0.87). For fine motor and personal-social domains, self-efficacy played a protective role against infant developmental delay among non-empowered women, but not in empowered women.</p><p><strong>Conclusion: </strong>Maternal responsiveness and parenting self-efficacy were beneficial for infant development in Pakistani women, particularly among women with limited household-level economic empowerment. This study was prospectively registered at ClinicalTrials.gov (identifier NCT03880032) on March 19, 2019.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e546-e553"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693391","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":"The Interplay of Interventions and Social Determinants of Health on Neurodevelopmental Outcomes in Children With Congenital Heart Disease.","authors":"Elisa J Moran, Sukru Aras, Lisa Noll, Faridis Serrano, Chetna K Pande, Sonia Monteiro","doi":"10.1097/DBP.0000000000001502","DOIUrl":"10.1097/DBP.0000000000001502","url":null,"abstract":"<p><strong>Background: </strong>Neurodevelopmental disability is a chief concern of children with congenital heart disease longitudinally. Delays in cognition and language based on neurodevelopmental testing are known morbidities. Although it is known that school-age children often require special education (SPED) services, a closer look at this population correlating interventions and other environmental factors to developmental and school outcomes has not been explored.</p><p><strong>Methods: </strong>Demographic and clinical data were obtained on children who were seen in a cardiac developmental outcomes program, who underwent cardiac surgery in the first year of life, and who had neurodevelopmental testing using the Bayley Scales for Infant and Toddler Development, third edition, at 36 months or prior (n = 216). Receipt of therapies, daycare, educational programming, preschool, and SPED at school age were noted, as well as age at school entry.</p><p><strong>Results: </strong>Of 216 children with Bayley Scales for Infant and Toddler Development, third edition scoring, higher maternal education was associated with higher cognitive and language scores. Receipt of early childhood intervention (ECI) was associated with lower cognitive scores. Of the 216 children, 165 had documentation of whether SPED was or was not received. 55.8% of these children received SPED, with high Child Opportunity Index levels serving as a protective factor and ECI speech therapy and preschool SPED (ECSE) increasing the likelihood of receipt of SPED services.</p><p><strong>Conclusion: </strong>Social determinants of health such as maternal education and neighborhood opportunity are key influencing factors on neurodevelopmental outcomes and receipt of SPED at school age when examining different sociodemographic factors and interventions.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e518-e526"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609614","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":"Challenging Case-In the Teens it Takes a Team.","authors":"Rachel Vuolo, Joshua August, Paul Hammerness, Katie Campbell, Marilyn Augustyn","doi":"10.1097/DBP.0000000000001500","DOIUrl":"10.1097/DBP.0000000000001500","url":null,"abstract":"<p><strong>Case: </strong>Derrick is a 17-year-old young man who presents to the DBP clinic with a several year concern that he is \"neurodivergent.\" He presents with his father, who states that he has been worried as well since Derrick was about 3 years old. He was a late talker, and he had no friends in middle school. He often was teased by his classmates. Derrick's father felt that his primary care clinician did not recognize his concerns, particularly as middle school was at the start of COVID and school shutdowns. Derrick was much happier with virtual learning. When he went back in person at the start of high school, he mostly kept to himself and academically did exceptionally well. He is now in 11th grade and starting the college admissions process, and he has been feeling immobilized about the future. He has started refusing to attend school and he told his pediatric clinician at the last primary care visit in an off-hand manner, that he is \"better off dead.\" He typically goes to sleep around 2 am. He is very groggy for wakeup at 6 am , so his family has been letting him miss school. He is \"too sleepy to pay attention.\" This academic year he has had 30 absences and the school is threatening action, even though he is getting A's to B's on tests. He states he does not enjoy going to school, feels he has no friends, and eats lunch alone. He has not joined any extracurricular activities. Nevertheless, his strongest interests lie in academics, and he scrolls on college websites in the middle of the night, reading course options and intrigued by the possibilities. His primary care clinician referred to a pediatric specialty program. How would you approach his care to support him and his family?</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e573-e575"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391782","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":"Predictors of Clinically Significant Anxiety in Non-autistic Siblings of Children With Autism.","authors":"Lindsey DeVries, Kelly T Cosgrove, Jack Dempsey","doi":"10.1097/DBP.0000000000001501","DOIUrl":"10.1097/DBP.0000000000001501","url":null,"abstract":"<p><strong>Objective: </strong>As the prevalence of autism rises, attention to the well-being of siblings of autistic individuals is increasingly important. The present study aimed to identify predictors of clinically significant anxiety in non-autistic siblings of youth with autism.</p><p><strong>Method: </strong>Data were derived from the Simons Simplex Collection. Participants included 53 siblings with clinically significant anxiety (anxious group) and 53 siblings without elevated anxiety (comparison group), who were matched to the anxious group on various demographic characteristics. Logistic regression was used to assess factors associated with group status. A nonparametric supervised machine learning model was used to confirm predictor strength.</p><p><strong>Results: </strong>Maternal anxiety emerged as a robust predictor of siblings being in the anxious group ( b = 2.75, odds ratio [OR] = 15.56, p < 0.01). Stereotyped ( b = 0.16, OR = 1.17, p = 0.04) and ritualistic behaviors ( b = 0.28, OR = 1.32, p = 0.04) in probands, alongside poorer adaptive behavior in non-autistic siblings ( b = -0.05, OR = 0.95, p = 0.01), were also significantly associated, albeit less strongly, with anxious group classification.</p><p><strong>Conclusion: </strong>Maternal anxiety may be a salient predictor of clinically significant anxiety in non-autistic siblings of youth with autism. The present findings offer novel insights for possible intervention considerations for autistic youth and their families.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e500-e505"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425975","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":"Screening Tool for Autism in Toddlers and Young Children (STAT) Training: Clinician Confidence, Implementation Barriers, and Ongoing Support Needs.","authors":"Tori E Foster, Gabija Z Bender, Jeffrey F Hine, Amy Swanson, Zachary E Warren","doi":"10.1097/DBP.0000000000001511","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001511","url":null,"abstract":"<p><strong>Objective: </strong>The STAT-MD training program aims to address limited access to specialty autism evaluation services by teaching pediatric professionals to conduct autism assessments using the Screening Tool for Autism in Toddlers and Young Children (STAT). While previous research has demonstrated increased autism-focused assessment and diagnosis in community settings following STAT-MD training, implementation in real-world practice has been hindered by logistical barriers, limited follow-up support, and challenges with integration into community-based care. This study aimed to gather input from past STAT-MD training participants to better inform diagnostic training offerings for primary care clinicians and community providers.</p><p><strong>Method: </strong>We invited 1,190 eligible participants from past STAT-MD trainings (2004-2024) to complete an electronic survey. Survey respondents (n = 58) reported on the training's long-term impact on provider confidence, clinical use, and barriers to implementation.</p><p><strong>Results: </strong>Results showed significant increases in provider confidence across 9 assessment-related domains (p < 0.001), but only 64% of respondents reported applying training content in practice or administering the STAT, and only 54% reported diagnosing autism following training. Reported barriers to implementation included time constraints, limited access to specialists, and inadequate reimbursement. Respondents highlighted the need for ongoing support, implementation guidance, and additional training on caregiver counseling and assessing a broader range of autism presentations.</p><p><strong>Conclusion: </strong>These findings underscore the need for training models that provide tailored resources and sustained support around integration within existing practice systems. Future efforts should refine diagnostic training based on provider feedback to increase their long-term impact and facilitate community-based autism assessment.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867491","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":"An Investigation into Referrals Placed Following Positive Screening With the Modified Checklist for Autism in Toddlers, Revised With Follow-up.","authors":"Kendall Abbas, Katherine Steingass, Mary A Abrams, Courtney M Brown, Ann Levine, Brett G Klamer, Elizabeth Barnhardt","doi":"10.1097/DBP.0000000000001512","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001512","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to examine referral practices after positive autism spectrum disorder screening with the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F) for potential variability based on demographic factors focusing on language and patient-reported need for interpretation.</p><p><strong>Methods: </strong>This was a retrospective cohort study. The study population consisted of 776 patients (mean age 25 months) with a positive M-CHAT-R/F (367 high risk, 409 moderate risk). Data collected included self-reported race, ethnicity, preferred language, interpreter need, screening results, and referrals placed at the time of screening. Patients with a prior autism spectrum disorder diagnosis were excluded. Data were analyzed using Pearson's χ2 test of independence and logistic regression to determine if demographic factors, focusing on preferred language and need for an interpreter, were associated with placement of recommended referrals.</p><p><strong>Results: </strong>Among children with a positive M-CHAT-R/F screen, 69% were referred to developmental behavioral pediatrics, 76% to behavioral health, 83% for early intervention, 93% for speech therapy, and 91% for audiology. In unadjusted stratified analysis, no significant differences were found in rates of referral to recommended services in relation to race, language spoken, or interpreter need. After a logistic regression analysis, no factors were predictive of higher or lower rates of referral to any service studied.</p><p><strong>Conclusion: </strong>We found no disparities in referrals after a positive M-CHAT-R/F in relation to preferred language or interpreter need. Further research could examine what factors can help prevent disparities in referral placement to recommended services.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820191","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":"Challenging Case: A Diagnosis of a Sex Chromosome Aneuploidy in Autism Spectrum Disorder.","authors":"Emily Zalimeni, Meredith Close, Maya Chopra, Marilyn Augustyn","doi":"10.1097/DBP.0000000000001508","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001508","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800692","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 of Breakfast Habits at Age 3 With Academic Performance in Elementary School: A Retrospective Population-based Cohort Study.","authors":"Aoi Kawamura, Masahiro Nishiyama, Hiroshi Yamaguchi, Tomoya Hirasaki, Takuya Ueda, Shizuka Oikawa, Kandai Nozu, Hiroaki Nagase","doi":"10.1097/DBP.0000000000001507","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001507","url":null,"abstract":"<p><strong>Objective: </strong>The long-term relationship between breakfast habits in early childhood and academic performance remains unclear. Therefore, this study aimed to investigate the association between breakfast habits at age 3 years and academic performance in the first grade of elementary school.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of a population-based cohort in Amagasaki City that followed children from birth until entry into elementary school. Academic outcomes included performance in the national language and math, as well as subdomains within each subject.</p><p><strong>Results: </strong>Among 7847 children, regular breakfast consumption at age 3 years was associated with higher academic performance. Children who ate breakfast daily had higher mean scores in national language (73.12 ± 19.19 vs 66.16 ± 22.33) and math (81.09 ± 19.19 vs 73.31 ± 24.71). In multivariable regression analyses, daily breakfast consumption at age 3 years was modestly associated with higher first-grade academic performance, specifically with overall math scores (β = 2.46, 95% confidence interval [CI]: 0.07-4.85), calculation-related skills (β = 1.94, 95% CI: 0.29-3.59), and language-related skills (β = 1.74, 95% CI: 0.02-3.46). Associations with other domains were not significant. These associations remained significant after adjusting for economic status, suggesting an independent association between early childhood breakfast habits and academic performance. Children who did not eat breakfast daily were more likely to have financial difficulties and irregular lifestyles.</p><p><strong>Conclusion: </strong>Regular breakfast consumption during early childhood was associated with higher subsequent academic achievement. However, the observed association may reflect underlying social and environmental factors.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714427","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":"Journal Article Reviews.","authors":"Kimberly Burkhart, Stacey Cobb, Oana deVinck-Baroody, Beth Bloom Emrick, Michele Ledesma","doi":"10.1097/DBP.0000000000001504","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001504","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580903","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}