Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"A Demographic Description of Children and Adolescents With Concomitant Autism and Anxiety Along With a Comparison of Receipt of Psychological Services.","authors":"Elizabeth Salt, Amanda T Wiggins, David N Toupin, Emma Parks, Chizimuzo Okoli, Mary Kay Rayens","doi":"10.1097/DBP.0000000000001321","DOIUrl":"10.1097/DBP.0000000000001321","url":null,"abstract":"<p><strong>Objective: </strong>(1) Evaluate differences in demographic distributions between those with autism alone and those with autism concomitant with anxiety and (2) assess demographic factors associated with receipt of psychological therapy in patients with autism.</p><p><strong>Methods: </strong>Using deidentified health care claims data, we extracted all encounters among children with the International Classification of Diseases-10-CM for Autism Spectrum Disorder (F84) and flagged those with concomitant anxiety (F41.9). Extracted data included age, sex, race, ethnicity, insurance status, and Rural-Urban Continuum Codes. Current procedural terminology codes for psychological services were extracted. Data were analyzed using Mann-Whitney U tests, χ 2 tests of association, and logistic regression.</p><p><strong>Results: </strong>Demographic differences between children/adolescents with autism alone versus autism concomitant with anxiety were noted for age, sex, and race/ethnicity, with a greater prevalence of autism/anxiety identified in older-aged children and children identifying as female and non-Hispanic White residing in an urban area. While 21% of those included in this study had received psychotherapy, the percentages within the autism only and autism/anxiety groups were 12% and 50%, respectively ( p < 0.001). Children/adolescents who were older age quartile, resided in an urban residence, and with a concomitant diagnosis of anxiety were more likely to receive psychological services, while non-Hispanic Other were less likely to, compared with the reference of non-Hispanic White.</p><p><strong>Conclusion: </strong>We identified demographic disparities in the diagnosis of autism versus autism with concomitant anxiety, including age, sex, race/ethnicity, and residence location. Age quartile, urban location, and concomitant anxiety were associated with increased likelihood of receipt of psychological services.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e33-e39"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958214","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":"Glutathione, Vitamin C, and Cysteine Use in Autistic Children With Disruptive Behavior: A Double-Blind, Placebo-Controlled Crossover Pilot Study.","authors":"Patricia Gail Williams, Lonnie Sears, Walter H Watson, Bakeerathan Gunaratnam, Yana Feygin, Stephen P Wright, Janice E Sullivan","doi":"10.1097/DBP.0000000000001334","DOIUrl":"10.1097/DBP.0000000000001334","url":null,"abstract":"<p><strong>Objective: </strong>Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication differences and restricted interests. One proposed biologic mechanism underlying ASD is oxidative stress, leading to the clinical use of glutathione based on anecdotal reports of improved behavior in autistic children. In this pilot study, we tested this observation using a randomized clinical trial format to collect preliminary data on glutathione safety and efficacy.</p><p><strong>Methods: </strong>Glutathione and glutathione in combination with vitamin C and N-acetylcysteine (Trio) were tested. Both treatments were administered in double-blind placebo-controlled randomized crossover studies. In total, 24 children between the ages of 5 and 16 years with ASD and severe behavior disorders were randomized to receive weekly intravenous injections of either placebo or 1 of the 2 interventions (glutathione or Trio) for 8 weeks. After a 1-week washout period, participants were crossed over for the subsequent 8 weeks. Behavioral measures and plasma levels of glutathione were obtained at baseline, during the washout period, and at the end of the study.</p><p><strong>Results: </strong>No differences between treatment groups in behavioral or biologic measures were found. No significant adverse side effects attributable to the treatments were observed. Small improvements in specific glutathione and behavioral measures occurred over the study period for all groups.</p><p><strong>Conclusion: </strong>Treatment with glutathione or glutathione in combination with vitamin C and N-acetylcysteine did not result in improvements in behavior or biologic measures. The positive trends over the course of the study were likely due to the placebo effect or decreased anxiety associated with the study routine.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"46 1","pages":"e17-e24"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442615","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":"Selective Mutism in the Context of Autism and Bilingualism.","authors":"Bridgette Carroll, Veronica Bordes Edgar, Sari H Bar, Cynthia R Call, Sarah S Nyp","doi":"10.1097/DBP.0000000000001333","DOIUrl":"10.1097/DBP.0000000000001333","url":null,"abstract":"<p><strong>Case: </strong>Juan is a 5-year-old boy who has been followed by a developmental-behavioral pediatrician and pediatric neuropsychologist since being diagnosed with language delay and autism spectrum disorder at age 2 years. He is otherwise healthy and was born at term after a healthy pregnancy. His primary language is Spanish, and he has minimal interactions in English. His first words were at 20 months; they were not functional but rather words related to his interests such as \"train.\" He began using 2 to 3-word phrases shortly after but only to request needs. He began speaking in complete sentences at age 4 years.A neuropsychological evaluation was conducted at age 2 years during which Juan demonstrated repetitive behaviors such as hand-flapping, toe-walking, body rocking, and head banging. He displayed sensory seeking behaviors such as rubbing items on his face and close visual inspection. He did not respond to his name and his use of eye contact was inconsistent. He demonstrated rigidity and difficulty transitioning between activities. He did not engage in social reciprocity, and his facial expressions were limited. Minimal spontaneous language was observed, and expressive language largely consisted of echolalia in both languages. Juan was diagnosed with autism spectrum disorder and applied behavior analysis, speech and language therapy, and occupational therapy were recommended.Developmental-behavioral follow-up over the next 2 years noted improvements in behavior, transitions, and social interactions. He participated in early childhood intervention and early childhood special education with significant advances for speech and language in English and Spanish, demonstrating a large vocabulary. At 4 years, parents noted Juan to have reluctance to speak in English. He stopped speaking in English entirely for 3 weeks, though he continued to speak in Spanish. When he resumed speaking in English, it was only with people he knew well (e.g., parents, teachers, babysitter). In clinic, he did not speak to the English-speaking developmental-behavioral pediatrician but spoke in short sentences to the Spanish-speaking neuropsychologist.A repeat neuropsychological evaluation completed at age 5 years revealed that Juan had stopped speaking in English completely, even among those previously deemed \"safe.\" Results were consistent with average cognitive abilities with a strength in verbal skills. Juan's single-word vocabulary in Spanish was exceptionally high. He did not provide expressive responses in English, but his receptive English vocabulary was high average. He responded to English language with nonverbal gestures or spoken language in Spanish. Parents reported Juan to display increased anxiety accompanied by extreme school refusal, behavioral difficulties, and reluctance to leave the home.Given this information, what are your diagnostic considerations and treatment recommendations?</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e87-e89"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734394","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":"Missed Opportunities for Intervening Early in Preschoolers with Developmental Concern: Perspectives From Head Start Parents, Teachers, and Healthcare Providers.","authors":"Karen Burkett, Courtney M Brown, Rita Pickler, Tina Stanton-Chapman, Phyllis Sharps, Farrah Jacquez, Teresa Smith, Amy Holland, Anna Heeman, Tanya Froehlich","doi":"10.1097/DBP.0000000000001327","DOIUrl":"10.1097/DBP.0000000000001327","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to discover the care meanings of facilitators and barriers to detection and intervention for developmental delay among Head Start preschool-aged children, as viewed by parents, teachers, and primary care providers.</p><p><strong>Methods: </strong>We used a qualitative focus group design and broad cultural lens to understand similarities and differences in family and professional care, as Head Start programs educate preschoolers living in poverty who are disproportionately from ethno-racial minoritized groups. We sought the perspectives of 15 Head Start parents equally representing Black, Latino(a), and White parents, 17 teachers, and 11 healthcare providers to discover facilitators and barriers to adherence with professional recommendations.</p><p><strong>Results: </strong>We found that silos in professional communications, parent distrust, knowledge deficits, and stigma were barriers to obtaining developmental recommendations. Participants also identified missed opportunities to facilitate interagency coordination, parental advocacy of a child's developmental needs, and professional alliances to take collaborative actions for early identification and treatment. Furthermore, a subculture of poverty adversely influenced adherence to developmental recommendations, and ethno-racial biases affected Black and Latino(a) families' follow-through.</p><p><strong>Conclusion: </strong>Our findings highlight how the lack of coordination between sectors resulted in the dismissal of parental concerns or denial of services by 1 system or the other, thus, at the very least reducing the child's chances for earlier intervention and treatment. We also identified potential benefits to children when the barriers of poverty and ethnoracial bias are addressed by professionals with coordinated actions, and new systems are developed for sharing developmental screening results and partnering to coordinate care across the preschool and primary healthcare settings.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e45-e55"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512161","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":"Abstracts of Posters and Research Platform Accepted for Presentation at the 2024 Annual Meeting of the Society for Developmental and Behavioral Pediatrics.","authors":"","doi":"10.1097/DBP.0000000000001339","DOIUrl":"10.1097/DBP.0000000000001339","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"46 1","pages":"e97-e153"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442504","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":"Parents' Experiences and Views About Use of Wearable Technology for Research and Treatment Monitoring of Children with Neurodevelopmental Disorders.","authors":"Rachel Xifaras, David J Amor, Erin Turbitt, Claudine M Kraan","doi":"10.1097/DBP.0000000000001337","DOIUrl":"10.1097/DBP.0000000000001337","url":null,"abstract":"<p><strong>Objective: </strong>Wearable technology has potential benefits for clinical measurement with children who have neurodevelopmental disorders (NDDs). However, this cohort may experience sensory processing disorder, behavioral dysregulation, and cognitive challenges. For effective and considerate implementation, the experiences and views of parents of children with NDDs on this topic need in-depth investigation.</p><p><strong>Method: </strong>This qualitative semi-structured interview study used purposeful sampling of families with experience with wearable technology in a research setting. The cohort included 12 parents of 14 children with a diagnosis of Fragile X (n = 6), Prader-Willi (n = 4), or Angelman (n = 4) syndromes. The data were processed using NVivo software (QSR International Ltd. 1999-2013). Data analysis was conducted using reflexive thematic analysis.</p><p><strong>Results: </strong>Theme 1: Parents are willing to use wearable technology in the home or community if it is feasible. Aspects of feasibility were the ease of embedding technology into existing routines, device robustness, and device invasiveness. Theme 2: Parents are guided by previous healthcare and research experiences. Wearables were considered low burden in the context of everything else their child experiences through health care. Theme 3: Early engagement with families in the design and research process of new technologies is important. Parents had strong views on how to introduce a wearable to their child. In this article, parents stressed that the child's behavioral phenotype needs to be considered early in the design and rollout phases.</p><p><strong>Conclusion: </strong>A shared decision-making approach between researchers and parents will improve the uptake and success of NDD-focused research adopting wearable technology approaches for clinical measurement.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"46 1","pages":"e4-e9"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442623","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 Between Sleep Health and Child Behavior at Age 6 Years in the INSIGHT Study.","authors":"Adwoa Dadzie, Lindsay Master, Emily E Hohman, Erika Hernandez Acton, Sara Tauriello, Ian M Paul, Jennifer S Savage, Stephanie Anzman-Frasca, Orfeu M Buxton","doi":"10.1097/DBP.0000000000001326","DOIUrl":"10.1097/DBP.0000000000001326","url":null,"abstract":"<p><strong>Objective: </strong>Suboptimal sleep is associated with disruptive behaviors in childhood. We evaluate associations of mean and variability (SD) of sleep duration, quality, and timing with emotion regulation, impulsivity, and prosocial and antisocial behavior in children.</p><p><strong>Methods: </strong>Intervention Nurses Start Infants Growing on Healthy Trajectories, a randomized controlled trial designed for obesity prevention, compared a responsive parenting intervention delivered in the first 2.5 years after birth with a home safety control group. At age 6 years, children wore an actigraphy device for 7 days and participated in behavioral tasks evaluating behavioral control, emotion regulation, and prosocial and antisocial behaviors. Separate linear regression models examined associations between sleep and behavioral variables, adjusting for study group, child sex, and household income. Moderation analysis investigated whether the study group moderated relationships between sleep and positive age-appropriate behavior.</p><p><strong>Results: </strong>Children (N = 143, age 6.7 ± 0.3 years) were predominantly non-Hispanic White (95%). Mean actigraphic sleep duration, quality, and timing were not associated with behavioral variables. By contrast, greater variability in sleep onset timing was associated with greater impulsivity (B = 0.85, p = 0.004) and poorer emotion regulation (B = -0.65, p = 0.01). Greater variability in sleep midpoint timing was associated with greater impulsivity (B = 0.80, p = 0.03). The study group moderated the effect of sleep onset variability on behavior; only the home safety control group exhibited a significant negative relationship between variability in sleep onset timing and emotion regulation (B = -1.28, p = 0.0002).</p><p><strong>Conclusion: </strong>Findings support the importance of consistency in sleep timing and how this may play a greater role in children's behavioral and emotional outcomes than mean actigraphic sleep duration and quality.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e56-e63"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607048","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":"Navigating the Pandemic: A Call for Deeper Insights on Disabilities and Social Determinants.","authors":"Mahindra Bandari, Manisha Bandari, Cindy Osei","doi":"10.1097/DBP.0000000000001346","DOIUrl":"10.1097/DBP.0000000000001346","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e94"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014304","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":"Improving Executive Function in Children and Adolescents with Cognitive-Engaging Physical Activity: A Systematic Review and Multilevel Meta-Analysis.","authors":"Gesi Teng, Haishuo Xia, Qing Li, Antao Chen","doi":"10.1097/DBP.0000000000001330","DOIUrl":"10.1097/DBP.0000000000001330","url":null,"abstract":"<p><strong>Abstract: </strong>Executive function (EF) development is vital for children and adolescents, with physical activity (PA) playing a key role in its enhancement. Through a systematic review and multilevel meta-analysis, this study investigates the effectiveness of cognitively engaging physical activity (CEPA) over traditional PA in fostering EF in children and adolescents. The research involved 1671 participants across 15 studies to determine if CEPA is superior to PA in enhancing EF and to analyze interventions and dose-response effects. Results demonstrated that CEPA had a more pronounced impact on EF development compared with PA, with a Hedges' g of 0.50 (95% confidence interval, 0.10-0.48), although potentially overestimated due to small-study effects and publication bias. Subgroup analyses did not find notable differences in effectiveness among various intervention types. The most substantial effect was observed with 45-minute interventions, while frequencies less than twice weekly and durations beyond 12 weeks were less effective. These findings suggest that CEPA could be a more efficacious method for advancing EF in youth, indicating a need for larger-scale randomized controlled trial (RCTs) to confirm the results and more accurately estimate their magnitude.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e76-e82"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734393","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":"Knowledge of Established Conditions List and Associated Policies and Procedures Among Pediatricians and Early Intervention Personnel.","authors":"Asha Yadav, Randall Alan Phelps, Jane Squires","doi":"10.1097/DBP.0000000000001329","DOIUrl":"10.1097/DBP.0000000000001329","url":null,"abstract":"<p><strong>Objective: </strong>Despite automatic eligibility, many children with medical conditions associated with increased risk of disability do not receive Early Intervention (EI) services. State EI programs have compiled lists of established conditions to facilitate automatic enrollment; yet little is known about professionals' knowledge and utilization of these lists. This study examined the knowledge of these established conditions lists and associated policies and procedures among pediatricians and EI personnel. State initiatives and approaches undertaken to improve familiarity and utilization of the list, along with recommendations for its improvement were examined.</p><p><strong>Method: </strong>In this mixed-methods study, self-rated survey data were collected from 193 EI personnel responsible for intake and eligibility evaluations, and 69 pediatricians providing primary care. Follow-up interviews were then conducted with 45 EI personnel and 22 pediatricians. Quantitative data were analyzed using descriptive statistics, and qualitative data underwent thematic analysis.</p><p><strong>Results: </strong>Pediatricians rated their knowledge of their state's established conditions list and related policies and procedures lower than EI personnel. Both groups emphasized the significance of the list in referral and eligibility determination but highlighted its underutilization and lack of professional development activities. Consequently, recommendations were made to improve state established conditions lists and their utilization in ensuring direct EI enrollment for eligible children.</p><p><strong>Conclusion: </strong>The lack of shared knowledge and utilization of established conditions lists and associated policies and procedures among pediatricians and EI personnel may result in referral failure for eligible children. Addressing this challenge requires improvement in the content and statewide distribution to improve accessibility and usability.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e64-e70"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774339","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}