Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"Acceptability and Feasibility of Rapid Tube Weaning During Intensive Multidisciplinary Feeding Intervention.","authors":"Valerie M Volkert, Rashelle Berry, Heather Farling, Caitlin Waddle, Emily Malugen, Sandhya Rajagopal, Laura M Johnson, Scott Gillespie, Derianne Buckley, Meara McMahon, Lawrence Scahill, William G Sharp","doi":"10.1097/DBP.0000000000001392","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001392","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this pilot trial was to determine to what extent hunger provocation, via rapid weaning from enteral feedings, was acceptable and feasible and to evaluate the effect of this intervention when used during intensive multidisciplinary feeding intervention for children dependent on enteral feedings.</p><p><strong>Method: </strong>The study was conducted at an Intensive Multidisciplinary Program located in the Southeastern United States from May 2021 to October 2023. Children were randomly assigned 1:1 to standard wean or rapid wean using permuted blocks of 2 and 4 with allocation pattern concealed to investigators resulting in respective cohort sizes of 8 (N = 16 participants, total) for 8 weeks. Feasibility benchmarks and data completeness were summarized using percentages and means. The study also evaluated the effect of intervention on treatment outcomes including weight-for-age z-score, percentage of daily caloric needs met by mouth, percent of patients achieving ≥1 day where 100% of caloric needs were met via oral feeding, and time to effect.</p><p><strong>Results: </strong>Feasibility and acceptability benchmarks were achieved. Preliminary outcome data suggest rapid tube weaning did not influence reaching 100% oral intake or fully weaning from a feeding tube when used as an adjunct to behavioral intervention.</p><p><strong>Conclusion: </strong>This study was a prerequisite to support a future efficacy randomized clinical trial to further study how to optimize outcomes to achieve full weaning from tube feeding.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700243","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":"Demographic and Clinical Predictors of Suicide Risk in Pediatric Surgical Clinics: A Retrospective Study of 79,000 Screenings.","authors":"Alyssa Barré, De-An Zhang, Victoria Holm, Daphne Lew, Alexander Van Speybroeck, Henry Iwinski, Selina C Poon","doi":"10.1097/DBP.0000000000001397","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001397","url":null,"abstract":"<p><strong>Objective: </strong>Suicide is the second leading cause of death for adolescents. Children in surgical clinics have diagnoses that may predispose mental health challenges. This study explored associations between demographics, diagnoses, and suicide risk screenings in the outpatient pediatric surgical setting.</p><p><strong>Methods: </strong>A database of suicide risk screenings administered across a pediatric surgical health care system from 2019 to 2023 was analyzed. Demographic variables and diagnoses were collected, and multilevel logistic regression models calculated odds ratio (OR) and 95% confidence interval (CI) for the relationships.</p><p><strong>Results: </strong>In total, 79,384 suicide risk screenings were collected for 50,796 patients. 5.6% (n = 4476) were positive for suicidal thoughts. Asians were less likely to screen positive (OR, 0.65; 95% CI, 0.56-0.76), and females were more likely (OR, 1.92; CI, 1.80-2.05). Patients with Medicaid or uninsured were more likely to screen positive (OR, 1.47; CI, 1.38-1.57 and OR, 1.17, CI, 1.002-1.36, respectively). As affluence increased, there was decreased likelihood of positive screens (OR, 0.93; CI, 0.91-0.96). The diagnosis most associated with increased risk was mental, behavioral, and neurodevelopmental disorders (OR, 3.41; CI, 2.92-3.97), followed by pain (OR, 1.88; CI, 1.71-2.05), burns (OR, 1.43; CI, 1.21-1.69), and scoliosis (OR, 1.10; CI, 1.02-1.17).</p><p><strong>Conclusion: </strong>When screening for suicide risk in outpatient pediatric surgical subspecialty clinics, females and patients with Medicaid or uninsured have increased risk of screening positive for suicidal ideations. Youth with mental, behavioral, and neurodevelopmental disorders were most at risk, followed by pain, burns, and scoliosis. It is important to understand how these factors influence mental health to aid in providing resources for at-risk patients.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700244","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":"Preliteracy Skills in Young Children Who are Deaf/Hard of Hearing: Secondary Analysis of the Technology-assisted Language Intervention Randomized Trials.","authors":"Elodie Betances, Susan Wiley, Meredith Tabangin, Rose Sheldon, Laura Lane, Deborah Mood, Pamela Williams-Arya, Jayna Schumacher, Jareen Meinzen-Derr","doi":"10.1097/DBP.0000000000001394","DOIUrl":"10.1097/DBP.0000000000001394","url":null,"abstract":"<p><strong>Objectives: </strong>Most children exhibit preliteracy skills by preschool. Children who are deaf/hard of hearing (DHH) with a language gap are at risk for delayed preliteracy skills. Our study aimed to describe preliteracy skill development in preschool-aged DHH children and investigate associated factors.</p><p><strong>Methods: </strong>Children, aged 3 to 5 years, were included in the analysis if enrolled in randomized trials of a language intervention using augmentative and alternative communication, shown to boost language skills. Evaluations using the Clinical Evaluations of Fundamentals-Preschool Preliteracy Rating Scale (PRS) were conducted at baseline, 24 weeks, and 48 weeks. Repeated-measures models assessed changes in total PRS scores and Early Reading and Early Writing subdomains. Results were presented as least square mean values with 95% confidence intervals.</p><p><strong>Results: </strong>Forty-five children had completed pre-data and post-data. The mean nonverbal IQ was 99.3 (SD 14.3), and receptive and expressive language were 82.3 (14.9) and 76.8 (17.0), respectively. Significant (p < 0.0001) skill growth was observed with all preliteracy outcomes, ranging from 11 to 15 points in the first 24 weeks. Increasing receptive and expressive language over time was significantly associated with increasing scores. Factors such as aided hearing thresholds, caregiver education level, and hearing device use were not significant in models.</p><p><strong>Conclusion: </strong>Language is essential for literacy development. Language-enhancing interventions could facilitate literacy skills. Monitoring preliteracy skills in DHH children is crucial, given their increased risk for language delays. Further research is needed to support early literacy development in this population, ensuring they have the tools they need for future success.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700245","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 Parenting Behavior and Preschoolers' Sleep Problems: The Mediating Role of Effortful Control in a Korean Population.","authors":"Jae Eun Jeong, Bomi Lee, Hyeon Chung Hong, Nana Shin","doi":"10.1097/DBP.0000000000001391","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001391","url":null,"abstract":"<p><strong>Objective: </strong>Sleep quality and quantity are critical for preschoolers' physical, cognitive, social, and emotional development. This study examined the individual and environmental factors associated with preschoolers' sleep problems. Specifically, we investigated the direct effects of maternal parenting behavior and the indirect effects mediated by preschoolers' effortful control.</p><p><strong>Method: </strong>A total of 774 mothers with preschool-aged children (aged 3-6 years) participated in this study. They completed a questionnaire assessing their parenting behavior, as well as their children's effortful control and sleep problems.</p><p><strong>Results: </strong>Our analysis yielded 3 major findings. First, we found that rejecting and chaotic maternal parenting behaviors were directly associated with sleep problems in preschoolers. Second, preschoolers' effortful control mediated the relationship between positive maternal parenting behavior and preschoolers' sleep problems. Third, among the 3 dimensions of negative maternal parenting behavior, the mediating effect of effortful control was observed only in the context of chaotic parenting.</p><p><strong>Conclusion: </strong>These results suggest that maternal negative and positive parenting behaviors may be differentially related to preschoolers' sleep problems, with the former exhibiting a more proximal association and the latter potentially linked through mediated processes. Furthermore, when home environments are unpredictable or inconsistent, preschoolers may struggle to develop appropriate behavioral regulation, which can contribute to sleep problems.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651023","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":"Experiences of Children With Down Syndrome and Caregivers Using Contactless Sleep Monitoring as Polysomnography Alternative.","authors":"Kiara Sclip, Andrew Collaro, Jasneek Chawla","doi":"10.1097/DBP.0000000000001396","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001396","url":null,"abstract":"<p><strong>Background: </strong>Sleep disordered breathing (SDB) is more prevalent in children with Down syndrome (DS), and polysomnography (PSG) is routinely performed by 4 years of age. However, application of sensors to the scalp and midface is often poorly tolerated in this population because of behavioral and sensory sensitivities, resulting in failed studies and incomplete data.</p><p><strong>Objective: </strong>This study aimed to explore caregiver experiences and perspectives of contactless sleep monitoring using Sonomat as an alternative to PSG.</p><p><strong>Methods: </strong>This was a cohort study of children with DS undergoing PSG for evaluation of SDB. Caregivers completed study-specific questionnaires on their child's experiences with PSG and Sonomat (in-hospital, home). Descriptive statistics of responses are reported.</p><p><strong>Results: </strong>Fifty-six children underwent simultaneous Sonomat and PSG monitoring, with 28 continuing home monitoring. Airflow sensors were poorly tolerated during PSG, with 30% of children unable to tolerate both nasal prongs and oronasal thermistor. All caregivers who used the Sonomat at home rated the experience positively; however, only 56% preferred it over in-lab PSG, indicating mixed preferences. Most caregivers found Sonomat easy to use, and a majority reported typical sleep patterns during home monitoring.</p><p><strong>Conclusion: </strong>The Sonomat represents a promising contactless tool for screening sleep disordered breathing in children with Down syndrome, particularly in cases where standard PSG is not tolerated. Its ease of use and acceptability suggest value in complementing traditional diagnostics, especially in home settings.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651022","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":"Food Insecurity Before and During the COVID-19 Pandemic and Early Childhood Development.","authors":"Jennifer O Lambert, Eliana M Perrin, Raymond Sturner, Barbara J Howard, Sara B Johnson","doi":"10.1097/DBP.0000000000001393","DOIUrl":"10.1097/DBP.0000000000001393","url":null,"abstract":"<p><strong>Objective: </strong>To describe changes in household food security status among families with young children before and during the COVID-19 pandemic, when many families experienced changes in food security status because of pandemic disruptions and relief programs, and to investigate the association between household food insecurity (FI) before and/or during the pandemic and developmental milestone attainment.</p><p><strong>Method: </strong>We used an interrupted time series design to evaluate the association between household FI and developmental milestone attainment before and during the pandemic. Our sample included US children 0 to 5 years with FI and developmental screenings prepandemic (June 2017 to February 2020) and intrapandemic (May 2020 to May 2022) in the Comprehensive Health and Decision Information System. Children with no food insecurity were compared to children with only intrapandemic (new), only prepandemic (resolved), or both intrapandemic and prepandemic (persistent) FI.</p><p><strong>Results: </strong>We found lower developmental milestone attainment only in the persistent FI group, with significantly lower communication (adjusted difference = -0.17; 95% CI, -0.33 to -0.01) and personal-social (adjusted difference = -0.15; 95% CI, -0.30 to -0.01) scores, versus children with no FI. There were no differences in developmental milestone attainment in any domains for children with new or resolved FI compared to children with no FI.</p><p><strong>Conclusion: </strong>Using the pandemic as a natural experiment to study how changes in household food security status are associated with development, we found that persistent, but not transient, household FI is associated with suboptimal early childhood development. To promote healthy development, pediatricians should promptly intervene to address FI and advocate for governmental programs that promote food security.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602068","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 Coexistence of Adverse Childhood Experiences, Positive Childhood Experiences, and Parent-Reported Attention-Deficit/Hyperactivity Disorder Severity: National Survey of Children's Health.","authors":"Suk-Joon Hong, My H Vu, Douglas Vanderbilt, Larry Yin, Karen Kay Imagawa, Alexis Deavenport-Saman","doi":"10.1097/DBP.0000000000001395","DOIUrl":"10.1097/DBP.0000000000001395","url":null,"abstract":"<p><strong>Objective: </strong>Children with higher adverse childhood experiences (ACEs) experience more severe parent-reported attention-deficit/hyperactivity disorder (ADHD). Positive childhood experiences (PCEs) help to build resilience and mitigate the impact of ACEs on ADHD. Prior studies have measured the 2 constructs as independent factors, but no research has examined their combined influence on children with ADHD. The first aim was to categorize children with different levels of parent-reported ADHD severity into classes based on shared characteristics of ACE and PCE promoters. The second aim was to examine the relationship between the classes and ADHD severity.</p><p><strong>Methods: </strong>Participants included children 6 to 17 years with data on the 2019 National Survey of Children's Health ADHD severity questionnaire (n = 19,715; weighted n = 49,149,269). Latent class analysis (LCA) identified subgroups of children experiencing patterns among PCE promoters and ACEs, which were measured as independent variables in an adjusted ordinal regression model to estimate their composite effects on ADHD severity.</p><p><strong>Results: </strong>Using LCA, one class belonging to children with low ACEs and high PCE promoters (class 1) and another belonging to children with high ACEs and low PCE promoters (class 2) were identified. Class 2 was 2.2 times more likely to have more severe ADHD (aOR 2.2; 95% confidence interval, 1.8-2.6).</p><p><strong>Conclusion: </strong>Findings suggest ACEs and PCE promoters do not operate independently; children with high ACEs had low PCE promoters and had more severe parent-reported ADHD. Clinicians should consider actively screening for the presence of ACEs and PCEs in all children, especially those with high ADHD severity, and build strong alliances with families.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602069","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":"Discussing Race With Families With Young Children: Pediatric Clinician Attitudes and Practice.","authors":"Grace S Lee, Melissa C Nguyen, Mariana Glusman, Alyssa Cohen, Nikki Shearman, Ashaunta Anderson, Clare Crosh, Tracy Truong, Teandra Ramos, Elizabeth Erickson","doi":"10.1097/DBP.0000000000001380","DOIUrl":"10.1097/DBP.0000000000001380","url":null,"abstract":"<p><strong>Objective: </strong>To describe clinician attitudes and practices regarding discussions about race-related topics with families of children aged 0 to 5 years.</p><p><strong>Methods: </strong>The authors distributed a survey to the Reach Out and Read (ROR) medical provider network to assess clinicians' prior education, attitudes and clinical practice discussing the impact of racism on child health, racial identity formation, and development of ethnic-racial pride. The authors report item response frequencies with a sub-analysis of respondent race, ethnicity, level of training, and practice region and setting.</p><p><strong>Results: </strong>Six hundred fifty-two surveys with 80% or more completion rate were analyzed. Over 90% of respondents agreed that racism affects child health. Although most agreed that clinicians have a role in discussing the impact of racism on a child's health, racial identity formation, and development of ethnic-racial pride with families, the majority did not regularly do so. Barriers included lack of time and education, clinician discomfort, and fear of damaging the therapeutic relationship. Many agreed that receiving education about these topics was very important, but fewer than 25% had prior education or knew of resources. Nearly 90% agreed that books and ROR can support these discussions; 79% were interested in additional ROR training.</p><p><strong>Conclusion: </strong>Although surveyed clinicians agree that they have a role in discussing race-related topics with families with infants and young children, they do not feel equipped to have these discussions. Pediatricians are interested in incorporating culturally diverse, developmentally appropriate books, and ROR to discuss issues related to race.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e348-e354"},"PeriodicalIF":2.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of the Integrated Caregiver Language Intervention Program via Telepractice for Toddlers and Caregivers.","authors":"Hale Hancer, Suna Tokgoz-Yilmaz","doi":"10.1097/DBP.0000000000001390","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001390","url":null,"abstract":"<p><strong>Objective: </strong>Although active involvement of the caregiver is crucial in early intervention for toddlers at risk for developmental language disorders (DLD), challenges in accessing and participating in these programs often exist. Telepractice offers a potential solution to address this issue. This study aims to examine the effectiveness of an Integrated Caregiver Language Intervention Program via Telepractice (ICLIP-T).</p><p><strong>Methods: </strong>A quasi-experimental model with a pretest-posttest format and matched control groups was used. The ICLIP-T, comprising basic language modelling strategies and environmental arrangements, was developed. The session protocol included a video analysis of strategies from previous sessions, a discussion of new strategies, and a question-answer segment. The ICLIP-T intervention was conducted with 21 dyads (study group) over a 12-week period, with each session lasting 45 minutes. The outcomes were analyzed for both caregivers and toddlers and compared with those of the 21 dyads in the control group.</p><p><strong>Results: </strong>Significant differences were observed between the pretest and posttest language scores of toddlers in the study group, and in comparison with those of the control group. Furthermore, the study group revealed significant differences in caregivers' strategies between the pretest and posttest assessments.</p><p><strong>Conclusion: </strong>These results suggest that the language scores of toddlers at risk for DLD improved after the implementation of ICLIP-T by caregivers. Therefore, ICLIP-T should be conducted with larger cohorts and in toddlers with varying severities of DLD to confirm its utility.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585480","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":"Engagement With Recommended Developmental Follow-up and Supports Among Infants With Intrauterine Opioid Exposure.","authors":"Margarida Mascarenhas, Elizabeth Peacock-Chambers, Yarden S Fraiman, Leslie S Kerzner, Davida M Schiff","doi":"10.1097/DBP.0000000000001372","DOIUrl":"10.1097/DBP.0000000000001372","url":null,"abstract":"<p><strong>Objective: </strong>Describe the engagement of opioid-exposed infants (OEI) with recommended developmental surveillance and supports in the first year of life.</p><p><strong>Methods: </strong>We conducted a single-site retrospective cohort study of OEI delivered between 2016 and 2021, linking birth hospitalization, developmental follow-up (DFU) clinic, and early intervention (EI) records. Primary outcomes were attendance at DFU clinic and evaluation by EI. We used multivariable modified Poisson regression to examine how birthing parent-, infant-, and clinic-level factors are associated with service engagement.</p><p><strong>Results: </strong>Of 256 OEI, 75% engaged in at least 1 developmental service. Referral and attendance rates at the DFU clinic were 69% and 33%, respectively. Ninety-three percent were referred to EI, 73% evaluated and 58% enrolled in services. EI evaluation was positively associated with prolonged infant hospitalization (adjusted risk ratio [aRR] 1.01; CI, 1.002-1.01) and exposure to antidepressants (aRR 1.23; CI, 1.02-1.49) and cocaine (aRR 1.28; CI, 1.09-1.50). Probability of attendance at DFU was higher for infants born to parents receiving care at an integrated perinatal substance use clinic (aRR 2.13; CI, 1.07-4.24) and exposed to antipsychotics (aRR 1.73; CI, 1.12-2.67), whereas those remaining in parental custody had lower probability of engagement (aRR 0.62; CI, 0.39-0.97).</p><p><strong>Conclusion: </strong>Three-quarters of the OEI engaged in developmental surveillance services in the first year of life. Factors relating to disease severity, location of birthing parent care, birthing parent co-exposures, and parental custody were associated with engagement. Efforts to improve engagement in recommended follow-up should elicit the perspectives of caregivers to better understand the mechanisms that drive these differences.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e375-e382"},"PeriodicalIF":2.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555595","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}