Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"Weight and Health Behavior Conversations in Adolescent Primary Care: A Qualitative Examination.","authors":"Katherine E Darling, Annabelle Derrick, Emma Smrstik, Emily Panza, Andrea B Goldschmidt, Elissa Jelalian","doi":"10.1097/DBP.0000000000001495","DOIUrl":"10.1097/DBP.0000000000001495","url":null,"abstract":"<p><strong>Objective: </strong>Current clinical practice guidelines recommend that pediatricians screen all youth for overweight/obesity and provide or refer to treatment those with elevated weight status. Despite pediatricians' intentions to provide high-quality care, weight stigma and bias impede health care delivery. A shift in training is needed to optimize the experiences of adolescents with high weight status (body mass index ≥85 th percentile) during primary care visits. The present study sought adolescent, caregiver, and pediatrician perspectives on current practice, gaps in care, and needs for training to address health behaviors in youth at high weight status.</p><p><strong>Methods: </strong>Individual qualitative interviews were conducted with adolescents with high weight status (ages 13-17), their caregivers, and pediatricians. Recruitment occurred primarily through a hospital-based primary care practice in the Northeastern United States. Interviews were audio recorded, transcribed, and analyzed using an applied thematic analysis approach.</p><p><strong>Results: </strong>A total of 13 adolescents, 13 caregivers, and 11 pediatricians participated in the study. Themes from adolescents and caregivers included preferences for weight-specific communication, the importance of patient centered care, and specific guidance for pediatricians delivering care. Themes from pediatricians included philosophy of addressing high weight status, gaps in training, and preferred components of a future training.</p><p><strong>Conclusion: </strong>Multiple perspectives, including patients and pediatricians, emphasize the need to develop further training for pediatricians to improve care for adolescents at high weight status to meet current clinical practice guidelines. Findings provide specific guidance for development of pediatrician-focused training to navigating health behavior and weight-related conversations using a patient-centered approach.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e445-e452"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266920","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":"Clinical Research Facilitators, Barriers, and Preferences of Parents of Children With Overweight and Obesity.","authors":"Crystal S Lim, Devanshi J Patel, Hannah Casady, Shanda Sandridge, Cameronne A Dodd, Lacy Malloch, Robert D Annett","doi":"10.1097/DBP.0000000000001482","DOIUrl":"10.1097/DBP.0000000000001482","url":null,"abstract":"<p><strong>Objective: </strong>Recruiting, enrolling, and retaining families in pediatric obesity clinical trials is challenging. This study examined perceptions of facilitators and barriers related to clinical research, and preferences of specific research formats, in parents of a child with overweight or obesity. Associations between parental research perceptions and sociodemographic and health factors were also explored.</p><p><strong>Method: </strong>A descriptive, cross-sectional online survey of 103 parents of children 2 to 17 years with overweight or obesity was conducted between May 2021 and March 2022 in the southeastern US. Barriers and facilitators of research participation, child weight status, child COVID-19 health care and parental COVID-19 stress, demographic characteristics (e.g., child age, child gender, child race/ethnicity, family income, geographic location), and preferences for specific research formats (e.g., telehealth, in person, group sessions, individual sessions, COVID-19 testing, single-dose COVID-19 vaccine, and multiple-dose COVID-19 vaccine) were assessed. Linear regression analyses were conducted.</p><p><strong>Results: </strong>Parents endorsed more reasons and benefits for participation than mistrust, social pressure, and reasons against participation. Lower child body mass index was associated with higher perceptions of research participation benefits. Pandemic parental stress was associated with increased social pressure and benefits. Parents of non-Hispanic White and male youth endorsed more mistrust of clinical research.</p><p><strong>Conclusion: </strong>Findings can inform future pediatric overweight and obesity clinical research and trial designs to enable equitable recruitment, reduce participation burden, and increase feasibility and sustainability of interventions.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e453-e460"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678344","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":"Separation Anxiety Disorder in Youth With Mitral Valve Prolapse: Associations With Parental Attitudes and Anxiety Sensitivity.","authors":"Zeynep D Yetkin, Öykü Tosun, Alperen Bıkmazer, Vahdet Görmez","doi":"10.1097/DBP.0000000000001492","DOIUrl":"10.1097/DBP.0000000000001492","url":null,"abstract":"<p><strong>Objectives: </strong>Mitral valve prolapse (MVP) is generally benign in youth but is often accompanied by somatic sensations that resemble anxiety symptoms. This study examined the prevalence and severity of separation anxiety disorder in children and adolescents with MVP and explored associations with parental attitudes and anxiety sensitivity (AS).</p><p><strong>Methods: </strong>Sixty-five youth with MVP (ages 7-18 years) and 60 age-matched healthy controls underwent structured cardiologic and mental health evaluation. Diagnoses were established using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Validated scales assessed separation anxiety symptoms, parental attitudes, and AS.</p><p><strong>Results: </strong>Separation anxiety disorder prevalence and symptom severity were significantly higher in the MVP group than in controls ( p < 0.001). Parents of children with MVP reported higher levels of overprotection. AS did not differ significantly between groups. Mitral regurgitation jet length correlated positively with physical AS ( p = 0.043) and negatively with perceived maternal emotional warmth ( p = 0.026). In a parsimonious multivariable model, only physical AS independently predicted separation anxiety severity.</p><p><strong>Conclusion: </strong>Youth with MVP exhibit elevated separation anxiety, suggesting that somatic cues linked to benign cardiac findings may interface with family context to increase separation-related vulnerability. Integrating mental health assessment into routine pediatric cardiology care may facilitate early identification and intervention.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e419-e426"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151236","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: Navigating End-of-life in Neuro-inclusive Cancer Care.","authors":"Joan W Hanania, Melissa Levin, Damien M Miran, Katiuska J Ramirez, John Y Rhee, Ludmila A Svoboda, Robert G Voigt","doi":"10.1097/DBP.0000000000001489","DOIUrl":"10.1097/DBP.0000000000001489","url":null,"abstract":"<p><strong>Case: </strong>Roy is a 13-year-old boy with autism spectrum disorder who has a recurrent glioblastoma. He initially underwent a surgical resection followed by 5 months of intensive systematic chemotherapy that required multiple hospitalizations. Although a clinical trial was considered, Roy was excluded from enrollment because of concerns around his ability to consent and adhere to a complex protocol. Imaging soon revealed significant disease progression and his care plan shifted toward palliative therapies.Roy was the only child of his aging parents. Roy's mother was navigating her own chronic medical condition, and his father worked a night shift at a manufacturing plant. Roy's parents described him as a \"beam of light\" that came into their life as a \"healing miracle\" after experiencing multiple miscarriages. Roy shined in his love for art and would often sketch portraits to connect with and interpret the world around him.Roy was typically accompanied by his parents during medical visits and hospitalizations. He was largely participatory with medical procedures and formed an especially warm bond with an infusion nurse during treatment. Roy soon developed persistent severe headaches, intermittent emesis, balance concerns, and a visual field cut interfering with his daily functioning. His frustration grew as these symptoms hindered his autonomy and ability to engage in meaningful activities, including drawing.Roy's worsened symptoms in the setting of his growing tumor resulted in multiple emergency room visits and poor pain control. While Roy benefited from the continuity of care provided during clinic visits, the emergency room was overstimulating, which contributed to the challenge of managing his care effectively. Roy was eventually admitted to the hospital for the management of an acute neurological decline. During prognostic dialogues with Roy's trusted primary oncology team, his parents remained focused on \"finding a cure - a miracle\" deferring hospice care and opting for life-prolonging treatments. As Roy continued to decline, he would repeatedly ask to go home. His parents remained guarded about engaging Roy in discussions about his prognosis and end-of-life decisions, hopes, fears, and wishes.Where do you go from here? What consultations might be helpful in this situation? What are relevant considerations for providing tailored end-of-life care for children and adolescents with developmental disabilities?</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e477-e480"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822921","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":"Investigating the Quality of Chat Generative Pretrained Transformer's (ChatGPT) Parenting Advice.","authors":"Tiffany Munzer, Phoebe Jordan, Julie Sturza, Libby M Milkovich","doi":"10.1097/DBP.0000000000001493","DOIUrl":"10.1097/DBP.0000000000001493","url":null,"abstract":"<p><strong>Objectives: </strong>Chat Generative Pretrained Transformer (ChatGPT) is a widely adopted tool that can provide immediate parenting guidance. The aim of this study was to examine the quality of ChatGPT parenting advice.</p><p><strong>Methods: </strong>Clinically relevant ChatGPT queries (n = 100) were created by investigators from a national poll on parents' most pressing concerns (screen media, mental health, feeding, school violence, smoking/vaping, and cost of health care/health insurance). ChatGPT 4o was queried for responses to these questions (June-July 2024). A coding scheme on parenting advice quality was adapted from previous literature with 15 items (presence or absence) and independently coded by an interdisciplinary team. Disagreements were resolved by majority consensus. Seven of these codes were summed, creating an overall quality variable (range 0-7, 7 = high). ANOVA with post hoc Tukey-Kramer analyses compared the overall quality of advice across topics (except cost of health care/health insurance). Analyses were conducted in SAS 9.4.</p><p><strong>Results: </strong>ChatGPT frequently shared accurate information about the benefits of parenting approaches and infrequently shared information about risks or psychosocial nuances such as developmental information, race/ethnic diversity, neurodiversity, and social drivers of health. There were differences in response quality between categories (F-value 4.29, p = 0.003). Post hoc analyses found that screen media advice (mean = 3.7, SD = 1.0) was of lower quality versus mental health (mean = 4.6, SD = 1.5, p = 0.03) and smoking/vaping (mean = 5.0, SD = 1.3, p = 0.03). Feeding mean was 3.7 (SD = 1.3); school violence mean was 4.8 (SD = 1.2); cost of health care/health insurance mean was 2.8 (SD = 0.6).</p><p><strong>Conclusion: </strong>ChatGPT's information was overall accurate; however, the quality of advice varied by parenting topic. ChatGPT quality may be lower for topics such as screen media, which may have more nuanced or variable approaches.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e390-e396"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057972","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":"Safety-net Leadership Perspectives on Collaborative Care for Children With Developmental Disabilities.","authors":"Anisha P Srinivasan, Melanie Venegas, R Scott Akins, Erik Fernandez Y Garcia, Aubyn C Stahmer","doi":"10.1097/DBP.0000000000001476","DOIUrl":"10.1097/DBP.0000000000001476","url":null,"abstract":"<p><strong>Objective: </strong>To identify key barriers and facilitators to designing and implementing collaborative care (CC) for children with developmental disabilities (DD) in safety-net primary care.</p><p><strong>Methods: </strong>This pre-implementation qualitative study involved semi-structured interviews with safety-net primary care leaders. Using purposive and respondent-driven sampling, interviews were conducted with 16 leaders across 9 safety-net organizations in Northern California between August 2024 and January 2025. Key Consolidated Framework for Implementation Research (CFIR) constructs guided data collection. Data were analyzed using the Rapid Assessment Process and validated through structured member checking.</p><p><strong>Results: </strong>Leaders from 8 of 9 organizations reported existing integrated behavioral health programs staffed by mental health counselors and/or psychiatrists, but nearly all noted that these programs did not address the specific needs of children with DD. When asked about developing a CC intervention for this population, leaders identified implementation barriers and facilitators that mapped to CFIR inner and outer setting domains. Four themes were distilled: inner setting barriers (space and cost), inner setting facilitators (perceived clinical need among leadership), outer setting barriers (restrictive Medicaid reimbursement policies and limited performance measurement pressure), and outer setting facilitators (alternative financing mechanisms).</p><p><strong>Conclusion: </strong>Safety-net leaders indicate a clinical need for CC models specifically for children with DD, but implementation success will depend on addressing space, financing, and policy barriers through targeted implementation strategies.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e461-e466"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516557","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":"Are we Sacrificing Developmental Opportunity for Diagnostic Certainty?","authors":"Vadivelan Kanniappan, Abishek Jayapal Rajeswari, Swetha Karuppiah, Selva Rani Murugesan","doi":"10.1097/DBP.0000000000001506","DOIUrl":"10.1097/DBP.0000000000001506","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e485"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580929","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":"Active Parent-Child Leisure, Sedentariness, and Sleep in Toddlerhood Promise Later Active Lifestyle in Early Adolescence.","authors":"Kianoush Harandian, Laurie-Anne Kosak, Mark Tremblay, Linda S Pagani","doi":"10.1097/DBP.0000000000001478","DOIUrl":"10.1097/DBP.0000000000001478","url":null,"abstract":"<p><strong>Background/objective: </strong>Approximately 80% of adolescents worldwide do not meet recommendations for physical activity, raising health concerns. Influenced by family lifestyle and parenting, childhood habits originate and become habitual from birth onward, representing a protective or risk factor for healthy development. However, there is little compelling longitudinal evidence about behavioral persistence into adolescence. Spanning over a decade, this population-based prospective-longitudinal birth cohort study examines associations between typical activities in toddlerhood and early adolescent lifestyle.</p><p><strong>Method: </strong>Participants are 849 boys and 819 girls born between 1997 and 1998 from the Quebec Longitudinal Study of Child Development. Linear regression analyses examined associations between parent-reported daily movement behaviors (active leisure, screen time, and sleep) at age 2.5 years and self-reported indicators of an active lifestyle (outdoor play and leisure physical activity level) at age 12 years, while adjusting for pre-existing individual and family factors.</p><p><strong>Results: </strong>Adjusted results revealed associations between distinct movement behaviors and future active lifestyle indicators for boys and girls. Combined daily movement behaviors in early childhood explained more subsequent time spent playing outdoors for boys (β = 0.15, p ≤ 0.001) and girls (β = 0.11, p ≤ 0.01) and higher levels of leisure physical activity for girls (β = 0.13, p ≤ 0.001) a decade later.</p><p><strong>Conclusion: </strong>Early family participation in active leisure with toddlers and limitations on screen use forecasted more active lifestyle habits by early adolescence, above and beyond pre-existing individual/family factors. Parental awareness and monitoring of early child movement guidelines foster healthy growth and development trajectories, thus promoting long-term wellness.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e437-e444"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634759","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":"Opportunities to Incorporate Health Equity Principles in Child Health Research.","authors":"Kate E Wallis, Nia Heard-Garris, Diana Montoya-Williams","doi":"10.1097/DBP.0000000000001494","DOIUrl":"10.1097/DBP.0000000000001494","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e388-e389"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680760","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":"Intensive Outpatient Treatment for Patients With Severe Externalizing Behavior and Intellectual and Developmental Disability: An Electronic Health Record Review.","authors":"Meara X H McMahon, Mindy C Scheithauer, Jessica L Herrod, Joanna E Lomas Mevers, Nadrat N Nuhu, Alexis Pavlov, Lauren N Layman, Nathan A Call, Courtney R Mauzy, Courtney Hannula, William G Sharp, Colin S Muething","doi":"10.1097/DBP.0000000000001498","DOIUrl":"10.1097/DBP.0000000000001498","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the outcomes of individuals with intellectual and developmental disabilities (IDD) admitted to an intensive behavior treatment program to reduce severe externalizing behavior (e.g., aggression; self-injury).</p><p><strong>Methods: </strong>The authors conducted a retrospective electronic health record review of 40 consecutive patients aged 6 to 19 years with severe externalizing behavior causing imminent risk of harm to self or others over a 4-year period (January 2020 to December 2023). The intensive outpatient model involved daily intervention (Monday-Friday; 5 hours per day across an approximate 5-month period) that was structured and individualized based on the tenants of applied behavior analysis. Systematic data extraction included participant characteristics, outcomes of behavioral assessments, components of the behavioral intervention, percent reduction of externalizing behavior, and percent of caregiver-directed goals met.</p><p><strong>Results: </strong>All participants had a diagnosis of autism and 80% had a co-occurring intellectual disability. Participants presented with 3 primary types of externalizing behavior-aggression (87.5%), disruption (82.5%), and self-injury (67.5%). At discharge, participants had a 90.74% reduction in externalizing behavior and 82.5% of participants met their primary caregiver-directed goal.</p><p><strong>Conclusion: </strong>Findings provide provisional evidence regarding the benefits of intensive behavioral treatment for children with IDD and severe externalizing behavior.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e467-e473"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354629","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}