Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"The Role of Developmental-Behavioral Clinicians in FASD Diagnosis and Management: Insights From a National Survey.","authors":"Yasmin Senturias, Catherine Lipman, Kimberly Burkhart, Tanaporn Jasmine Wilaisakditipakorn, Denise Bothe","doi":"10.1097/DBP.0000000000001461","DOIUrl":"10.1097/DBP.0000000000001461","url":null,"abstract":"<p><strong>Objective: </strong>To examine the role of developmental and behavioral pediatric clinicians in diagnosing and managing Fetal Alcohol Spectrum Disorders (FASD), identify barriers related to diagnostic system variability and clinician preparedness, and propose a functional framework to complement existing diagnostic systems based on findings from the 2023 Society of Developmental and Behavioral Pediatrics (SDBP) survey.</p><p><strong>Methods: </strong>An anonymous survey of SDBP members assessed diagnostic practices, clinician preparedness, and training needs regarding FASD. Responses were analyzed descriptively to identify patterns in diagnostic system use and perceived training adequacy.</p><p><strong>Results: </strong>Of 913 members surveyed, 199 responded (22%), with 97 reporting active involvement in FASD care. Among these, 34% used the University of Washington 4-Digit Code, 34% used Diagnostic and Statistical Manual of Mental Disorders-5 criteria, and 26% followed the Hoyme guidelines. Only 24% felt \"very prepared\" to diagnose FASD, whereas 58% desired additional training in both diagnosis and management. The lack of a standardized diagnostic framework contributed to variability in clinical practice and clinician confidence.</p><p><strong>Conclusion: </strong>Findings highlight significant gaps in clinician confidence and the lack of standardized diagnostic practices. This article underscores the importance of enhancing FASD education within medical and psychology training and proposes adopting a functional classification system (FASD levels 1, 2, and 3) to bridge existing diagnostic frameworks and promote consistency in care. Strengthening clinician capacity in FASD recognition and management is essential to improving early identification, timely intervention, and long-term outcomes for affected children.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e326-e332"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054359","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 Predictors of Diagnostic Timing in Autism Spectrum Disorder and Co-occurring Mental Health Conditions: Evidence From Pediatric Electronic Health Records.","authors":"Erin E Long, Michael S Gaffrey","doi":"10.1097/DBP.0000000000001455","DOIUrl":"10.1097/DBP.0000000000001455","url":null,"abstract":"<p><strong>Objective: </strong>The present study examined the diagnostic sequencing of co-occurring autism spectrum disorder (ASD) and mental health diagnoses in youth and the impact of demographic factors on diagnostic patterns.</p><p><strong>Methods: </strong>Data were extracted from the electronic health record of youth (n = 3357) under age 18 years in a pediatric health care system in the midwestern United States. Patients with co-occurring ASD and mental health disorders were categorized based on the order in which they were diagnosed: ASD first, mental health disorder first, or concurrent diagnoses. T -tests and linear and multinomial regressions were used to examine whether age at ASD diagnosis differed based on the presence of a mental health disorder and to examine demographic variables as predictors of diagnostic patterning.</p><p><strong>Results: </strong>ASD was diagnosed 3 years later in youth with a mental health disorder, t(13,464) = 34.26, p < 0.001. Youth were most often diagnosed with a mental health disorder before ASD. Girls were 0.65 times less likely than boys to receive an ASD diagnosis first compared with a mental health diagnosis first ( p = 0.006) and were diagnosed with ASD later than boys (B = 0.97, p = 0.006). Black and multiracial Hispanic children were more likely than White children to receive an ASD diagnosis first compared with a mental health diagnosis (odds ratios 1.37-1.93) and were diagnosed with ASD earlier. Minoritized children were more likely to receive externalizing diagnoses.</p><p><strong>Conclusion: </strong>Findings highlight issues of diagnostic overshadowing in the diagnosis of ASD and co-occurring mental health conditions, and elucidate demographic groups who may be at risk for late diagnosis of ASD.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e308-e313"},"PeriodicalIF":1.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890480","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":"Ronald E Becker, Oana deVinck-Baroody, Beth Bloom Emrick, Michele Ledesma, Amber Wright","doi":"10.1097/DBP.0000000000001477","DOIUrl":"10.1097/DBP.0000000000001477","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582820","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: Complex Developmental Care and Management in a Child With a Chromosomal Deletion.","authors":"Ishan Poudel, Lianna R Lipton, Emily Z Tucker, Marilyn Augustyn","doi":"10.1097/DBP.0000000000001454","DOIUrl":"10.1097/DBP.0000000000001454","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e264-e266"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890485","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":"When There is no Available Evidence-Targeted Management of Comorbid Anxiety to Address Aggression in a Child With Severe Autism Spectrum Disorder and Intellectual Disability.","authors":"Apurva Parikh, Saurabh Gupta, Debra Reicher, Maria Hensley-Spera, Susan D Walker, Robert G Voigt","doi":"10.1097/DBP.0000000000001449","DOIUrl":"10.1097/DBP.0000000000001449","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Case: &lt;/strong&gt;Jake is a 13-year-old boy with autism spectrum disorder with an accompanying language impairment and intellectual disability of unknown cause (despite a comprehensive medical workup), who is nonverbal. He was referred by his pediatrician, and after 3 months on a wait list, he was evaluated as an outpatient by a child psychiatrist for a 6-month history of having multiple daily episodes of aggression and self-injury. These episodes often lasted upward of an hour and were usually triggered by transitions or delayed gratification. Prior trials of risperidone, aripiprazole, and guanfacine yielded minimal benefit. Despite enrollment in a self-contained special education program, he was removed from school because of severe aggression.Jake's aggression has persisted despite trials of clonazepam (up to 2 mg daily), clonidine (up to 0.2 mg daily), and a retrial of aripiprazole (up to 20 mg) in various combinations. The family described significant property destruction at home, frequent injuries to others, and persistent self-injury. During this time, Jake presented to the Emergency Room (ER) 6 times, often requiring physical restraints and 2:1 observation. Treatment with chlorpromazine (titrated up to 300 mg daily) and valproate (titrated up to 1500 mg daily) were initiated in the ER. He was denied admission to multiple acute inpatient units and residential centers because of his aggression. Attempts at in-home behavioral services failed when therapists refused to return. Services through a state office for individuals with developmental disabilities were pursued for over 2 years and are yet to be established.Jake was followed weekly by his child psychiatrist. His treatments with valproate and aripiprazole were both discontinued for lack of efficacy, and his treatment with chlorpromazine was consolidated to 100 mg nightly given its benefit for sleep. His treatments with clonidine and clonazepam were maintained, with minor dose adjustment, offering partial symptom relief in the setting of otherwise refractory behavioral dysregulation. Trazodone was trialed briefly for sleep but discontinued because of lack of benefit. Although these regimens occasionally blunted the outbursts, they were limited by sedation, often prompting the parents to self-adjust doses.Most recently, Jake's parents described certain anxious behaviors, such as insistence on sleeping in their room and intense aggression episodes whenever his father would attempt to leave the house. Suspected comorbid anxiety prompted initiation of sertraline at a dose of 12.5 mg/day with reported reduction in aggression within 1 week. With titration to 100 mg/day, Jake's outbursts became less frequent, shorter, and easier to de-escalate, and his sleep schedule normalized. Because of these improvements in association with his initiation of treatment with sertraline, Jake was successfully weaned off his treatment with clonazepam and clonidine. His current psychotropic medication re","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"47 2","pages":"e261-e263"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693441","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":"Correction for \"Disparity in Internet Access Among Parents With Disabilities in the United States\".","authors":"Frank S Li, Sarah Davidson, Zachary Williams, Miriam Heyman, Luci Duffy, J Dalton Stevens, Monika Mitra","doi":"10.1097/DBP.0000000000001471","DOIUrl":"https://doi.org/10.1097/DBP.0000000000001471","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"47 2","pages":"e279"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693519","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":"Phenotypic Description of Autism Spectrum Disorder and Psychopathology in Maternal 15q Duplication Syndrome.","authors":"Ilaria Venezia, Sara Passarini, Silvia Guerrera, Massimo Apicella, Viola Alesi, Gemma D'Elia, Ester Sallicandro, Piera Bontempo, Andrea Bartuli, Lorenzo Sinibaldi, Stefano Vicari, Giovanni Valeri","doi":"10.1097/DBP.0000000000001428","DOIUrl":"10.1097/DBP.0000000000001428","url":null,"abstract":"<p><strong>Objective: </strong>Maternal 15q11-q13 duplication syndrome (Dup15q) has been associated with 0.5% of all cases of autism spectrum disorder (ASD). There is no established protocol for the neuropsychiatric evaluation of individuals with this syndrome. This study aims to define a protocol incorporating gold standard assessments.</p><p><strong>Methods: </strong>Six individuals with Dup15q underwent assessment of cognitive and adaptive functioning (Leiter-3, Adaptive Behavior Assessment System-Second Edition), autistic traits (Autism Diagnostic Observation Schedule-2 [ADOS-2], Autism Diagnostic Interview-Revised [ADI-R], Social Communication Questionnaire, Social Responsiveness Scale, Repetitive Behaviors Scale-R), co-occurring psychopathology (Kiddie Schedule for Affective Disorders and Schizophrenia, Child Behavior Checklist, Swanson, Nolan, and Pelham-Forth Edition, Sleep Disturbance Scale for Children), and family functioning (Parenting Stress Index-Short Form, PedsQL). Parents were required to fill the Symptom Checklist 90 (SCL-90) and Autism-Spectrum Quotient (AQ) to gather information about their psychiatric co-occurrences and autistic traits. A molecular analysis was performed to confirm the genetic alteration.</p><p><strong>Results: </strong>Two siblings inherited the duplication through maternal transmission, whereas 4 individuals had a de novo maternal duplication. No participant exhibited preserved cognitive abilities; 4 of 5 showed below average adaptive functioning and 2 of 6 received a diagnosis of ASD. ADOS-2 revealed greater difficulties in the Social Affect domain compared with the Repetitive and Restricted Behaviors domain ( p < 0.05), findings confirmed by ADI-R ( p < 0.05). K-SADS indicated clinical scores in 5 individuals, with anxiety disorder in 3 participants. High levels of parental stress and a poor quality of life were reported. The mother carrier of the duplication showed clinical scores on the \"Positive Symptom Total\" of the SCL-90 and on the AQ.</p><p><strong>Conclusion: </strong>Individuals with an in tandem 15q-11q13 duplication seems to exhibit cognitive and adaptive difficulties along with psychiatric co-occurrences and autistic traits. Parents, with or without the duplication, may experience psychopathological difficulties and impaired family functioning.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e221-e231"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330658","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":"Do Irritability and Sensory Over-responsivity Mediate Sleep Problems in Preschool Anxiety Disorders? A Comprehensive Investigation.","authors":"Esra Yurumez, Merve Cikili-Uytun, Gokce Yagmur Efendi, Hande Konsuk-Unlu, Serpil Aktas-Altunay, Didem Behice Oztop","doi":"10.1097/DBP.0000000000001443","DOIUrl":"10.1097/DBP.0000000000001443","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether irritability and sensory over-responsivity (SOR) mediate the relationship between anxiety disorders and sleep problems in preschool-aged children. Although previous research has demonstrated a link between anxiety and sleep disturbances, the specific contributions of irritability and SOR remain unclear.</p><p><strong>Methods: </strong>The sample included 45 preschool children (24-72 months, 44.4% male) diagnosed with anxiety disorders and 85 healthy controls (24-72 months, 50.6% male). Diagnoses were determined using the Preschool Age Psychiatric Assessment, a structured DSM-5-based clinical interview. Parents completed the Child Behavior Checklist 1.5 to 5 to assess behavioral and emotional symptoms, including sleep problems and irritability.</p><p><strong>Results: </strong>Children with anxiety disorders showed significantly higher levels of irritability ( p = 0.003) and SOR ( p < 0.05) compared with controls. Sleep problems were more frequent in the anxiety group compared with the controls ( p = 0.003). Multiple regression analyses revealed that irritability and SOR significantly mediated the relationship between anxiety and sleep problems ( p < 0.001).</p><p><strong>Conclusion: </strong>The irritability and SOR seem to play key mediating roles in the development of sleep problems among preschoolers with anxiety disorders. These findings highlight the importance of addressing regulatory and sensory-emotional functioning in the assessment and treatment of young children with anxiety and sleep difficulties.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e186-e191"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745633","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":"School Readiness Promotion in Primary Care: Latino Parent Feedback on Interventions and Programs.","authors":"Jaime W Peterson, Galilea Estrada Sanchez, Maya Postigo, Veronica I Underwood Carrasco, Alejandro Robles, Vanessa Hernandez-Zepeda, Nelda Reyes, Ellen Stevenson, Katharine E Zuckerman","doi":"10.1097/DBP.0000000000001452","DOIUrl":"10.1097/DBP.0000000000001452","url":null,"abstract":"<p><strong>Objective: </strong>To explore the feasibility and acceptability of interventions to promote school readiness (SR) in primary care through qualitative analysis of \"SR Design Maps\" created by Latino families.</p><p><strong>Method: </strong>Caregivers participated in design thinking to assess benefits, barriers, and desirable characteristics of eight SR interventions to create a final SR Design Map. Qualitative analysis included a content analysis to determine the frequency of each intervention and deductive theme analysis to create a summary of key features, content, and timing preferences. Two coders completed analysis in the source language.</p><p><strong>Results: </strong>Participants included 32 Latino caregivers from four Oregon clinics with primarily US born children with preschool experience. Most caregivers were monolingual Spanish or bilingual-speakers, born in Mexico, with a high school education or higher. Across 16 distinct \"SR Design Maps,\" 100% included SR Coaching, preschool navigation, library information, and a community coordinator; most included a SR Checklist (92%), TipsByText (88%), and parent groups (81%). The most desired and feasible interventions were Coaching, preschool navigation, SR Checklist, library information, and TipsByText. A \"future state\" model compiles caregiver preferences from birth to age 5 years.</p><p><strong>Conclusion: </strong>Latino families gave detailed feedback to integrate multiple SR interventions from pregnancy to 5-year-old well-child visits. Families were most interested in an overview of SR skills (SR Checklist), tips for early math and literacy at home (SR Coaching, TipsByText), preschool information and application support, and reminders about library programs. These findings inform a culturally responsive package of interventions to promote SR in primary care.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e213-e220"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114784","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 Prospective Relationship Between Childhood Self-control and Adult Parenting Behaviors: A Thirty-year Follow-up Study.","authors":"Molly Kuehn, Sara B Johnson, Radhika Raghunathan, Kristin M Voegtline, Tracey Chambers Thomas, Nicholas S Ialongo, Rashelle J Musci","doi":"10.1097/DBP.0000000000001447","DOIUrl":"10.1097/DBP.0000000000001447","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether self-control in first grade predicts later parenting.</p><p><strong>Method: </strong>Participants were first graders enrolled in a universal preventive intervention trial in 1993 to improve behavior and school achievement. By 2023, n = 221 participants were parents of children aged 4 to 15 years. Pre-intervention, self-control was assessed using the Teacher Observation of Classroom Adaptation-Revised. Latent profile analysis identified 3 profiles of childhood self-control: high (n = 101, 45.7%), inattentive (n = 87, 39.4%), and inattentive/hyperactive (n = 33, 14.9%). The association between self-control profiles and later parent-rated discipline consistency and enjoyment of parenting from the Structured Interview of Parent Management Skills and Practices was evaluated using latent profile regression. The association between self-control and observed parent sensitivity, intrusiveness, and positive/negative regard for the child was explored in a subset (n = 81).</p><p><strong>Results: </strong>The high and inattentive childhood self-control profiles were more likely to discipline consistently versus the inattentive/hyperactive profile (Wald(2) = 8.55, p = 0.01). Self-control did not predict enjoyment of parenting (Wald(2) = 3.30, p = 0.19). Compared with the high profile, the inattentive/hyperactive and inattentive profiles exhibited greater positive regard for the child (Wald(2) = 11.03, p = 0.004).</p><p><strong>Conclusion: </strong>Childhood self-control may provide a foundation for discipline consistency as a parent. Individual differences in regulatory functioning that pose challenges in childhood might confer unexpected parenting benefits, underscoring the need for a life course perspective.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e169-e175"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821808","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}