Journal of Developmental and Behavioral Pediatrics最新文献

{"title":"The Living Lab at Home: Feasibility and Acceptability of Multimodal In-Home Data Collection Among Youth Across the Developmental Spectrum.","authors":"Katelynn E Boerner, Veronica Dudarev, Leora Pearl-Dowler, Marie-Noelle Wharton, Harold Siden, Liisa Holsti, Tim F Oberlander","doi":"10.1097/DBP.0000000000001319","DOIUrl":"10.1097/DBP.0000000000001319","url":null,"abstract":"<p><strong>Objective: </strong>Dynamic, real-time, in-home methods of data collection are increasingly common in child health research. However, these methods are rarely cocreated or used with families of youth with developmental disabilities. We aimed to determine the feasibility of codesigned methods for in-home data collection for youth across the developmental spectrum.</p><p><strong>Methods: </strong>Sixteen youth (14-18 years) with autism spectrum disorder, cerebral palsy, and/or chronic pain completed 14 days of data collection, wearing an accelerometer, answering Ecological Momentary Assessment (EMA) questionnaires, and collecting salivary cortisol samples. Participants completed a poststudy interview regarding their experiences. Data were analyzed for feasibility, quantity, and quality.</p><p><strong>Results: </strong>At least 1 EMA response was provided on 73% of days, with 54% of the total number of administered prompts answered before the next prompt arrived. In total, 77% of participants wore the accelerometer ≥10 hours for at least 7 days. Adherence to 8-day saliva sampling after accounting for protocol violations and dry samples was 28%. No significant adverse events were reported aside from mild emotional distress (25%). Families reported generally high satisfaction, willingness to participate again, and acceptability, with moderate burden and interference. Qualitative interviews described: (1) the research question's value to the family as a motivator of engagement; (2) in-home data collection is not a passive or neutral experience; (3) personalized approaches and context are important to families; and (4) a clear need for continued iteration and engagement.</p><p><strong>Conclusion: </strong>In-home multimodal data collection is potentially feasible for families across the developmental spectrum but requires iteration based on family feedback to increase adherence.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e522-e530"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512162","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":"Association Between Positive Childhood Experiences and Caregiver-Reported ADHD Diagnosis and Severity.","authors":"Elizabeth Crouch, Elizabeth Radcliff, Emma Boswell, Monique J Brown, Peiyin Hung","doi":"10.1097/DBP.0000000000001315","DOIUrl":"10.1097/DBP.0000000000001315","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the prevalence of positive childhood experiences (PCEs), a counter to adverse childhood experiences, in children with an attention-deficit hyperactivity disorder (ADHD) diagnosis. The purpose of this study was to examine the relationship between PCEs and ADHD diagnosis and severity, adjusting for child, family, and household characteristics, using a nationally representative data set.</p><p><strong>Methods: </strong>Using the 2020 to 2021 National Survey of Children's Health, our sample included children 6 years of age or older, as this is the age at which PCE questions are asked (n = 56,224). Multivariable logistic regression was used to examine the association between PCE type and ADHD diagnosis and severity, controlling for child and household characteristics.</p><p><strong>Results: </strong>In multivariable regression analyses, children who had volunteered in their community had lower odds of a reported ADHD diagnosis than children who had not volunteered in their community (adjusted odds ratio [aOR] 0.83; 95% confidence interval [CI], 0.73-0.95). Children with a connected caregiver had a lower likelihood of ADHD diagnosis than children without a connected caregiver (aOR 0.66; 95% CI, 0.58-0.74). Children reporting moderate to severe ADHD were less likely to report exposure to any of the 7 PCEs examined, when compared with children reporting mild ADHD.</p><p><strong>Conclusion: </strong>The findings from this study can be important for clinicians and families to mitigate the negative social and academic outcomes that children with ADHD may face.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e531-e536"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394858","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":"Toward More Equitable Care: A Closer Look at Autism Clinic Intake Practices and Paperwork.","authors":"Anisha P Srinivasan, Erika Phelps Nishiguchi, Cassandra Gonzalez, Manuel E Jimenez, Katharine E Zuckerman, Katherine C Lion","doi":"10.1097/DBP.0000000000001312","DOIUrl":"10.1097/DBP.0000000000001312","url":null,"abstract":"<p><strong>Objective: </strong>To describe intake requirements among autism clinics and to assess how well intake paperwork aligns with national standards for enhancing language and literacy accessibility.</p><p><strong>Methods: </strong>This was a survey of 126 autism clinics in the Children's Hospital Association, assessing intake processes and intake paperwork readability conducted between November 2021 and August 2022. Descriptive analyses characterized intake requirements and paperwork components. Free-text responses about intake support strategies were categorized into themes. Logistic regression models examined associations between clinic patient demographics and odds of requiring intake paperwork. Intake packet length, content, and reading grade level were examined.</p><p><strong>Results: </strong>Of the invited clinics, 73% completed the survey. Among the participating clinics, 55% required intake paperwork before scheduling appointments, 34% offered English forms only, and 89% had no plain language forms. Clinic patient demographics were not associated with intake paperwork requirements. Analyzed intake packets (n = 67) averaged 11 pages long, and most were written above the fifth-grade reading level. Most packets solicited medical, developmental, and educational/therapy history. Many also requested psychoeducational evaluations and teacher rating forms. Reported intake support strategies for families with language or literacy needs included making ad hoc exceptions to the usual process, task shifting to outside organizations, providing support at family's request, and delegating to support staff.</p><p><strong>Conclusion: </strong>Many autism clinics nationwide require intake paperwork before diagnostic evaluation. Many clinics offer intake paperwork in English only, and paperwork often does not meet health literacy standards. Reducing paperwork requirements and providing more routine and robust intake support may facilitate equitable access to autism diagnostic evaluations.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e505-e512"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977063","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":"Nocebo Effect on Pain Perception and Attention with Children With and Without Attention Deficit And/Or Hyperactivity Disorder.","authors":"Carmen-Édith Belleï-Rodriguez, Luana Colloca, Dominique Lorrain, Serge Marchand, Guillaume Léonard","doi":"10.1097/DBP.0000000000001314","DOIUrl":"10.1097/DBP.0000000000001314","url":null,"abstract":"<p><strong>Objective: </strong>Attention deficit disorder with or without hyperactivity (ADHD) has negative consequences for children. The effectiveness of medical interventions and educational outcomes are strongly influenced by expectations, which can be modulated by nocebo effects. The aims of this study were to compare the nocebo effect on pain perception and attention in children with and without ADHD as well as to characterize the associations of the nocebo effect with personal variables, such as anxiety, sleep, and pain catastrophizing.</p><p><strong>Methods: </strong>Data were collected from 30 children with and without ADHD. The nocebo effect was induced using an inactive pill, \"increasing\" pain perception and attention deficits. Experimental thermal pain was evoked using a thermode and recorded using a computerized visual analog scale. Attention abilities were measured with the Stop-Signal Task. We also used questionnaires to measure personal variables.</p><p><strong>Results: </strong>When combining groups, the nocebo treatment led to comparable nocebo effects for pain (increased pain perception) and attention (increased time needed for inhibition). When comparing groups, the nocebo effect on pain perception was similar for children with and without ADHD. Inattention, learning problems, anxiety, and sleep problems were associated with the nocebo response for pain and attention.</p><p><strong>Conclusion: </strong>This exploratory study conducted in an experimental setting emphasizes the importance of managing children's expectations for pain perception and attention as well as the potentially deleterious impact of negative suggestions on elementary school children.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e537-e544"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394860","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":"Maternal Mobile Device Use and Mealtime Interactions With Children.","authors":"Jenny S Radesky, Heidi M Weeks, Harlan McCaffery, Niko Kaciroti, Julie C Lumeng, Alison L Miller","doi":"10.1097/DBP.0000000000001317","DOIUrl":"10.1097/DBP.0000000000001317","url":null,"abstract":"<p><strong>Objective: </strong>This study examined (1) whether different types of mobile device use are associated with quantity/quality of parent-child interactions and (2) moment-to-moment changes in quantity/quality of parent-child interactions when devices are used.</p><p><strong>Method: </strong>In 47 videorecorded home mealtimes conducted in 2011 to 2013, we conducted detailed coding of maternal device use (talking, texting/scrolling, having device on table), frequency of mother and child verbalizations, child bids for attention, and maternal response to bids (contingent, no response, negative response) in 5-second intervals. We examined between-mother differences in parent-child interaction variables for a 10-percentage point increase in each type of device use comparisons using negative binomial or logistic regression. We then compared intervals when there was active mobile device use to nonuse intervals using generalized estimating equation logistic regression, predicting the odds of each parent-child interaction variable.</p><p><strong>Results: </strong>Mothers averaged 29.8 years (SD 6.10), child age 5.97 years (SD 0.56), and 55% had completed at least some college. Higher percentage of time spent texting/scrolling was associated with a lower rate of maternal verbalization (adjusted rate ratio 0.89 [95% confidence interval, 0.84-0.95]) and contingent response (adjusted rate ratio 0.92 [0.84-1.00]) and higher odds of nonresponse (adjusted odds ratio 1.13 [1.04-1.22]). In each 5-second interval of active device use, there was decreased odds of maternal verbalizations (adjusted odds ratio 0.48 [0.34-0.69]), child verbalizations (0.62 [0.44-0.88]), contingent response (0.45 [0.28-0.74]), and higher odds of maternal nonresponse (2.36 [1.40-4.00]).</p><p><strong>Conclusion: </strong>These results demonstrate decreased parent-child verbal interaction and lower parent responsiveness during mobile device use, particularly with texting and scrolling.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e545-e551"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Food Insecurity and Developmental Delay and Behavioral Problems in US Children 2 to 5 Years of Age.","authors":"Devina Savant, Annie Gjelsvik, Yvette Yatchmink, Pamela High","doi":"10.1097/DBP.0000000000001307","DOIUrl":"10.1097/DBP.0000000000001307","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between food insecurity and developmental delay and/or behavior problems (DD/PB) in US children aged 2 to 5 years before the COVID-19 pandemic.</p><p><strong>Methods: </strong>Data from 14,464 children aged 2 to 5 years from the National Survey of Children's Health from 2016 to 2017 were analyzed. Children with food insecurity came from families reporting they sometimes or often could not afford nutritious meals. Diagnosis of DD/PB by a professional was obtained through a caregiver report.</p><p><strong>Results: </strong>A quarter of children aged 2 to 5 years lived in food insecure homes, and 9% were diagnosed with DD/PB. Children in food insecure households were more likely to be from minoritized populations publicly insured, with single parents, without high school education, living =< 130% Federal poverty line, and receiving supplemental nutrition assistance program (SNAP) benefits (all p < 0.001). Adjusting for age, sex, race, ethnicity, poverty, family structure, and parent education, children in food insecure households had 1.57 times the odds of being diagnosed with DD/PB compared with children in food secure households. In similarly adjusted models excluding poverty and stratified by SNAP use, homes not receiving SNAP maintained this association between food insecurity and diagnosis of DD/PB, whereas in homes receiving SNAP, the association was not significant.</p><p><strong>Conclusion: </strong>In this population-based study, US children aged 2 to 5 years in food insecure households were more likely to be diagnosed with DD/PB compared with those in food secure households. When stratified, there was no association between food insecurity and DD/PB among those receiving SNAP; the association remained for those not receiving SNAP. The potential long-term impact of this safety net program on our most vulnerable citizens must be considered as policymakers contemplate federal spending priorities.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e552-e559"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977100","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":"Training and Sustaining: Training and Learning Collaborative Outcomes Across a Statewide Network for Early Autism Diagnosis.","authors":"Rebecca McNally Keehn, Angela Paxton, Mary Delaney, Mary Ciccarelli","doi":"10.1097/DBP.0000000000001313","DOIUrl":"10.1097/DBP.0000000000001313","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to describe the development of a primary care professional (PCP) autism diagnosis training model and to report on outcomes related to PCP training and sustained engagement in a longitudinal learning collaborative.</p><p><strong>Methods: </strong>We developed Accelerating the Diagnosis of Autism with Primary care Training (ADAPT), a training program to prepare PCPs to develop independent competency in evaluation of autism in children aged 14 to 48 months. ADAPT includes didactic and case-based modules and practice-based coaching delivered by an expert diagnostic specialist; after training, PCPs participate in a longitudinal learning collaborative. Aligned with competency-based medical education standards, measures of autism evaluation knowledge and diagnostic competency are collected.</p><p><strong>Results: </strong>From 2021 to 2023, 13 PCPs completed ADAPT didactic and practicum training to reach competency in independent autism evaluation. Clinicians demonstrated significant improvement in total autism knowledge after didactic training ( p = 0.02). Scoring agreement on an autism observational assessment tool between clinicians and expert diagnosticians improved over case observations and practicum evaluations. Similarly, PCPs demonstrated improved evaluation competence, moving on average from Advanced Beginner to Competent Performer as rated by expert diagnosticians. After training, PCPs attended 57% of monthly learning collaborative sessions.</p><p><strong>Conclusion: </strong>Training PCPs to deliver autism evaluations for young children as part of tiered community-based models of care is a promising solution to address access and waitlist challenges. ADAPT is an intensive, standardized PCP training model that results in achievement of independent competency and sustained engagement in autism evaluation. Effectiveness-implementation studies are needed to ensure scalability and sustainability of training models.</p>","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e513-e521"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074429","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":"Boosting Autism Screening and Referrals with EHR-Integrated Tools at Well-Child Visits.","authors":"Shravani Vundavalli, Courtney M Brown, Juan D Chaparro, Aarti Chandawarkar, Stefanie Bester, Amy Newmeyer, Elizabeth W Barnhardt","doi":"10.1097/DBP.0000000000001325","DOIUrl":"10.1097/DBP.0000000000001325","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e578-e584"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512159","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":"Teletherapy and Medication Management of Attention-Deficit/Hyperactivity Disorder with Co-occurring Internalizing Symptoms and Suicidality During the Pandemic.","authors":"Heather Potts, Deepika Shaligram, Rose Ashraf, Elizabeth Diekroger, Jason Fogler","doi":"10.1097/DBP.0000000000001324","DOIUrl":"10.1097/DBP.0000000000001324","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Case: &lt;/strong&gt;Sam (he/him) is an 11-year-old cisgender white male with previous diagnoses of attention-deficit/hyperactivity disorder, anxiety, and major depressive disorder who was referred to an outpatient psychiatry clinic after hospitalization for suicidal ideation and agitation. Family history is significant for bipolar disorder, depression, anxiety, substance use/abuse, and suicidality. Sam started a trial of atomoxetine 10 mg po QAM in December 2019 due to increasing inattention in the backdrop of worsening anxiety. Sam received school-based counseling through his IEP, which Sam declined due to embarrassment from being pulled out of the classroom, and services were quickly discontinued. In January 2020, obsessive-compulsive symptoms emerged, specifically obsessions about cleanliness with related compulsions. He started biweekly cognitive behavioral therapy with an outpatient provider to target obsessive-compulsive disorder symptoms. Concomitantly, a developmental-behavioral pediatrician who diagnosed obsessive-compulsive disorder started Sam on fluoxetine 10 mg po QAM. Atomoxetine was also increased to 25 mg po QAM for 4 weeks and built up to 40 mg po QAM in February 2020.Depressive symptoms emerged in Spring 2020, around the time of the COVID-19 pandemic, despite ongoing treatment with fluoxetine. There was a significant increase in aggression, agitation, and compulsive cleaning, which did not respond to the addition of lorazepam 0.5 mg po daily. Owing to concerns that medication was exacerbating his presentation, his prescriber began to wean him off both atomoxetine and fluoxetine.Sam presented to the Emergency Department in the summer of 2020 due to worsening symptoms, including suicidal ideation and aggression, in the context of medication adjustment, social isolation, and academic difficulty with virtual schooling. He completed a 3-week inpatient hospitalization followed by a 2-week virtual partial hospitalization program, during which Sam struggled with attention and engagement. As part of his discharge plan, he was referred to the outpatient psychiatry department to continue outpatient therapy and medication management.During the virtual transfer appointment to outpatient therapy, his parents reported persistent concerns for ongoing attention-deficit/hyperactivity disorder, depression, anxiety, and obsessive-compulsive symptoms, along with a fear of a resurgence of suicidal thinking. Sam reported exhaustion from virtual partial hospitalization program sessions he attended earlier in the day and was eager to leave the appointment. He minimized concerns, denied suicidal ideation or intent, and reported a strong disinterest in doing \"another virtual therapy.\" In-person sessions would be ideal for Sam, given his history of attention difficulties, clinical complexity, and acuity and his self-identified dislike for virtual settings. However, services needed to be done virtually due to the quarantine shutdown. How would you pro","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":" ","pages":"e599-e601"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607050","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":"Journal Article Reviews.","authors":"Audrey Christiansen, Beth Bloom Emrick, Jan Harold D Sia, Carol C Weitzman","doi":"10.1097/DBP.0000000000001338","DOIUrl":"10.1097/DBP.0000000000001338","url":null,"abstract":"","PeriodicalId":50215,"journal":{"name":"Journal of Developmental and Behavioral Pediatrics","volume":"45 6","pages":"e602-e605"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819992","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}