Journal Of Developmental And Behavioral Pediatrics[JOURNAL]
Sun
200 papers
Intensive Outpatient Treatment for Patients With Severe Externalizing Behavior and Intellectual and Developmental Disability: An Electronic Health Record Review.
McMahon MXH, Scheithauer MC, Herrod JL … +9 more , Lomas Mevers JE, Nuhu NN, Pavlov A, Layman LN, Call NA, Mauzy CR, Hannula C, Sharp WG, Muething CS
J Dev Behav Pediatr · 2026 Jun · PMID 42377401 · Publisher ↗
OBJECTIVE: 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-i...
OBJECTIVE: 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). METHODS: 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. RESULTS: 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. CONCLUSION: Findings provide provisional evidence regarding the benefits of intensive behavioral treatment for children with IDD and severe externalizing behavior.
Positive Parenting is Associated With Higher Self-reported Resilience in Children With Attention-Deficit Hyperactivity Disorder.
Euaputtajunya J, Roongpraiwan R, Wantanakorn P … +3 more , Numthavaj P, Sitthisorn S, Chirdkiatgumchai V
J Dev Behav Pediatr · 2026 Jun · PMID 42328816 · Publisher ↗
OBJECTIVE: To investigate whether positive parenting is associated with higher self-report resilience in children with attention-deficit hyperactivity disorder (ADHD) after controlling for other possible related factors....
OBJECTIVE: To investigate whether positive parenting is associated with higher self-report resilience in children with attention-deficit hyperactivity disorder (ADHD) after controlling for other possible related factors. METHOD: After providing informed consent, children with ADHD aged 7 to 11 years completed the Resilience Scale for Children (RS10), and adolescents aged 12 to 18 years completed the 14-item Resilience Scale (RS14). Higher resilience was defined as a resilience score above the mean score minus 1 SD (> mean - 1SD) for comparable age groups provided in the manuals. Children with scores under this cut-point were defined as having lower resilience. Parents completed the Parenting Styles and Dimensions Questionnaire and the Vanderbilt ADHD Rating Scale. Factors associated with higher resilience were analyzed using univariable and multivariable logistic regression analyses. RESULTS: A total of 181 children participated in the study. The mean participant age was 11.15 (SD: 2.46) years. Of the participants, 79% were boys. A total of 118 children (65.19%) comprised the higher resilience group. Multivariable logistic regression analyses showed that higher positive parenting behavior score (adjusted odds ratio [aOR]: 1.40, 95% confidence interval [CI]: 1.08-1.83) and peer acceptance (aOR: 4.14, CI: 1.83‒9.37) were associated with higher resilience. Older age and having a diagnosis of borderline intelligence were associated with lower resilience: aORs: 0.84 (95% CI: 0.73-0.97) and 0.08 (95% CI: 0.01-0.75), respectively. CONCLUSION: Positive parenting and peer acceptance were associated with higher self-perceived resilience. Health care providers should promote positive parenting and social skills to nurture resilience in children with ADHD.
Weight and Health Behavior Conversations in Adolescent Primary Care: A Qualitative Examination.
Darling KE, Derrick A, Smrstik E … +3 more , Panza E, Goldschmidt AB, Jelalian E
J Dev Behav Pediatr · 2026 Jun · PMID 42307973 · Publisher ↗
OBJECTIVE: 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...
OBJECTIVE: 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 ≥85th 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Diverse Caregiver Perspectives on Sleep Health in School-aged Children: A Mixed-Methods Study.
Wang G, Page J, Robbins R … +3 more , Dos Santos C, St Martin A, Owens J
J Dev Behav Pediatr · 2026 Jun · PMID 42290649 · Publisher ↗
OBJECTIVE: To explore sleep health knowledge, perspectives, and experiences in diverse caregivers of school-aged children receiving care from community health care centers to inform clinical practice. METHOD: Mixed-metho...
OBJECTIVE: To explore sleep health knowledge, perspectives, and experiences in diverse caregivers of school-aged children receiving care from community health care centers to inform clinical practice. METHOD: Mixed-methods study including surveys and semistructured interviews with caregivers of school-aged children were conducted to provide understanding of their sleep beliefs, child sleep disturbances, and home sleep environment. Survey data (n = 19) were summarized descriptively and examined using Fisher exact tests. Qualitative data (n = 21) were analyzed using constant comparative analysis. RESULTS: Survey data indicated a few caregiver misconceptions about sleep health, such as "Most school-aged children need about 8 hours of sleep per night," reported by 95% of caregivers and the belief that "If a child has trouble falling asleep, you should move their bedtime earlier," reported by 84% of caregivers. Four major qualitative themes were identified for caregivers: (1) perceptions of their child's sleep; (2) experiences in the primary care setting regarding their child's sleep health; (3) experiences searching for information about sleep; (4) needed information and resources to help support their child's sleep. CONCLUSION: Findings emphasize the need for (1) health care providers to integrate sleep health education into routine care and (2) the development of sleep health education for diverse caregivers of school-aged children.
Separation Anxiety Disorder in Youth With Mitral Valve Prolapse: Associations With Parental Attitudes and Anxiety Sensitivity.
Yetkin ZD, Tosun Ö, Bıkmazer A … +1 more , Görmez V
J Dev Behav Pediatr · 2026 Jun · PMID 42228469 · Publisher ↗
OBJECTIVES: 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 di...
OBJECTIVES: 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). METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Investigating the Quality of Chat Generative Pretrained Transformer's Parenting Advice.
Munzer T, Jordan P, Sturza J … +1 more , Milkovich LM
J Dev Behav Pediatr · 2026 May · PMID 42212568 · Publisher ↗
OBJECTIVES: 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. METHODS:...
OBJECTIVES: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Near-fatal Food Aspiration in a Young Child With Down Syndrome.
Miyahara M, Osaki K
J Dev Behav Pediatr · 2026 May · PMID 42132543 · Publisher ↗
OBJECTIVE: To highlight the multifactorial risks of food aspiration in children with Down syndrome (DS), including anatomical, functional, and behavioral vulnerabilities, through a case of near-fatal choking. METHOD: We...
OBJECTIVE: To highlight the multifactorial risks of food aspiration in children with Down syndrome (DS), including anatomical, functional, and behavioral vulnerabilities, through a case of near-fatal choking. METHOD: We describe a case involving a 4-year-old boy with DS who presented with near-asphyxiation after aspirating a large piece of fried chicken. The patient's medical history, clinical findings, imaging results, and treatment course were reviewed. RESULTS: The patient exhibited delayed language development, absent protective airway reflexes, impulsive eating behavior, and possible streptococcal tonsillitis. A large food bolus was visualized in the upper airway but could not be removed because of agitation. Spontaneous coughing expelled the object, and the patient recovered fully after a course of antibiotics. Imaging confirmed the obstruction, and group A Streptococcus was detected on a throat swab. CONCLUSION: This case underscores the need for proactive feeding and swallowing assessments, especially during transitions to self-feeding in children with DS. Individualized preventive strategies, including caregiver education and early behavioral assessment, are critical to reducing aspiration-related morbidity in this vulnerable population.
Challenging Case: Navigating End-of-life in Neuro-inclusive Cancer Care.
Hanania JW, Levin M, Miran DM … +4 more , Ramirez KJ, Rhee JY, Svoboda LA, Voigt RG
J Dev Behav Pediatr · 2026 May · PMID 42081264 · Publisher ↗
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 hospit...
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?
Early Intervention Enrollment Among Substance-exposed Infants in Massachusetts: A Population-level Analysis.
Peacock-Chambers E, Gu KQ, Miller E … +7 more , Shieh MS, Jurkowski BL, Palmer S, Diop H, Singh R, Litt JS, Leyenaar JK
J Dev Behav Pediatr · 2026 May · PMID 42081262 · Full text
OBJECTIVE: This study aimed to assess EI referral and enrollment rates among substance-exposed newborns (SENs) with and without a diagnosis of NAS in MA and to compare rates to infants and toddlers without known substanc...
OBJECTIVE: This study aimed to assess EI referral and enrollment rates among substance-exposed newborns (SENs) with and without a diagnosis of NAS in MA and to compare rates to infants and toddlers without known substance exposure. METHODS: We analyzed the 2013-2020 Pregnancy to Early Life Longitudinal dataset, which includes maternal-infant birth hospitalization records linked with EI data. SEN and NAS were identified using ICD-9/10 codes. We conducted descriptive statistics and bivariate analysis to compare EI referral and enrollment between (1) SENs with and without NAS diagnoses and (2) SENs and the unexposed population. RESULTS: Among 6565 SENs, 85.3% (n = 5602) were referred to EI, and of those referred, 49.5% (n = 2775) enrolled. Compared with SENs without an NAS diagnosis, SENs with an NAS diagnosis were more likely to be referred to (87.6%, n = 4242 vs 79.0%, n = 1360) and enroll in (53.2%, n = 2255 vs 38.2%, n = 520) EI. Among infants and toddlers without identified substance exposure, referral rates were lower (34.6%), but enrollment rates were higher among those referred (56.7%). CONCLUSION: Substance-exposed newborns in MA had relatively high rates of EI referral but lower rates of enrollment compared with the general population, particularly among SENs without a diagnosis of NAS, suggesting a referral-to-enrollment gap.
Maternal Distress Due to the COVID-19 Pandemic and Changes in Young Children's Behavior.
Martin A, Gross RS, Miller EB … +3 more , Morris-Perez PA, Shaw DS, Mendelsohn AL
J Dev Behav Pediatr · 2026 May · PMID 42081256 · Full text
OBJECTIVES: Given the known link between maternal and child mental health, it is likely that children whose mothers experienced more distress because of the COVID-19 pandemic were at greater risk for increased behavior p...
OBJECTIVES: Given the known link between maternal and child mental health, it is likely that children whose mothers experienced more distress because of the COVID-19 pandemic were at greater risk for increased behavior problems. Yet research to date has not tested this hypothesis among families who were hit hardest by the pandemic-those with low incomes and from Black and Hispanic backgrounds. Research is also needed that focuses on young children and uses a longitudinal design. DESIGN: We harmonized data from 4 cohorts originally designed to study pediatric parenting interventions with underresourced families in 2 US cities. We examined, first, whether maternal distress because of the pandemic was associated with change over the next 1 to 2 years in preschool-aged children's anxiety/depression and aggression, and second, whether such associations were moderated by maternal depression. RESULTS: Maternal pandemic-related distress predicted a small increase in child aggression but no change in anxiety/depression. There was no moderation by maternal depression. CONCLUSION: Among families at risk of the most severe health and financial hardships because of the pandemic, maternal pandemic-related distress was associated with increases in child aggression 1 to 2 years later. Maternal mental health must be made a priority in the future disasters not only in its own right but also because of possible spillover effects on young children.
Advancing Physician Skills in Discussing Development in Primary Care: A Brief Intervention for Pediatric Residents.
Kastner K, Sleeth C, Tayler B … +1 more , Cederna C
J Dev Behav Pediatr · 2026 Apr · PMID 42053104 · Publisher ↗
BACKGROUND: General pediatricians are often the first to discuss developmental differences with caregivers. Unlike when sharing a definitive developmental diagnosis, there is often diagnostic uncertainty during these ini...
BACKGROUND: General pediatricians are often the first to discuss developmental differences with caregivers. Unlike when sharing a definitive developmental diagnosis, there is often diagnostic uncertainty during these initial discussions and caregivers may not be prepared to hear the information. Research examining pediatric resident training to discuss developmental differences is lacking. OBJECTIVE: Study aims included the following: (1) Understand pediatric residents' experience and comfort sharing information about developmental differences. (2) Evaluate the impact of a brief educational intervention on residents' comfort, confidence, and perceived readiness. METHODS: In 2023, Pediatric residents (N = 48) from 2 Midwestern programs completed a pre-intervention survey regarding experience, comfort, and confidence discussing developmental differences. After a 90-minute skill-building educational intervention that included an adaptation of the SPIKES framework to fit discussions of development, residents completed postsession surveys. Matched responses were compared to evaluate changes in comfort and confidence (N = 22, 45%). Descriptive statistics, Wilcoxon signed rank tests, χ2 test, and McNemar analysis were used to analyze data. RESULTS: Despite prior communication training, many residents lacked experience, comfort, and confidence in discussing developmental differences with caregivers pre-intervention. Post-intervention, residents reported significantly improved comfort and confidence with components of developmental conversations, and with the use of a consistent framework for discussing developmental differences. CONCLUSION: Findings suggest that a one-time, brief, multimethod educational intervention using an adapted SPIKES framework can improve resident readiness to discuss developmental differences.
Impact of Neonatal Intensive Care Units Experience on Child and Parent: A Developing Country Perspective.
Metin Baz H, Durak U, Deveci MF … +3 more , Buyukavcı MA, Seydaoglu G, Ozdemir R
J Dev Behav Pediatr · 2026 Apr · PMID 42053100 · Publisher ↗
OBJECTIVE: To examine the associations of maternal psychological distress and neonatal medical risk during Neonatal Intensive Care Unit (NICU) hospitalization with child developmental outcomes, parental burnout, and perc...
OBJECTIVE: To examine the associations of maternal psychological distress and neonatal medical risk during Neonatal Intensive Care Unit (NICU) hospitalization with child developmental outcomes, parental burnout, and perceived family impact at 18 to 24 months corrected age in a middle-income country setting with limited perinatal mental health infrastructure. METHODS: This prospective, observational study included 175 mother-infant dyads admitted to a tertiary NICU transitional unit. Maternal depression and anxiety were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Perinatal Anxiety Screening Scale-Turkish Version (PASS-TR), respectively. Neonatal medical complexity was quantified using a composite Neonatal Risk Score (NRS). At 18 to 24 months corrected age, 112 infants and 96 mothers completed follow-up assessments including the Ages and Stages Questionnaire (ASQ-3), the Parental Burnout Assessment, and the Impact on Family Scale. RESULTS: Maternal depressive (39.9%) and anxiety (75.8%) symptoms were common during the NICU stay but not linked to sociodemographic factors. Higher EPDS and PASS-TR scores were associated with developmental delays in communication, problem-solving, and personal-social domains. Parental burnout correlated with maternal depression, poorer child communication and motor outcomes, and higher NRS. Mothers of infants with hydrocephalus reported the highest distress and burnout. CONCLUSION: Maternal mental health and neonatal medical risk during NICU hospitalization were important correlates of later child and family outcomes. Routine psychosocial screening and risk stratification in NICU settings may facilitate early identification of at-risk dyads. In low-resource settings, integrated perinatal mental health support may be essential to improving long-term developmental and psychosocial outcomes.
Predictors of Autism Spectrum Disorder Among Children With Diagnostic Uncertainty After Initial Developmental-Behavioral Pediatric Evaluation.
Tan RR, Nevill R, Intagliata V … +5 more , Higgins A, White E, Burns A, Herrera J, Davis BE
J Dev Behav Pediatr · 2026 Apr · PMID 42025131 · Publisher ↗
OBJECTIVE: To examine demographic and child/family factors predictive of autism spectrum disorder (ASD) in children with diagnostic uncertainty after initial assessment by experienced Developmental Behavioral Pediatric (...
OBJECTIVE: To examine demographic and child/family factors predictive of autism spectrum disorder (ASD) in children with diagnostic uncertainty after initial assessment by experienced Developmental Behavioral Pediatric (DBP) clinicians. METHODS: A retrospective cohort of 87 consecutive children was seen for Interdisciplinary Autism Diagnostic Team (IADT) assessment between January 2022 and March 2023 because of initial DBP clinician diagnostic uncertainty. Sociodemographic and child/family characteristics including IADT results were analyzed using Mann-Whitney U tests, χ2 tests, and logistic regression to determine predictors of ASD diagnosis. RESULTS: Mean age of referred children was 6.9 (SD 3.02) years, 74% were male, and 78% did not exhibit cognitive delays. Demographic factors did not significantly differ between ASD and non-ASD diagnostic groups. The ASD group had lower rates of prenatal substance exposure (p < 0.001), physical aggression (p = 0.033), family history of non-ASD mental health conditions (p = 0.002), and adverse childhood events (p = 0.016). Autism spectrum disorder diagnostic testing best predicted an ASD diagnosis. The ASD group had significantly higher Autism Diagnostic Observation Schedule (ADOS) Total (p < 0.001) and Comparison scores (p < 0.001) than the non-ASD group. CONCLUSION: Children with ASD diagnostic uncertainty often share similar demographic and clinical features. This study found that family history of non-ASD conditions and child experiences of early adversity are significant factors in differentiating ASD and non-ASD. Child and family factors at point-of-referral may help discern need for an ASD team evaluation including structured observational tools (e.g., ADOS-2) and improve efficiency of assessment planning.
Examining the Relationship Between Family-centered Care and Family Resilience in Families of Children and Adolescents With Attention-Deficit Hyperactivity Disorder.
Wheelhouse CA, Wichman C, Ellis C … +2 more , Watanabe-Galloway S, Tibbits M
J Dev Behav Pediatr · 2026 May-Jun 01 · PMID 42012356 · Publisher ↗
OBJECTIVES: Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with multilevel risk and prognostic factors. Family resilience (FR) has a positive impact on youth ADHD prognosis. Research sug...
OBJECTIVES: Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with multilevel risk and prognostic factors. Family resilience (FR) has a positive impact on youth ADHD prognosis. Research suggests health care interventions can enhance FR. Family-centered care (FCC), a component of the Medical Home Model often missed in families of youth with ADHD, is 1 possible health care intervention. This secondary analysis examined the relationship between FCC and FR in families of youth with ADHD in the United States. METHODS: The 2018 National Survey of Children's Health data on families of 6- to 17-year-olds with ADHD were analyzed. A cumulative logistic regression analysis was conducted to model the relationship between FCC and FR as defined by the Family Resilience and Connection Index (FRCI) in families of 6- to 17-year-olds with ADHD. RESULTS: There is a significant association between FCC and FRCI. Although only 13.31% of families of 6- to 17 year-olds with ADHD had an FRCI of 6, the highest measure of FR in this study, families who reported receiving FCC were more likely to have an FRCI 6 when compared with similar families that did not report receiving FCC. CONCLUSION: Results suggest a positive association between FCC and FRCI in families of youth with ADHD in the United States, supporting FCC as an important health care factor in youth ADHD prognosis and management. Future research may consider measuring the impact of FCC on FRCI in families of youth with ADHD and/or implementation of FCC within youth ADHD health care management.
Correction for "Disparity in Internet Access Among Parents With Disabilities in the United States".
Li FS, Davidson S, Williams Z … +4 more , Heyman M, Duffy L, Stevens JD, Mitra M
J Dev Behav Pediatr · 2026 Mar-Apr 01 · PMID 41985011 · Publisher ↗
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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.
Parikh A, Gupta S, Reicher D … +3 more , Hensley-Spera M, Walker SD, Voigt RG
J Dev Behav Pediatr · 2026 Mar-Apr 01 · PMID 41985010 · Publisher ↗
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...
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 regimen includes sertraline at a dose of 100 mg daily and chlorpromazine at a dose of 100 mg nightly. Jake has continued to show improved aggressive and self-injurious behavior over the course of 6 months of this treatment regimen.In a combined Child Psychiatry/Developmental-Behavioral Pediatrics case conference, what teaching points are raised by this case?
The Effect of Social Determinants of Health on Health Care Delivery for Children With Cerebral Palsy in the US Health Care System: A Scoping Review.
Radulovacki K, Fox BQ, Zirbes C … +7 more , Shao R, Hunter E, Shabana S, Sanneh M, Shenoy DA, Hendren S, Catanzano AA
J Dev Behav Pediatr · 2026 Mar-Apr 01 · PMID 41985009 · Publisher ↗
OBJECTIVE: This scoping review evaluated the impact of social determinants of health (SDOH) on health care delivery and access for US children with cerebral palsy (CP). METHOD: A comprehensive literature search was condu...
OBJECTIVE: This scoping review evaluated the impact of social determinants of health (SDOH) on health care delivery and access for US children with cerebral palsy (CP). METHOD: A comprehensive literature search was conducted using Medline, Embase, CINAHL Complete, and Scopus. Studies lacking extractable data or published before 2010 or outside the United States were excluded. Two independent investigators screened abstracts and a third resolved disagreements. Selected manuscripts underwent full-text review and data extraction for thematic and comparative analysis. Descriptive statistics were calculated in Excel. RESULTS: In total, 6482 articles were identified and 146 underwent full-text review. Ultimately, 9 studies were included. The 3 main themes discussed were race (n = 6), economic standing (n = 5), and insurance status (n = 3). Three articles examined multiple themes. Black and multiracial individuals had significantly higher postoperative complication rates and unmet care coordination needs, and lower rates of receiving special services (e.g., physical therapy). Higher economic status was associated with greater health care expenses and service access. Public insurance was associated with insufficient care coordination, decreased special service utilization, and increased rates of readmission and inpatient complications. CONCLUSION: Included articles demonstrate that race, insurance status, and economic standing are significantly associated with unequal health care access and outcomes for US children with CP. Future efforts should prioritize standardization of reported metrics for SDOH and investigation into systemic inequalities in health care access.
Parental Cognitive Stimulation of Young Children Before and After the Onset of the COVID-19 Pandemic.
Martin A, Miller EB, Zhong D … +17 more , Gross RS, Morris-Perez PA, Shaw DS, Piccolo LDR, Hill J, Scott MA, Messito MJ, Canfield CF, Roby E, O'Connell L, Sadler RC, Aviles AI, Krug CW, Kim CN, Gutierrez J, Hunter L, Mendelsohn AL
J Dev Behav Pediatr · 2026 Mar-Apr 01 · PMID 41985008 · Full text
OBJECTIVES: Much research has documented disruptions to parent well-being and family functioning because of the COVID-19 pandemic in the United States, but little is known about how parents' provision of cognitive stimul...
OBJECTIVES: Much research has documented disruptions to parent well-being and family functioning because of the COVID-19 pandemic in the United States, but little is known about how parents' provision of cognitive stimulation to young children has been affected. This question is of added importance for families with low incomes, who were disproportionately disadvantaged by the pandemic. The current study examined whether and how provision of cognitive stimulation at home, as measured by the parent-reported StimQ2, changed for parents with low incomes after onset of the COVID-19 pandemic. We examined scores on a total scale and subscales tapping multiple aspects of verbal responsivity and reading. DESIGN: Data from 7 cohorts of families with low incomes across 3 US cities were de-identified and combined into a single analytic sample for secondary analysis. Cohorts ranged in timing relative to the onset of the pandemic (i.e., as early as 2015 and as late as April 2023). Each study contributed data from families assessed at multiple timepoints between birth and age 4 years. RESULTS: Total scores on the StimQ2 increased after the onset of the COVID-19 pandemic. Subscales reflecting reading stayed the same (quantity) or declined (quality), whereas subscales reflecting verbal responsivity increased. CONCLUSION: Relative to prepandemic levels, low-income parents' child-directed speech and responsivity increased postpandemic, but the quantity of parent-child reading was unchanged and its quality declined. Findings suggest the possibility of stability or improvement among parents with low incomes during the pandemic and opportunities for intervention.
Maternal Responsiveness, Parenting Self-efficacy, and Economic Empowerment: Determinants of Infant Development in Pakistan.
Khanna D, Toscano M, Park S … +5 more , Rahman A, Atif N, Osborne LM, Malik A, Surkan PJ
J Dev Behav Pediatr · 2026 Apr · PMID 41984574 · Full text
OBJECTIVE: Maternal responsiveness and parenting self-efficacy may be constrained by a woman's ability to make household decisions. We evaluated if maternal responsiveness and parenting self-efficacy were associated with...
OBJECTIVE: Maternal responsiveness and parenting self-efficacy may be constrained by a woman's ability to make household decisions. We evaluated if maternal responsiveness and parenting self-efficacy were associated with infant development. We further examined economic empowerment as a potential effect modifier of these relationships. METHOD: Data for this cross-sectional substudy included 400 participants of the 1,200 total participants included in the Happy Mother-Healthy Baby study investigating a cognitive behavioral therapy-based intervention among Pakistani women with anxiety symptoms conducted from 2019 to 2022. We examined the relationships between maternal responsiveness and parenting self-efficacy with 5 domains of child development at 6 weeks postpartum. We performed logistic regression analyses to assess these relationships and used interaction terms to examine economic empowerment as an effect modifier. RESULTS: A 10-point increase in responsiveness score was associated with a 40%, 36%, and 32% reduction in the odds of developmental delay in communication (aOR = 0.60, 95% confidence interval [CI]: 0.42-0.85), problem-solving (aOR = 0.64, 95% CI: 0.46-0.88), and personal-social skills (aOR = 0.68, 95% CI: 0.47-0.98). A 4-point increase in the score for self-efficacy was related to a 30%, 45%, and 37% decrease in the odds of developmental delay in gross motor (aOR = 0.70, 95% CI: 0.51-0.96), problem-solving (aOR = 0.55, 95% CI: 0.40-0.74), and personal-social skills (aOR = 0.63, 95% CI: 0.45-0.87). For fine motor and personal-social domains, self-efficacy played a protective role against infant developmental delay among non-empowered women, but not in empowered women. CONCLUSION: Maternal responsiveness and parenting self-efficacy were beneficial for infant development in Pakistani women, particularly among women with limited household-level economic empowerment. This study was prospectively registered at ClinicalTrials.gov (identifier NCT03880032) on March 19, 2019.
Clinical Research Facilitators, Barriers, and Preferences of Parents of Children With Overweight and Obesity.
Lim CS, Patel DJ, Casady H … +4 more , Sandridge S, Dodd CA, Malloch L, Annett RD
J Dev Behav Pediatr · 2026 Apr · PMID 41979151 · Publisher ↗
OBJECTIVE: 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...
OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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.
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