Journal Of Developmental And Behavioral Pediatrics[JOURNAL]
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200 papers
Pediatric Resident Participation in Primary Care Autism Evaluations: A Novel Continuity Clinic Training Opportunity.
Perry B, Cooper J, Zhang R … +1 more , Harrison M
J Dev Behav Pediatr · 2026 Mar-Apr 01 · PMID 41380037 · Full text
OBJECTIVE: There is a growing need for autism evaluations in young children. Wait times to evaluation are long due to the limited specialty workforce. Primary care autism evaluations are 1 solution, but many providers la...
OBJECTIVE: There is a growing need for autism evaluations in young children. Wait times to evaluation are long due to the limited specialty workforce. Primary care autism evaluations are 1 solution, but many providers lack training and confidence in autism care. Literature highlights the need for improvement in developmental and behavioral pediatrics training among pediatric residents. This study evaluates resident confidence in autism care after participation in a novel autism evaluation pathway in a primary care pediatric resident continuity clinic. METHODS: Pediatric residents led a primary care autism evaluation with a trained pediatrician in their continuity clinic. Residents were provided with enhanced autism education which included neurodiversity-affirming strategies and training on the use of an autism assessment tool. Presurveys and postsurveys were used to assess resident confidence in autism care before and after the educational intervention. Survey data were compared using Mann-Whitney U tests appropriate for ordinal, nonpaired data. RESULTS: Thirty resident-led autism evaluations were conducted during the study period. There was statistically significant improvement in resident confidence in autism screening, use of assessment tools, evaluation, diagnosis, treatment recommendations, sharing resources, understanding of neurodiversity, and use of a strength-based approach after participation. CONCLUSION: Providing autism education and hands-on primary care autism evaluation training opportunities for residents in pediatric continuity clinic improves confidence in autism care. This model is 1 way to enhance autism education and training during pediatric residency which may have a positive impact on the care provided to autistic patients.
The Febrile Effect in Autism Spectrum Disorder: An Investigation of Behavioral Improvements During Episodes of Fever in Chinese Children.
Li C, Yang M, Tan C … +2 more , An Y, Zhang J
J Dev Behav Pediatr · 2026 Mar-Apr 01 · PMID 41347927 · Publisher ↗
PURPOSE: Some individuals with autism spectrum disorder (ASD) demonstrate marked behavioral improvements during febrile episodes, which is called febrile effect. This study aimed to investigate the prevalence and charact...
PURPOSE: Some individuals with autism spectrum disorder (ASD) demonstrate marked behavioral improvements during febrile episodes, which is called febrile effect. This study aimed to investigate the prevalence and characteristics of the febrile effect in children with ASD in China. METHODS: One hundred fifty-seven patients diagnosed with ASD were recruited to participate in the study; the parents completed a self-compiled questionnaire regarding the febrile effect. Children who reportedly improved with fever (Improve Group) were compared with those who reportedly did not improve (No Improve Group) on the core symptoms and developmental status. RESULTS: Parent reports of 16.56% of children exhibited behavioral improvements during fever. Improvements included reduced problem behaviors, enhanced cognitive or learning abilities, increased social interaction, and decreased stereotypical behaviors. The Improve Group scored higher in Autism Diagnostic Observation Schedule, Second Edition and Social Responsiveness Scale. There were no significant differences in the incidence of infectious diseases during pregnancy among mothers in the 2 groups; however, a marked disparity was observed in the frequency of febrile episodes within the preceding year. The duration of the febrile effect varied, with 76.92% being temporary and 23.08% showing sustained improvements postfever. Children with sustained improvements had more severe social deficits. CONCLUSION: The febrile effect is observed in a subset of ASD children and may be associated with more severe social deficits. The heterogeneity in the duration of the febrile effect suggests the need for further research to elucidate the underlying mechanisms and potential therapeutic applications.
Partnering With Physical Therapists and Speech-Language Pathologists in Early Childhood to Promote Access to Assistive Technology for a Child With Medical Complexity.
Sloane BM, Vincent S, Crawford S … +2 more , Zuckerman KE, Augustyn M
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 41220065 · Publisher ↗
Noah is an 18-month-old boy with Rubinstein-Taybi syndrome, diagnosed at 3 months through genetic testing that revealed a cyclic adenosine monophosphate response element-binding protein (CREBBP) variant. At 7 months, Noa...
Noah is an 18-month-old boy with Rubinstein-Taybi syndrome, diagnosed at 3 months through genetic testing that revealed a cyclic adenosine monophosphate response element-binding protein (CREBBP) variant. At 7 months, Noah was socially engaged, smiling and responding to familiar caregivers, but his motor differences were evident: limited head control, frequent fisting of his hands, difficulty grasping objects because of syndactyly, the need for assistance with rolling, and difficulty tolerating time on his stomach.By 9 months, Noah was referred to Part C Early Intervention services and began occupational and physical therapy. With support, he was developing postural control and reaching skills. Still, his opportunities for exploration and communication remained largely dependent on adult facilitation. At this point, Noah did not have independent or reliable ways to move across his environment or consistent methods for communication to share his wants, needs, or make choices.The central challenge in this case: How can pediatric clinicians and therapists partner to bring assistive technology into the lives of children, like Noah, at the right time?
New Onset of Suicidal Ideation in Children With Neurologic, Developmental, and Behavioral Disorders From Longitudinal Universal Suicide Risk Screening.
Gornik AE, Schindel BJ, Kim A … +5 more , Ngur M, Zabel TA, Lopez-Arvizu C, Rybczynski S, Lipkin PH
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 41145221 · Publisher ↗
OBJECTIVE: This naturalistic, observational study aimed to assess the frequency and timing of new and recent suicidal ideation (SI) in youth with neurologic, developmental, and behavioral disorders (NDBDs) after an initi...
OBJECTIVE: This naturalistic, observational study aimed to assess the frequency and timing of new and recent suicidal ideation (SI) in youth with neurologic, developmental, and behavioral disorders (NDBDs) after an initial negative suicide risk screening within medical and behavioral health settings. METHOD: A total of 5030 children aged 8 to 17 years were included, all of whom received at least 2 routine suicide risk screenings between July 2019 and February 2024 as part of their larger clinical care appointments (N = 20,177 total screenings). Screenings were conducted using the Ask Suicide-Screening Questions tool. Analyses examined the interval between an initial negative screening and the emergence of new SI, with stratification by clinic type and age group. Predictors of new onset of SI were also examined. RESULTS: Overall, a significant proportion of children screened positive for new SI after an initial negative screening (8.4%). Rates were higher in behavioral health clinics (11.3%) compared with medical clinics (5.4%), with a median interval of 5 to 6 months to the first positive screening for both settings. Females were more likely to report new SI, as were those in seen in behavioral health as compared with medical clinics. CONCLUSION: The findings highlight the importance of repeated suicide risk screening in children with NDBDs as a significant proportion of new SI is reported in the months after an initial negative screening. Screening only annually appears likely to underdetect risk, underscoring the need for more frequent screening particularly within the first year of care to improve early detection and intervention opportunities.
Parental Feeding Strategies and Outcomes During Complementary Food Introduction Among Preterm Infants at 12 Months Corrected Age.
Thompson KL, Park J, McComish C … +2 more , Thoyre S, Erickson K
J Dev Behav Pediatr · 2026 Mar-Apr 01 · PMID 41144330 · Publisher ↗
OBJECTIVE: The introduction to complementary food is an important stage, particularly for preterm infants and their parents as they navigate a changing feeding relationship. Parental feeding strategies during this period...
OBJECTIVE: The introduction to complementary food is an important stage, particularly for preterm infants and their parents as they navigate a changing feeding relationship. Parental feeding strategies during this period can influence long-term feeding outcomes, but the influence of specific strategies on later feeding skills and feeding problem symptoms is unknown. METHOD: Parents of preterm infants completed surveys about their infant's feeding at regular intervals from 1 to 12 months of age. At each time point, parents reported on their use of feeding strategies and their infants' feeding skills (Child Oral and Motor Proficiency Scale) and feeding problem symptoms (Pediatric Eating Assessment Tool). Patterns of parental strategy use across the early complementary feeding period were examined and associations with feeding skills and problems at 12 months corrected age was assessed. RESULTS: Seventy-four parents completed the surveys. Frequency and type of strategies used changed over time. Four patterns of parental strategy use emerged: low-moderate, schedule dominant, dual dominant, and modification dominant. Parental use of 2 or more types of strategies at relatively high levels was associated with more feeding problem symptoms at 12 months but not feeding skills. CONCLUSION: Parents of preterm infants use different strategies during the complementary feeding period to navigate their infant's feeding, with potential implications for later feeding problems. Future research should explore causal mechanism behind parental strategy use and feeding problem symptoms through longitudinal analyses and investigate how parental perceptions and decision-making regarding mealtime strategy use evolve over the first year of life.
Phenotypic Description of Autism Spectrum Disorder and Psychopathology in Maternal 15q Duplication Syndrome.
Venezia I, Passarini S, Guerrera S … +9 more , Apicella M, Alesi V, D'Elia G, Sallicandro E, Bontempo P, Bartuli A, Sinibaldi L, Vicari S, Valeri G
J Dev Behav Pediatr · 2026 Mar-Apr 01 · PMID 41114666 · Publisher ↗
OBJECTIVE: 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 individual...
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Promoting Collaboration Among Pediatrics, Education, and Law in a Preschooler With Co-occurring Attention-deficit Hyperactivity Disorder and Cerebral Palsy.
Loe I, Spinks-Franklin A, Espiritu D … +3 more , Koski WS, Diekroger EA, Fogler JM
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 41114658 · Full text
Marcus is a 4-year-old African-American boy with cerebral palsy, Gross Motor Function Classification System level 1, and attention-deficit hyperactivity disorder (ADHD), Combined Presentation who presents to Developmenta...
Marcus is a 4-year-old African-American boy with cerebral palsy, Gross Motor Function Classification System level 1, and attention-deficit hyperactivity disorder (ADHD), Combined Presentation who presents to Developmental-Behavioral Pediatrics clinic for evaluation because of preschool difficulties. He is very active, jumping up and down at circle time, bumping into classmates, and impulsively hitting other children when they take his toys. As a toddler, his cognitive and social-emotional skills were on track, and he received early intervention for language and motor delays. He qualified for an IEP and transitioned to a district-based inclusive preschool setting with speech therapy and adaptive physical education. Marcus spends the week with his grandparents, and they live in a school district that is well-resourced and has inclusive school and therapy settings. The teachers call parents or grandparents frequently to pick him up. In response to misbehavior, they also put him in a separate timeout area, away from the other children, with a 1:1 aide for the rest of the day. On 2 occasions, he was strapped into a therapy chair for nonambulatory children after biting or hitting another child. Because he does well with 1:1 support, the school has switched him to a special day class with smaller class size, comprised primarily of autistic preschoolers who are minimally verbal. Marcus' parents have just started parent training in behavior management for ADHD after struggling to find a therapist that was covered by their insurance. His mother noticed while volunteering in his original class that other children with similar behavior were not sent home or transferred to a special education class. They are upset with the transfer to the more restrictive environment, but they are worried if they speak up that the district will send him to a less resourced school in the district where the family, rather than grandparents, reside. How would you advise the family to proceed?
Screening for Developmental Delays in Primary Health Care in Northeastern Brazil.
Bessa FR, Viana-Cardoso KV, Martins JDN … +3 more , Moreira RS, Alves CRL, de Castro Magalhães L
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 41081544 · Publisher ↗
OBJECTIVE: To estimate the frequency of suspected neurodevelopmental delays (NDD) and to investigate the measurement properties and usability of the Survey of Well-Being of Young Children-Brazilian version (SWYC-BR). MET...
OBJECTIVE: To estimate the frequency of suspected neurodevelopmental delays (NDD) and to investigate the measurement properties and usability of the Survey of Well-Being of Young Children-Brazilian version (SWYC-BR). METHODS: We conducted a cross-sectional study in Basic Health care Units in Northeastern Brazil. The participants were 645 mothers/caregivers of children between 2 and 65 months of age who completed the SWYC-BR and a socioeconomic questionnaire. We estimated the frequency of suspected NDD using the SWYC-BR, assessed the respondents' experience with the questionnaire, and examined test-retest reliability and internal consistency of the SWYC-BR items, as well as the construct validity of the Developmental Milestones questionnaire (DM-SWYC). RESULTS: The sample consisted primarily of families residing in urban areas and belonging to very low socioeconomic classes. The frequency of suspected NDD was 37.9%. The internal consistency of the SWYC-BR ranged from 0.56 to 0.97, and the test-retest reliability of the items was high (>0.75). Significant associations with risk factors for developmental delays confirmed the construct validity of the DM-SWYC. Most mothers/caregivers found the SWYC-BR easy to respond (85.7%) and enjoyed responding to the questions (95.8%). CONCLUSION: The high frequency of suspected NDD highlights the need for special attention to early child development. The SWYC-BR was well accepted, and its measurement properties were confirmed, demonstrating its feasibility in identifying children requiring closer primary health care monitoring.
The Father's Role in Complementary Feeding During Infancy in Turkey.
Aydın B, Tekindal MA, Özmert EN
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 41051376 · Publisher ↗
OBJECTIVE: The aim of this study was to determine the effect of fathers' participation in complementary feeding on the occurrence of parent-reported behavioral feeding problems in infants. METHOD: Both parents in the int...
OBJECTIVE: The aim of this study was to determine the effect of fathers' participation in complementary feeding on the occurrence of parent-reported behavioral feeding problems in infants. METHOD: Both parents in the intervention group and mothers in the control group were trained for 20 minutes in accordance with the national complementary feeding guideline. Behavioral feeding status were evaluated by Behavioral Pediatrics Feeding Assessment Scale. RESULTS: The frequency of fathers engaged in infant feeding increased in the intervention group compared with in the control group at the follow-ups ( p < 0.05), respectively. The frequency of behavioral feeding problems at 9th and 12th months in the intervention group was 44.7% and 18.8%, respectively, compared with 79.5% and 65% in the control group ( p < 0.05). Problems related to the attitudes of fathers during feeding in the intervention group were lower than the control group. The Behavioral Pediatrics Feeding Assessment Scale scores in the intervention group were 54.36 ± 6.82 and 53.31 ± 6.62 for fathers, while they were 62.54 ± 6.69 and 61.28 ± 7.73 for fathers in the control group, at the 9th and 12th months, respectively ( p < 0.01). CONCLUSION: Training and engaging fathers on complementary feeding positively affects the feeding attitudes and behaviors of parents and reduces early behavioral feeding problems in infants.
The Relations Among GI Symptoms, Mental Health, and Online Schooling for Youth With GI Conditions During the COVID-19 Pandemic.
Robbertz AS, Nelson CI, Peugh J … +3 more , Hommel K, Armistead LP, Cohen LL
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 41042534 · Full text
OBJECTIVES: For youth with gastrointestinal (GI) conditions, mental health symptoms can exacerbate GI symptoms. In a cyclical fashion, experiencing GI symptoms at school can contribute to depression, anxiety, and embarra...
OBJECTIVES: For youth with gastrointestinal (GI) conditions, mental health symptoms can exacerbate GI symptoms. In a cyclical fashion, experiencing GI symptoms at school can contribute to depression, anxiety, and embarrassment. This study evaluated the impact of school instruction type on mental health and GI symptoms for youth with GI conditions during the COVID-19 pandemic. METHOD: Data were collected from caregivers and patients aged 8 to 17 years with inflammatory bowel disease, celiac disease, and irritable bowel syndrome (N = 146) from September to December 2020. Patients completed measures of depression, anxiety, anger, and GI symptoms; caregivers provided their child's school instruction type (online, hybrid, or in-person). Analyses were conducted to examine the relations of mental health symptoms, GI symptoms, and school instruction type. RESULTS: Participants generally had mild levels of depressive symptoms (T = 55.50), and anxiety (T = 53.02) and anger (T = 49.92) symptoms were within normal limits. Anxiety and GI symptoms were positively related ( b = 0.14, p < 0.01), and if participants were attending school online, they had worse GI symptoms ( b = 0.46, p < 0.05). However, there was no significant interaction between anxiety and instruction type. Depression and anger were not significantly related to GI symptoms and there were no significant interactions. CONCLUSION: For children with GI conditions during the pandemic, as their anxiety symptoms increased, so did their GI symptoms. Further research should examine the long-term effects of virtual learning for those with GI conditions.
Disability Visibility: First-person Stories From the Twenty-first Century.
Foster CC
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 41002164 · Publisher ↗
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A Child With Oppositional Behavior After a Burn Injury: A Role for Inpatient Developmental Pediatrics Consults.
Seabury A, Campbell K, Clay CJ … +4 more , Minges EC, Carbone PS, Kreier F, Augustyn M
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 41002151 · Publisher ↗
A 5-year-old girl with a history of autism spectrum disorder was admitted to inpatient rehabilitation after extensive accidental burns requiring skin grafts to her upper body. During her admission, she had increasingly a...
A 5-year-old girl with a history of autism spectrum disorder was admitted to inpatient rehabilitation after extensive accidental burns requiring skin grafts to her upper body. During her admission, she had increasingly aggressive behaviors toward staff, hyperactivity, impulsivity, and refusal to participate in therapies. She resisted transitions between activities, hit her bed rails, and eloped from her room. Goals during physical therapy sessions included stretching and strengthening her scarred extremities to increase mobility. Her behavior increased her risk of healing complications and became a significant barrier to progress in her rehabilitation. The medical team consulted developmental and behavioral pediatrics to recommend medications for oppositional behaviors not responding to behavioral strategies.A developmental and behavioral pediatrics consulting team of physicians and nurses met the patient, gathered history, and observed the child in the hospital. The patient's developmental history was significant for expressive language delay and autism spectrum disorder. At home, she preferred solitary play and spinning objects and had an intense interest in horses. In the school setting, she was supported with an individualized education plan and special education services. In crowded areas, she wore noise-canceling headphones to accommodate auditory sensory hypersensitivity. Her mother reported maintaining a strict schedule at home around mealtimes, bath time, and bedtime, which provided comfort and limited tantrums. She had never needed medication to manage behaviors at home or at school in the past.When the developmental pediatrics team observed her in the hospital, she eloped from a physical therapy session in the gym and refused to participate in a hospital school session. Therapies occurred at variable times throughout the day, and she resisted transitions between therapies. She frequently complained of itching from healing burn sites and had developed new daytime urinary incontinence. During examination, she engaged in back-and-forth ball play and sought reassurance from her parent. Therapists, nurses, and behavioral health providers were interested to hear any ideas to support her. What should the developmental and behavioral pediatrics team recommend?
Family and Caregiver Quality of Life in Pediatric Neuromuscular Diseases: Psychosocial and Disease-related Predictors.
Ortega J, Vázquez N, García-Sanchoyerto M … +1 more , Amayra Caro I
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 40960360 · Publisher ↗
OBJECTIVE: This study aimed to explore family and caregiver's quality of life, identifying psychosocial factors related to it. METHOD: A cross-sectional quantitative study was carried out with 153 caregivers of children...
OBJECTIVE: This study aimed to explore family and caregiver's quality of life, identifying psychosocial factors related to it. METHOD: A cross-sectional quantitative study was carried out with 153 caregivers of children and adolescents with various neuromuscular diagnosis. Caregivers responded to the PedsQL FIM, PAS, MOS, and FACES III scales. RESULTS: Medium to low levels of quality of life (QoL) were found in caregivers of children with neuromuscular diseases. Caregivers reported low perceived family resources, but most of them presented good psychological adaptation and social support. QoL differences were found according to child's functional dependence and access to pharmacological treatment. Multiple regression analysis showed a model for Family QoL explained by family resources, caregiver's age, social support, and child's functional dependence. CONCLUSION: Families had better levels of QoL because they have a higher perception of their family resources, caregivers are older, have more functional social support, and the child has a higher degree of dependency. Results emphasized the need to adopt a psychological and family approach in the management of neuromuscular diseases.
"Keeping the Door Open": The Lived Experiences of Developmental Pediatricians in Caring for Families.
Koller D, Grech L, Matthiesen A
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 40960356 · Publisher ↗
OBJECTIVE: Within an evolving and increasingly complex pediatric context, little is known about how developmental pediatricians experience their interactions with families within nuanced clinical practices that demand fl...
OBJECTIVE: Within an evolving and increasingly complex pediatric context, little is known about how developmental pediatricians experience their interactions with families within nuanced clinical practices that demand flexibility and a tolerance for ambiguity. To address this gap, this study explored the perspectives and experiences of developmental pediatricians regarding their communications and interactions with children and families. METHOD: A qualitative exploratory design informed by phenomenology was used. Individual semi-structured interviews were conducted with 12 developmental pediatricians across Canada. Issues involving children's agency and their right to participate in shared decision-making were examined. RESULTS: Developmental pediatrics emerged as an inherently relational practice that involves building strong long-term relationships with caregivers through a strength-based, humble, and self-reflexive approach. "Keeping the door open" and "planting the seed" arose as metaphorical representations of developmental pediatricians' commitment to ensuring caregivers feel supported and understood. Moreover, challenges associated with involving children in decision-making processes, as well as managing caregivers' understandings and desires for their child's diagnosis were evident. CONCLUSION: The findings generated by this study elucidate the clinical approaches and communication styles of developmental pediatricians. Despite participants' strong family-centered approach to care, future clinical considerations should accentuate the promotion of children's autonomy and rights in developmental pediatrics.
Effectiveness of a Time-limited Parent Training Program via Telehealth for Children With Autism Spectrum Disorder and Externalizing Behavior.
Greathouse AD, Zemantic PK, Strong-Bak W … +2 more , Lieneman C, Hayes LB
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 40956139 · Publisher ↗
OBJECTIVE: The Research Units in Behavioral Intervention (RUBI) Autism Network Parent Training Program is an effective behavioral parent training program for reducing child externalizing behavior and parenting stress in...
OBJECTIVE: The Research Units in Behavioral Intervention (RUBI) Autism Network Parent Training Program is an effective behavioral parent training program for reducing child externalizing behavior and parenting stress in families of children with autism spectrum disorder (ASD). The present study examined the effectiveness, feasibility, and acceptability of a time-limited (i.e., 6-10 sessions), telehealth delivered, and community-based adaptation of the RUBI program for families of children with suspected or diagnosed ASD. METHOD: Twenty-six parents started treatment, and 18 were considered treatment completers (i.e., completed a minimum of 6 sessions). To assess effectiveness, the Aberrant Behavior Checklist, Parenting Stress Index-Short Form (PSI-4-SF), and Clinical Global Impression-Improvement (CGI-I) were used. Feasibility was evaluated through therapist fidelity, Therapist-Reported Parent Objectives, session attendance, and homework completion. Parent satisfaction was measured via a post-treatment questionnaire. RESULTS: No significant differences were found from pretreatment to post-treatment on the ABC-2; however, there were significant reductions in the PSI-4-SF Parent-Child Dysfunctional Interaction subscale ( p < 0.05) along with reductions in the PSI-4-SF Total Stress score ( p < 0.05). Half of the treatment completers showed clinically significant improvement on the CGI-I. Overall, there were high therapist treatment fidelity, parent completed objectives, attendance, and homework completion. Furthermore, there were high approval ratings across several satisfaction categories. CONCLUSION: Results provide support for the continued research and use of brief, flexible, telehealth intervention formats in community settings for children suspected of or diagnosed with ASD diagnosis and their families.
Impact of Intersecting Identities on Student Well-being.
Valdez P, Stransky AD, Grant C … +1 more , Augustyn M
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40920172 · Publisher ↗
John is a 12-year-old African-American boy with a Specific Learning Disorder in Reading and Generalized Anxiety Disorder who you are seeing in follow-up at your clinic. Last fall, when John was having an escalation of hi...
John is a 12-year-old African-American boy with a Specific Learning Disorder in Reading and Generalized Anxiety Disorder who you are seeing in follow-up at your clinic. Last fall, when John was having an escalation of his anxiety symptoms at school, he enacted the behavior intervention plan (BIP) that had been previously established by his educational team of informing his teacher that he needed to leave the classroom. He then paced the hallway outside of his classroom as a method of coping with the anxiety that he was experiencing. Approximately 3 months prior, John's teacher was unable to visualize him from her position in the classroom and subsequently called the School Resource Officer (SRO) to locate him. The SRO found John, who was in an emotionally dysregulated state. The SRO subsequently approached John who noted that he wanted to jump off a cliff. Rather than following the BIP which details the need to involve the school counselor and social worker when John is in an emotionally dysregulated state to perform a self-harm/threat assessment, the SRO bypassed this step and, instead, notified the emergency response team, who initiated a petition for psychiatric evaluation, thus temporarily limiting parental rights to make certain treatment decisions. This led to John being transported to the local Emergency Department (ED) in the backseat of a police vehicle.While in the ED, a urine toxicology assessment was performed which returned negative and John was subsequently evaluated by the child and adolescent psychiatrist on call who deemed that John was not an immediate threat to himself or others and discharged him home with his mother. Subsequent to this event, John exhibited refusal to return to school and would remain in his family's car for 30 to 60 minutes before entering the school in the morning. Once at school, he would go to an administrator's office where he felt safe, and his school work was brought to him. His long-standing therapist, who he had been seeing for management of anxiety, began providing Eye Movement Desensitization and Reprocessing therapy with John as a trauma-focused intervention to address the events he experienced at school.John continued to exhibit school avoidance and was placed on home-bound instruction by the school in the spring, which comprised 60 minutes of special education instruction in the home each week, without provision of general education instruction. John went from being an A/B student to earning Ds and Fs, and he was denied compensatory instructional services by the school in the summer.The family comes to your DBP clinic that summer asking for evaluation of his traumatic symptoms and to create a plan for the fall and returning to school.
Effectiveness of Enhanced Developmental Screening at 18 Months to Identify Developmental Delays.
Hamovitch E, Raveendran T, Cohen E … +7 more , Guttmann A, Altaf A, Diong C, Evans A, Stukel TA, Janus M, Saunders NR
J Dev Behav Pediatr · 2026 Jan-Feb 01 · PMID 40920171 · Full text
OBJECTIVE: We sought to measure whether receipt of an enhanced 18-month well-baby visit with use of a developmental screening tool versus a routine 18-month well-baby visit (which typically involves developmental surveil...
OBJECTIVE: We sought to measure whether receipt of an enhanced 18-month well-baby visit with use of a developmental screening tool versus a routine 18-month well-baby visit (which typically involves developmental surveillance without screening) is associated with time to identification of developmental delays. METHOD: We conducted a cohort study of children (17-22 months) in Ontario who received an 18-month well-baby visit (March 2020‒March 2022), followed to September 2022 using linked health administrative datasets. Visits were categorized as enhanced (n = 83,554) or routine (n = 15,723). The outcome was the identification of a developmental delay within 6 months (early) and more than 6 months after (late) the 18-month visit. Piecewise Cox proportional hazards models estimated hazard ratios (aHR) adjusted for child, maternal, and physician factors, comparing developmental delay diagnosis by visit type. RESULTS: Children who received an enhanced visit were slightly older, had a lower representation in the most deprived group, and a higher percentage of patients with pediatricians as their usual provider of care. After adjustment, children with enhanced compared with routine visits were more likely to have developmental delays detected in the early period (aHR 1.19 95% CI 1.11‒1.28) but not in the late period following the well-baby visit. CONCLUSION: Enhanced visits are associated with earlier identification of developmental delays compared with routine visits in the 6 months following the 18-month well-baby visit. Enhanced developmental monitoring using screening tools may facilitate earlier recognition of developmental concerns.
Precision Medicine in Pediatric Attention-deficit/Hyperactivity Disorder: A Systematic Review of Behavioral, Neurobiological and Genetic Diagnostic Biomarkers.
Pranjić M, Peisch V, Vukšić N … +2 more , Subedi S, Arnett AB
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40910865 · Publisher ↗
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders and a common presenting concern in primary and developmental pediatric care. However, objective diagnos...
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders and a common presenting concern in primary and developmental pediatric care. However, objective diagnostic tools are currently not available, leading to delayed and missed diagnoses. The current systematic review aimed to determine whether objective indices can serve as diagnostic markers for pediatric ADHD. METHOD: We conducted a systematic review of objective behavioral, neurobiological, and genetic biomarkers that could inform a precision medicine approach to diagnosis of pediatric ADHD. Following the PRISMA guidelines, we searched three major databases (MEDLINE, PsycInfo, and Scopus) for articles published between 2012 and 2024 that evaluated diagnostic biomarkers with a translational aim. RESULTS: A total of 111 studies met inclusion criteria, including 42 behavioral, 44 neuroimaging, and 25 genetic studies. Among behavioral studies, measures of physical activity achieved discriminant validity in the good to excellent range. Neuroimaging biomarkers were strongest when machine learning and multiple-features models were used. A particularly promising direction involved task-based NIRS paradigms targeting cognitive control. The results of the genetic studies underscored the complexity of the genetic architecture of ADHD, implicating rare and common variants, as well as epigenetic mechanisms. MicroRNA and methylation profiles demonstrated the strongest accuracy, overall. CONCLUSION: Our systematic review identified promising candidate diagnostic markers for ADHD across behavioral, neuroimaging, and genetic methods. Multimethod approaches are likely to yield the strongest diagnostic accuracy. The complexity and cost of these approaches limits potential for implementation of a precision medicine approach to pediatric ADHD diagnosis in primary care settings.
Bridging the Gap in Autism Diagnosis: An Evaluation of a Novel Primary Care Training Model.
Bickel J, Hatoun J, Fry M … +5 more , Prock L, Vernacchio L, Patane LB, Coop A, Weitzman C
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40879428 · Publisher ↗
OBJECTIVE: The current study assesses the impact of an educational program designed to train primary care clinicians (PCCs) to diagnose children between age 18 and 36 months at high risk for autism spectrum disorder (ASD...
OBJECTIVE: The current study assesses the impact of an educational program designed to train primary care clinicians (PCCs) to diagnose children between age 18 and 36 months at high risk for autism spectrum disorder (ASD). METHODS: Two cohorts of PCCs completed an 8-session training over a 9-month period. Clinicians were surveyed at baseline and 3 months after training completion. Information was collected regarding PCCs knowledge of ASD, their diagnostic beliefs, and perceived comfort and competence regarding all aspects of an ASD diagnostic evaluation. RESULTS: A total of 35 participants completed training, and 29 (82%) completed presurvey and postsurvey. At baseline, 89% of PCCs reported no additional training in developmental behavioral pediatrics or diagnosing children with ASD, although 31% had diagnosed a child with ASD in the past year. After training, PCCs reported significantly greater comfort diagnosing ASD in children between age 18 and 36 months with mild ASD (2.31 vs 3.02, p < 0.0001), moderate ASD (3.03 vs 3.83, p < 0.001), and severe ASD (3.45 vs 4.34, p < 0.0001). PCCs also reported a significant increase in their knowledge and perceived competence in completing an autism evaluation, including taking an autism history, completing a structured observation, scoring the Childhood Autism Rating Scale-Second Edition, writing a letter of medical necessity, and discussing findings with families. CONCLUSION: After training, PCCs reported a significant improvement in their knowledge, comfort, and competence regarding all aspects of diagnosing young children 18 to 36 months of age at high risk of ASD. PCCs can help to improve access to services for young children at risk for ASD.
Consensus Training Priorities for Developmental-behavioral Pediatric Mini-fellows.
Blum NJ, Jackel C, Jaffe N … +8 more , Perlman D, Ayeni O, Chiu K, DeHaan S, Evans D, Hughes K, Jungblut M, van der List L
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40879423 · Publisher ↗
OBJECTIVE: Identify training priorities for primary care clinicians who commit to a minimum of 300 hours of training in developmental-behavioral pediatrics (DBP mini-fellows). METHODS: Eight mini-fellows from 13 DBP fell...
OBJECTIVE: Identify training priorities for primary care clinicians who commit to a minimum of 300 hours of training in developmental-behavioral pediatrics (DBP mini-fellows). METHODS: Eight mini-fellows from 13 DBP fellowship training programs funded by the Health Resources and Services Administration participated in a focus group discussion of training priorities (round 1) resulting in 105 potential priorities. One faculty member from each funded program (13 faculty) and all 14 mini-fellows in Spring, 2024 were invited to complete a survey to rate the importance of each of 105 suggested priorities on a 9-point Likert scale (round 2). Training priorities rated as 6 or higher by 60% of mini-fellows and/or faculty were retained for the round 3 survey, which included the mean score on the item from mini-fellows and faculty and asked the group to rate the items on the 9-point Likert scale considering the round 2 ratings. Items in round 3 with a median score of at least 7 and a 25th percentile score of at least 6 were categorized as consensus training priorities. RESULTS: In round 2, 68 of 105 items met criteria to advance. In round 3, 46 of these 68 qualified as consensus training priorities. Many priorities related to care for children with autism spectrum disorder, attention-deficit hyperactivity disorder, and/or systems-based practice. Seven items not rated as consensus priorities by the full group, did meet criteria among mini-fellows. CONCLUSION: This study identified high priority topics for training mini-fellows that can provide foundational guidance for developing mini-fellow training curricula.
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