Journal Of Developmental And Behavioral Pediatrics[JOURNAL]
Sun
200 papers
Early Life Neurodevelopment of Infants Across a Wide Gestational Age Range.
Chan PHY, Lai CM, Lam HS … +1 more , Wong PCM
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40864546 · Full text
OBJECTIVE: Neural development differs between in-utero and ex-utero environments. Length of gestational age (GA) is associated with brain development and early life neurodevelopmental outcomes, affecting both preterm and...
OBJECTIVE: Neural development differs between in-utero and ex-utero environments. Length of gestational age (GA) is associated with brain development and early life neurodevelopmental outcomes, affecting both preterm and term infants. This study aimed to examine a wide range of GA and provide a more comprehensive understanding of its effects on various developmental domains. METHOD: Four hundred fifty-four infants who were born at 24 to 41 weeks of GA were included in this analysis. Cognitive, language, and motor development between 8 and 30 months of age were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Associations between GA and outcomes were analyzed using linear and logistic mixed-effects models. RESULTS: GA was positively associated with all examined developmental domains with a small-sized effect (Pearson's correlation coefficients: 0.08-0.15; p < 0.05). After adjusting for covariates, linear mixed-effect models estimated that each additional week of GA was associated with an increase in Bayley III composite scores: cognitive (0.6 points), language (0.6 points), and motor (0.62 points). Logistic mixed-effect models showed that after adjusting for the covariates, each additional week of GA reduced the adjusted odds ratio of delay in 1 of the language subdomains (i.e., receptive communication) by 13%. CONCLUSION: We found a small impact of GA on cognitive, language, and motor development across a wide range of GA. Language and its subdomains seem particularly sensitive to the effects of prematurity. Thus, regular monitoring and parent-based early intervention, especially in the language domain, are warranted for early-term and preterm infants.
A Systematic Study on Prenatal Opioid Exposure: A Review of Neurodevelopmental Consequences.
Cao Q, Kable J
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40862649 · Full text
OBJECTIVE: A systematic review using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted to evaluate the potential adverse impacts on neurodevelopment associated with prenatal opia...
OBJECTIVE: A systematic review using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted to evaluate the potential adverse impacts on neurodevelopment associated with prenatal opiate exposure. METHOD: After applying exclusion criteria to the identified collection of studies, 86 studies were included in this review. Each article was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations system. Results were grouped into 6 neurobehavioral function domains (executive, language, general development, motor, neurosensory, and socioemotional) and 1 neuroimaging domain. RESULT: Risk difference analyses showed the neurosensory domain in children prenatally exposed to opioid had highest risk of impairment (76.9%), whereas the executive domain had lowest risk (44.8%). The meta-analysis of pooled estimates after statistical adjustments associated with the Egger's test results showed effect size (Hedge's g) was largest in the socioemotional domain (-1.14; 95% CI, -1.61 to -0.66) and smallest in the general development domain (-0.44; 95% CI, -0.70 to -0.18). Neuroimaging studies on prenatal exposure to opioid were limited and varied in the techniques and topographical focus in their approaches, resulting in a heterogenous body of literature. CONCLUSION: Maternal opioid use during pregnancy can serve as a risk indicator for an at-risk child and the potential need for monitoring the child's neurodevelopmental growth. The conclusions related to the direct teratogenic effects of maternal opioid use, however, are often limited by poor experimental and statistical controls used to address other substances and social adversity that co-occur with opioid use.
Adverse Childhood Experiences and Behavioral and Emotional Problems in Adolescents With and Without Autism.
Wiggins LD, DiGuiseppi C, Overwyk K … +10 more , Barger B, Dichter G, Durkin M, Hightshoe K, Moody E, Nadler C, Powell P, Reyes N, Thompson-Paul AM, Anderson KN
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40862645 · Full text
OBJECTIVES: We sought to examine differences in caregiver-reported adverse childhood experiences (ACEs) in adolescents with and without autism and explore associations between ACEs and behavioral and emotional problems i...
OBJECTIVES: We sought to examine differences in caregiver-reported adverse childhood experiences (ACEs) in adolescents with and without autism and explore associations between ACEs and behavioral and emotional problems in those with ACEs. METHODS: Children were classified as having autism, another developmental disability (DD), or population comparison (POP) after a comprehensive evaluation in the Study to Explore Early Development (SEED) between 2 to 5 years of age. Caregivers of these same children completed the SEED Teen survey and answered questions about ACEs and current behavioral and emotional problems at 12 to 16 years of age. RESULTS: Adolescents with autism (n = 198) and other DD (n = 330) were more likely than POP (n = 330) to experience income insufficiency (29.8%, 25.2%, and 12.2%, respectively) and parental divorce (29.3%, 25.7%, and 18.4%, respectively) (all p < 0.05). Living with someone with an alcohol or drug problem was associated with conduct problems only in adolescents with autism; living in a family that received financial assistance was associated with hyperactivity problems only in adolescents with other DD. Living with anyone experiencing mental illness, suicidality, or severe depression was associated with conduct and emotional problems in all 3 study groups. CONCLUSION: Families of children with atypical development may need more financial and emotional/marital support than others. Moreover, adolescents with autism and other DD could benefit from behavioral supports in response to a few specific ACEs while addressing household mental health problems could have widespread benefits that improve pediatric health. These findings can be used to encourage evidence-based programs and practices to prevent ACEs and offer supports when needed.
The Essential Guide to Raising Complex Kids With ADHD, Anxiety, and More by Elaine Taylor-Klaus.
Garcia J, Farley M
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40838765 · Publisher ↗
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Improving Metabolic Monitoring of Atypical Antipsychotics in a Developmental and Behavioral Pediatrics Ambulatory Clinic.
Dreyer JE, Glasheen JJ, Orth LE … +3 more , Garay K, Koch AZ, Reynolds A
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40838761 · Publisher ↗
Atypical antipsychotics are high-risk medications with serious side effects including weight gain, hyperlipidemia, and insulin resistance. Safe use in youth with autism spectrum disorder and other neurodevelopmental diso...
Atypical antipsychotics are high-risk medications with serious side effects including weight gain, hyperlipidemia, and insulin resistance. Safe use in youth with autism spectrum disorder and other neurodevelopmental disorders is especially important due to inherent risks of high obesity rates and barriers to a healthy lifestyle. Metabolic monitoring rates are low in this population in part due to difficulties with obtaining labs and other vitals. In our Developmental and Behavioral Pediatrics clinic, 31% of patients had once-yearly metabolic monitoring parameters completed. We aimed to increase metabolic monitoring rates through multi-disciplinary interventions. A pharmacist provided educational presentations to staff, the pharmacist identified patients needing monitoring and provided recommendations to the medical provider, nursing staff notified families by phone if labs were needed, and child life support services were offered. Average once-yearly metabolic monitoring rates increased from 31% to 64% 1 year after beginning interventions. Three educational presentations were provided, 183 recommendations for monitoring were made on 141 patients, and nursing made 38 phone calls to families. Of the 141 patients identified as needing monitoring at the time of clinic visit, 72 (51%) obtained the monitoring parameters within 3 months. Abnormal metabolic labs requiring additional action were found in 31/72 (43%) patients. Patients with in-person visits were more likely to obtain labs overall and on the day of clinic visit than those with telehealth appointments. Using a multidisciplinary approach within a Developmental and Behavioral Pediatrics clinic, metabolic monitoring rates in patients taking atypical antipsychotics greatly improved.
Preferences for Outcome Data Collection and Access in a Pediatric Autism Learning Health Network Registry.
Murray DS, Anixt JS, Vasudevan V … +7 more , Cole LL, Fedele A, Karpur A, Cornell WL, Latten LM, Butter EM, Coury DL
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40838760 · Publisher ↗
OBJECTIVE: Health professionals participating in learning health networks collect data for informing clinical decision-making, research, and quality improvement (QI). To optimize the collection and use of clinical and Pa...
OBJECTIVE: Health professionals participating in learning health networks collect data for informing clinical decision-making, research, and quality improvement (QI). To optimize the collection and use of clinical and Parent Reported Outcome (PRO) data for these purposes, it is important to understand the priorities of patient registry "end users" (clinicians, researchers, and patients/families). METHODS: The analysis used a sequential mixed-methods approach with parent (n = 93) and clinician (n = 167) surveys followed by targeted interviews (parent n = 9, clinician/researcher n = 7) completed at Autism Care Network (ACNet) sites to better understand current use of registry data and parent/clinician priorities. RESULTS: Sixty percent of parents reported receiving behavioral data regarding their child from their health provider in the past, and 90% felt these data would help them understand their child's behavior. Among data access options parents preferred an online portal (72%) and/or the clinic's electronic medical record (59%). Parents indicated willingness to complete surveys longitudinally if the assessments correlated with their child's specific areas of difficulty. Priorities for clinicians included easy access to the data (84%), meaningful connection to clinical outcomes (81%), and measures that can demonstrate change in symptoms over time (76%) and that are easy for families to complete (80%). Both groups recommend assessing parenting stress and social determinants of health. CONCLUSION: Consideration of end-user priorities can improve patient registry data collection, analysis, and utilization. Families may be more willing to participate if they can receive direct benefit by accessing their own data and clinicians use this data to optimize clinical care.
Specific Behaviors of Young Healthy Children During Toilet Training and Their Associations With Functional Constipation: A Cohort Study.
Naenen L, Van Aggelpoel T, Roelant E … +4 more , De Wachter S, De Baets K, De Win G, Vermandel A
J Dev Behav Pediatr · 2025 Aug · PMID 40815791 · Publisher ↗
OBJECTIVES: To assess the association between specific toilet training (TT) behaviors and functional constipation (FC) in young, healthy children. METHODS: This cross-sectional descriptive study distributed 2917 question...
OBJECTIVES: To assess the association between specific toilet training (TT) behaviors and functional constipation (FC) in young, healthy children. METHODS: This cross-sectional descriptive study distributed 2917 questionnaires to parents of healthy children across 38 nursery schools in Flanders. Parents were given questions regarding their child's TT and TT-related behaviors such as stool toileting refusal (STR), hiding, and requesting a diaper for defecation, along with questions about current stool issues, which involved assessing stool consistency using the Bristol Stool Chart. RESULTS: From a 42.1% (n = 1228) response rate, 1218 questionnaires were analyzed. Parents reported that during TT, 23.6% (n = 285; 95% confidence intervals [CIs], 21.2-26.0%) of their children refused to defecate on a potty, 13.0% (n = 157; 95% CI, 11.2-15.0%) hid while defecating, and 9.7% (n = 117; 95% CI, 8.1-11.5%) asked for a diaper to defecate. The prevalence of FC was 16.8% (n = 204; 95% CI, 14.7-19.0%). Chi-square tests showed significant associations between each of these TT behaviors and FC. The odds on FC was 2.8 (95% CI, 1.8-4.2) times higher when the child asked for a diaper, 3.2 (95% CI, 2.3-4.3) times higher in the presence of STR, and 3.7 (95% CI, 2.6-5.4) times higher for those who hid. CONCLUSION: Refusing to defecate, hiding, and asking for a diaper have a significant association with FC, especially when multiple behaviors are present. These findings are clinically relevant for parents and pediatricians, aiding them in understanding behaviors that can be associated with FC and raising awareness to identify potential signs.
Comparison of Available Tools to Screen for Autism at 12 and 15 Months.
Porto KS, Wieckowski AT, Fein DA … +3 more , Barton ML, Baranek GT, Robins DL
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40758867 · Full text
OBJECTIVE: To determine the performance of autism screeners at 12 and 15 months of age. METHODS: Children were screened either at 12- (n = 1473) or 15-month (n = 1227) primary care visits. Children were screened with bot...
OBJECTIVE: To determine the performance of autism screeners at 12 and 15 months of age. METHODS: Children were screened either at 12- (n = 1473) or 15-month (n = 1227) primary care visits. Children were screened with both the Infant/Toddler Checklist (ITC) and the First Year Inventory-Lite (FYI-L) at 12 months and FYI-L and the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) at 15 months. After a positive screen and/or clinical concern, families were offered a no-cost diagnostic evaluation. RESULTS: Of the 1473 toddlers screened at 12 months, 223 screened positive and 107 attended a diagnostic evaluation. Of the 1227 children screened at 15 months, 252 screened positive and 94 attended the evaluation. Overall, specificity for autism was high (>0.94) for all screeners at 12 and 15 months. At 12-month screening, sensitivity for autism was low on the ITC (0.26) and moderate on the FYI-L (0.67). Positive predictive value (PPV) was low for both screeners (0.24 for ITC and FYI-L). At 15 months, both the FYI-L and the M-CHAT-R/F demonstrated moderate sensitivity (0.61 for FYI-L and 0.60 for the M-CHAT-R/F) and low PPV (0.16 for FYI-L and 0.31 for M-CHAT-R/F). CONCLUSION: Although data do not support universal screening at younger ages, the study identifies tools that can be used at 12 and 15 months. Importantly, screening at these ages does not identify all cases of autism, and repeat screening at 18 months and beyond is essential to support autism detection as early as possible.
Rethinking the Scope of Developmental-behavioral Pediatric Fellowship Training: Is It Time to Recalibrate?
Weitzman CC
J Dev Behav Pediatr · 2025 Jul · PMID 40743482 · Publisher ↗
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Assessing the Relationship Between Child Maltreatment and Disordered Eating Among Youth: A Systematic Review and Meta-analysis.
Korth CX, Kutash LA, Coifman KG … +1 more , Sato AF
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40743452 · Publisher ↗
OBJECTIVE: Exposure to child maltreatment is highly prevalent and associated with a myriad of adverse physical and mental health outcomes, including disordered eating (DE). However, most of this work has been limited to...
OBJECTIVE: Exposure to child maltreatment is highly prevalent and associated with a myriad of adverse physical and mental health outcomes, including disordered eating (DE). However, most of this work has been limited to adults with eating disorders, and the association between maltreatment and DE specifically among youth has yet to be systematically quantified. This systematic review and meta-analysis aimed to quantify the association between child maltreatment and indicators of DE among children and adolescents. METHOD: Electronic databases were searched to identify original, peer-reviewed articles. Effect sizes were calculated to quantify the association between child maltreatment (physical, sexual, emotional abuse, or neglect) and DE among youth. RESULTS: Across 13 studies, the odds of engaging in DE among youth who experienced child maltreatment were significantly greater than the odds of engaging in DE among youth who had never experienced child maltreatment (odds ratio = 2.16; 95% CI, 1.77-2.63; p < 0.001). CONCLUSION: These meta-analytic findings indicate that youth who experience maltreatment may be vulnerable to patterns of DE during childhood/adolescence. Notable methodological limitations of these findings are discussed, and this broader field of research would benefit from methodologically rigorous future studies.
COVID-19 Infection and Mitigation for Young Children With Autism and Other Disabilities.
Fitzgerald R, Eck L, Pazol K … +3 more , Wiggins L, Durkin M, Nadler C
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40743451 · Full text
OBJECTIVE: This study investigated prevalence of positive tests for COVID-19 infection and difficulties with mitigation strategies among young children with autism spectrum disorder (ASD) and other developmental disabili...
OBJECTIVE: This study investigated prevalence of positive tests for COVID-19 infection and difficulties with mitigation strategies among young children with autism spectrum disorder (ASD) and other developmental disabilities (DD) compared with children from the general population (population comparison group [POP]). METHODS: Before the pandemic, children aged 2 to 5 years in the Study to Explore Early Development (SEED) completed a developmental assessment assigning them to a study group (ASD, other DD, or POP). Caregivers were recontacted in 2021 to complete a questionnaire assessing the impact of the pandemic in 2020 when children were aged 3 to 8 years. Modified Poisson regression models assessed the relationship between study group and difficulty with mitigation strategies and nasal swabbing. RESULTS: Caregivers of 1027 SEED participants completed the survey. Prevalence of having 1 or more positive COVID-19 tests was 3 times higher for children in the ASD and DD groups versus the POP group. In adjusted models, children in the ASD group were more likely to have difficulty with all 3 mitigation strategies and nasal swabbing compared with children in the POP group. The DD group were more likely than the POP group to experience difficulty with handwashing and physical distancing. CONCLUSION: Compared with the general population, youth with ASD and DD were more likely to have at least 1 positive COVID-19 test and difficulty following mitigation strategies. These findings underscore the importance of supporting youth with ASD and DDs in anticipation of future public health emergencies and the annual respiratory disease season.
Caregiver's Perspectives on Disclosing the Diagnosis of Autism Spectrum Disorder to Their Children.
Rostollan MA, Pulliam EH, Scott AL
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40729753 · Publisher ↗
OBJECTIVE: There is growing literature emphasizing the importance of early and tailored parental disclosure of an autism diagnosis to their children. While there are barriers to disclosure, most parents agree that childr...
OBJECTIVE: There is growing literature emphasizing the importance of early and tailored parental disclosure of an autism diagnosis to their children. While there are barriers to disclosure, most parents agree that children have a right to know of their diagnosis, with early disclosure being associated with a better quality of life and self-image. Within the literature, however, there is scarcity of populations from the United States represented in qualitative disclosure studies. With the impact of culture and location on language, this study aims to address this gap. METHOD: Caregivers of children with prior diagnosis of ASD (n = 16) were recruited to participate in semistructured interviews. Blinded transcripts of interviews were used to individually create codes that were formed into themes based on consensus of the researchers through thematic analysis. RESULTS: Of the 16 caregivers interviewed, 14 were White and all 16 were female. Twelve caregivers reported working or volunteering in areas with high exposure to the autism community. Thematic analysis yielded 4 themes relating to diagnosis disclosure: (1) Language of Disclosure, (2) Disclosure as a Journey, (3) Purpose of Disclosure, and (4) Process of Disclosure. CONCLUSION: This exploratory, qualitative study examines caregiver's perspectives on the disclosure process, strengthening the consensus with emerging literature surrounding the process of disclosure and highlighting the role language plays in the disclosure process. More specifically, the metaphors used by parents to describe autism change from generally positive euphemisms to more well-balanced and realistic metaphors that encapsulate both triumphs and struggles that accompany an autism diagnosis.
Child and Family Characteristics Associated With Age of Autism Spectrum Disorder Diagnosis in a Primary Care Population.
Rea CJ, Lesch K, Hernandez B … +5 more , Sprecher E, Hauptman M, Epee-Bounya A, Wilson K, Shah SN
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40729749 · Publisher ↗
OBJECTIVE: To compare a sample of pediatric primary care patients diagnosed with autism spectrum disorder (ASD) with the general clinic population, as well as associations of child and caregiver characteristics with age...
OBJECTIVE: To compare a sample of pediatric primary care patients diagnosed with autism spectrum disorder (ASD) with the general clinic population, as well as associations of child and caregiver characteristics with age of diagnosis. METHOD: Cross-sectional data for patients from 2 large, urban primary care practices diagnosed with ASD between March 1, 2018, and February 28, 2022, were collected from the medical record through extraction and chart review. The sample was compared with the total primary care population using χ 2 analysis. Unadjusted bivariate linear regression and multivariate linear regression were used to evaluate associations of each variable with age of diagnosis. RESULTS: Patients diagnosed with ASD were more likely to be male, Hispanic, publicly insured and medically complex than the general clinic population. There was also a higher maternal education level in the autism group. In unadjusted linear regression analyses, language delay, connection with Early Intervention (EI), earlier age of parental concern, earlier age of referral, having an M-CHAT completed, higher M-CHAT scores, and having a first-degree relative with ASD were associated with earlier age of diagnosis. In multivariate linear regression analysis, connection with EI, better continuity of care, higher M-CHAT scores and having commercial insurance were associated with earlier diagnosis. Race/ethnicity, language, and Social Vulnerability Index ≥ 90%ile were not significantly associated with age of ASD diagnosis. CONCLUSION: This study reflects shifting prevalence patterns of ASD, but a persistent disparity in age of diagnosis among publicly insured children. It highlights the importance of developmental monitoring, continuity of care, and navigation support to help families obtain ASD diagnoses promptly.
Feeding Problems Among Typically Developing Children From India Aged 1 to 5: A Cross-sectional Study.
Kuniyil VN, Nayak S, VeeraBhadrappa RC … +2 more , Mundkur SC, Devadas U
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40729744 · Full text
OBJECTIVE: Feeding problems in typically developing children (TDCs) are quite common in early childhood and are of great concern for parents, as they significantly impact nutritional intake and overall health. This study...
OBJECTIVE: Feeding problems in typically developing children (TDCs) are quite common in early childhood and are of great concern for parents, as they significantly impact nutritional intake and overall health. This study aimed to evaluate the prevalence of feeding difficulties in typically developing children from India aged 1 to 5 years using the Kannada version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). METHOD: Data were gathered from 253 parents of typically developing children via a purposive sampling method. The parents completed a self-reported demographic questionnaire and a Kannada version of the BPFAS. RESULTS: The survey analyzed the responses of 124 (49%) male and 129 (51%) female children. According to the BPFAS cutoff scores, the prevalence of feeding difficulties among TDCs in the study was 28.9% (n = 73) (TFS >84) and 18.2% (n = 46) (TPS >9). Even though a higher percentage of children exhibited negative feeding behaviors, very few parents considered these behaviors problematic for them. Furthermore, analysis revealed a weak negative correlation between BMI and TFS and TPS scores (Pearson r values of -0.027 [ p = 0.669] for the TFS score and -0.049 [ p = 0.436] for the TPS score). CONCLUSION: The present study reveals a higher prevalence of parent-perceived feeding issues in young, typically developing children from India. This highlights the necessity of educating Indian parents about feeding issues in young children, their potential long-term consequences, and the need for early intervention.
Self-management in Youth and Young Adults With Spina Bifida: Associations With Caregiver Expectation and Attention-Deficit/Hyperactivity Disorder Symptoms.
Simpson TS, Bold E, Peterson RL … +3 more , Lantagne A, Wilson P, Petranovich C
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40729732 · Publisher ↗
PURPOSE: To determine whether caregiver expectation and symptoms of attention deficit/hyperactivity disorder (ADHD) were significantly associated with self-management behavior in a sample of youth and young adults with s...
PURPOSE: To determine whether caregiver expectation and symptoms of attention deficit/hyperactivity disorder (ADHD) were significantly associated with self-management behavior in a sample of youth and young adults with spina bifida (SB), while accounting for several other condition-related and sociodemographic factors. METHODS: Participants were drawn from clinical cases seen through a multidisciplinary outpatient SB clinic at a children's hospital between 2022 and 2023. Participants included 52 youth and young adults younger than 21 years diagnosed with SB. Caregiver report of youth and young adult self-management behavior and caregiver expectation were obtained using the Kennedy Krieger Independence Scales-Spina Bifida Version (KKIS-SB). Caregiver report of youth and young adult ADHD symptoms were obtained using the National Institute for Children's Health Quality Vanderbilt Assessment Scale-Parent Version. RESULTS: Caregiver expectation and symptoms of ADHD were significantly associated with self-management behaviors in youth and young adults with SB, including the ability to initiate daily self-care and home living routines independently and the ability to use prospective memory to complete tasks that are needed for good health. More ADHD symptoms were associated with poorer ratings of self-management behavior and higher caregiver expectation was associated with better ratings of self-management behavior. CONCLUSION: The findings of this study suggest that caregiver expectations and co-occurring neurocognitive challenges may be influential when considering self-management behaviors in youth and young adults with SB. Family-based interventions that target caregiver perceptions and behaviors and provide psychoeducation about neurocognitive challenges as they relate to self-management behaviors may be an important target for future research.
Acceptability and Feasibility of Rapid Tube Weaning During Intensive Multidisciplinary Feeding Intervention.
Volkert VM, Berry R, Farling H … +9 more , Waddle C, Malugen E, Rajagopal S, Johnson LM, Gillespie S, Buckley D, McMahon M, Scahill L, Sharp WG
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40700749 · Publisher ↗
OBJECTIVE: The primary objective of this pilot trial was to determine to what extent hunger provocation, via rapid weaning from enteral feedings, was acceptable and feasible and to evaluate the effect of this interventio...
OBJECTIVE: The primary objective of this pilot trial was to determine to what extent hunger provocation, via rapid weaning from enteral feedings, was acceptable and feasible and to evaluate the effect of this intervention when used during intensive multidisciplinary feeding intervention for children dependent on enteral feedings. METHOD: The study was conducted at an Intensive Multidisciplinary Program located in the Southeastern United States from May 2021 to October 2023. Children were randomly assigned 1:1 to standard wean or rapid wean using permuted blocks of 2 and 4 with allocation pattern concealed to investigators resulting in respective cohort sizes of 8 (N = 16 participants, total) for 8 weeks. Feasibility benchmarks and data completeness were summarized using percentages and means. The study also evaluated the effect of intervention on treatment outcomes including weight-for-age z-score, percentage of daily caloric needs met by mouth, percent of patients achieving ≥1 day where 100% of caloric needs were met via oral feeding, and time to effect. RESULTS: Feasibility and acceptability benchmarks were achieved. Preliminary outcome data suggest rapid tube weaning did not influence reaching 100% oral intake or fully weaning from a feeding tube when used as an adjunct to behavioral intervention. CONCLUSION: This study was a prerequisite to support a future efficacy randomized clinical trial to further study how to optimize outcomes to achieve full weaning from tube feeding.
Demographic and Clinical Predictors of Suicide Risk in Pediatric Surgical Clinics: A Retrospective Study of 79,000 Screenings.
Barré A, Zhang DA, Holm V … +4 more , Lew D, Van Speybroeck A, Iwinski H, Poon SC
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40700747 · Publisher ↗
OBJECTIVE: Suicide is the second leading cause of death for adolescents. Children in surgical clinics have diagnoses that may predispose mental health challenges. This study explored associations between demographics, di...
OBJECTIVE: Suicide is the second leading cause of death for adolescents. Children in surgical clinics have diagnoses that may predispose mental health challenges. This study explored associations between demographics, diagnoses, and suicide risk screenings in the outpatient pediatric surgical setting. METHODS: A database of suicide risk screenings administered across a pediatric surgical health care system from 2019 to 2023 was analyzed. Demographic variables and diagnoses were collected, and multilevel logistic regression models calculated odds ratio (OR) and 95% confidence interval (CI) for the relationships. RESULTS: In total, 79,384 suicide risk screenings were collected for 50,796 patients. 5.6% (n = 4476) were positive for suicidal thoughts. Asians were less likely to screen positive (OR, 0.65; 95% CI, 0.56-0.76), and females were more likely (OR, 1.92; CI, 1.80-2.05). Patients with Medicaid or uninsured were more likely to screen positive (OR, 1.47; CI, 1.38-1.57 and OR, 1.17, CI, 1.002-1.36, respectively). As affluence increased, there was decreased likelihood of positive screens (OR, 0.93; CI, 0.91-0.96). The diagnosis most associated with increased risk was mental, behavioral, and neurodevelopmental disorders (OR, 3.41; CI, 2.92-3.97), followed by pain (OR, 1.88; CI, 1.71-2.05), burns (OR, 1.43; CI, 1.21-1.69), and scoliosis (OR, 1.10; CI, 1.02-1.17). CONCLUSION: When screening for suicide risk in outpatient pediatric surgical subspecialty clinics, females and patients with Medicaid or uninsured have increased risk of screening positive for suicidal ideations. Youth with mental, behavioral, and neurodevelopmental disorders were most at risk, followed by pain, burns, and scoliosis. It is important to understand how these factors influence mental health to aid in providing resources for at-risk patients.
Preliteracy Skills in Young Children Who are Deaf/Hard of Hearing: Secondary Analysis of the Technology-assisted Language Intervention Randomized Trials.
Betances E, Wiley S, Tabangin M … +6 more , Sheldon R, Lane L, Mood D, Williams-Arya P, Schumacher J, Meinzen-Derr J
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40700591 · Full text
OBJECTIVES: Most children exhibit preliteracy skills by preschool. Children who are deaf/hard of hearing (DHH) with a language gap are at risk for delayed preliteracy skills. Our study aimed to describe preliteracy skill...
OBJECTIVES: Most children exhibit preliteracy skills by preschool. Children who are deaf/hard of hearing (DHH) with a language gap are at risk for delayed preliteracy skills. Our study aimed to describe preliteracy skill development in preschool-aged DHH children and investigate associated factors. METHODS: Children, aged 3 to 5 years, were included in the analysis if enrolled in randomized trials of a language intervention using augmentative and alternative communication, shown to boost language skills. Evaluations using the Clinical Evaluations of Fundamentals-Preschool Preliteracy Rating Scale (PRS) were conducted at baseline, 24 weeks, and 48 weeks. Repeated-measures models assessed changes in total PRS scores and Early Reading and Early Writing subdomains. Results were presented as least square mean values with 95% confidence intervals. RESULTS: Forty-five children had completed pre-data and post-data. The mean nonverbal IQ was 99.3 (SD 14.3), and receptive and expressive language were 82.3 (14.9) and 76.8 (17.0), respectively. Significant ( p < 0.0001) skill growth was observed with all preliteracy outcomes, ranging from 11 to 15 points in the first 24 weeks. Increasing receptive and expressive language over time was significantly associated with increasing scores. Factors such as aided hearing thresholds, caregiver education level, and hearing device use were not significant in models. CONCLUSION: Language is essential for literacy development. Language-enhancing interventions could facilitate literacy skills. Monitoring preliteracy skills in DHH children is crucial, given their increased risk for language delays. Further research is needed to support early literacy development in this population, ensuring they have the tools they need for future success.
Maternal Parenting Behavior and Preschoolers' Sleep Problems: The Mediating Role of Effortful Control in a Korean Population.
Jeong JE, Lee B, Hong HC … +1 more , Shin N
J Dev Behav Pediatr · 2025 Sep-Oct 01 · PMID 40669054 · Publisher ↗
OBJECTIVE: Sleep quality and quantity are critical for preschoolers' physical, cognitive, social, and emotional development. This study examined the individual and environmental factors associated with preschoolers' slee...
OBJECTIVE: Sleep quality and quantity are critical for preschoolers' physical, cognitive, social, and emotional development. This study examined the individual and environmental factors associated with preschoolers' sleep problems. Specifically, we investigated the direct effects of maternal parenting behavior and the indirect effects mediated by preschoolers' effortful control. METHOD: A total of 774 mothers with preschool-aged children (aged 3-6 years) participated in this study. They completed a questionnaire assessing their parenting behavior, as well as their children's effortful control and sleep problems. RESULTS: Our analysis yielded 3 major findings. First, we found that rejecting and chaotic maternal parenting behaviors were directly associated with sleep problems in preschoolers. Second, preschoolers' effortful control mediated the relationship between positive maternal parenting behavior and preschoolers' sleep problems. Third, among the 3 dimensions of negative maternal parenting behavior, the mediating effect of effortful control was observed only in the context of chaotic parenting. CONCLUSION: These results suggest that maternal negative and positive parenting behaviors may be differentially related to preschoolers' sleep problems, with the former exhibiting a more proximal association and the latter potentially linked through mediated processes. Furthermore, when home environments are unpredictable or inconsistent, preschoolers may struggle to develop appropriate behavioral regulation, which can contribute to sleep problems.
Experiences of Children With Down Syndrome and Caregivers Using Contactless Sleep Monitoring as Polysomnography Alternative.
Sclip K, Collaro A, Chawla J
J Dev Behav Pediatr · 2025 Nov-Dec 01 · PMID 40668731 · Publisher ↗
BACKGROUND: Sleep disordered breathing (SDB) is more prevalent in children with Down syndrome (DS), and polysomnography (PSG) is routinely performed by 4 years of age. However, application of sensors to the scalp and mid...
BACKGROUND: Sleep disordered breathing (SDB) is more prevalent in children with Down syndrome (DS), and polysomnography (PSG) is routinely performed by 4 years of age. However, application of sensors to the scalp and midface is often poorly tolerated in this population because of behavioral and sensory sensitivities, resulting in failed studies and incomplete data. OBJECTIVE: This study aimed to explore caregiver experiences and perspectives of contactless sleep monitoring using Sonomat as an alternative to PSG. METHODS: This was a cohort study of children with DS undergoing PSG for evaluation of SDB. Caregivers completed study-specific questionnaires on their child's experiences with PSG and Sonomat (in-hospital, home). Descriptive statistics of responses are reported. RESULTS: Fifty-six children underwent simultaneous Sonomat and PSG monitoring, with 28 continuing home monitoring. Airflow sensors were poorly tolerated during PSG, with 30% of children unable to tolerate both nasal prongs and oronasal thermistor. All caregivers who used the Sonomat at home rated the experience positively; however, only 56% preferred it over in-lab PSG, indicating mixed preferences. Most caregivers found Sonomat easy to use, and a majority reported typical sleep patterns during home monitoring. CONCLUSION: The Sonomat represents a promising contactless tool for screening sleep disordered breathing in children with Down syndrome, particularly in cases where standard PSG is not tolerated. Its ease of use and acceptability suggest value in complementing traditional diagnostics, especially in home settings.
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