Journal Of Developmental And Behavioral Pediatrics[JOURNAL]
Sun
200 papers
CARE-Squared: Teaching a Novel Parallel-Process Approach to Crisis Management.
Myers BR, Allen KE, Szarkowski A … +3 more , Hardell M, Phelps RA, Fogler JM
J Dev Behav Pediatr · 2025 Apr · PMID 40267334 · Publisher ↗
OBJECTIVE: Given rising national rates of depression, anxiety, suicidality, and trauma, and with the associated rise in screening for mental health concerns in medical settings, medical and behavioral health clinicians i...
OBJECTIVE: Given rising national rates of depression, anxiety, suicidality, and trauma, and with the associated rise in screening for mental health concerns in medical settings, medical and behavioral health clinicians increasingly identify and manage mental health crises during time-limited visits. Through 2 clinical case examples, this article introduces CARE-squared , a novel approach to teaching crisis management, grounded in client support and clinician self-care, that can be used in a variety of health care settings. METHOD: This article describes the need for crisis management in health care settings, reviews literature on existing Psychological First-Aid frameworks, and highlights principles of trauma-informed care. The article then introduces CARE-squared , a four-step parallel-process model of crisis management, designed to guide health care trainees' support of clients in crises while simultaneously maintaining patient alliance, de-escalating, and managing clinician stress during a crisis. RESULTS: Two clinical cases highlight the applicability of CARE-squared to rapid crisis management during in-person and telehealth visits. CONCLUSION: CARE-squared provides a novel, parallel-process approach to support patient care and clinician wellness. It has broad applicability to clinician training and practice and potential utility for a variety of presenting concerns and health care settings.
The Initial Creation of a Family Well-being Index Using the National Survey of Children's Health.
Nielson M, Fong KS, Crandall A
J Dev Behav Pediatr · 2025 Jul-Aug 01 · PMID 40239181 · Publisher ↗
OBJECTIVE: The well-being of families is critical for health, but a family well-being metric has not yet been developed for use in federal surveys, making it impossible to assess national trends in family well-being. The...
OBJECTIVE: The well-being of families is critical for health, but a family well-being metric has not yet been developed for use in federal surveys, making it impossible to assess national trends in family well-being. The National Survey for Children's Health (NSCH) includes items relating to different dimensions of family well-being. The purpose of this study was to conduct exploratory research to create an index of family well-being using items from the NSCH to examine trends in family well-being among families with children in the United States. METHODS: Using the 2016 and 2021 NSCH, we created an index of family well-being. We compared family well-being across families with children in different age groups and examined trends over time between 2016 and 2021. Finally, we examined correlations between family well-being and 6 child health outcomes (chronic headaches, diabetes, depression, anxiety, attention-deficit hyperactivity disorder (ADHD), and behavioral and conduct disorders). RESULTS: The final family well-being index had 10 items/constructs. Children 0 to 5 years were more likely than older children to have caregivers whose responses met criteria for most family well-being items. Between 2016 and 2021, family health remained relatively steady, but there were significant changes in 6 of the 10 family well-being index items, with some items increasing and some decreasing in 2021 compared with 2016. Family well-being was modestly correlated with all 6 children's health outcomes. CONCLUSION: By having a family well-being index in federal surveys, trends in family well-being can be examined over time. Changes in children's health can also be assessed relating to family well-being.
Neurodevelopmental and Mental Health Outcomes in a National Clinical Sample of Youth With Sex Chromosome Trisomies Compared With Matched Controls.
Hall A, Furniss A, Tartaglia NN … +16 more , Janusz J, Wilson R, Middleton C, Martin S, Frazier J, Martinez-Chadrom M, Hansen-Moore J, Ikomi C, Ross J, Vogiaski MG, Morrow L, Christakis DA, Lean RE, Nokoff N, Pyle L, Davis SM
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 40232995 · Full text
OBJECTIVE: To compare the prevalence of neurodevelopmental and mental health diagnoses in a national sample of youth with sex chromosome trisomies (SCTs) with matched controls. METHODS: Patients in PEDSnet and a diagnosi...
OBJECTIVE: To compare the prevalence of neurodevelopmental and mental health diagnoses in a national sample of youth with sex chromosome trisomies (SCTs) with matched controls. METHODS: Patients in PEDSnet and a diagnosis code mapping to 47,XXY/Klinefelter syndrome (n = 1171), 47,XYY/Double Y syndrome (n = 243), or 47,XXX/Trisomy X syndrome (n = 262) were matched with controls using propensity scores. Generalized estimating equations computed odds ratios (OR) with 95% confidence intervals (CI) for the prevalence of diagnoses within the neurodevelopmental and mental health composites, psychotropic medication prescriptions, and encounters with behavioral health and therapy providers. Alpha was set at 0.0025 to account for multiple comparisons. RESULTS: Patients with SCTs had higher odds of diagnoses within the neurodevelopmental (OR 6.3, 95% CI, 5.7-7.2) and mental health composites (OR 2.7, 95% CI, 2.3-3.2) compared with matched controls. All neurodevelopmental diagnoses were more prevalent among all SCT groups compared with controls. Within the mental health composite, only the prevalence of anxiety and mood disorder was higher in all SCT groups. A higher proportion of patients with SCTs had psychotropic prescriptions compared with controls (stimulants 13.1% vs 5.2%, selective serotonin reuptake inhibitors 8.7% vs 2.8%, antipsychotics 6.5% vs 2.4%, p < 0.0001 for all). Overall, 48% of patients with SCTs had a clinical encounter with a behavioral health provider vs 16.6% of controls (OR 5.6, 95% CI, 4.1-5.1). CONCLUSION: Compared with matched controls, youth with SCTs receiving care at US tertiary care pediatric centers have disproportionately high rates of neurodevelopmental and mental health conditions, emphasizing the need for appropriate screening and intervention in these populations.
Embedding Universal Language Promotion in Pediatric Primary Care to Optimize Early Child Development and Reduce Long-Term Health Disparities.
Salley B, von Bevern H, Grasley-Boy N … +3 more , Fleming K, Weltmer K, Carta J
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 40232994 · Full text
OBJECTIVE: To report on the feasibility and outcomes of universal language promotion intervention (Talk With Me Baby [TWMB]) embedded within routine well-child care for children from birth to 3-years old. METHODS: Across...
OBJECTIVE: To report on the feasibility and outcomes of universal language promotion intervention (Talk With Me Baby [TWMB]) embedded within routine well-child care for children from birth to 3-years old. METHODS: Across 2 primary care clinics, 29 health care team members participated in a 12-month trial to deliver TWMB within well-child care visits. Feasibility was based on clinician feedback during the trial, clinician knowledge assessments, and clinic data. Sixty-three parents and their infant/toddlers were enrolled to provide feedback on TWMB and to assess parent language promotion behaviors, specifically, parents' self-reported use of their language-building interactions during daily activities with their child. RESULTS: Clinician feedback and clinic data support TWMB as an acceptable and feasible intervention that can be used successfully within standard of care well-child visits by health care teams. Initial outcome data show positive changes for increasing parent-child language promoting interactions during daily activities. CONCLUSION: Results support the promise of leveraging primary care as a low-cost, scalable way to deliver universal language promotion intervention to optimize the developmental potential of all young children.
The Value of ECHO Autism to Primary Care Providers: Building Community and Capacity.
Smith JD, Vaughn LM, Page E … +2 more , Mitchell T, Anixt JS
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 40232993 · Publisher ↗
OBJECTIVES: The Extension for Community Healthcare Outcomes (ECHO) model has been shown to increase primary care providers' (PCPs) knowledge and self-efficacy in caring for patients with autism spectrum disorder (ASD). B...
OBJECTIVES: The Extension for Community Healthcare Outcomes (ECHO) model has been shown to increase primary care providers' (PCPs) knowledge and self-efficacy in caring for patients with autism spectrum disorder (ASD). Benefits of ECHO Autism participation may not be fully captured in studies measuring only quantitative outcomes. Qualitative methodology was used to explore the perceptions, meaning, and impact of ECHO Autism from the perspective of participating PCPs. METHODS: We used group level assessment, a large-group participatory, qualitative research method modified to a virtual format to explore the perceptions, meaning, and impact of the ECHO Autism program from the perspective of 6 participating PCPs, 1 family member, and 5 hub team members. Individual, semi-structured interviews were conducted with 4 ECHO Autism participants to further explore the identified themes. RESULTS: Participants identified 6 primary themes corroborated by interview participants: (1) direct benefits to PCPs, (2) appreciation of the "all teach, all learn" approach, (3) sense of community, (4) value of the multidisciplinary conceptualization of care for children with ASD, (5) demystification of care for children with ASD, and (6) benefits to the PCPs' patients and their families. Feedback about ways to enhance the ECHO Autism program was categorized into 5 areas for improvement. CONCLUSION: ECHO Autism builds a community for providers who may otherwise feel isolated and hesitant to manage complex needs of children with ASD. ECHO Autism is an innovative approach to build capacity for PCPs to provide high-quality evidence-based care to these children within their own communities.
Eco-anxiety and Climate Anxiety: Bellwethers of the Climate Crisis's Mental Health Impact on Children and Adolescents.
Cook R, Nam X, Weitzman M
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 40232809 · Publisher ↗
OBJECTIVE: To highlight the need for more research about climate change's effects on child and adolescent mental health. METHOD: Articles and reports were searched for in 12 pediatric journals and 10 international societ...
OBJECTIVE: To highlight the need for more research about climate change's effects on child and adolescent mental health. METHOD: Articles and reports were searched for in 12 pediatric journals and 10 international societies using the mesh terms "climate change and mental health," "climate change and children's mental health," and "eco-anxiety." Articles were scanned for relevancy using the terms "climate change," "climate crisis," "mental health," "child," "anxiety," and "mental anxiety." Relevant literature was compiled and analyzed. RESULTS: Although the climate crisis has been highlighted as a critical threat to the physical health of adolescents worldwide, its mental health impacts are far less recognized. Existing research on climate change and mental health is limited, primarily focusing on the acute response of adults directly affected by extreme weather events rather than climate change's emerging indirect mental health effects. Far more limited is the literature focusing on the mental health effects of climate change on adolescents and children, who are hypothesized to bear the brunt of the mental health detriment of climate change. In addition, nonstandardized scales and definitions and lack of nationally representative data, among many other things, hinder current understanding, attention, and evidence-based action to prevent and treat these effects. CONCLUSION: Gathering information regarding the climate crisis and children's mental health is paramount. Consequently, the development of a research workforce, a funding stream, and standardized methodology is necessary to properly investigate and aid adolescents and children facing the climate crisis's mental health effects.
Attention-Deficit/Hyperactivity Disorder and Teen Self-Report on Health Behaviors and Social-Emotional Wellbeing: United States, July 2021-December 2022.
Katz SM, Claussen AH, Black LI … +4 more , Leeb RT, Newsome K, Danielson ML, Zablotsky B
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 40232808 · Full text
OBJECTIVE: Promoting health during adolescence can support long-term well-being, especially for teens diagnosed with attention-deficit/hyperactivity disorder (ADHD), who face increased risks due to the disorder's impact...
OBJECTIVE: Promoting health during adolescence can support long-term well-being, especially for teens diagnosed with attention-deficit/hyperactivity disorder (ADHD), who face increased risks due to the disorder's impact on development and health behaviors. ADHD is often associated with difficulties in social interactions, a higher likelihood of bullying involvement, and co-occurring mental health conditions. These factors may also be influenced by health factors such as physical activity, sleep quality, and screen time usage. Nationally representative teen self-reports provide a novel perspective on ADHD-related health outcomes compared with relying on parent reports. METHOD: We used nationally representative data from the National Health Interview Survey (NHIS) and NHIS-Teen from July 2021 to December 2022, to examine teen-reported health and well-being factors, stratified by parent-reported ADHD diagnoses among teens aged 12 to 17 years. Weighted prevalence estimates and adjusted prevalence ratios (aPR) adjusting for teen age, sex, and family income, all with 95% confidence intervals (CIs), were calculated. RESULTS: Just over 10% of teens had ADHD and they reported higher prevalence of bullying victimization (aPR = 1.64, CI = 1.27-2.11), difficulties making friends (aPR = 1.83, CI = 1.15-2.90), difficulty getting out of bed (aPR = 1.29, CI = 1.02-1.64), irregular wake times (aPR = 2.17, CI = 1.45-3.25), and >4 hours daily screen time (aPR = 1.26, CI = 1.05-1.52) than teens without ADHD; teens with ADHD reported a lower prevalence of lacking peer support (aPR = 0.70, CI = 0.51-0.96). CONCLUSION: Teens with ADHD face distinct challenges related to social-emotional well-being and health behaviors that support overall wellness. Findings may inform opportunities for health promotion among teens with ADHD.
Characterizing Referrals to Mental and Behavioral Health and Community Resources in Urban Pediatric Primary Care.
Patel NS, Huth-Bocks AC, Cipolla K … +2 more , Burkhart K, Ronis S
J Dev Behav Pediatr · 2025 Apr · PMID 40209217 · Publisher ↗
OBJECTIVE: Examine patient characteristics and practice processes associated with referrals to social and behavioral health resources in an urban/inner-city primary care pediatric practice. METHOD: Retrospective chart re...
OBJECTIVE: Examine patient characteristics and practice processes associated with referrals to social and behavioral health resources in an urban/inner-city primary care pediatric practice. METHOD: Retrospective chart review was conducted on Safe Environment for Every Kid (SEEK) screening and immediate and later clinician responses to positive screens (documented by the practice's early relational health specialist) from well-child visits for children 6 months to 6 years. Bivariate and multivariate analyses were used to examine associations between demographics, screening results, and referral acceptance. RESULTS: Of 1104 SEEK screens, 152 (13.8%) were excluded for incomplete screens and 25 (2.3%) for duplicate caregiver screens. Of 927 included, responses were discussed at the time of screening for 286 (30.9%, "immediate") and/or attempted to be discussed at a later time by phone for 397 (42.8%, "later," median 11 days [interquartile range 6-19] between screen and discussion); 14 (1.5%) had both forms of contact; and 230 (24.8%) had no documented discussion at any time. Demographics were similar across groups. Clinician discussion was more likely if caregivers reported harsh punishment ( p = 0.036), caregiver stress ( p < 0.001), or caregiver depression ( p < 0.001) on screen. After clinician discussion, referral was offered and subsequently accepted by 225 of 697 caregivers (32.3%). Each additional stressor endorsed increased odds of accepting referral by 25% (95% confidence interval, 1.07-1.47). Referrals to parenting groups, social needs navigation support, and social work were completed by 33 of 68 (48.5%) referred families. CONCLUSION: Safe Environment for Every Kid screening in urban pediatric primary care can be used to identify families' unmet social and behavioral health care needs to provide support.
The Continuum of Environmental Effects on Preterm Speech and Language Development and Outcomes.
Mayne J, Vohr B
J Dev Behav Pediatr · 2025 Apr · PMID 40209212 · Publisher ↗
OBJECTIVE: Examine the trajectories of speech and language delay and proficiency, risk factors contributing to outcomes, and efficacy of interventions for preterm infants from infancy to adulthood. METHOD: Review the lit...
OBJECTIVE: Examine the trajectories of speech and language delay and proficiency, risk factors contributing to outcomes, and efficacy of interventions for preterm infants from infancy to adulthood. METHOD: Review the literature on speech and language outcomes of preterm infants from infancy to adulthood. RESULTS: Speech and language delays continue to be a common challenge among preterm-born infants, with important biological and socioenvironmental factors contributing to long-term language impairment as well as recovery. The variable preterm infant language experience in-utero, in the neonatal intensive care unit (NICU), and in the home environment plays an important role in outcomes. Evidence suggests a lasting impact of prematurity on language outcomes in early childhood through adulthood. CONCLUSION: There is a need for clinician recognition and implementation of interventions that promote positive language input in the NICU and the home, combined with parent, professional, and community-based partnerships to nurture and facilitate a language-rich environment.
Effects of the COVID-19 Pandemic on Early Child Development: A Systematic Review & Meta-Analysis.
O'Connor H, DiSalvo M, Gersten M … +2 more , Boyden S, Uchida M
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 40198822 · Full text
OBJECTIVE: To explore the effects of the COVID-19 pandemic on early childhood development and identify areas of interest surrounding development. METHODS: A systematic literature review was performed to identify articles...
OBJECTIVE: To explore the effects of the COVID-19 pandemic on early childhood development and identify areas of interest surrounding development. METHODS: A systematic literature review was performed to identify articles examining how the COVID-19 pandemic has affected early childhood development, and a meta-analysis was conducted from the results of those articles to examine the degree of the impact of the pandemic on the areas of childhood development. RESULTS: Ten articles from 6 countries were identified that met all inclusion and exclusion criteria. The multivariate meta-analysis showed no significant difference in overall development (pooled Cohen's d = 0.28, 95% CI, -0.33 to 0.88; p = 0.18) or odds for developmental delay (pooled odds ratio (OR) = 1.44, 95% CI, 0.77 to 2.67; p = 0.20) between pre-COVID-19 development and COVID-19 development. However, there was significantly more impairment ( d = 0.46, p = 0.003) and greater odds (72%; OR = 1.72, p = 0.01) for developmental delay in the language and communication domain for COVID-19 children versus pre-COVID-19 children. CONCLUSION: While exposure to the COVID-19 pandemic was not associated with global developmental delays, it had a significant impact on child development regarding language and communication. Further research monitoring effects of the COVID-19 pandemic is necessary, and parents and communities should focus on increasing early intervention and enriched curriculum to offset these delays.
Reducing Excessive Screen Time Among Primary School-aged Children Through Caregivers' Parenting Behaviors: A Feasibility Pilot Study in China.
Xie QW, Fan XL, Chen R … +1 more , Chen L
J Dev Behav Pediatr · 2025 Apr · PMID 40193704 · Publisher ↗
OBJECTIVE: Given the well-documented associations between excessive screen time (ST) and adverse health outcomes, this pilot study aimed to examine the applicability and effectiveness of a multicomponent intervention tha...
OBJECTIVE: Given the well-documented associations between excessive screen time (ST) and adverse health outcomes, this pilot study aimed to examine the applicability and effectiveness of a multicomponent intervention that combined strategies to enhance caregivers' screen-related parenting practices with efforts to create a supportive community environment to reduce children's ST in a county in China. METHODS: A 2-arm, cluster-randomized, wait-list controlled design was used. Eight communities and 336 caregivers of primary school-aged children were randomly assigned to intervention and control groups. Wilcoxon signed-rank tests and McNemar's χ 2 tests were applied to evaluate within-group changes over time. A linear mixed model was used to assess intervention effects. RESULTS: The intervention significantly reduced children's daily average total ST and entertainment ST on weekends (β = -43.81; p < 0.05; β = -22.29, p < 0.05) and on a weekly basis (β = -30.32; p < 0.05; β = -14.40, p < 0.05). Moreover, it significantly reduced the odds of excessive entertainment ST on weekdays (β = -2.32, p < 0.05) weekly (β = -2.34, p < 0.05) and excessive academic ST weekly (β = -1.71, p < 0.05). No significant treatment effect was found for parenting practices and children's physical activities. CONCLUSION: This study supports the feasibility of a multicomponent intervention and its effectiveness in reducing children's excessive ST, particularly in addressing entertainment ST.
Internet-delivered Parent-Child Interaction Therapy and Sleep Quality in Children With Developmental Delay: Examining the Mediating Role of Bedtime Resistance Behaviors.
Warner M, Gillenson CJ, Parent J … +2 more , Comer JS, Bagner DM
J Dev Behav Pediatr · 2025 Apr · PMID 40193697 · Publisher ↗
OBJECTIVE: Sleep problems are frequently reported and associated with externalizing behavior problems in young children, especially those with developmental delay (DD). Parent-child interaction therapy (PCIT) led to impr...
OBJECTIVE: Sleep problems are frequently reported and associated with externalizing behavior problems in young children, especially those with developmental delay (DD). Parent-child interaction therapy (PCIT) led to improved sleep in young children with DD, but research has not examined the effect of internet-delivered PCIT (iPCIT) on sleep quality or changes in bedtime resistance behaviors as a mediator. This study examined iPCIT's effect on sleep quality in young children with DD through its impact on bedtime resistance behaviors. METHOD: Participants were from a previously completed randomized controlled trial and included 150 children with DD ( M age = 36.2 months, SD = 1.0 months) and their caregivers who were randomized to iPCIT or referrals as usual (RAU). Path analyses examined links between treatment condition, post-treatment bedtime resistance, and sleep quality reported at 6-month follow-up. RESULTS: Treatment condition significantly influenced bedtime resistance behaviors (β = 0.17, 90% CI, [0.04, 0.29], p = 0.01), and these changes, in turn, significantly affected sleep quality reported at 6-month follow-up (β = 0.18, 90% CI, [0.03, 0.33], p = 0.02). Caregivers receiving iPCIT reported fewer bedtime resistance behaviors after treatment and improved child sleep quality at 6-month follow-up than caregivers receiving RAU. CONCLUSION: Although effects were smaller than in other studies examining PCIT's effect on sleep, these results highlight how iPCIT led to improved sleep quality in children with DD through changes in bedtime resistance. Further research is needed to explore differences in the effectiveness of in-person versus iPCIT, as well as other mechanisms (such as parenting behaviors) through which iPCIT affects child sleep quality.
Self-talk in a Patient With Down Syndrome: When Is It a Concern?
Prout KK, Kitchen J, Tobler L … +1 more , Nyp SS
J Dev Behav Pediatr · 2025 Apr · PMID 40193695 · Publisher ↗
Thomas is a 12-year-old boy with Trisomy 21, hypothyroidism, and hearing loss. During a recent follow-up visit to the multidisciplinary Down syndrome clinic, his parents expressed concern regarding changes related to Tho...
Thomas is a 12-year-old boy with Trisomy 21, hypothyroidism, and hearing loss. During a recent follow-up visit to the multidisciplinary Down syndrome clinic, his parents expressed concern regarding changes related to Thomas's overall functioning and increasing problematic self-talk behavior. Thomas's parents report that he has talked to "imaginary friends" (e.g., "no, don't do that" or "that's not nice") since he was in preschool. Previously, parents have been reassured that this behavior is likely externalized self-talk and have been advised to not be concerned by the behavior as it is fairly common in youth with Down syndrome.His parents shared that he has always been "in his own world," but over the past 6 months, the frequency of self-talk behavior has increased, and the content of self-talk has focused more on "bad men" (e.g., "bad men do bad things"). Thomas's parents have also noticed that it has become difficult to engage him in conversation or other tasks, including preferred activities, because of his preoccupation with "talking to imaginary friends." In addition, Thomas has begun picking at his skin to the point of bleeding, his artwork/drawings have become more rudimentary (now drawing stick figures), his sleep onset and maintenance have reduced, and he refuses to go into his bedroom because of "whispers in the walls."At school, Thomas's teachers have reported that his speech has become more difficult to understand, and he has been increasingly distracted by "talking to imaginary friends," including in the middle of class time. Classroom behavioral interventions (e.g., positive reinforcement program) have not been helpful.When asked about recent stressors, Thomas's parents shared that there was a string of car break-ins in the neighborhood around 7 months ago and have wondered if overhearing about this event could have affected Thomas in some way.Given this history, what would you consider in development of a differential diagnosis and what would be your next steps in providing care for Thomas?
Integrated Behavioral Health and Implementation of the Safe Environment for Every Kid Approach in Pediatric Primary Care: A Mixed Methods Study.
Palinkas LA, Belanger R, Saldana L … +4 more , Magder L, Landsverk J, Schaper H, Dubowitz H
J Dev Behav Pediatr · 2025 Apr · PMID 40193694 · Full text
OBJECTIVE: To determine whether the presence of integrated behavioral health care (IBH) in a pediatric practice is associated with improved implementation of Safe Environment for Every Kid (SEEK), an evidence-based appro...
OBJECTIVE: To determine whether the presence of integrated behavioral health care (IBH) in a pediatric practice is associated with improved implementation of Safe Environment for Every Kid (SEEK), an evidence-based approach to prevention of child maltreatment. METHODS: Pediatric primary care practices across the United States (n = 44) expressed interest in participating in a longitudinal multisite trial. Half of the practices included IBH. Semi-structured interviews were conducted at different points in time with 49 practice leaders, primary care professionals, behavioral health professionals, and nursing and administrative staff. Quantitative data on implementation stage and phase, proportion of activities completed at each stage, and length of time to complete each stage were collected by the Stages of Implementation Completion measure. RESULTS: Qualitative data revealed several instances in which IBH facilitated the adoption and implementation of SEEK and where SEEK supported IBH. However, apart from a longer duration devoted to program startup among IBH practices, none of the quantitative differences in rate of program startup, better completion of implementation activities, more tasks completed within each stage, and greater competency were statistically significant. CONCLUSION: Integrated behavioral health care in pediatric primary care settings may help to facilitate the implementation of interventions like SEEK designed to address social determinants of health and reduce the risk of child maltreatment. However, the current study did not find evidence, based on quantitative analyses, that IBH significantly affected the uptake of Project SEEK and that more research may be warranted.
Mental Health and Quality of Life of Adolescents with Physical, Intellectual and Developmental Disabilities: Perspectives of Parents and Children.
Veer SK, Williams-Arya P
J Dev Behav Pediatr · 2025 Apr · PMID 40193693 · Publisher ↗
Abstract loading — click title to view on PubMed.
Examination of Driving Performance Across Autistic Drivers: A Meta-analysis.
Mercier A, Sherrod G, Ennis R … +3 more , Clay OJ, Richter CG, Stavrinos D
J Dev Behav Pediatr · 2025 Apr · PMID 40193691 · Publisher ↗
OBJECTIVE: It is becoming evident that the unique challenges faced by autistic drivers are contingent on the driving context and specific skills required. This meta-analysis examined the driving performance of both autis...
OBJECTIVE: It is becoming evident that the unique challenges faced by autistic drivers are contingent on the driving context and specific skills required. This meta-analysis examined the driving performance of both autistic and nonautistic drivers, aiming to clarify the reasons behind inconsistencies in published findings and identify the relative strengths and challenges faced by autistic drivers. METHOD: This study was performed within a theoretical model of driving skills to break down the complex process of driving and identify specific strengths and challenges displayed by autistic drivers. Data were extracted from included studies, and a meta-analysis using random-effects models was conducted. Risk of bias was assessed, and sensitivity analyses were also conducted. RESULTS: The results from 16 studies suggested that autistic drivers show a small yet significant deficit in their overall driving performance compared with nonautistic drivers. Autistic drivers showed significant challenges and variation in performance at the operational level of driving compared with the tactical level of driving. Variation across driving performance was found to be related to licensure status but not age. CONCLUSION: This paper was able to build upon prior work by clarifying strengths and challenges that are evident in autistic drivers and their driving performance. Notable differences were found to be most related to operational driving skills. These differences may subside with driving experience compared to nonautistic peers. Future studies should further assess potential reasonings for the variation seen across driving performance by examining the interplay of related factors.
The Hidden Academic Curriculum and Inequality in Early Education: How Class, Race, Teacher Interactions, and Friendship Influence Student Success, 1st Edition.
Lane M, Koolwijk I
J Dev Behav Pediatr · 2025 Apr · PMID 40193689 · Publisher ↗
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Care Coordination for Children with Neurodevelopmental Disorders and Medical Complexity: Is Child Behavioral Health a Key Mediator of Caregiver Stress?
Estes M, Currie G, Materula D … +8 more , Richard C, Taylor K, Heathcote G, Deliscar S, Gall N, Gibbard WB, Zwicker JD, MacEachern S
J Dev Behav Pediatr · 2025 Feb · PMID 40168675 · Publisher ↗
INTRODUCTION: Children with neurodevelopmental disorders and medical complexity experience care that is fragmented, costly, and ineffective, causing health disparities and harm. The Neurodevelopmental Disorders Care Coor...
INTRODUCTION: Children with neurodevelopmental disorders and medical complexity experience care that is fragmented, costly, and ineffective, causing health disparities and harm. The Neurodevelopmental Disorders Care Coordination (NDD-CC) program addresses these issues by connecting families with support across medical and social services. While NDD-CC has improved outcomes in several areas, many families continue to experience challenges. OBJECTIVE: Using data from a longitudinal study, we investigated patterns of change across child health and behavior and caregiver stress during care coordination (CC). METHODS: We performed an exploratory analysis of prospectively collected data from 67 caregivers of children with a neurodevelopmental disorder aged 2 to 17 years referred for CC. We examined changes in child health states (EQ-5D-Y), care-related quality of life (CarerQoL), and parenting stress (Parental Stress Index-Short Form) to assess impacts of CC over time and within subgroups. RESULTS: Most caregivers who reported CarerQoL scores in the bottom half of the distribution at baseline saw improvements at 3 (89%) and 12 months (71%). Gains were strongly associated with improvements in mental health at both time points. Similarly, child health states in the bottom half of the distribution improved the most. The difficult child domain of the parenting stress index was the key contributor to clinically significant stress scores, and changes in the difficult child score were negatively associated with changes in CarerQoL, explaining 36% of the variance. CONCLUSION: Findings show that CC has the most impact on those with the greatest need; yet clinically significant child behavior may prevent sustained improvements if left unaddressed.
A Case Report of Orofacial Dyskinesia With Transdermal Methylphenidate.
Rogge C, Barnhardt E
J Dev Behav Pediatr · 2025 Feb · PMID 40168652 · Publisher ↗
BACKGROUND: Methylphenidate transdermal systems are a generally safe and effective treatment option for individuals with attention deficit hyperactivity disorder (ADHD). CASE PRESENTATION: A 9-year-old boy with a history...
BACKGROUND: Methylphenidate transdermal systems are a generally safe and effective treatment option for individuals with attention deficit hyperactivity disorder (ADHD). CASE PRESENTATION: A 9-year-old boy with a history of autism spectrum disorder, insomnia, ADHD combined type, and historical global developmental delays with high suspicion for intellectual disability presented to a developmental and behavioral pediatrics clinic for medication management related to his diagnosis of ADHD. Other pertinent medical history includes a history of pica, a branchial cleft cyst that has since been removed, intermittent constipation and early childhood trauma, resulting in permanent placement with his maternal grandparents. His birth history is notable for a presumed history of in utero exposure to marijuana. He has a family history of substance use disorder, depression, autism and ADHD. A chromosomal microarray and testing for Fragile X were completed in the past and unremarkable. Shortly after a first-time application of a starting dose methylphenidate transdermal system, he was noted to demonstrate involuntary lip puckering, tongue thrusting, and repetitive jaw opening and closing. Upon immediate discontinuation of the patch, the dyskinesia subsided with no persistent remaining symptoms. CONCLUSION: To inform medication management for ADHD in children with comorbidities, it is valuable to define specific risk factors for adverse effects and intolerability of medication. Identifying if patient age, weight, comorbidities, previous antipsychotic or stimulant use, and concurrent medication use are demonstrable risk factors for dyskinesia can help practitioners develop a more individualized medication treatment plan for children with ADHD.
Challenging Case: 2 Year Old With "Autistic Behaviors".
Harris BA, Trier KA, Cormier D … +2 more , Reilly M, Augustyn M
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 40168651 · Publisher ↗
"George" is a 2-year, 9-month-old boy who presented for Developmental Behavioral Pediatric evaluation with the concern of global developmental delay and autistic behaviors. He had been receiving early intervention suppor...
"George" is a 2-year, 9-month-old boy who presented for Developmental Behavioral Pediatric evaluation with the concern of global developmental delay and autistic behaviors. He had been receiving early intervention support since he turned 2 years, receiving a parent coaching model with a developmental specialist.During the clinical interview, parents endorsed limited expressive language skills and felt that his receptive language outpaced his expressive language skills. They reported consistent response to name when called and integration of eye contact and other nonverbal gestures (e.g., point, smile, and nod). Regarding social interaction skills, parents reported that when around other children, he tends to copy the play of the other child or engage in parallel play. George frequently shares items of interest with his caregivers and attempts to initiate play with his younger sibling. Parents state that he always carries around an item such as a cable wire and repetitively twirls it.Owing to lack of other "B" criteria symptoms outside of the perseverative interest in cable wires, a diagnosis of global developmental delay was established, and he did not meet criteria for a diagnosis of autism spectrum disorder. Speech and language, occupational, and physical therapy were recommended as well as guidance on how to initiate special education services with the local school district when he turned 3 years old. Genetic testing was offered-Fragile X analysis returned negative and chromosomal microarray revealed a variant of unknown significance in an autosomal recessive gene, which was noncontributory to explain his developmental delays.Over time, George continued to present with slow, yet steady progress in all areas of his development as he transitioned to receiving special education services through an individualized education plan and continued to receive intensive outpatient therapy. Parents continued to contend with multiple providers and teachers raising concerns about autism and recommending applied behavioral analysis therapy.Almost 3 years later, the family re-connected with Genetics to pursue interval testing as technology has improved. Whole-exome sequencing (WES) was able to confirm a rare, autosomal dominant mutation that presents as a multisystem disorder characterized by significant neurodevelopmental compromise with limited to absent speech, behavioral issues, and craniofacial anomalies. Behavioral issues may include autistic features, hyperactivity, and aggressiveness. What supports will help the family move on in this next phase of his care?
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