Journal Of Developmental And Behavioral Pediatrics[JOURNAL]
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200 papers
Associations Among Problematic Internet Usage in Adolescents, Parental Internet Factors, and Parent-Adolescent Communication.
Milkovich LM, Randell KA, Sherman AK … +1 more , Moreno MA
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39960784 · Full text
OBJECTIVE: Adolescents with problematic internet use (PIU) have excessive, impulsive, or risky internet use that negatively affects social, physical, and functional outcomes. The role of parents in the prevention of adol...
OBJECTIVE: Adolescents with problematic internet use (PIU) have excessive, impulsive, or risky internet use that negatively affects social, physical, and functional outcomes. The role of parents in the prevention of adolescent PIU remains unclear. The purpose of this study was to evaluate possible association between adolescent PIU, parent PIU, and internet-related parenting factors. METHODS: Adolescents aged 12 to 18 years and a parent were recruited through national Qualtrics panels for an online cross-sectional survey. Adolescents and parents completed the Problematic and Risky Internet Use Screening Scale-3 (PRIUSS-3) and Internet-Specific Parenting Practices (ISPP) scales for (1) internet content (ISPP-content) and (2) time on the internet (ISPP-time). Adolescents completed ISPP for quality of parent communication regarding internet use (ISPP-Quality). Bivariate analyses examined relationships between adolescent PIU, parent PIU, and ISPP. RESULTS: In total, 4558 adolescents and 4568 parents completed surveys. Adolescent PIU prevalence was 69.9%. Parent PIU prevalence was 61.4%. Among parents with PIU, 87% had an adolescent with PIU compared with only 42% of parents without PIU (OR = 9.54, 95% CI: 8.24-11.05). More lenient content parenting practices and stricter time parenting practices were associated with increased likelihood of adolescent PIU. The quality of parent communication around the internet was lower for adolescents with PIU. CONCLUSION: Study findings suggest that coaching around positive parent-child relationships and healthy family internet use habits that include shared digital experiences may more effectively address PIU than enforcing child screen time limits.
Glutathione, Vitamin C, and Cysteine Use in Autistic Children With Disruptive Behavior: A Double-Blind, Placebo-Controlled Crossover Pilot Study.
Williams PG, Sears L, Watson WH … +4 more , Gunaratnam B, Feygin Y, Wright SP, Sullivan JE
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39960783 · Publisher ↗
OBJECTIVE: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication differences and restricted interests. One proposed biologic mechanism underlying ASD is oxidative...
OBJECTIVE: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by social communication differences and restricted interests. One proposed biologic mechanism underlying ASD is oxidative stress, leading to the clinical use of glutathione based on anecdotal reports of improved behavior in autistic children. In this pilot study, we tested this observation using a randomized clinical trial format to collect preliminary data on glutathione safety and efficacy. METHODS: Glutathione and glutathione in combination with vitamin C and N-acetylcysteine (Trio) were tested. Both treatments were administered in double-blind placebo-controlled randomized crossover studies. In total, 24 children between the ages of 5 and 16 years with ASD and severe behavior disorders were randomized to receive weekly intravenous injections of either placebo or 1 of the 2 interventions (glutathione or Trio) for 8 weeks. After a 1-week washout period, participants were crossed over for the subsequent 8 weeks. Behavioral measures and plasma levels of glutathione were obtained at baseline, during the washout period, and at the end of the study. RESULTS: No differences between treatment groups in behavioral or biologic measures were found. No significant adverse side effects attributable to the treatments were observed. Small improvements in specific glutathione and behavioral measures occurred over the study period for all groups. CONCLUSION: Treatment with glutathione or glutathione in combination with vitamin C and N-acetylcysteine did not result in improvements in behavior or biologic measures. The positive trends over the course of the study were likely due to the placebo effect or decreased anxiety associated with the study routine.
Parents' Experiences and Views About Use of Wearable Technology for Research and Treatment Monitoring of Children with Neurodevelopmental Disorders.
Xifaras R, Amor DJ, Turbitt E … +1 more , Kraan CM
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39960782 · Publisher ↗
OBJECTIVE: Wearable technology has potential benefits for clinical measurement with children who have neurodevelopmental disorders (NDDs). However, this cohort may experience sensory processing disorder, behavioral dysre...
OBJECTIVE: Wearable technology has potential benefits for clinical measurement with children who have neurodevelopmental disorders (NDDs). However, this cohort may experience sensory processing disorder, behavioral dysregulation, and cognitive challenges. For effective and considerate implementation, the experiences and views of parents of children with NDDs on this topic need in-depth investigation. METHOD: This qualitative semi-structured interview study used purposeful sampling of families with experience with wearable technology in a research setting. The cohort included 12 parents of 14 children with a diagnosis of Fragile X (n = 6), Prader-Willi (n = 4), or Angelman (n = 4) syndromes. The data were processed using NVivo software (QSR International Ltd. 1999-2013). Data analysis was conducted using reflexive thematic analysis. RESULTS: Theme 1: Parents are willing to use wearable technology in the home or community if it is feasible. Aspects of feasibility were the ease of embedding technology into existing routines, device robustness, and device invasiveness. Theme 2: Parents are guided by previous healthcare and research experiences. Wearables were considered low burden in the context of everything else their child experiences through health care. Theme 3: Early engagement with families in the design and research process of new technologies is important. Parents had strong views on how to introduce a wearable to their child. In this article, parents stressed that the child's behavioral phenotype needs to be considered early in the design and rollout phases. CONCLUSION: A shared decision-making approach between researchers and parents will improve the uptake and success of NDD-focused research adopting wearable technology approaches for clinical measurement.
Does Early Exposure Change Pediatric Residents' Perceptions of Developmental-Behavioral Pediatric Care?
Stefanski KJ, Foster J, Brown M … +1 more , Langkamp D
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39960534 · Publisher ↗
OBJECTIVE: To explore the impact of a new "Intro to DBP" rotation on pediatric residents' interest in developmental-behavioral pediatrics (DBP) and comfort in providing DBP care. METHODS: All first-year pediatric residen...
OBJECTIVE: To explore the impact of a new "Intro to DBP" rotation on pediatric residents' interest in developmental-behavioral pediatrics (DBP) and comfort in providing DBP care. METHODS: All first-year pediatric residents participated in a new 1-week DBP rotation. Experiences included clinic visits; interdisciplinary evaluations; asynchronous online learning; and lectures, journal clubs, and/or case conferences. Participants completed pre- and postrotation surveys. Surveys focused on awareness of the DBP field; career plans; and perceived importance of, comfort with, and interest in learning about DBP care. We analyzed data using descriptive statistics and Bhapkar's test to compare distribution differences on pre- and postrotation Likert scales; we reviewed open-ended questions to identify themes. RESULTS: Thirty-two residents participated; 56% had no previous exposure to DBP. After the rotation, there was a statistically significant increase in resident-reported importance of DBP care (p < 0.0001), comfort in providing DBP care (p < 0.0001), and interest in pursuing a DBP fellowship (p = 0.0048). Themes identified from open-ended responses suggested that the rotation led to a broader understanding of the DBP field, reinforcement and expansion of knowledge pertinent to all pediatric care, and improved understanding of systems of care. CONCLUSION: Brief, early exposure to DBP during pediatric residency training led to increased awareness of and comfort in providing DBP care. Residents described a broader understanding of the depth and breadth of DBP and its applicability to all aspects of pediatric care. Early introduction to DBP during residency training may stimulate greater interest in the field and greater comfort among general pediatricians to provide DBP care.
Health Equity Guidance for Authors at the Journal of Developmental & Behavioral Pediatrics.
Heard-Garris N, Pachter LM
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39960533 · Publisher ↗
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Health Care Providers' Attitudes and Knowledge Related to Tic Disorder Identification and Treatment.
Newsome K, Hutchins HJ, Bitsko RH … +4 more , Robinson LR, Katz SM, Uba N, Rattay KT
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 39820450 · Full text
OBJECTIVE: Our study assessed child-serving health care providers' attitudes and knowledge related to identification and treatment of tic disorders including Tourette syndrome (TS), among children. METHODS: We analyzed c...
OBJECTIVE: Our study assessed child-serving health care providers' attitudes and knowledge related to identification and treatment of tic disorders including Tourette syndrome (TS), among children. METHODS: We analyzed cross-sectional data from the 2022 Fall DocStyles, a web-based survey of health care providers. The analytic sample included 1058 child-serving providers (403 family practitioners, 232 internists, 251 pediatricians, and 172 nurse practitioners or physician assistants). We calculated point prevalence estimates and 95% confidence intervals and used χ 2 tests to statistically test differences by provider type and metro status of practice setting. RESULTS: Less than two-thirds of providers (62.4%) considered evaluation of tics as their role, less than half (40.8%) considered diagnosis of tic disorders their role, and around one-fourth considered treatment of patients with tic disorders to be their role (27.3%). Lack of knowledge of tics/TS and lack of comfort evaluating patients for tics and tic disorders were the most often reported barriers to identification and diagnosis for most provider types, and across practice metro status categories. Online training was the most preferred source of information about tics and tic disorders overall and for each provider type. CONCLUSION: These findings support previous reports indicating challenges in health care provider comfort and knowledge in identifying and diagnosing tic disorders, and the need for more education opportunities around evaluation and diagnosis. Communication and training to support the needs of child-serving providers could improve the access to care for children with tics and tic disorders.
All on the Same Team: Simulated Learning to Introduce Pediatric Residents to Interprofessional Collaboration With Individualized Education Program Teams.
Minor TJ, Goode R
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 39820305 · Publisher ↗
OBJECTIVE: Our study sought to determine if participation in a simulated Individualized Education Program (IEP) meeting improved pediatric medical residents' attitudes toward the IEP team as an interprofessional health c...
OBJECTIVE: Our study sought to determine if participation in a simulated Individualized Education Program (IEP) meeting improved pediatric medical residents' attitudes toward the IEP team as an interprofessional health care team. METHODS: Pediatric medical residents on the Developmental-Behavioral and Advocacy rotations at an urban medical center participated in a simulated IEP eligibility meeting for a case of a fourth grader with a specific learning disability. Standardized actors portrayed the child's parent, principal, school psychologist, and classroom teacher. Residents were instructed to participate as members of the team. After participation, changes in the residents' readiness to participate on the IEP team were measured by the Interprofessional Socialization and Valuing Scale 9A (presimulation) and 9B (postsimulation). RESULTS: Sixty-six pediatric residents participated over 24 months. The mean scores of the aggregate pre- (4.92, SD = 0.83) and postsurveys (5.75, SD = 0.74) illustrated residents' improvement in 3 areas of interprofessional practice: understanding their role as a member of an IEP team; appreciation of an IEP team as an interprofessional health care team; and comfort and confidence in working as a member of an IEP team (Z = -6.37; p < 0.001; r = 0.78). Comparison of disaggregated data illustrated improvement for post-graduate year 1 (Z = -4.95; p < 0.001; r = 0.85) and categorical pediatric residents (Z = -5.86; p < 0.001; r = 0.83). CONCLUSION: Simulated IEP meetings help pediatric residents reconceptualize their role in the school health of children with disabilities to include participation in and understanding of the IEP process.
Navigating the Pandemic: A Call for Deeper Insights on Disabilities and Social Determinants.
Bandari M, Bandari M, Osei C
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39820161 · Publisher ↗
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Social, Emotional, and Behavioral Functioning in Adolescents With Klinefelter Syndrome.
Jünger AL, Lasecke M, Foland-Ross LC … +7 more , Jordan TL, Sundstrom JL, Wun VL, Witkin GA, Ikomi C, Ross J, Reiss AL
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 39819970 · Full text
OBJECTIVE: Klinefelter syndrome (KS) is a common genetic condition in males associated with an extra X chromosome (i.e., 47,XXY). Individuals with KS often experience androgen insufficiency and tall stature and are at in...
OBJECTIVE: Klinefelter syndrome (KS) is a common genetic condition in males associated with an extra X chromosome (i.e., 47,XXY). Individuals with KS often experience androgen insufficiency and tall stature and are at increased risk for depression, anxiety, and social challenges. This cross-sectional study investigates social and emotional functions in 52 boys with KS and 62 typically developing (TD) boys, aged 8 to 13 years. METHODS: Self-report measures of anxiety, depression, and behavior and parent-report measures of social functioning and behavior were completed. In primary analyses, linear regression was used to test the effect of group (KS, TD) on standardized scores derived from widely used rating scales. In secondary analyses, we explored the influence of pubertal status on these scores and concordance between self- and parent ratings. RESULTS: Our results indicate that boys with KS exhibit significantly increased anxiety, depression, and social difficulties relative to TD peers. Among participants with KS, peripubertal boys generally experienced more difficulties in aspects of social and emotional functioning as compared to prepubertal boys. Concordance analyses revealed differences between parent- and child-reports. CONCLUSION: These findings indicate that alterations in social, emotional, and behavioral functions are present in boys and adolescents with KS and may be influenced by puberty.
Improving Resident Physician History and Physical in Challenging Situations.
Rockwell N, Tofil NM, Rutledge C … +6 more , Gaither SL, Norwood C, Zinkan JL, Aban I, Willig J, Kong M
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 39819852 · Publisher ↗
OBJECTIVE: To educate physician trainees using simulation on best management of children with autism spectrum disorder who have neurocognitive and behavioral challenges when experiencing acute illness. METHOD: A simulati...
OBJECTIVE: To educate physician trainees using simulation on best management of children with autism spectrum disorder who have neurocognitive and behavioral challenges when experiencing acute illness. METHOD: A simulation-based curriculum including baseline assessment, communication techniques, and use of calming resources was developed to educate residents in assessing children with sensory barriers. Traditional simulation and deliberate practice were used to teach this curriculum to second- and third-year pediatric and internal medicine-pediatric residents. Using alternating assignment, residents were placed into 3 groups: deliberate practice, traditional simulation-based debriefing, and control (no simulation training). The residents were assessed on the initial visit, 2 weeks and 4 to 6 months follow-up periods with a sensory assessment tool. Assessment scores were analyzed using a general linear mixed model with random intercept based on Poisson regression to approximate distribution of the total score. RESULTS: Forty-three residents participated: 46.5% men, 53.5% women. There were 15, 16, and 12 residents in the control, deliberate practice and traditional simulation groups, respectively. Both teaching styles showed improved performance at 2 weeks follow-up. In addition, these groups demonstrated higher performance when compared with the control group. We were able to show that resident physicians were able to learn important principles and retain them during 4 to 6 months follow-up. However, there was not a difference between 2 teaching styles both in improvement and retention. CONCLUSION: Simulation education, both deliberate and traditional, can be used to enhance teaching of key components in assessing children with sensory and communication barriers, including those with autism spectrum disorder when presenting with acute illness.
Effect of Childhood Adversity on the Relationship Between Family Resilience and Behavioral or Conduct Problems in Children With Special Healthcare Needs.
Chowdhury SK, Aydin RA, Puri H … +8 more , Sundaramurugan S, Rao NR, Skinner H, Sauls R, Brice DJ, Tsang S, Bakour C, Kirby RS
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 39819812 · Publisher ↗
OBJECTIVE: Behavioral or conduct problems (BCPs) are common co-occurring conditions in children with special health care needs (CSHCNs), affecting their developmental and functional milestones. The role of family resilie...
OBJECTIVE: Behavioral or conduct problems (BCPs) are common co-occurring conditions in children with special health care needs (CSHCNs), affecting their developmental and functional milestones. The role of family resilience in mitigating BCPs among these children and how adverse childhood experiences (ACEs) affect this dynamic remain largely unclear. The aim of the study was to disentangle the complex interplay between family resilience, ACEs, and BCPs by examining how ACEs moderate the relationship between family resilience and BCPs. METHODS: The study included 19,922 CSHCNs aged 3 to 17 years from the 2020-2021 National Survey of Children's Health. Weighted analysis was conducted using the Rao-Scott χ 2 test and multivariable logistic regression to account for the complex survey design. RESULTS: Children from families with no and low resilience as compared with high-resilient families had 1.78 times (odds ratio [OR]: 1.78, 95% confidence interval [CI], 1.31-2.43) and 1.44 times (OR: 1.44, 95% CI, 1.18-1.76) higher odds of BCPs, respectively. While the odds of BCPs decreased in nonresilient families as ACEs increased from none to 1 ACE, 2 or more ACEs versus no ACE increased the odds of BCPs in low-resilient families from 1.42 times (OR: 1.42, 95% CI, 1.03-1.94) to 1.51 times (OR: 1.51, 95% CI, 1.13-2.02). CONCLUSION: The findings suggest that family resilience is associated with a lower likelihood of BCPs in CSHCNs. ACEs have varying effects on the relationship between family resilience and BCPs across different levels of family resilience. These results highlight the importance of strengthening family resilience and addressing ACEs in interventions to reduce behavioral issues in CSHCNs.
A Demographic Description of Children and Adolescents With Concomitant Autism and Anxiety Along With a Comparison of Receipt of Psychological Services.
Salt E, Wiggins AT, Toupin DN … +3 more , Parks E, Okoli C, Rayens MK
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39787493 · Full text
OBJECTIVE: (1) Evaluate differences in demographic distributions between those with autism alone and those with autism concomitant with anxiety and (2) assess demographic factors associated with receipt of psychological...
OBJECTIVE: (1) Evaluate differences in demographic distributions between those with autism alone and those with autism concomitant with anxiety and (2) assess demographic factors associated with receipt of psychological therapy in patients with autism. METHODS: Using deidentified health care claims data, we extracted all encounters among children with the International Classification of Diseases-10-CM for Autism Spectrum Disorder (F84) and flagged those with concomitant anxiety (F41.9). Extracted data included age, sex, race, ethnicity, insurance status, and Rural-Urban Continuum Codes. Current procedural terminology codes for psychological services were extracted. Data were analyzed using Mann-Whitney U tests, χ 2 tests of association, and logistic regression. RESULTS: Demographic differences between children/adolescents with autism alone versus autism concomitant with anxiety were noted for age, sex, and race/ethnicity, with a greater prevalence of autism/anxiety identified in older-aged children and children identifying as female and non-Hispanic White residing in an urban area. While 21% of those included in this study had received psychotherapy, the percentages within the autism only and autism/anxiety groups were 12% and 50%, respectively ( p < 0.001). Children/adolescents who were older age quartile, resided in an urban residence, and with a concomitant diagnosis of anxiety were more likely to receive psychological services, while non-Hispanic Other were less likely to, compared with the reference of non-Hispanic White. CONCLUSION: We identified demographic disparities in the diagnosis of autism versus autism with concomitant anxiety, including age, sex, race/ethnicity, and residence location. Age quartile, urban location, and concomitant anxiety were associated with increased likelihood of receipt of psychological services.
Nonpharmaceutical Interventions and Neurodevelopmental Outcomes in School-Age Preterm Children and Adolescents: A Systematic Review.
Ha-Vinh Leuchter R, Siffredi V
J Dev Behav Pediatr · 2024 Nov-Dec 01 · PMID 39671172 · Full text
OBJECTIVE: To systematically review nonpharmaceutical interventions aiming to enhance neurodevelopment in preterm children and adolescents (aged 4-18 years). METHOD: A systematic review of the literature was conducted fo...
OBJECTIVE: To systematically review nonpharmaceutical interventions aiming to enhance neurodevelopment in preterm children and adolescents (aged 4-18 years). METHOD: A systematic review of the literature was conducted for all studies published up to May 1, 2022, across Medline, Web of Science, and PsycINFO databases. Studies were evaluated for inclusion by 2 independent reviewers using predetermined inclusion criteria. The Risk of Bias In Non-randomized Studies of Interventions and the Cochrane risk-of-bias tool for randomized trials (RoB 2) tools were used to assess bias in the selected studies. RESULTS: Of the 1778 articles identified, 23 were included. Quality assessment revealed moderate bias in 52.2%, low bias in 21.7%, and serious bias in 26.1%. The selected studies comprised 60.9% randomized controlled trials and 21.7% pre- versus postdesigns. Interventions included Cogmed Working Memory Training® (43.5%), BrainGame Brian (13%), physiotherapy (13%), and others (30.4%). Qualitative analysis showed the limited impact of interventions on neurodevelopmental outcomes in preterm children aged 4-18 years. CONCLUSION: Despite recent efforts to use more rigorous methodologies, current research on school-age interventions for preterm neurodevelopment exhibits methodological limitations. There is a pressing need for well-designed, large-scale clinical trials to evaluate the efficacy of nonpharmaceutical interventions in this vulnerable population.
Case Report: A Comprehensive Early Childhood Mental Health Evaluation for Children in the Foster Care System.
Lucke CM, Stone KJ, Gustafson K … +1 more , Kroupina MG
J Dev Behav Pediatr · 2025 Mar-Apr 01 · PMID 39636295 · Publisher ↗
BACKGROUND: Children in the foster care system often have a host of prenatal and postnatal risk factors that can compromise development including disruptions in important attachment relationships. We argue that to effect...
BACKGROUND: Children in the foster care system often have a host of prenatal and postnatal risk factors that can compromise development including disruptions in important attachment relationships. We argue that to effectively address this complex history and inform specific recommendations for intervention, it is important for an Early Childhood Mental Health (ECMH) evaluation to include both an assessment of the caregiver-child relationship status and neurodevelopment. CASE PRESENTATION: We describe an ECMH evaluation for a 21-month-old girl who was referred to a multidisciplinary birth to three specialty clinic for difficulties separating from her preadoptive mother, indiscriminate friendliness, and emotional and behavioral dysregulation. She had a history of prenatal substance exposure and several disruptions in important attachment relationships. We gained insight into the caregiver-child relationship through behavioral observations and used standardized testing to assess neurodevelopment. This combination of assessment techniques revealed inconsistencies in secure base attachment patterns between the parent and child. She also performed lower than what would be expected for her age across several domains of development. CONCLUSION: This case highlights a comprehensive approach to an ECMH evaluation. Recommendations for intervention prioritized the parent-child relationship given the importance of attunement between caregiver and child to first optimize stress regulation and thus set the foundation for higher-order cognitive processes to develop.
Knowledge of Established Conditions List and Associated Policies and Procedures Among Pediatricians and Early Intervention Personnel.
Yadav A, Phelps RA, Squires J
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39625642 · Publisher ↗
OBJECTIVE: Despite automatic eligibility, many children with medical conditions associated with increased risk of disability do not receive Early Intervention (EI) services. State EI programs have compiled lists of estab...
OBJECTIVE: Despite automatic eligibility, many children with medical conditions associated with increased risk of disability do not receive Early Intervention (EI) services. State EI programs have compiled lists of established conditions to facilitate automatic enrollment; yet little is known about professionals' knowledge and utilization of these lists. This study examined the knowledge of these established conditions lists and associated policies and procedures among pediatricians and EI personnel. State initiatives and approaches undertaken to improve familiarity and utilization of the list, along with recommendations for its improvement were examined. METHOD: In this mixed-methods study, self-rated survey data were collected from 193 EI personnel responsible for intake and eligibility evaluations, and 69 pediatricians providing primary care. Follow-up interviews were then conducted with 45 EI personnel and 22 pediatricians. Quantitative data were analyzed using descriptive statistics, and qualitative data underwent thematic analysis. RESULTS: Pediatricians rated their knowledge of their state's established conditions list and related policies and procedures lower than EI personnel. Both groups emphasized the significance of the list in referral and eligibility determination but highlighted its underutilization and lack of professional development activities. Consequently, recommendations were made to improve state established conditions lists and their utilization in ensuring direct EI enrollment for eligible children. CONCLUSION: The lack of shared knowledge and utilization of established conditions lists and associated policies and procedures among pediatricians and EI personnel may result in referral failure for eligible children. Addressing this challenge requires improvement in the content and statewide distribution to improve accessibility and usability.
Characteristics of Young Children Associated with Diagnostic Utility of the Autism Diagnostic Observation Schedule: A DBPNet Study.
Fussell JJ, Stein REK, Friedman S … +5 more , Hansen R, Roizen N, Sideridis G, Vanderbilt D, Barbaresi W
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39620995 · Publisher ↗
OBJECTIVE: The aim of this study is to identify characteristics of children for whom a developmental-behavioral pediatrician's (DBP) diagnostic impressions of autism spectrum disorder (ASD) or non-ASD were changed by Aut...
OBJECTIVE: The aim of this study is to identify characteristics of children for whom a developmental-behavioral pediatrician's (DBP) diagnostic impressions of autism spectrum disorder (ASD) or non-ASD were changed by Autism Diagnostic Observation Schedule (ADOS) results. METHOD: A prospective study of children 1½ to <6 years consecutively referred to 8 sites for possible ASD. Cognitive/developmental, language, and adaptive testing varied, as each site followed its usual clinical approach. DBPs documented diagnosis as ASD or non-ASD and their degree of diagnostic certainty (1-10) pre- and post-ADOS. Cases where DBP diagnostic impression did not change after ADOS administration ("Stable Group," n = 314) were compared with those for whom it did change ("Changed Group," n = 35), followed by matched random sample comparisons. RESULTS: There were no significant differences in child characteristics (age, gender, race, ethnicity, insurance, caregiver education) between the Stable and Changed groups. DBPs' diagnostic certainty was significantly lower, both pre- and post-ADOS, in the Changed versus Stable group. Change was associated with milder symptoms of ASD and less impaired language. In an age- and gender-matched comparison, significant differences remained for diagnostic certainty and severity of social communication impairments. Cognitive scores were significantly higher in the Changed Group. Because of significantly higher caregiver education and a trend toward more privately insured children among the Changed Group, samples (n = 35 each) were then matched on those characteristics, revealing the same differences for diagnostic certainty, severity of ASD symptoms, and language skills. CONCLUSION: Young children with milder ASD symptoms and less impaired language may benefit most from the administration of the ADOS.
Selective Mutism in the Context of Autism and Bilingualism.
Carroll B, Bordes Edgar V, Bar SH … +2 more , Call CR, Nyp SS
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39591527 · Publisher ↗
Juan is a 5-year-old boy who has been followed by a developmental-behavioral pediatrician and pediatric neuropsychologist since being diagnosed with language delay and autism spectrum disorder at age 2 years. He is other...
Juan is a 5-year-old boy who has been followed by a developmental-behavioral pediatrician and pediatric neuropsychologist since being diagnosed with language delay and autism spectrum disorder at age 2 years. He is otherwise healthy and was born at term after a healthy pregnancy. His primary language is Spanish, and he has minimal interactions in English. His first words were at 20 months; they were not functional but rather words related to his interests such as "train." He began using 2 to 3-word phrases shortly after but only to request needs. He began speaking in complete sentences at age 4 years.A neuropsychological evaluation was conducted at age 2 years during which Juan demonstrated repetitive behaviors such as hand-flapping, toe-walking, body rocking, and head banging. He displayed sensory seeking behaviors such as rubbing items on his face and close visual inspection. He did not respond to his name and his use of eye contact was inconsistent. He demonstrated rigidity and difficulty transitioning between activities. He did not engage in social reciprocity, and his facial expressions were limited. Minimal spontaneous language was observed, and expressive language largely consisted of echolalia in both languages. Juan was diagnosed with autism spectrum disorder and applied behavior analysis, speech and language therapy, and occupational therapy were recommended.Developmental-behavioral follow-up over the next 2 years noted improvements in behavior, transitions, and social interactions. He participated in early childhood intervention and early childhood special education with significant advances for speech and language in English and Spanish, demonstrating a large vocabulary. At 4 years, parents noted Juan to have reluctance to speak in English. He stopped speaking in English entirely for 3 weeks, though he continued to speak in Spanish. When he resumed speaking in English, it was only with people he knew well (e.g., parents, teachers, babysitter). In clinic, he did not speak to the English-speaking developmental-behavioral pediatrician but spoke in short sentences to the Spanish-speaking neuropsychologist.A repeat neuropsychological evaluation completed at age 5 years revealed that Juan had stopped speaking in English completely, even among those previously deemed "safe." Results were consistent with average cognitive abilities with a strength in verbal skills. Juan's single-word vocabulary in Spanish was exceptionally high. He did not provide expressive responses in English, but his receptive English vocabulary was high average. He responded to English language with nonverbal gestures or spoken language in Spanish. Parents reported Juan to display increased anxiety accompanied by extreme school refusal, behavioral difficulties, and reluctance to leave the home.Given this information, what are your diagnostic considerations and treatment recommendations?
Complex Attention-Deficit Hyperactivity Disorder in a 4-Year-Old With Repaired Critical Congenital Heart Disease and Autism Spectrum Disorder.
Campbell K, Wallis KE, El-Messidi Hampton L … +6 more , Burnham A, Mercer-Rosa L, Miller O, Mazza L, Diekroger E, Fogler J
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39591526 · Full text
BACKGROUND: Congenital heart disease (CHD) is a risk factor for developmental delay and for attention-deficit hyperactivity disorder (ADHD). The Cardiac Neurodevelopmental Outcome Collaborative has developed recommendati...
BACKGROUND: Congenital heart disease (CHD) is a risk factor for developmental delay and for attention-deficit hyperactivity disorder (ADHD). The Cardiac Neurodevelopmental Outcome Collaborative has developed recommendations for ongoing monitoring of this at-risk population to be able to detect developmental, learning, and behavioral concerns, as they become apparent as a child ages. CASE PRESENTATION: A 4-year-old boy with tetralogy of Fallot with a ventricular septal defect repaired in infancy was followed periodically in the cardiac neurodevelopmental follow-up clinic and diagnosed with autism spectrum disorder as well as additional developmental and medical issues. He received early childhood special education and therapeutic interventions as well as social skills training and applied behavior analysis. At age 4 years, Alex presented with symptoms of hyperactivity, inattention, impulsivity, and immediate safety concerns for elopement. The clinician diagnosed him with ADHD-combined type. He was recommended to start medication in addition to behavioral and developmental supports. Managing medications in a child with CHD and ADHD presents unique challenges, and medication decisions were carefully made in collaboration with the child's cardiologist. After some medication adjustments and ongoing behavioral therapy to address behaviors associated with ADHD and autism spectrum disorder, the child is doing well academically and socially. CONCLUSION: Attention-deficit hyperactivity disorder medications can be safely prescribed in patients with CHD. However, pharmacotherapy for co-occurring ADHD and CHD needs an additional level of oversight and collaboration between cardiology and prescribing clinicians. Behavioral therapies can be transdiagnostic and address challenges associated with autism and symptoms related to ADHD.
Improving Executive Function in Children and Adolescents with Cognitive-Engaging Physical Activity: A Systematic Review and Multilevel Meta-Analysis.
Teng G, Xia H, Li Q … +1 more , Chen A
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39591519 · Publisher ↗
Executive function (EF) development is vital for children and adolescents, with physical activity (PA) playing a key role in its enhancement. Through a systematic review and multilevel meta-analysis, this study investiga...
Executive function (EF) development is vital for children and adolescents, with physical activity (PA) playing a key role in its enhancement. Through a systematic review and multilevel meta-analysis, this study investigates the effectiveness of cognitively engaging physical activity (CEPA) over traditional PA in fostering EF in children and adolescents. The research involved 1671 participants across 15 studies to determine if CEPA is superior to PA in enhancing EF and to analyze interventions and dose-response effects. Results demonstrated that CEPA had a more pronounced impact on EF development compared with PA, with a Hedges' g of 0.50 (95% confidence interval, 0.10-0.48), although potentially overestimated due to small-study effects and publication bias. Subgroup analyses did not find notable differences in effectiveness among various intervention types. The most substantial effect was observed with 45-minute interventions, while frequencies less than twice weekly and durations beyond 12 weeks were less effective. These findings suggest that CEPA could be a more efficacious method for advancing EF in youth, indicating a need for larger-scale randomized controlled trial (RCTs) to confirm the results and more accurately estimate their magnitude.
Associations Between Sleep Health and Child Behavior at Age 6 Years in the INSIGHT Study.
Dadzie A, Master L, Hohman EE … +6 more , Acton EH, Tauriello S, Paul IM, Savage JS, Anzman-Frasca S, Buxton OM
J Dev Behav Pediatr · 2025 Jan-Feb 01 · PMID 39514718 · Full text
OBJECTIVE: Suboptimal sleep is associated with disruptive behaviors in childhood. We evaluate associations of mean and variability (SD) of sleep duration, quality, and timing with emotion regulation, impulsivity, and pro...
OBJECTIVE: Suboptimal sleep is associated with disruptive behaviors in childhood. We evaluate associations of mean and variability (SD) of sleep duration, quality, and timing with emotion regulation, impulsivity, and prosocial and antisocial behavior in children. METHODS: Intervention Nurses Start Infants Growing on Healthy Trajectories, a randomized controlled trial designed for obesity prevention, compared a responsive parenting intervention delivered in the first 2.5 years after birth with a home safety control group. At age 6 years, children wore an actigraphy device for 7 days and participated in behavioral tasks evaluating behavioral control, emotion regulation, and prosocial and antisocial behaviors. Separate linear regression models examined associations between sleep and behavioral variables, adjusting for study group, child sex, and household income. Moderation analysis investigated whether the study group moderated relationships between sleep and positive age-appropriate behavior. RESULTS: Children (N = 143, age 6.7 ± 0.3 years) were predominantly non-Hispanic White (95%). Mean actigraphic sleep duration, quality, and timing were not associated with behavioral variables. By contrast, greater variability in sleep onset timing was associated with greater impulsivity (B = 0.85, p = 0.004) and poorer emotion regulation (B = -0.65, p = 0.01). Greater variability in sleep midpoint timing was associated with greater impulsivity (B = 0.80, p = 0.03). The study group moderated the effect of sleep onset variability on behavior; only the home safety control group exhibited a significant negative relationship between variability in sleep onset timing and emotion regulation (B = -1.28, p = 0.0002). CONCLUSION: Findings support the importance of consistency in sleep timing and how this may play a greater role in children's behavioral and emotional outcomes than mean actigraphic sleep duration and quality.
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