Journal of Developmental and Behavioral Pediatrics最新文献

Objective: Problems with hearing feature prominently in autism spectrum disorder (ASD) but remain poorly characterized within population-based samples and according to symptom heterogeneity.

Method: We analyzed cross-sectional, caregiver-reported data from the National Survey of Children's Health (2016-2020). Our US-based sample included children with data on the presence/absence of "deafness or problems with hearing" (DPHs) and ASD (ages 3-17 years; n = 150,327). We used weighted logistic regression to examine the association between DPHs and (1) ASD diagnosis (no, yes), (2) ASD symptom severity (none, mild, moderate/severe), and (3) co-occurrences of ASD with intellectual disability (ID) (neither, ASD only, ID only, both) or attention deficit/hyperactivity disorder (ADHD) (neither, ADHD only, ADHD only, both). We also assessed effect modification by sex and preterm birth.

Results: Deafness or problems with hearing were associated with greater odds of ASD (OR = 2.7; 95% CI, 1.8-3.9), with 4% of children with ASD having DPHs versus 1% of children without ASD. Associations were stronger for: moderate/severe ASD symptoms (OR = 3.5; 95% CI, 2.1-5.7) versus mild symptoms (OR = 1.8; 95% CI, 1.1-3.1); children with co-occurring ID (OR = 5.0; 95% CI, 2.8-9.0) or ID only (OR = 8.6; 95% CI, 6.0-12.4); and children with co-occurring ADHD (OR = 4.3; 95% CI, 2.5-7.2) than for ASD only. Findings persisted after adjustment and were stronger for females versus males but were not modified by preterm birth.

Conclusion: Deafness or problems with hearing are associated with ASD, particularly-though not exclusively among children with more severe symptoms and co-occurring ID. Future research is needed to determine whether DPHs in ASD are driven by sensory, cognitive, and/or motivational processes or residual confounding (e.g., congenital anomalies).

Background: Musical hallucinations are a rare auditory phenomenon, with fewer than 50 pediatric cases reported in the literature. They are particularly uncommon in children without hearing impairment or psychosis.

Case presentation: A Thai girl with ADHD, diagnosed at age 5 years and treated with methylphenidate, presented with a 1-week history of bilateral musical hallucinations. The hallucinations consisted of instrumental music without lyrics, were nonpulsatile, occurred predictably during specific hours, and were emotionally distressing. Audiologic evaluation showed normal hearing bilaterally, and EEG showed normal background activity with no epileptiform changes during hallucination episodes. She also exhibited frequent eye blinking consistent with simple motor tics. Developmental assessment revealed some developmental delays, with a KBIT-2 composite IQ of 87, showing a moderate discrepancy between verbal (79) and nonverbal (98) domains, potentially reflecting both neurodevelopmental vulnerabilities and sociolinguistic factors. Initial nonpharmacological interventions including media restriction and behavioral techniques were unsuccessful. Low-dose risperidone (0.25 mg/day) led to complete resolution of hallucinations, tics, and associated emotional distress within 3 weeks. She remained symptom-free at the 3-month follow-up.

Conclusion: Musical hallucinations can occur in children with ADHD even in the absence of hearing impairment, epilepsy, or psychosis. Early recognition, comprehensive evaluation, and multidisciplinary management are essential. When symptoms cause significant distress, low-dose risperidone may be an effective treatment. Recognizing the structured and nonpsychotic nature of musical hallucination in neurodevelopmental contexts may help avoid misdiagnosis and guide appropriate intervention.

Objective: This naturalistic, observational study aimed to assess the frequency and timing of new and recent suicidal ideation (SI) in youth with neurologic, developmental, and behavioral disorders (NDBDs) after an initial negative suicide risk screening within medical and behavioral health settings.

Method: A total of 5030 children aged 8 to 17 years were included, all of whom received at least 2 routine suicide risk screenings between July 2019 and February 2024 as part of their larger clinical care appointments (N = 20,177 total screenings). Screenings were conducted using the Ask Suicide-Screening Questions tool. Analyses examined the interval between an initial negative screening and the emergence of new SI, with stratification by clinic type and age group. Predictors of new onset of SI were also examined.

Results: Overall, a significant proportion of children screened positive for new SI after an initial negative screening (8.4%). Rates were higher in behavioral health clinics (11.3%) compared with medical clinics (5.4%), with a median interval of 5 to 6 months to the first positive screening for both settings. Females were more likely to report new SI, as were those in seen in behavioral health as compared with medical clinics.

Conclusion: The findings highlight the importance of repeated suicide risk screening in children with NDBDs as a significant proportion of new SI is reported in the months after an initial negative screening. Screening only annually appears likely to underdetect risk, underscoring the need for more frequent screening particularly within the first year of care to improve early detection and intervention opportunities.

Objectives: For youth with gastrointestinal (GI) conditions, mental health symptoms can exacerbate GI symptoms. In a cyclical fashion, experiencing GI symptoms at school can contribute to depression, anxiety, and embarrassment. This study evaluated the impact of school instruction type on mental health and GI symptoms for youth with GI conditions during the COVID-19 pandemic.

Method: Data were collected from caregivers and patients aged 8 to 17 years with inflammatory bowel disease, celiac disease, and irritable bowel syndrome (N = 146) from September to December 2020. Patients completed measures of depression, anxiety, anger, and GI symptoms; caregivers provided their child's school instruction type (online, hybrid, or in-person). Analyses were conducted to examine the relations of mental health symptoms, GI symptoms, and school instruction type.

Results: Participants generally had mild levels of depressive symptoms (T = 55.50), and anxiety (T = 53.02) and anger (T = 49.92) symptoms were within normal limits. Anxiety and GI symptoms were positively related ( b = 0.14, p < 0.01), and if participants were attending school online, they had worse GI symptoms ( b = 0.46, p < 0.05). However, there was no significant interaction between anxiety and instruction type. Depression and anger were not significantly related to GI symptoms and there were no significant interactions.

Conclusion: For children with GI conditions during the pandemic, as their anxiety symptoms increased, so did their GI symptoms. Further research should examine the long-term effects of virtual learning for those with GI conditions.

Objective: This study aimed to explore family and caregiver's quality of life, identifying psychosocial factors related to it.

Method: A cross-sectional quantitative study was carried out with 153 caregivers of children and adolescents with various neuromuscular diagnosis. Caregivers responded to the PedsQL FIM, PAS, MOS, and FACES III scales.

Results: Medium to low levels of quality of life (QoL) were found in caregivers of children with neuromuscular diseases. Caregivers reported low perceived family resources, but most of them presented good psychological adaptation and social support. QoL differences were found according to child's functional dependence and access to pharmacological treatment. Multiple regression analysis showed a model for Family QoL explained by family resources, caregiver's age, social support, and child's functional dependence.

Conclusion: Families had better levels of QoL because they have a higher perception of their family resources, caregivers are older, have more functional social support, and the child has a higher degree of dependency. Results emphasized the need to adopt a psychological and family approach in the management of neuromuscular diseases.

Objective: Although the impact of parental technoference on family dynamics has been increasingly studied, its association with preschoolers' social-emotional development and the underlying mechanism behind the association remain underexplored. This study aimed to examine the relationship between parental technoference and preschoolers' social-emotional development among Chinese families, with coparenting as a potential mediator.

Method: This study involved 207 Chinese families with preschoolers (mean age = 4.72 years). Both mothers and fathers reported on their perceptions of technoference, coparenting quality, and their child's social-emotional development.

Results: Parental technoference was negatively associated with both mother- and father-reported coparenting quality. However, only father-reported coparenting, but not mother-reported coparenting, was significantly related to children's social-emotional development. Analysis of the indirect effects showed that both father-reported supportive and undermining coparenting partially mediated the relationship between parental technoference and certain aspects of children's social-emotional development. By contrast, mother-reported coparenting did not significantly mediate the association between parental technoference and children's social-emotional development.

Conclusion: Our findings highlight the importance of managing parental technoference and strengthening coparenting to promote social-emotional development in Chinese preschool children.

Objective: We sought to measure whether receipt of an enhanced 18-month well-baby visit with use of a developmental screening tool versus a routine 18-month well-baby visit (which typically involves developmental surveillance without screening) is associated with time to identification of developmental delays.

Method: We conducted a cohort study of children (17-22 months) in Ontario who received an 18-month well-baby visit (March 2020‒March 2022), followed to September 2022 using linked health administrative datasets. Visits were categorized as enhanced (n = 83,554) or routine (n = 15,723). The outcome was the identification of a developmental delay within 6 months (early) and more than 6 months after (late) the 18-month visit. Piecewise Cox proportional hazards models estimated hazard ratios (aHR) adjusted for child, maternal, and physician factors, comparing developmental delay diagnosis by visit type.

Results: Children who received an enhanced visit were slightly older, had a lower representation in the most deprived group, and a higher percentage of patients with pediatricians as their usual provider of care. After adjustment, children with enhanced compared with routine visits were more likely to have developmental delays detected in the early period (aHR 1.19 95% CI 1.11‒1.28) but not in the late period following the well-baby visit.

Conclusion: Enhanced visits are associated with earlier identification of developmental delays compared with routine visits in the 6 months following the 18-month well-baby visit. Enhanced developmental monitoring using screening tools may facilitate earlier recognition of developmental concerns.

Objective: To estimate the frequency of suspected neurodevelopmental delays (NDD) and to investigate the measurement properties and usability of the Survey of Well-Being of Young Children-Brazilian version (SWYC-BR).

Methods: We conducted a cross-sectional study in Basic Health care Units in Northeastern Brazil. The participants were 645 mothers/caregivers of children between 2 and 65 months of age who completed the SWYC-BR and a socioeconomic questionnaire. We estimated the frequency of suspected NDD using the SWYC-BR, assessed the respondents' experience with the questionnaire, and examined test-retest reliability and internal consistency of the SWYC-BR items, as well as the construct validity of the Developmental Milestones questionnaire (DM-SWYC).

Results: The sample consisted primarily of families residing in urban areas and belonging to very low socioeconomic classes. The frequency of suspected NDD was 37.9%. The internal consistency of the SWYC-BR ranged from 0.56 to 0.97, and the test-retest reliability of the items was high (>0.75). Significant associations with risk factors for developmental delays confirmed the construct validity of the DM-SWYC. Most mothers/caregivers found the SWYC-BR easy to respond (85.7%) and enjoyed responding to the questions (95.8%).

Conclusion: The high frequency of suspected NDD highlights the need for special attention to early child development. The SWYC-BR was well accepted, and its measurement properties were confirmed, demonstrating its feasibility in identifying children requiring closer primary health care monitoring.