Showing papers in "Journal of Developmental and Behavioral Pediatrics in 1997"
641 citations
TL;DR: A blindness to past, future, and time more generally, as well as an inability to direct behavior toward the future and to sustain it are among many of the deficits predicted by this model for persons with ADHD.
Abstract: This article describes the current clinical view of attention-deficit/hyperactivity disorder (ADHD) and suggests a model of prefrontal lobe executive functions that explains better than current theories the cognitive and behavioral deficits associated with ADHD. The model shows how behavioral inhibition is related to and necessary for the proficient performance of four executive functions that subserve self-regulation: nonverbal working memory; the internalization of speech; the self-regulation of affect, motivation, and arousal; and reconstitution. These functions permit the construction, execution, and control of behavior by internally represented information, which removes behavior from control by the immediate context and brings it under the control of time. ADHD disrupts this process and returns control of behavior to the temporal now. A blindness to past, future, and time more generally, as well as an inability to direct behavior toward the future and to sustain it are among many of the deficits predicted by this model for persons with ADHD.
408 citations
TL;DR: A randomized clinical trial was conducted to compare the early development of children with d-transposition of the great arteries repaired by an arterial switch operation that used either predominantly total circulatory arrest or predominantly continuous low-flow cardiopulmonary bypass.
Abstract: A randomized clinical trial was conducted to compare the early development of children with d-transposition of the great arteries (N = 171) repaired by an arterial switch operation that used either predominantly total circulatory arrest or predominantly continuous low-flow cardiopulmonary bypass. The children assigned to the circulatory arrest group scored lower than those assigned to low-flow bypass on the Bayley Scales of Infant Development at 1 year of age. Responses to parental questionnaires completed when the children were 2.5 years old indicated that the children in the circulatory arrest group, especially those with a ventricular septal defect, also manifested poorer expressive language and were considered to display more internalizing and externalizing problem behaviors. The use of circulatory arrest to protect vital organs during open heart surgery might place children at increased risk of early developmental difficulties, especially in the domains of motor and language function.
135 citations
TL;DR: One day, you will discover a new adventure and knowledge by spending more money as mentioned in this paper. But when? Do you think that you need to obtain those all requirements when having much money? Why don't you try to get something simple at first?
Abstract: One day, you will discover a new adventure and knowledge by spending more money. But when? Do you think that you need to obtain those all requirements when having much money? Why don't you try to get something simple at first? That's something that will lead you to know more about the world, adventure, some places, history, entertainment, and more? It is your own time to continue reading habit. One of the books you can enjoy now is company they keep friendships in childhood and adolescence here.
133 citations
TL;DR: Ineffective parenting styles and daytime disruptive behaviors were more likely to be associated with the milder sleep disturbances found in children in a primary care setting than in the general pediatric population.
Abstract: Fifty-two children without significant sleep disturbance seen at a primary care clinic for well-child care were compared on measures of temperament, parenting style, daytime behavior, and overall sleep disturbance to three diagnostic subgroups identified in a pediatric sleep clinic: children with obstructive sleep apnea (n = 33), parasomnias (night terrors, sleepwalking, etc.) (n = 16), and behavioral sleep disorders (limit-setting disorder, etc.) (n = 31). The mean age of the entire sample was 5.7 years. Temperamental emotionality in the behavioral sleep disorders group was associated with a higher level of sleep disturbance (p < .001); parenting laxness was associated with sleep disturbance in the general pediatric population (p < .01); and intense and negative temperament characteristics seemed to be associated with clinically significant behavioral sleep disturbances. Ineffective parenting styles and daytime disruptive behaviors were more likely to be associated with the milder sleep disturbances found in children in a primary care setting.
120 citations
TL;DR: Exploratory multiple regression analyses point to factors that might influence sibling adjustment and suggest counseling strategies and avenues for future research.
Abstract: We investigated the psychosocial effects of bone marrow transplantation (BMT) on siblings of transplant recipients. We asked how donor siblings compared with nondonor siblings on quantitative measures of behavior, psychological distress, and sense of self. Participants included 44 siblings (21 donors and 23 nondonors, ages 6-18 yr) of surviving pediatric BMT patients. On self-report measures, donors reported significantly more anxiety and lower self-esteem than nondonors. On teacher-rated scales, donors showed significantly more adaptive skills in school. On these same scales, nondonors showed significantly more school problems than donors. One-third of the siblings in each group reported a moderate level of post-traumatic stress reaction. Exploratory multiple regression analyses point to factors that might influence sibling adjustment and suggest counseling strategies and avenues for future research.
104 citations
TL;DR: The Stop Signal Task as discussed by the authors is a measure of inhibitory control in which subjects must press a button in response to a stimulus on certain trials and must withhold his/her response during those trials.
Abstract: The Stop Signal Task is a measure of inhibitory control in which subjects must press a button in response to a stimulus. On certain trials, the subject receives a second stimulus (the Stop Signal) after the primary stimulus and must withhold his/her response during those trials. The onset of the Stop Signal is varied, sometimes coming immediately after the primary stimulus (inhibition is easy); at other times, the Stop Signal arrives quite late, making inhibition difficult. Results from the Stop Signal Task were obtained from children with attention-deficit/hyperactivity disorder (ADHD) and from controls; children with ADHD had significantly more difficulty inhibiting their responses than did controls. In a second study, results from the Stop Signal Task were obtained from a large sample of both behaviorally disturbed and community children; variables from the Stop Signal Task correlated well with both laboratory observations and teacher ratings of inattention and hyperactivity.
91 citations
TL;DR: Family environment, as measured by the Parenting Stress Index at 1, 2, and 3 years, was the most powerful predictor of parent-reported behavioral problems, suggesting that this index is useful as an early screen for children at risk for behavioral problems and that a reduction of parenting stress is an appropriate target of preventive interventions.
Abstract: In a prospective study of 137 children (47 with cystic fibrosis, 48 with congenital heart disease, 42 with no chronic illness), four domains were examined as predictors of parent-reported behavioral problems, particularly internalizing problems, at 4 years of age: child health, child tempera
88 citations
TL;DR: Important conceptual issues include the following: there is continuity of underlying processes or functions in development; canalized behaviors might give the appearance of discontinuity; integrated functions are more predictive of later developmental levels than are individual functions.
Abstract: Effective screening requires an understanding of underlying conceptual issues and their relationship to pragmatic concerns. Pragmatic concerns include the concepts that there are many underlying reasons for an "abnormal" screening result; that sensitivity and specificity should be combined with relative risk when considering developmental outcome; and that patterns of congruence among motor, language, cognitive, and adaptive/personal social areas of development should be considered. Important conceptual issues include the following: there is continuity of underlying processes or functions in development; canalized behaviors might give the appearance of discontinuity; integrated functions are more predictive of later developmental levels than are individual functions; the "window" of assessment and the developmental emergence of a specific function will affect screening results; one must consider biologic and environmental risks and their specific effects; and different types of neural structures and their relationship to environmental input help to explain why screening results vary over time.
83 citations
TL;DR: Responses of preterm infants to swaddling after a heel lance showed an immediate and spontaneous return to behavioral patterns similar to those observed during the no-blood-sample condition, regardless of treatment condition.
Abstract: We examined responses of preterm infants to swaddling after a heel lance. Fifteen preterm infants from two postconceptional age (PCA) groups (Group 1: n = 7, PCA or = 31 wk) were observed for 30 minutes during blood sampling followed by routine care; blood sampling followed by swaddling; and no blood sampling and routine care. In both groups, blood sampling resulted in concurrent increases in heart rate and state of arousal, in negative facial displays, and in reductions in blood oxygensaturation. After the blood was drawn, infants less than 31 weeks PCA exhibited an immediate and spontaneous return to behavioral patterns similar to those observed during the no-blood-sample condition, regardless of treatment condition. Infants 31 weeks PCA or older exhibited protracted behavioral disturbance that was significantly reduced by the use of swaddling. We discuss the significance of these findings.
80 citations
TL;DR: The dominant motivation for the child doing the teasing seemed at every age to be sadistic pleasure in the discomfort of the child being teased, although one sees some playful, benign teasing by late adolescence.
Abstract: .This study was undertaken because there are almost no reports in the scientific literature on the subject of teasing. Teasing changes as it expresses developmental issues from playing peek-a-boo in infancy to expressing personal issues, such as boy/girl relationships, in adolescence. The fo
TL;DR: Movement from low neurobiologic risk status to poor outcome status at 4 years of age was associated with a number of psychosocial variables, including maternal education and early levels of maternal daily stress.
Abstract: . The continuing contribution of early biological and psychosocial risk factors to developmental outcome of 55 very low birth weight infants (≤ 1500 g) was assessed at 4 years of age. Biological risk, assessed by the Neurobiologic Risk Score, accounted for significant portions of the variance in the perceptual-performance (17%) and motor (35%) dimensions of the McCarthy Scales of Children's Abilities. Psychosocial risk, reflected in maternal appraisals of daily stress during the newborn period, did not account for a significant portion of variance in any of the McCarthy Scales. Maternal education level, however, another measure of psychosocial risk, accounted for significant portions of variance (from 6% to 34%) on each of the McCarthy Scales. Movement from low neurobiologic risk status to poor outcome status at 4 years of age was associated with a number of psychosocial variables, including maternal education and early levels of maternal daily stress. The findings are discussed in terms of early markers for very low birth weight infants who require careful follow-up and of potential intervention targets to promote developmental outcome.
TL;DR: Although use of parent-completed questionnaires, such as the Child Behavior Checklist and the Pediatric Symptom Checklist, can increase identification of child behavioral dysfunction in Pediatrics, it is unclear whether screening will cause a change in physician behaviors necessary to improve child functional outcomes.
Abstract: We reviewed the current status of behavior screening methods, such as parental questionnaires, for identifying behavioral problems in children seen in pediatric settings. Information is organized around basic criteria for implementing screening procedures. We conclude that although use of parent-completed questionnaires, such as the Child Behavior Checklist and the Pediatric Symptom Checklist, can increase identification of child behavioral dysfunction in pediatric settings, it is unclear whether screening will cause a change in physician behaviors necessary to improve child functional outcomes. Clinical and research implications are discussed.
TL;DR: The management of NE requires an investment of time but is quite rewarding, because families that have had success are very grateful, and the next decade promises new developments in the understanding of NE.
Abstract: Nocturnal enuresis (NE) is a common developmental symptom which, in a nonsupportive environment, might have negative effects on the growth of positive self-concept in children. A careful history and physical examination helps to establish a rapport with the child and family and can rule out important organic disease. Constipation might be a contributing factor and should be relieved when present. Treatments are available that can result in either a cure or symptomatic relief for approximately 80% of children older than 7 years. Children with monosymptomatic NE respond best to conditioning alarms or, as second-line therapy, to one of two classes of pharmaceuticals: desmopressin acetate or tricyclic antidepressants. Anticholinergic drugs might have a role in diurnal enuresis, but their role in NE with daytime symptoms is not yet established. Therapies such as hypnosis and dietary restriction have some promise but require additional study and are not recommended at the present time. Combined therapy with desmopressin and conditioning alarms might be helpful for some of the more resistant cases but also needs additional study. The management of NE requires an investment of time but is quite rewarding, because families that have had success are very grateful. Treatment might assist children in developing positive self-concept. The next decade promises new developments in our understanding of NE.
TL;DR: The results support an association between maternal well-being and sibling adjustment but show it is unlikely that nonspecific social support will improve adjustment.
Abstract: This multi-institutional study investigated the association of behavioral/emotional adaptation among siblings of children with cancer with maternal general well-being, physical health, and resource use. One hundred seventy siblings and mothers completed standardized interviews and self-report measures 6 to 42 months after the cancer was diagnosed. As a group, mothers of children with cancer reported significantly lower levels of well-being than matched controls. When stratified according to the level of the sibling's behavioral/emotional adaptation, mothers of siblings in the Dysfunctional group (1) reported the lowest levels of well-being; (2) during the preceding year, were more likely to have sought professional services than mothers of children in the Resilient group; and (3) were least likely to have found social support helpful. Our results support an association between maternal well-being and sibling adjustment but show it is unlikely that nonspecific social support will improve adjustment. The rationale for problem-solving training for mothers is provided.
TL;DR: The amount of perceived support from all sources increased over time, but 78% of mothers and 60% of fathers reported at least one instance of nonsupport from these same sources, primarily from extended family members and health professionals.
Abstract: We questioned parents of 182 young children with a variety of chronic health conditions concerning the amount of emotional, informational, and tangible social support they received from the family, community, and service providers. We also asked parents to describe nonsupportive or hurtful behaviors received from family or community members. Both mothers and fathers reported that family members provided the most emotional and tangible social support and service providers the most informational support. The amount of perceived support from all sources increased over time, but 78% of mothers and 60% of fathers reported at least one instance of nonsupport from these same sources, primarily from extended family members and health professionals. We encourage health professionals to show respect and to provide timely, accurate information in a sensitive manner to parents whose child has a chronic health condition and to assist parents in handling nonsupportive behaviors from family and friends.
TL;DR: It is concluded that children with “growing pains” are rated by their parents, but not their teachers, as having different temperamental and behavioral profiles than controls.
Abstract: Parents of 183 children identified them as having "pain in arms, legs, or joints during the previous 12 months." This group was compared with a group of children without pains selected randomly from the rest of a 1605-member community-based cohort in a study of chronic illness. The pains were most likely to be deep seated, to involve predominantly the lower limbs, and to be described in vague, nonspecific terms. These children were significantly more likely to have recurrent abdominal pain, a negative mood, and behavior problems, and to be aggressive, anxious, and hyperactive. There were no differences between the groups on any teacher ratings of behavior, temperament, social skills, or academic achievement. We conclude that children with "growing pains" are rated by their parents, but not their teachers, as having different temperamental and behavioral profiles than controls. These data suggest a psychosocial contribution to growing pains akin to that seen with other pain syndromes.
TL;DR: A 4-month-old African-American infant who was born full term after a healthy gestation, labor, and delivery is brought to the pediatrician for a health supervision visit, and her physical examination reveals an emotionally disturbed child.
Abstract: CASEJaquette, a 4-month-old African-American infant, is brought to the pediatrician for a health supervision visit. She was born full term after a healthy gestation, labor, and delivery. She nurses vigorously, developmental milestones are normal, and her physical examination reveals an emotionally r
TL;DR: The SHIF offers a reliable and valid addition to the HOME for use with young children living in impoverished urban environments and had good psychometric properties, e.g., high inter-rater reliability, internal consistency, item-total reliability, and intact construct validity.
Abstract: A Supplement to the HOME (Home Observation for Measurement of the Environment Scale) for impoverished Families (SHIF) was developed for use with young children living in impoverished urban environments. After interviews with clinicians and pilot studies with families, we developed 20 items and added them to the HOME. The supplement was field tested in a sample of 73 high-risk families to evaluate its psychometric properties and ease of use. During the home visit, the Nursing Child Assessment Feeding Scale and the Nursing Child Assessment Teaching Scale were also administered to examine construct validity. Results indicated that the SHIF provided new clinical data, was easy to administer, and, when added to the HOME, had good psychometric properties, e.g., high inter-rater reliability, internal consistency, item-total reliability, and intact construct validity. The SHIF offers a reliable and valid addition to the HOME for use with young children living in impoverished urban environments.
TL;DR: A photographic essay documenting biophysical differences, aberrant pre-orthograde movement strategies, and selected adaptive techniques is presented, finding that fine and gross motor skills were found to be more delayed than previously reported.
Abstract: Achondroplasia, the most common skeletal dysplasia, is characterized by delayed and aberrant motoric development in childhood. Delays and aberrancy are secondary to the anatomical differences inherent in people with achondroplasia. We present a photographic essay documenting biophysical differences, aberrant pre-orthograde movement strategies, and selected adaptive techniques. A parental questionnaire assessed the presence of, predominance, and ages at which various types of pre-orthograde locomotion were observed. Fine and gross motor skills were assessed contemporaneously by use of the Denver Developmental Screening Test in 93 children with achondroplasia and were found to be more delayed than previously reported. Physicians, therapists, early-childhood educators, and parents should recognize that aberrant does not mean maladaptive and that different development is not defective development.
TL;DR: Among patients in whom ANV developed, level of distress and expectations of severity of postchemotherapy symptoms were positively correlated with the severity of ANV and PNV symptoms.
Abstract: We examined the influence of cognitive factors and conditioning variables on anticipatory nausea and vomiting symptoms (ANV) in 32 pediatric cancer patients with postchemotherapy nausea and vomiting (PNV) who received ondansetron. The patients were compared with 18 patients without ANV (NANV). Age, gender, history of motion sickness, aggressiveness of the chemotherapy, PNV severity, number of chemotherapy treatments, number, type, and efficacy of self-reported coping strategies, and expectations of severity of postchemotherapy symptoms failed to differentiate the ANV and NANV groups. The amount of subjective distress associated with nausea and vomiting was significantly greater in the ANV group. Among patients in whom ANV developed, level of distress and expectations of severity of postchemotherapy symptoms were positively correlated with the severity of ANV and PNV symptoms. Therefore, greater distress might increase the likelihood of ANV conditioning. Once ANV is conditioned, cognitive factors might influence the severity of symptoms.
TL;DR: Three years after the colicky period, families with moderately and severely colicky infants did not differ significantly from control families with respect to psychological family characteristics.
Abstract: Infantile colic causes stress to many families during the first weeks of an infant's life. In our previous studies, we found that families with severely colicky infants had more problems in their daily functioning than did families without colicky infants and that the affective state in these families was anxious and conflicted. These characteristics showed some stability from the colicky period to 1 year of age. In the present study, we examined the functioning of these families 3 years after the colicky period. The McMaster Family Assessment Device was used to evaluate the family interaction in 59 families with previously colicky infants and 58 control families. Three years after the colicky period, families with moderately and severely colicky infants did not differ significantly from control families with respect to psychological family characteristics.
TL;DR: Results indicated that negative relationship qualities were more closely related to younger sisters engaging in problem, delinquent-like behavior and sexual behavior than were positive relationship qualities, such as warmth and closeness.
Abstract: On the basis of social modeling theory and a sibling interaction hypothesis, it was hypothesized that specific relationship qualities between a pregnant or parenting teen and her younger sister would be associated with permissive younger sister outcomes, such as permissive childbearing attitudes and permissive sexual behavior. Results indicated that negative relationship qualities, such as rivalry, competition, and conflict, were more closely related to younger sisters engaging in problem delinquent-like behavior and sexual behavior than were positive relationship qualities, such as warmth and closeness. Additionally, a shared friendship network with the older sister was found to be associated with extensive younger sister problem behavior and sexual behavior. Three potential explanatory processes are discussed.
TL;DR: It is found that birth weight and neonatal health were associated with both maternal and teacher reports, and that although mothers' reports of objective measures were accurate, their assessments of behavioral problems and social competence often differed from those of teachers.
Abstract: To examine the concordance of mother and teacher ratings of children born at different birth weights on measures of school functioning, behavioral problems, and social competencies, we used a prospective cohort study involving children in two previously studied multisite birth cohorts whom we recontacted at 8 to 10 years of age. This provided a multisite sample of 784 low birth weight children and 334 normal birth weight children. Teacher reports of children's behaviors were obtained from 80% of the 1400 teachers contacted. We found that birth weight and neonatal health were associated with both maternal and teacher reports; that maternal characteristics, e.g., low levels of education and poor mental health, were associated with the greatest discrepancies in reports; and that although mothers' reports of objective measures were accurate, their assessments of behavioral problems and social competence often differed from those of teachers.
TL;DR: The results suggest that neither the FMR1 nor theFMR2 mutation is a common etiology of academic failure among school-age children without mental retardation and that the prevalence of the F MR1 premutation is no more frequent in children with academic failure than it is in the general population.
Abstract: The prevalence of the fragile X mental retardation (FMR) 1 and FMR2 full mutations (fM) was examined among 1014 school-age children with academic difficulties but without mental retardation. Both Southern blot and polymerase chain reaction analyses for FMR1 and FMR2 were performed on samples obtained from these children. No fM genes were found, and one FMR1 premutation was identified. The distribution of allele sizes for both genes was comparable to those reported for other clinical and normal population samples. These results suggest that neither the FMR1 nor the FMR2 mutation is a common etiology of academic failure among school-age children without mental retardation and that the prevalence of the FMR1 premutation is no more frequent in children with academic failure than it is in the general population.
TL;DR: Findings support the usefulness of a multidimensional approach to the measurement of attention problems and a multivariate approach to prediction and suggest that quality of home environment, in interaction with characteristics of the infant, influences the development of self-regulation and attention among low birth weight children.
Abstract: The prediction of early childhood attention problems was investigated prospectively within a sample of low birth weight children. Medical risk, temperament, quality of home environment, and developmental status were correlated with task measures of inattention and impulsivity; developmental status and quality of home environment were correlated with examiner ratings of inattention, impulsivity, and hyperactivity during testing; and quality of home environment was correlated with parental reports of hyperactivity. Multiple regression analyses indicated that attention problems were predicted by temperament, environment, and the interaction between developmental status and quality of home environment. These findings support the usefulness of a multidimensional approach to the measurement of attention problems and a multivariate approach to prediction and suggest that quality of home environment, in interaction with characteristics of the infant, influences the development of self-regulation and attention among low birth weight children.
TL;DR: It is indicated that in the context of intermittent nasogastric feedings, NNS engagement in tube-fed infants depends on stomach cues and/or temperature changes associated with tube feedings.
Abstract: Non-nutritive sucking (NNS) activities were recorded in preterm infants born at gestational age 32 weeks or less during nasogastric feedings. Six infants on intermittent nasogastric feeding schedules were tested with a pacifier in their mouth for three 5-minute periods (before, during, and after gavage feeding). Analysis of the recordings revealed that NNS activities increased markedly during the intermittent nasogastric feeding schedule. The overall proportions of sucking engagement, the mean duration of sucking burst, the mean number of sucks per burst, and the mean duration of individual sucks within a burst increased markedly during gavage feeding compared with both pre-test and post-test periods. NNS by a group of five infants on continuous nasogastric feedings was similar to the pre-test and post-test of the infants on the intermittent nasogastric feeding schedule. These results indicate that in the context of intermittent nasogastric feedings, NNS engagement in tube-fed infants depends on stomach cues and/or temperature changes associated with tube feedings.
TL;DR: It is demonstrated that milk effectively quiets human newborns, that its quieting effects endure, and that the mechanisms that quiet and that underlie hand-in-mouth engagement are separable and independent.
Abstract: Milk (Similac), sucrose (12% wt/vol), or water were delivered to crying normal newborns once per minute for 5 minutes, in a volume of 0.1 mL/delivery. Milk and sucrose markedly reduced infant crying, and this calm persisted during the 3 minutes after substance delivery. Infants who received water were only marginally quieted, and this calm did not persist. Despite quieting agitated infants, milk did not cause them to bring their hands to their mouths during the period of milk treatment, whereas infants who received sucrose did bring their hands to their mouths. These data demonstrate that milk effectively quiets human newborns, that its quieting effects endure, and that the mechanisms that quiet and that underlie hand-in-mouth engagement are separable and independent.