摘要:

Behavioral counterconditioning was conducted during simulated medical routines to supplement medical management of five children's distress during invasive procedures (bone marrow aspiration, lumbar puncture, tracheostomy care, venipuncture, and finger pricks). Preferred activities were paired in vivo with medical stimuli, and differential positive reinforcement was provided contingent on engagement with the preferred activities and on compliance with adult instructions, first during simulations and later during actual procedures. Data on cooperation, escape/avoidance, and negative vocalizations were evaluated using both single-subject experimental methods and a baseline-treatment group statistical comparison. Results support the benefits of this approach as an adjunctive intervention to decrease behavioral distress in some children requiring repeated invasive procedures. Discussion emphasizes the potential for training medical personnel to implement these techniques preventively, for decreasing or discontinuing sedation for some children treated under local anesthesia, and for preparing children with developmental disabilities for invasive procedures.J Dev Behav Pediatr 16:133–141, 1995.Index terms:invasive procedures, behavior therapy.

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

To examine the role of genetic factors in oppositional defiant disorder (ODD) and conduct disorder (CD), 38 variables realating to the relevant DSM-III-R criteria, as well as other angry and aggressive behaviors, were examined in 1177 Tourette syndrome (TS) and attention-deficit hyperactivity disorder (ADHD) probands, their first-degree relatives, and controls. Two techniques were used: (1) a genetic loading technique comparing the frequency of symptoms in groups with progressively less genetic loading forGtsandADHDgenes, and (2) comparison of the frequency of symptoms in relatives with, versus relatives without, TS or ADHD. When significant, the latter rules out ascertainment bias and inappropriate controls. For TS, the results were significant with mostpvalues less than 10-8. The same trends were seen in the smaller number of ADHD families. A polygenic model is proposed inwhich TS and ADHD alone represent lesser degree of genetic loading and expression and TS + CD ADHD represents a higher degree of genetic loading and expression of genes common to all three disorders. These studies emphasize the important role of genetic factors in ODD and CD. The therapeutic implications are discussed.J Dev Behav Pediatr 16:142–157, 1995.Index terms:Tourette syndrome, attention-deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, aggression, genetic.

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The efficacy of two contrasting short term preventative interventions administered to a heterogeneous sample of new mothers during the perinatal period was evaluated. The first was infant-centered and used the Brazelton Neonatal Behavioral Assessment Scale (NBAS) as a method of highlighting newborn behavior to new mothers. The second was mother-centered and consisted of an in-depth interview focused on the mothers' concerns about parenting. Mothers were randomized into groups and were administered intervention by experienced clinicians at 3 days in the hospital and again at 14 and 30 days at home. Effects of intervention on maternal reports of parenting stress, mother-infant interactive behavior, and infant developmental quotient were evaluated at 4 months infant age. It was hypothesized that participation in the infant-centered intervention would be related to more positive maternal and infant outcomes at 4 months. It was also expected that the impact of each intervention would be moderated by differences in maternal and infant risk and parity. Hierarchical multiple regressions controlling for risk and parity yielded no significant main effects of intervention at 4 months. However, significant interactions of intervention with parity and risk were observed, indicating that intervention was beneficial for specific groups of mothers. These data suggest that early intervention should be tailored to the needs of individual groups of mothers.J Dev Behav Pediatr 16:158–166, 1995.Index terms:parent-infant intervention, Brazelton Neonatal Behavior Assessment Scale, intrauterine growth retardation, parenting stress, mother-infant interaction.

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Although the findings from recent controlled studies suggest that methylphenidate is a safe and effective treatment for many children with attention-deficit hyperactivity disorder (ADHD) and comorbid tic disorder, relatively little is known about drug effects on school behavior. Thirty-four prepubertal children with ADHD and tic disorder received placebo and 3 doses of methylphenidate (0.1, 0.3, and 0.5 mg/kg) twice daily for 2 weeks each under double-blind conditions. Treatment effects were assessed using direct observations of child behavior in classroom, lunchroom, and playground settings. Treatment with methylphenidate resulted in marked reductions of hyperactive, disruptive, and aggressive behavior, which was evident even for the 0.1 mg/kg dose. There were no “nonresponders.‘’ The only observed changes in tics were a small but statistically significant increase in the frequency of motor tics (classroom, 0.1 mg/kg dose) and a tendency for fewer vocal tics (lunchroom). However, these changes in motor tic frequency were not perceived by care providers as a worsening in the severity of the child's tic disorder. Most dose-response relationships were linear, but the mean (operationally defined) minimal effective dose (MED) was 0.3 mg/kg. In summary, the findings support the conclusions that (1) methylphenidate suppresses ADHD behaviors in the classroom and aggressive behavior in all settings and that (2) a low dose may have a weak exacerbation effect on the frequency of motor tics; but, in general, the majority of youngsters do not experience clinically significant tic worsening with a MED.J Dev Behav Pediatr 16:167–176, 1995.Index terms:attention-deficit hyperactivity disorder, methylphenidate, aggression, tic disorder, Tourette disorder.

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The purpose of this investigation was to examine quantitative methods used to determine reliability in developmental research. Procedures used to compute reliability estimates in 30 studies published in three developmental journals were examined. Four types of reliability studies were identified and analyzed. These included interrater reliability, stability (test-retest and intrarater reliability), equivalence reliability, and internal consistency. Interrater reliability investigations were the most frequently reported in the developmental literature reviewed (45%). The Pearson product moment correlation (r) was the most commonly reported reliability statistic. The findings reveal that researchers in developmental pediatrics frequently analyze reliability data using the Pearson product moment correlation and interpret the results as indicating consensus (agreement) among raters or across instruments. The Pearson product moment correlation (r) provides information on covariation among variables but does not indicate agreement. Thus, the findings suggest that developmental researchers may be misinterpreting the statistical results of reliability investigations. The argument is made that the intraclass correlation coefficient (ICC) is a more appropriate method of analysis when the purpose of the research is to examine consensus.J Dev Behav Pediatr 16:177–182, 1995.Index terms:consistency, measurement, data analysis.

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The association between nutritional status (percentage of weight for height) and infant-mother relationship was studied over 4 years in 38 children diagnosed with cystic fibrosis in the first year of life. Infant-mother relationship was assessed in a standardized laboratory observation. Although they could not be distinguished medically from the others at the time of diagnosis, infants showing a specific form of insecure relationship with their mothers (insecure-avoidant) differed from the others in: (1) failure to improve in nutritional status in the first year; (2) continuing decline in weight for height in the first 3 years; and (3) significantly lower weight for height at 1, 2, and 3 years of age. These data suggest that attention to mother-infant relationships, particularly feeding interactions, may improve nutritional status in children with cystic fibrosis.J Dev Behav Pediatr 16:183–186, 1995.Index terms:infancy, cystic fibrosis, nutrition, attachment.

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Homesickness is a problem that is well known to parents but is little discussed in the medical literature. The goal of this study was to describe the prevalence of homesickness at one summer camp and to assess the hypothesis that children who are homesick are more frequent users of the camp infirmary than children who are not homesick. Homesickness was assessed by a questionnaire devised by the authors that was completed by the child's counselor at the end of camp. Homesickness was found in 20% of the campers. Two of three measures of homesickness derived from the questionnaire were significantly associated with multiple visits to the infirmary, and the third measure showed a trend in the same direction. Our findings led us to the conclusion that homesickness is a common problem and that multiple visits to a camp infirmary might be a warning signal of lack of adjustment to the camp environment.J Dev Behav Pediatr 16:187–191, 1995.Index terms:homesickness, separation, camp.

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

CASE. Philip, a 14-year-old male, is brought to your office by his anxious parents who recently discovered that he was using marijuana. Over the past 2 months, he has appeared moody, irritable, and has been losing interest in his school work. His parents had attributed these behavior changes to “teenage years‘’ until his mother discovered a marijuana cigarette in his room. His father responded with anger directed at the youth. Philip had a happy and productive childhood before this event. He was a solid “B‘’ student with several friends and a modest interest in participatory sports. He has two older siblings in college. The family was close and previously had enjoyed time together. Philip's father stated that the use of drugs was absolutely forbidden in his family, and he felt that Philip had “let ‘him’ down.J Dev Behav Pediatr 16:196–198, 1995.Index Terms:early adolescence, marijuana use.

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1995

数据来源: OVID