摘要:

A retrospective review of 21 patients ages 12 years and younger (age of onset range 7 to 12 years) with anorexia nervosa showed diagnostic delay in the youngest ones, high incidence of family psychiatric history, a remarkable severity of illness, and positive response to intensive treatment. Additional findings included significant comorbidity, a distinct subgroup with personality disorder and another with features of the “vulnerable child syndrome.” This broad clinical spectrum of anorexia nervosa in children may explain the great variability in outcome. The development of anorexia nervosa in children relates to a complex combination of etiological and trigger factors. Precipitants identified in this study were physical maturation, entry into junior high, loss, or some combination thereof. J Dev Behav Pediatr 14:211–216, 1993. Index terms:childhood anorexia nervosa, comorbidity of anorexia nervosa, vulnerable child syndrome.

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Children with chronic illness need to adapt to more stresses than do healthy children. Research highlights the problems of children with chronic illnesses but not how they cope in response to the stress created by these problems. Cognitive appraisal of a stressor and of response options is an important aspect of coping. Our cross-sectional study investigated whether children with chronic illness used cognitive strategies for coping as often as did healthy children. One hundred seventy five children from summer camps with juvenile arthritis, asthma, or diabetes were compared with 145 healthy school children. Spontaneous responses to common painful and stressful events were categorized into coping or catastrophizing ideation. Data on anxiety, disease severity, and other sociodemographic variables were obtained. Coping strategies were reported by 64% of children with chronic illness and 63% of healthy children and varied significantly with age (p< .05) in both groups. Children with different chronic illnesses performed similarly except for a trend among children with severe juvenile rheumatoid arthritis who had higher rates of coping. For the individual stressful events, the rate of coping varied from 46% to 86%. The highest rates of coping responses were found with the child's recent personal stressful event where adolescents with chronic illness were twice as likely to offer more complex coping responses. More children with chronic illness than healthy children offered coping strategies in response to venipuncture (p< .001) but not to dental injection. Children with chronic illness report coping as their predominant strategy for adapting to common painful and stressful events. We need to recognize the role of cognitive strategies and how their use varies as a function of the different stresses faced by children with chronic illness.J Dev Behav Pediatr 14:217–223, 1993.Index terms:chronic illness, coping, arthritis, asthma, diabetes.

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Child passenger safety, a major public health concern, has been addressed by state laws mandating use of child restraint devices. Usage rates in poor and minority communities are disproportionately low. To determine the influence of the child care center within these communities to improve routine use, an educational clinical trial, based on social learning theory was designed. Two urban child care centers enrolling high-risk 2− through 6-year-old children were monitored for correct child restraint use during a 5-month educational intervention at one center. Key features of intervention programming included weekly, developmentally appropriate presentations by the staff to the children and documented parental awareness of the child care center's policy advisory regarding child restraint use. Results demonstrate statistically significant (p< .01) increases in use at the intervention center. This study finds that child care center policy and programming can be effective in promoting child passenger safety.J Dev Behav Pediatr 14:224–229, 1993.Index terms:child care, injury prevention, child restraint devices.

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Although there are several scales routinely used for assessment of temperament during the first year of life, none of them is well suited to the infant younger than 4 months old. The Early Infancy Temperament Questionnaire (EITQ) was designed to meet this need. The EITQ is a 76-item parent questionnaire for assessing the nine New York Longitudinal Study temperament characteristics in 1 - to 4-month-old infants. The majority of the items were adapted from the Revised Infant Temperament Questionnaire to be developmentally appropriate for the very young infant. The standardization population consisted of 404 infants from one pediatric practice. Means for the nine categories were calculated separately for infants from 1 to 2 months and 3 to 4 months old. Intermal consistency for the nine categories ranged from .42 to .76. Test-retest scores, completed between 2 to 3 weeks after the first rating, ranged from .43 to .87, with generally increasing retest levels in the older age group. None of the categories showed significant differences between male and female infants. This newly developed instrument should enhance the ability of both researchers and clinicians to assess temperament reliably and to understand better its contribution to clinical problems in the very young child.J Dev Behav Pediatr 14:230–235, 1993.Index terms:temperament, measurement of temperament, early infancy.

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Children's and parent's subjective ratings of the frequency and severity of nausea and emesis were assessed among 33 children with acute lymphoblastic leukemia receiving identical chemotherapy. Parents were trained to record the frequency of the child's actual emesis episodes during chemotherapy. Although parent and child ratings of nausea were significantly correlated, children generally rated their nausea and emesis as more frequent and more severe than did their parents. Parent ratings showed inadequate external validity when compared with behavioral observations. Children with greater anxiety and higher subjective ratings subsequently exhibited more frequent episodes of emesis by observation, suggesting that their perceptions of symptoms based on previous chemotherapy experiences may predict emesis during different chemotherapy. In a stepwise multiple regression analysis, antiemetic regimen and the child's anxiety as rated by the parent combined to account for approximately 47% of the variance in number of episodes of emesis. These findings are discussed in the context of factors limiting validity of parent and child reports of children's symptomatology with implications for future epidemiologic and intervention research.J Dev Behav Pediatr 14:236–241, 1993.Index terms:childhood cancer, chemotherapy, emesis.

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Prematurity and low birth weight have been considered to be important risk factors for cognitive development during early childhood; however, it has been suggested that the developmental delays disappear with age. Eighty-one preterm (<38 weeks) low birth weight (<2500 g) children between 5 and 8 years old from the Children of the National Longitudinal Survey of Youth were compared with individually matched full-term normal birth weight children to investigate the catchup delays in cognitive functioning including language and mathematics skills. Preterm children showed a significant delay in cognitive functioning only until 6 years old. Regression analyses showed that environmental factors accounted for more variation in cognitive development than did perinatal factors. In support of a transactional model, preterm children exhibited a self-righting tendency during their early childhood so that eventually environmental influences overshadowed biological influences.J Dev Behav Pediatr 14:242–249, 1993.Index terms:transactional model, cognitive development, preterm, low birth weight.

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Telephone interviews offer an economical method of obtaining information, but little published experience addresses the use of telephone interviews for the sometimes lengthy questionnaires composed of scales with multiple-category items often required in developmental and behavioral research. In a study of the outcomes of very low birth weight infants, circumstances required that we administer a questionnaire, including seven scales composed of several Likert-type items each, to a substantial portion of the study population. Those contacted by telephone (n = 1067) differed from those responding face-to-face (n = 822) in being less likely to have a very low birth weight child and more likely to be white and of higher maternal education. The length of the interview was only slightly shorter by telephone (60.7 ± 27.9 vs 66.4 ± 21.0 minutes,p< .001), but respondent fatigue, as indicated by lower completion rates for scales at the end of the interview (92.5%) compared with those near the beginning (99.5%) did not differ by mode. Internal consistency of parental response (Cronbach's α) was high for most scales and did not differ by mode. Because assignment to mode was not random, other factors may influence our findings. However, high completion rates and comparable consistency of response supports the use of telephone interviews.J Dev Behav Pediatr 14:250–255, 1993.Index terms:health survey, child health status.

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Disproportionately high use of school health room (HR) services by small groups of users has been reported. This study investigated predictors of frequent HR use in two suburban middle schools involving 1089 students who made at least one HR visit during a single academic year. Subsets of high and low users were compared using logistic regression. Predictor variables included gender, grade, academic ability, and existence of a chronic health condition. Although demographic characteristics of the study schools varied significantly, a pattern of increasing HR use associated with progressive lowering of academic ability was demonstrated in both schools. Existence of a chronic health condition was associated with increased HR use, even when controlling for routine medication visits. Gender and grade were not predictive. These findings suggest that HR use reflects more than medical concerns. Patterns of HR use by students with chronic health conditions deserve additional study to determine whether current strategies to meet their needs are adequate.J Dev Behav Pediatr 14:259–263, 1993.Index terms:school health, health care, utilization.

ISSN:0196-206X    

出版商:OVID    

年代:1993

数据来源: OVID