摘要:

ABSTRACT.The study objective was to evaluate the quality of parent-child interactions in preschool-aged children exposed prenatally to cocaine. African-American mothers and their full-term newborns (n = 343) were enrolled prospectively at birth and classified as either prenatally cocaine-exposed (n = 157) or non–cocaine-exposed (n = 186) on the basis of maternal self-report and bioassays. Follow-up evaluations at 3 years of age (mean age, 40 mo) included a videotaped dyadic play session and maternal interviews to assess ongoing drug use and maternal psychological distress. Play interactions were coded using a modified version of Egeland et al’s Teaching Task coding scheme. Regression analyses indicated cocaine-associated deficits in mother-child interaction, even with statistical adjustment for multiple suspected influences on interaction dynamics. Mother-child interactions were most impaired in cocaine-exposed dyads when the mother continued to report cocaine use at the 3-year follow-up. Multivariate profile analysis of the Egeland interaction subscales indicated greater maternal intrusiveness and hostility, poorer quality of instruction, lower maternal confidence, and diminished child persistence in the cocaine-exposed dyads.

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ABSTRACT.The absence of a method for evaluating the olfaction of infants and children without structured language led us to perform a longitudinal study of the behavioral responses of very young children. The aim was to establish a tool for verifying a child’s olfactory ability during a pediatric examination. A total of 107 subjects were observed and filmed during a regular olfactory activity. Three years of filmed observations were analyzed and showed three types of stable behavioral responses that we consider to be specific to olfactory stimulus: modification of respiratory rhythm, fixed stare, and decrease of mobility. These responses were observed for 98% of the subjects in 100% of the first presentations of the odorized tissue. Response time was not influenced by age, socioeconomic situation, or position in the family, but it was influenced by ethnic background. These responses constitute items allowing the first step of an objective assessment of a prelanguage child’s olfaction without the subject’s verbal participation.

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ABSTRACT.A 1-year randomized trial compared intensive case management (ICM) versus basic case management (BCM) in facilitating early intervention (EI) service use among children in an urban health system. Of 159 participating families with delayed or at-risk preschool-aged children, 88 received ICM from paraprofessionals versus 71 families who received less comprehensive BCM from a nurse. In the ICM versus BCM group, a shorter interval to assessment (98 vs 140 d,p= .05) but similar assessment rate (86% vs 80%,p= .29) was observed. The ICM group had more services recommended per child (1.64 vs 1.16,p< .004) and initiated (1.20 vs 0.85,p< .04). There was no difference in median time to EI program initiation for ICM versus BCM (228 vs 200 d,p= .88) or initiation and visit compliance rate for EI services. Specific efforts to improve outcomes (e.g., decrease initiation time and increase use of EI services) are still needed.

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ABSTRACT.Currently, there are no clear methods for identifying children vulnerable to frequent school absences. Our study examined relationships between gender and laboratory pain reactivity to the cold-pressor task (CPT), and parent-involved school absences and self-initiated school nurse visits in 57 children (36 female; ages 8–10 years). Using multiple regression analyses, CPT pain ratings, tolerance, and gender were analyzed in relation to nurse visits and absences collected prospectively across 2 years. We found that higher pain ratings and female gender predicted more absences; female gender also predicted increased nurse visits for acute complaints with documented physical findings. Our results suggest that laboratory pain reactivity is a potentially useful indicator of vulnerability to parent-involved functional impairment, as indexed by school absences, and that girls are more likely than boys to miss school and visit the nurse for acute illnesses. Limitations and pathways for further study are discussed.

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ABSTRACT.The objectives of this study were to determine whether autistic children taking levetiracetam (1) showed improvement in the areas of aggression, impulsivity, hyperkinesis, and mood instability, and (2) showed a nootropic response. Ten white autistic boys ranging from 4 to 10 years were compared pretreatment and while taking levetiracetam for an average of 4.1 weeks. Inattention, hyperkinesis, and impulsivity were evaluated using the Achenbach Attention Problems scale, Conners DSM-IV Total scale, and the Conners Attention-Deficit Hyperactivity Disorder Index scale, all of which showed statistically significant improvements. Mood instability was measured with the Conners Global Index (CGI) Emotional Lability and CGI Total scales, both of which showed statistically significant improvements. Aggressive behavior, as measured with the Achenbach Aggression scale, showed statistically significant improvement only for subjects who were not recently weaned from medications that reduce aggression (e.g., risperidone, carbamazepine, desipramine). Levetiracetam may reduce hyperactivity, impulsivity, mood instability, and aggression in autistic children with these problems. No nootropic effect was observed.

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ABSTRACT.Little research exists that addresses the differences in feeding skills between preterm (PT) infants at term and full-term (FT) infants. The purpose of this study was to quantify and examine the differences in sucking abilities of PT infants when measured at 40 weeks postconceptional age (PCA) and newly born FT infants. The sample consisted of 213 infants who were divided into three groups on the basis of their gestational age at birth (24–29 wk, 30–32 wk, and 38–42 wk). The Kron Nutritive Sucking Apparatus (KNSA) was used to examine the microstructure of sucking and feeding behaviors. There were significant differences among the three groups in several of the sucking variables: number of bursts (p= .005), intersuck interval (p= .0212), sucks per burst (p= .0003), suck width (p< .0001), intersuck width (p< .0001), mean maximum pressure (p< .0001), and intersuck width/interburst width (p= .02). The findings from this study demonstrate the importance of both maturation at birth and experience as factors influencing feeding behaviors.

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ABSTRACT.Clinicians caring for adolescents may be better positioned to provide health care when equipped with an understanding of adolescents’ preferences regarding provider characteristics. The purpose of this study is to obtain a manageable framework of adolescents’ concerns about health care providers. A series of qualitative and quantitative data-collection methods were used to elicit and organize ideas about health care providers from ninth-grade students in Philadelphia. A 5-point Likert survey, based on ideas generated and prioritized in earlier qualitative stages, was administered in school. Exploratory and confirmatory factor analysis was used to uncover latent factors. A total of 2602 students returned usable surveys. A confirmatory factor analysis model including four latent factors (patient’s interpersonal relationship with provider, concern for physical safety, concern for emotional safety, and provider counseling ability) explained 51.6% of the model variability. Urban ninth graders want providers with whom they can develop strong relationships, feel emotionally and physically safe, and turn to for counseling. Communication with adolescent-aged patients should be a standard component of health care training and should promote provider sensitivity to adolescent fears and needs in the health care setting.

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ABSTRACT.We report results of the first longitudinal study of outcome correlates of parent-child bedsharing. Two hundred five families in nonconventional and conventional family lifestyles have been followed since 1975. A target child in each family was followed from the third trimester of mother’s pregnancy through age 18 years. Bedsharing in early childhood was found to be significantly associated with increased cognitive competence measured at age 6 years, but the effect size was small. At age 6 years, bedsharing in infancy and early childhood was not associated with sleep problems, sexual pathology, or any other problematic consequences. At age 18 years, bedsharing in infancy and childhood was unrelated to pathology or problematic consequences, nor was it related to beneficial consequences. We discuss these results in light of widespread fears of harm caused by parent-child bedsharing. We suggest that such fears are without warrant if bedsharing is practiced safely as part of a complex of valued and related family practices.

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:2002

数据来源: OVID