摘要:

Obtaining meaningful baseline measures of children's cardiovascular activity (CVA) has been difficult because of constraints inherent to laboratory procedures that are used to assess individual differences in response to stress. To circumvent these problems, we performed repeated baseline measures of pulse rate (PR) and blood pressure for 174 children (aged 7–10 yr) in their natural school setting throughout 2 1-week periods. In addition, experimental assessments of cardiovascular reactivity (CVR) were conducted after each baseline period while children participated in a challenging cognitive task. Multivariate analyses of physiological indices revealed three primary styles of cardiovascular functioning. Two of them, characterizing children either with high PR and low blood pressure or conversely with low PR and high blood pressure, have already been described in the research literature. However, analyses also revealed a third group of children (48% of the subjects) who had both low PR and low blood pressure. Findings indicate developmental differences in cardiovascular regulation and highlight the need to consider both variations in baseline CVA as well as in CVR when examining children's physiological adaptation in everyday settings.

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

No studies have compared toileting-specific behaviors of encopretic children with those of asymptomatic children and have controlled for environmental factors such as parental attitudes, parenting styles, and bathroom facilities. This study prospectively examined the toileting habits of 86 chronically encopretic children compared with those of 27 asymptomatic siblings and 35 asymptomatic nonsiblings. Although encopretic children experienced significantly more soiling than did controls, the total number of daily bowel movements passed in the toilet (±SD) was comparable in the three groups (.92 ± .76 in encopretic children compared with 1.14 ± .43 and 1.08 ± .47 in siblings and nonsiblings, respectively). Encopretic children experienced pain with defecation more often than did controls. During the 14-day study period, encopretic children complained of pain on 2.75 ± 4.03 days compared with .58 ± 1.84 days among sibling controls and 2.31 ± 3.21 days among nonsibling controls. The mean pain score in encopretic children was .76 ± 1.00 compared with .05 ± .15 and .26 ± .38 among siblings and nonsiblings, respectively. All three groups of children sat on the toilet without parental prompting the same number of times each day. In summary, children with chronic encopresis do not seem to avoid toileting, and they exhibit toileting behaviors that are very similar to those of asymptomatic siblings as well as to those of nonsibling controls.

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study explored an alternative self-report approach to the measurement of depressive symptoms in children that was hypothesized to be less prone to the distorting influences of defensiveness. Children with cancer (n = 107) and healthy controls (n = 442) completed measures of adaptive style (defensiveness, anxiety), a standard depression inventory, and an anhedonia measure used as a proxy estimate of depressive symptoms. As predicted, children with cancer reported significantly fewer depressive symptoms than did healthy controls on the depression inventory, whereas no differences were found on the measure of anhedonia. However, self-report of anhedonia was found also to be subject to the influence of defensiveness, and neither the depression inventory nor the anhedonia measure was significantly related to parent and physician ratings of depression. An approach that combined self-report measures of depression and anhedonia did not significantly improve the identification of children rated as depressed by parents or physicians. Measurement of anhedonia may provide an interesting avenue for further research, but there is still no adequately validated self-report instrument for the measurement of depressive symptoms in children with cancer.

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study was designed to assess social, emotional, and behavioral functioning of children with chronic illness and to evaluate three models addressing the impact of chronic illness on psychosocial functioning: discrete disease, noncategorical, and mixed. Families of children with cancer, sickle cell disease, hemophilia, and juvenile rheumatoid arthritis participated, along with families of classroom comparison peers without a chronic illness who had the closest date of birth and were of the same race and gender (COMPs). Mothers, fathers, and children provided information regarding current functioning of the child with chronic illness or the COMP child. Child Behavior Checklist and Children's Depression Inventory scores were examined. Results provided support for the noncategorical model. Thus, the mixed model evaluated in this study requires modifications before its effectiveness as a classification system can be demonstrated.

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study described the relationship between amount of sleep and behavior problems among preschoolers. Participants were 510 children aged 2 to 5 years who were enrolled through 68 private pediatric practices. Parents reported on the amount of sleep their child obtained at night and in 24-hour periods. With demographic variables controlled, regression models were used to determine whether sleep was associated with behavior problems. The relationship between less sleep at night and the presence of a DSM-III-R psychiatric diagnosis was significant (odds ratio = 1.23,p= .026). Less night sleep (p< .0001) and less sleep in a 24-hour period (p< .004) were associated with increased total behavior problems on the Child Behavior Checklist; less night sleep (p< .0002) and less 24-hour sleep (p< .004) were also associated with more externalizing problems on that measure. Further research is needed to ascertain whether sleep is playing a causal role in the increase of behavior problems.

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study examined the relation between internalizing and externalizing symptoms in two groups of prepubertal boys (with and without multiple chronic tic disorder) with diagnosed attention-deficit hyperactivity disorder (ADHD). Parents and teachers completed the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF), respectively. Children were carefully evaluated for the absence of a chronic tic disorder. Boys with ADHD and chronic multiple tic disorder (ADHD/+tics) received significantly higher (p= .0032, Bonferroni correction) scores for the Anxious/Depressed, Thought Problems, and Attention Problem scales of the CBCL and the Delinquent Behavior, Thought Problems, and Somatic Complaints scales of the TRF than did boys without chronic tic disorder (ADHD/−tics). Although many of the individual items that differentiated (p< .05) the two groups of boys pertained to behaviors that characterize motor tics, obsessions, or compulsions, the ADHD/+tics group exhibited higher rates of anxious behavior (CBCL) and obscene language (TRF) than did the ADHD/−tics group. Anxiety/depressive symptoms were associated with aggressive/oppositional behavior in both samples. Children with mild tic disorder were more similar (CBCL) to ADHD/−tics boys than they were to children with more severe tic disorder. The relatively higher rate of comorbidity in the ADHD/+tics group suggests that tics may be a marker for more severe symptomatology in clinic-referred samples of children with ADHD. Furthermore, these data suggest that it is not the presence, per se, but rather the severity of tic disorder that is associated with higher rates of emotional and behavioral disturbances.

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

When the pediatrician went to examine Jenny at 1 day of age in the hospital, she was not surprised to find a healthy, full-term neonate with a normal physical examination, including a normal developmental assessment. She was responsive and robust with wide open eyes that engaged her mother and the pediatrician.A review of the medical records revealed that both parents were significantly hearing-impaired. Jenny's mother had a familial form of congenital neurosensory deafness. Both maternal grandparents had the same condition. Her mother learned to sign at an early age and completed a college degree. Jenny's father acquired his deaf condition at 6 years of age after an episode of viral encephalitis. He communicated through sign language and was a successful administrator.When the pediatrician suggested a hearing test (brainstem auditory evoked potential), Jenny's mother, who was able to use spoken language as well as sign language, responded with a soft smile. “I don't think that will be necessary. We will know if she can hear in a short time.”

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The rapid growth of managed care, and especially that of managed behavioral healthcare organizations (MBHOs), is likely to diminish the role of developmental-behavioral pediatrics and separate care for medical and behavioral problems. Thus, a rethinking of the practice of developmental-behavioral pediatrics is required. This study reviews the structure of MBHOs, identifies barriers to the provision of services by developmental-behavioral pediatricians, describes alternative practice models for consideration, and makes recommendations. The aims of the recommendations are to stimulate an active discussion about these issues, spark an advocacy effort, and ensure the continued participation of developmental-behavioral pediatricians in the care of children with special needs. The study concludes that managed care will push developmental-behavioral pediatricians into integration with primary care group practices or into specialty mental health networks. Immediate discussion, action, and advocacy will be required to ensure a presence in these decisions for developmental-behavioral pediatricians.

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0196-206X    

出版商:OVID    

年代:1999

数据来源: OVID