Secondary Logo

Journal Logo

Video Gallery

Video Abstract: Best-Worst Scaling to Prioritize Outcomes Meaningful to Caregivers of Youth with Mental Health Multimorbidities: A Pilot Study

Video Author: University of Maryland School of Pharmacy
Published on: 12.12.2017
Associated with: Journal of Developmental & Behavioral Pediatrics. 39(2):101-108, February/March 2018

The video abstract highlights the significance and innovation of the research on caregiver preferences for outcomes in youth with mental health multimorbidity. Outcomes were identified in partnership with caregivers to include the range of outcome domains beyond clinical factors that are relevant when making treatment decisions. Best-Worst Scaling is a preference elicitation method where caregivers jointly considered multiple attributes related to treatment outcomes and selected the one most important to them, much as they do real life decisions. This work moves beyond a sole focus on disease-specific outcomes, and provides insight into the outcome priorities that influence treatment decisions. Click here to read the article.

  Official Journal of the
Society for Developmental and Behavioral Pediatrics
The journal is a benefit of membership. For membership information, click here.
All Videos
Most Viewed
Most Emailed



Creator: Andrew R. Riley
Duration: 3:24
Pediatric primary care is an important setting for promoting safe and effective parenting practices, especially with regards to child discipline, but many parents report they receive inadequate behavioral guidance. We conducted a survey to identify which behavioral topics are most important to parents and what delivery method (e.g., faceto- face, books, mobile apps) are most appealing. Participants were 396 parents of young children recruited from primary care offices. Nearly all parents (96%) endorsed a behavioral topic (e.g., aggression) as important, and most preferred to receive intervention during routine medical appointments, but preferences varied by known socioeconomic, child, and parenting risk factors. Tailoring intervention to parents’ preferences may increase engagement with available interventions.
Creator: Dr. Elizabeth Berry-Kravis
Duration: 6:23
In this study we characterized toileting milestones and factors related to delayed toilet training in children with Fragile X Syndrome (FXS). For FXS participants in the FORWARD Registry and Database, a multi-variate analysis showed low language ability, behavioral irritability, and autism spectrum disorder diagnosis were strongly associated with late toilet training (>age 10). A Cox proportional-hazards model showed language level and ASD diagnosis predicted chances of toilet training at all ages. Survival curves allow estimation of likelihood of toilet training at any age. These findings will help with setting toileting expectations and creating management plans for toilet training in FXS.
Creator: Fallon Cook
Duration: 4:50
It is unclear whether distinct trajectories of infant sleep problems exist and whether it is possible to predict which infants will have sleep problems. Drawing on longitudinal community cohort data, this study aimed to identify unique patterns of infant sleep problems across the first postnatal year and examine a range of pre and postpartum factors associated with these profiles. Heightened maternal prenatal depressive symptoms and poorer prenatal physical health and wellbeing were associated with increased risk for persistent severe infant sleep problems across the first postnatal year. Read the article.
Creator: Connie Campbell
Duration: 2:03
Early identification of children with Autism Spectrum Disorder (ASD) is important. We redesigned the model of our ASD clinic for children under 3yrs. One of the changes was the integration of a Level 2 screening tool component, the RITA-T (Rapid Interactive Screening Test for Autism in Toddlers). This study examined the psychometric properties of the RITA-T with concerns related to ASD. In the study group (239 participants), we obtained discriminative psychometric properties (sensitivity: 0.97, specificity 0.71) similar to previously published results by Choueiri. When integrated into an ASD screening and diagnostic process, the RITA-T improves the efficiency and helps predict a best estimate clinical diagnosis of ASD. Read the article.
Creator: Carol Duh-Leong
Duration: 2:30
Evidence has established the association between risk factors and ADHD severity, but less is known about factors that may have protective effects on clinical, academic, and social outcomes among children with ADHD. This cross sectional study using the 2016 National Survey of Children’s Health examined associations between family cohesion, caregiver social support, community support and 1) ADHD severity, 2) school engagement, and 3) difficulty making or keeping friends. Among children with ADHD, family cohesion and community support show protective effects in clinical, academic and social outcomes.
Creator: Paloma Ventura
Duration: 2:25
Brazilian specialists in neurodevelopment in infants and children together with researchers in pediatric infection disease followed a group of children with presumed congenital Zika virus infection. The study was designed to describe the gross motor trajectory during their first 2 years of life. Most of the children presented changes in their gross motor development up to18 months and remained stable in the following month. At the end of the study all participants were diagnosed with cerebral palsy and the majority experienced severe motor impairment according to the Gross Motor Function Classification System (GMFCS).
Creator: Rob Stowell, University of Canterbury
Duration: 2:54
Children born to opioid-dependent mothers are at high risk for poor growth and neonatal withdrawal, but little is known about their longer term outcomes. We examined the health and neurodevelopmental outcomes of a cohort of 100 children born to opioid dependent mothers during pregnancy. These mothers and children were followed prospectively from pregnancy to age 4.5 years alongside a comparison group of 110 randomly identified non-methadone-exposed children and their mothers. Findings highlight the complex developmental needs of these children. The risk of later problems was higher for male children born to higher social risk mothers who used more licit and illicit substances during pregnancy and when children were raised in lower quality home environments. Read the article.
Creator: Jean Paul Rukabyarwema
Duration: 4:38
We screened children at the main referral hospital in Rwanda using the Pediatric Symptom Checklist, translated into Kinyarwanda. Among 300 eligible children, 235 were recruited; none refused. PSC scores were positive in 74/234 cases; 28 of these children completed mental health assessments; 16 of these required treatment or further assessment. Screening sensitivity was 100%, specificity 71%, with favorable receiver operating curve characteristics and internal consistency. In a multivariate analysis, higher PSC scores were associated with outpatient care, CNS trauma or infection, and indices of malnutrition, and with the use of traditional, complementary and alternative medicine. Read the article.
Creator: Michelle Greene
Duration: 4:25
Mothers of very low birth weight infants (VLBW, birth weight less than 3 pounds, 5 ounces) experience maternal psychological distress, defined as depression, anxiety and perinatal post-traumatic stress (PPTS).This study estimated maternal distress at time of VLBW infants' birth, modeled change in distress over VLBW infants' first year of life, and examined predictors of distress. Distress declined over VLBW infants' first year of life. Mothers residing in lower income environments had lower PPTS and anxiety at VLBW infant birth. VLBW birth weight and maternal age, respectively, predicted change in anxiety over time, and change in depression over time. Read the article.
Creator: Philip Bertulfo
Duration: 4:25
We sought to develop an improved understanding of attitudes and beliefs surrounding play among families who live in predominantly low-income urban communities. Utilizing qualitative methods, our results demonstrated caregivers of young children describe many important benefits of play. Yet they have misconceptions regarding use of toys and media in promoting development as well as notable barriers to participating in play, which may be opportunities for intervention. Public health programs may be more effectively implemented if they consider these attitudes to develop new or refine existing strategies for promoting parent-child learning activities. Read the article.
Creator: Jessica VanOrmer, M.A.
Duration: 2:30
This study included 2,083 parents of children from the 2016 National Survey of Children’s health database. We examined the relationship between adverse childhood experiences (ACEs) and family resilience, including how these differed by diagnostic category (autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), comorbid ASD and ADHD, and neurotypically developing children). We found that ADHD children experienced significantly more ACEs and children with comorbid ASD and ADHD had the lowest levels of family resilience when controlling for demographic variables and ACEs. Further, as the number of ACEs increased, family resilience decreased. Results have implications for early intervention services. Read the article.
Creator: Kelly E. Rea
Duration: 4:17
This study sought to examine the use of one Autism Spectrum Disorder (ASD) screening tool, the Modified Checklist for Autism in Toddlers- Revised (MCHAT-R), in a racially and ethnically diverse urban pediatric clinic, to review screening rates and referral practices. Screening completion was significantly related to child age, and there was a greater rate of positive screenings for Hispanic vs. non-Hispanic children. Referrals were highly variable across positive screenings. Ethnic disparities in ASD positive screening rates and inconsistent referrals represent a critical issue in current pediatric practice. Implications and future directions for research and clinical practice are discussed. Read the article.
Creator: M. Jackson Wilkinson and Carol L. Wilkinson
Duration: 3:45
Primary care providers and parents rely on developmental milestone checklists as tools for tracking a child’s development. However, there are multiple published milestone checklists that vary in their structure and content. Our team systematically evaluated the consistency and variability between four commonly used milestone checklists. We found that there was limited overlap in the content across these four checklists. In addition, the milestones shared across checklists were inconsistent in their estimated ages of when milestones should occur. Our findings highlight the need for objectively defined and accurately normed developmental milestones. Read the article.
Creator: Elizabeth Sinclair, MD
Duration: 2:23
Shared reading practices and early literacy promotion in the first year of life. A summary of our publication detailing reading habits of families with infants during the first year of life. Read the article.
Creator: Jon Izaguirre, Xavier Vall, Dolores Miguel-Ruiz, Jose A. Alda, and Anna Huguet
Duration: 2:37
72 children aged 7-12 years with ADHD were randomized in two groups (mindfulness and control) with the aim to investigate efficacy of a structured mindfulness group intervention program targeting ADHD core symptoms and difficulties in emotion regulation. This study provides evidence supporting mindfulness as a useful intervention modality for the treatment of ADHD. Read the article.
Creator: Bill Hamilton
Duration: 3:15
Shared reading with young children is associated with improved language, literacy, and social-emotional outcomes. Shared reading is also believed to enhance parent-child relationships but the extent to which it reduces harsh parenting, an important aspect of the parent-child relationship, is understudied. In this study, we investigated associations between early shared reading and subsequent harsh parenting. We found that early shared reading was consistently associated with less harsh parenting later in the child’s life and that this association partially operated through enhanced child behaviors. Read the article.
Creator: Dr. Michal Vinker Shuster
Duration: 3:30
The objective of our cross-sectional study was to assess the interactions between Attention Deficit Hyperactivity Disorder (ADHD) and Type 1 Diabetes Mellitus (T1DM). As presented in this video and the article itself, ADHD is associated with unfavorable diabetes control with higher HbA1C levels and poor general health status. Although further research is needed, our data suggest that this group requires special care and attention of the medical staff. Read the article.
Creator: U.S. Centers for Disease Control and Prevention (CDC)
Duration: 5:52
Together with colleagues at the Brazilian Ministry of Health, the U.S. Centers for Disease Control and Prevention (CDC) conducted the Zika Outcomes and Development in Infants and Children, or ZODIAC, investigation following up with children conceived during the 2015-2016 Zika virus outbreak in Brazil, as well as their primary caregivers. The investigation was designed to document the health and development of children with evidence of congenital Zika virus infection as they approached toddlerhood and the impact on their families. Some children exposed to Zika before birth may have complex health and developmental challenges requiring specialized care throughout their lives. Read the article.

Read the video transcript.
Creator: Ursula Brain, Rob Lyons
Duration: 5:23
This study examined the impact of prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants and maternal depressed mood symptoms on markers of adiposity, dietary intake, and physical activity in 6 year olds. Maternal depression symptoms were assessed pre- and postnatally. Physical activity was assessed using maternal report and 3-day dietary total food intake were obtained using objective records. Birth weight, weight, height, and waist circumference at age 6 years were also collected. We found that prenatal SSRI exposure was associated with lower reports of physical activity, but was not associated with total diet energy intake or markers of adiposity. Read the article.
Creator: U.S. Centers for Disease Control and Prevention (CDC)
Duration: 5:28
Researchers conducted a multi-site, randomized controlled trial to examine the impact of the Legacy for Children program on child health and development. Results revealed Legacy has a positive impact on child emotional and behavioral outcomes, child IQ, and mother-child interactions. Read the article.



Creator: Andrew R. Riley
Duration: 3:24
Pediatric primary care is an important setting for promoting safe and effective parenting practices, especially with regards to child discipline, but many parents report they receive inadequate behavioral guidance. We conducted a survey to identify which behavioral topics are most important to parents and what delivery method (e.g., faceto- face, books, mobile apps) are most appealing. Participants were 396 parents of young children recruited from primary care offices. Nearly all parents (96%) endorsed a behavioral topic (e.g., aggression) as important, and most preferred to receive intervention during routine medical appointments, but preferences varied by known socioeconomic, child, and parenting risk factors. Tailoring intervention to parents’ preferences may increase engagement with available interventions.
Creator: Dr. Elizabeth Berry-Kravis
Duration: 6:23
In this study we characterized toileting milestones and factors related to delayed toilet training in children with Fragile X Syndrome (FXS). For FXS participants in the FORWARD Registry and Database, a multi-variate analysis showed low language ability, behavioral irritability, and autism spectrum disorder diagnosis were strongly associated with late toilet training (>age 10). A Cox proportional-hazards model showed language level and ASD diagnosis predicted chances of toilet training at all ages. Survival curves allow estimation of likelihood of toilet training at any age. These findings will help with setting toileting expectations and creating management plans for toilet training in FXS.
Creator: Fallon Cook
Duration: 4:50
It is unclear whether distinct trajectories of infant sleep problems exist and whether it is possible to predict which infants will have sleep problems. Drawing on longitudinal community cohort data, this study aimed to identify unique patterns of infant sleep problems across the first postnatal year and examine a range of pre and postpartum factors associated with these profiles. Heightened maternal prenatal depressive symptoms and poorer prenatal physical health and wellbeing were associated with increased risk for persistent severe infant sleep problems across the first postnatal year. Read the article.
Creator: Connie Campbell
Duration: 2:03
Early identification of children with Autism Spectrum Disorder (ASD) is important. We redesigned the model of our ASD clinic for children under 3yrs. One of the changes was the integration of a Level 2 screening tool component, the RITA-T (Rapid Interactive Screening Test for Autism in Toddlers). This study examined the psychometric properties of the RITA-T with concerns related to ASD. In the study group (239 participants), we obtained discriminative psychometric properties (sensitivity: 0.97, specificity 0.71) similar to previously published results by Choueiri. When integrated into an ASD screening and diagnostic process, the RITA-T improves the efficiency and helps predict a best estimate clinical diagnosis of ASD. Read the article.
Creator: Carol Duh-Leong
Duration: 2:30
Evidence has established the association between risk factors and ADHD severity, but less is known about factors that may have protective effects on clinical, academic, and social outcomes among children with ADHD. This cross sectional study using the 2016 National Survey of Children’s Health examined associations between family cohesion, caregiver social support, community support and 1) ADHD severity, 2) school engagement, and 3) difficulty making or keeping friends. Among children with ADHD, family cohesion and community support show protective effects in clinical, academic and social outcomes.
Creator: Paloma Ventura
Duration: 2:25
Brazilian specialists in neurodevelopment in infants and children together with researchers in pediatric infection disease followed a group of children with presumed congenital Zika virus infection. The study was designed to describe the gross motor trajectory during their first 2 years of life. Most of the children presented changes in their gross motor development up to18 months and remained stable in the following month. At the end of the study all participants were diagnosed with cerebral palsy and the majority experienced severe motor impairment according to the Gross Motor Function Classification System (GMFCS).
Creator: Rob Stowell, University of Canterbury
Duration: 2:54
Children born to opioid-dependent mothers are at high risk for poor growth and neonatal withdrawal, but little is known about their longer term outcomes. We examined the health and neurodevelopmental outcomes of a cohort of 100 children born to opioid dependent mothers during pregnancy. These mothers and children were followed prospectively from pregnancy to age 4.5 years alongside a comparison group of 110 randomly identified non-methadone-exposed children and their mothers. Findings highlight the complex developmental needs of these children. The risk of later problems was higher for male children born to higher social risk mothers who used more licit and illicit substances during pregnancy and when children were raised in lower quality home environments. Read the article.
Creator: Jean Paul Rukabyarwema
Duration: 4:38
We screened children at the main referral hospital in Rwanda using the Pediatric Symptom Checklist, translated into Kinyarwanda. Among 300 eligible children, 235 were recruited; none refused. PSC scores were positive in 74/234 cases; 28 of these children completed mental health assessments; 16 of these required treatment or further assessment. Screening sensitivity was 100%, specificity 71%, with favorable receiver operating curve characteristics and internal consistency. In a multivariate analysis, higher PSC scores were associated with outpatient care, CNS trauma or infection, and indices of malnutrition, and with the use of traditional, complementary and alternative medicine. Read the article.
Creator: Michelle Greene
Duration: 4:25
Mothers of very low birth weight infants (VLBW, birth weight less than 3 pounds, 5 ounces) experience maternal psychological distress, defined as depression, anxiety and perinatal post-traumatic stress (PPTS).This study estimated maternal distress at time of VLBW infants' birth, modeled change in distress over VLBW infants' first year of life, and examined predictors of distress. Distress declined over VLBW infants' first year of life. Mothers residing in lower income environments had lower PPTS and anxiety at VLBW infant birth. VLBW birth weight and maternal age, respectively, predicted change in anxiety over time, and change in depression over time. Read the article.
Creator: Philip Bertulfo
Duration: 4:25
We sought to develop an improved understanding of attitudes and beliefs surrounding play among families who live in predominantly low-income urban communities. Utilizing qualitative methods, our results demonstrated caregivers of young children describe many important benefits of play. Yet they have misconceptions regarding use of toys and media in promoting development as well as notable barriers to participating in play, which may be opportunities for intervention. Public health programs may be more effectively implemented if they consider these attitudes to develop new or refine existing strategies for promoting parent-child learning activities. Read the article.
Creator: Jessica VanOrmer, M.A.
Duration: 2:30
This study included 2,083 parents of children from the 2016 National Survey of Children’s health database. We examined the relationship between adverse childhood experiences (ACEs) and family resilience, including how these differed by diagnostic category (autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), comorbid ASD and ADHD, and neurotypically developing children). We found that ADHD children experienced significantly more ACEs and children with comorbid ASD and ADHD had the lowest levels of family resilience when controlling for demographic variables and ACEs. Further, as the number of ACEs increased, family resilience decreased. Results have implications for early intervention services. Read the article.
Creator: Kelly E. Rea
Duration: 4:17
This study sought to examine the use of one Autism Spectrum Disorder (ASD) screening tool, the Modified Checklist for Autism in Toddlers- Revised (MCHAT-R), in a racially and ethnically diverse urban pediatric clinic, to review screening rates and referral practices. Screening completion was significantly related to child age, and there was a greater rate of positive screenings for Hispanic vs. non-Hispanic children. Referrals were highly variable across positive screenings. Ethnic disparities in ASD positive screening rates and inconsistent referrals represent a critical issue in current pediatric practice. Implications and future directions for research and clinical practice are discussed. Read the article.
Creator: Elizabeth Sinclair, MD
Duration: 2:23
Shared reading practices and early literacy promotion in the first year of life. A summary of our publication detailing reading habits of families with infants during the first year of life. Read the article.
Creator: Jon Izaguirre, Xavier Vall, Dolores Miguel-Ruiz, Jose A. Alda, and Anna Huguet
Duration: 2:37
72 children aged 7-12 years with ADHD were randomized in two groups (mindfulness and control) with the aim to investigate efficacy of a structured mindfulness group intervention program targeting ADHD core symptoms and difficulties in emotion regulation. This study provides evidence supporting mindfulness as a useful intervention modality for the treatment of ADHD. Read the article.
Creator: Bill Hamilton
Duration: 3:15
Shared reading with young children is associated with improved language, literacy, and social-emotional outcomes. Shared reading is also believed to enhance parent-child relationships but the extent to which it reduces harsh parenting, an important aspect of the parent-child relationship, is understudied. In this study, we investigated associations between early shared reading and subsequent harsh parenting. We found that early shared reading was consistently associated with less harsh parenting later in the child’s life and that this association partially operated through enhanced child behaviors. Read the article.
Creator: U.S. Centers for Disease Control and Prevention (CDC)
Duration: 5:28
Researchers conducted a multi-site, randomized controlled trial to examine the impact of the Legacy for Children program on child health and development. Results revealed Legacy has a positive impact on child emotional and behavioral outcomes, child IQ, and mother-child interactions. Read the article.
Creator: Richard Watson, UNMC Public Relations
Duration: 4:53
Behavioral health issues routinely present during primary care visits. To address this, behavioral health providers have been integrating into primary care to improve access to care. This study provides preliminary evidence that offering behavioral health services in pediatric primary care settings results in youth accessing services sooner when symptoms are less severe. While disruptive behavior disorders were the most frequent presenting problem, youth with anxiety disorders were more likely to access services when receiving services within their pediatrician’s office. Read the article.
Creator: University of Maryland
Duration: 2:00
The use of actigraphy and sleep diary measures has been understudied in low-income families who are at increased risk of poor sleep. In our study, we compared these measures in a low-income sample and identified if toddlers were meeting National Sleep Foundation recommendations of bedtime before 9pm and 11-14 hours of sleep/day. We found that (1) sleep diary measures did not match actigraphy measures, (2) toddlers were going to bed past 9pm, and (3) toddlers were not getting enough sleep. Given our small sample, these results need to be replicated before they can be generalized to other low-income families. Read the article.
Creator: Dr. Elizabeth White, Dr. Rebecca Scharf, and Stephanie Fielding
Duration: 3:39
We analyzed data from 9,971 children who participated in the Early Childhood Longitudinal Study-Kindergarten: 2011, a nationally representative cohort of children entering kindergarten in the United States in 2010-2011. We examined the longitudinal relationships between performing chores in kindergarten and child perceived self-competence measures and academic outcomes in the third grade. Our study is unique in that we looked at how early childhood chores relate to development from a child’s own perspective. Performing chores in early elementary school was associated with later development of self-competence, pro-social behavior, and self-efficacy. Read the article.
Creator: Andrej Kopac
Duration: 5:47
Increased television viewing is associated with language delays in early childhood Unlike traditional screen time, mobile media devices offer the opportunity to interact with the interface. Studies examining the relationship between mobile media device use and developmental outcomes including communication outcomes in young children are lacking. The objective of our study was to examine the association between mobile media device use and communication delays in 18-month-old children. Read the article.
Creator: Ami Bax
Duration: 6:46
This study's purpose was to investigate the association between Race/Ethnicity, Socioeconomic, and other Demographic factors and ADHD Diagnosis and Treatment in children. Children who were white, had public insurance (i.e. Medicaid), were male, and raised by single parents appear to have increased access to ADHD diagnostic or medication services. ADHD prevalence was lower among Hispanic children but did not vary among other racial groups. New findings included boys and children raised in single-parent households potentially having higher rates of false positive diagnoses, which warrants further exploration. Read the article.
Creator: Jenny Radesky
Duration: 3:53
Dr. Jenny Radesky and Marisa Meyer discuss their article, Advertising in Children's Apps: A Content Analysis, with sample screen shots illustrating their findings. Read the article.
Creator: Philip Curtis
Duration: 3:33
The goal of this paper is to investigate the association between the two most commonly reported parental concerns about young children - disruptive behavior (e.g., irritable, aggressive, and noncompliant behaviors) and language delay in toddlers. Stronger language skills were associated with fewer disruptive behavior for children between 18 and 36 months of age. This negative association was stronger for girls than boys and stronger for children living in poverty than those above the poverty line. Findings from our study suggest a developmental co-occurrence pattern that begins at a very early age. Read the article.
Creator: Kevin Hunter, Thaddaeus Edwards
Duration:
This video describes findings from a randomized controlled trial of Pathways Triple P behavioral parent training intervention. This program was delivered to families receiving child welfare services for child maltreatment. Child outcomes were measured using the Pediatric Quality of Life Inventory (PedsQL 4.0). Findings indicate significant improvements in child health-related quality of life. Read the article.
Creator: Chloe Beacham
Duration: 5:34
First-author Chloe Beacham discusses findings from the article “Screening for Autism Spectrum Disorder: Profiles of Children Who Are Missed”. Screening measures such as the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Ages and Stages Questionnaire, 3rd Edition (ASQ-3) are parent-report questionnaires that target autism symptomatology and broad developmental delays respectively. This study sought to examine the profiles of children with autism spectrum disorder who are missed by these commonly used screening measures and also to build upon the current literature on the benefits of a combined screening approach. Read the article.
Creator: Helen Koechlin, Carolina Donado, Joe Kossowsky
Duration: 5:16
In our article, we examined data collected by the National Institute of Child Health and Development for the Study of Early Child Care and Youth Development. This longitudinal cohort followed more than 1,000 children and their families from the child’s birth until the age of 15. Our findings highlight the importance of the context within which a child grows up: not only the family context and the mental health of parents, but also the peer context and friendships are important influences that help decide whether a child develops adjustment problems or not in the face of stressful life events. Read the article.
Creator: Institute of Child Development, University of Minnesota
Duration: 4:47
First-author Melissa Engel discusses the longitudinal relationship between somatic complaints, anxiety, and depressive symptoms in a sample of young children at increased familial risk for psychopathology. Maternal psychopathology was found to be a risk factor for somatic complaints. Moreover, somatic complaints at preschool predicted somatic complaints, anxiety, and depression at school-age. Symptoms of internalizing disorders may be evident as early as the preschool years, suggesting the potential utility of early detection and intervention efforts, especially for young children at increased familial risk for internalizing disorders. Pediatric primary care is an ideal setting to integrate preventive efforts. Read the article.
Creator: Catherine A. Taylor and Ken Tyrolf
Duration: 5:12
Pediatricians are one of the most credible professional sources of advice for parents concerning how best to discipline their children. There is now an overwhelming body of scientific evidence that hitting children, even for disciplinary purposes (i.e., spanking or corporal punishment), leads to increased risk of harm to children’s overall health. This study shows that most U.S. pediatricians are aware of this evidence and do not support hitting children for discipline. Pediatricians can play a crucial role in shifting this long-standing, widely held social norm in the U.S. by sharing their views and pointing parents toward alternative forms of discipline. Read the article.
Creator: C. Thomas Lewis, IUPUI School of Informatics and Computing
Duration: 4:34
Lead author, Nerissa Bauer, MD, MPH presents findings of the second randomized controlled trial for TEACH (Tailoring Education for ADHD and Children’s Health), a family intervention delivered over 5 sessions to small groups of children with ADHD and their parents during follow up visits to the clinic. Participants in TEACH reported greater improvements in parental emotional health, child functioning in the home and several quality of life indicators compared to families receiving follow up care as individual visits. Our findings provide ongoing support for further research and refinement of the TEACH intervention. Read the article.
Creator: Suzanne Tough
Duration: 3:00
This study examines risk and protective factors associated with externalizing behavior among 1300 children. We found that moms who faced more mental health challenges when their children were two were more likely to report that their children had externalizing behaviors at age three. Children in daycare, or whose moms participated in community activities, such as story time at the library, were less likely to report externalizing behavior in their children. Opportunities for children to practice their self-regulation skills through structured interactions with same age peers can enhance school readiness and should be made accessible to all families. Read the article.
Creator: Sarah Kirsch, David Meryash
Duration: 5:41
Sarah Kirsch, lead author, describes a national study of the determinants of parent satisfaction with emergency or urgent care visits by their children with autism spectrum disorder. The researchers found that the factors most associated with parent satisfaction were indicators of the quality of interpersonal and communication skills of the medical and non-medical staff of the facility at which the patients were treated. These were more important, for example, than patient traits, reason for visit, or whether the patient was cooperative. The authors emphasize the importance of autism-specific training for emergency department staff to maximizing satisfaction with care. Read the article.
Creator: Dr. Annis Fung, Mr. Toney Lee
Duration: 9:14
Researchers from City University of Hong Kong examined the effectiveness of Chinese martial arts in reducing reactive and proactive aggression among schoolchildren with a longitudinal, placebo-controlled design. The intervention was developed based on the social-information processing model. 298 out of 3,511 schoolchildren were randomly assigned to one of four training conditions (Skills-and-Philosophy condition, Skills-only condition, Philosophy-only condition, Physical Fitness condition). Only the combined Skills-and-Philosophy condition showed a significant reduction in self-ratings of reactive and proactive aggression, delinquent behavior, anxious/depressed problems, and attention problems at post-test and/or 6-month follow-up. This provides important information for helping professionals to design non-labelling and effective intervention for high-risk schoolchildren to reduce reactive and proactive aggression. Read the article.
Creator: Pascal Burger
Duration: 3:44
We examined how the level and concordance of non-responsive feeding practices between mothers and fathers are associated with child fussy eating in a sample of socioeconomically disadvantaged families. Cohabiting mother-father pairs from the ‘Mums and Dads (MAD) for Mealtimes’ study reported on their non-responsive feeding practices (persuasive feeding, reward for eating and reward for behaviour) and their preschool-aged child’s fussy eating (i.e., picky eating). Less child fussy eating was reported when parents were concordant in avoiding non-responsive feeding practices. Our results highlight the need to use a whole-family approach in research and interventions to address fussy eating. Read the article.
Creator: Cincinnati Children’s Hospital Medical Center
Duration: 4:12
Lead author, Julia Anixt, MD presents findings from a research study evaluating the types of challenging behaviors parents of children with autism spectrum disorder (ASD) prioritize for treatment during Developmental Behavioral Pediatric (DBP) clinic visits. This study explores how much shared decision making (SDM) occurs during “usual care” DBP clinic visits, how often parent priorities are addressed in the treatment plan, and how often parents feel uncertain about the decision of whether to use medication to treat their children’s challenging behaviors. Read the article.
Creator: Veni Kandasamy; Krysten Carrera (HRSA's Maternal and Child Health Bureau); Milton Thomas (HRSA's Office of the Administrator)
Duration: 2:34
This is a video abstract for the Parental Perception of Flourishing in School-Aged Children: 2011-2012 National Survey of Children's Health manuscript. We discuss what flourishing in children is and its importance. We also discuss our data source, HRSA's National Survey of Children's Health. Our study findings that approximately half of school-aged children were found to be flourishing and that differences by sociodemographic factors in the likelihood of flourishing were reduced with the inclusion of environmental factors are also described. We close with next steps and areas for further study in flourishing. Read the article.
Creator: Carol Strong & Meng-Che Tsai
Duration: 5:25
This video is a quick summary of the paper, “Adolescent Internet Use, Social Integration, and Depressive Symptoms: Analysis from a Longitudinal Cohort Survey.” It examined the association between adolescent leisure-time internet use and social connection in the school context, and how this association affects later depressive symptoms among adolescents in Taiwan. The results highlighted the needs for stakeholders of adolescent health to carefully assess adolescents’ social networking and mental well-being. Read the article.
Creator: U.S. Centers for Disease Control and Prevention (CDC)
Duration: 4:18
Researchers from the Centers for Disease Control and Prevention (CDC) used parent-reported data from national studies in 2007 and 2011 to understand how having Tourette syndrome and other conditions affect how children do in school, like repeating a grade, school problems, or needing special services. Having other conditions along with Tourette Syndrome was related to having difficulty in school and needing educational services. This is important information for healthcare providers, teachers and parents. Being aware of the potential challenges related to both Tourette syndrome and other conditions can help them to best support the child’s education. For further information on CDC’s research in this area, visit: www.cdc.gov/tourette.Read the article.
Creator: Rutgers University
Duration: 5:00
This video discusses results from a study of pediatric residency program training directors across the country. This study was intended to identify perceptions of behavioral health training in pediatric residency programs, degree of involvement from behavioral health providers, and opportunities for/barriers to innovation in training. Despite substantial improvement in residency training in behavioral health over the past decade, additional improvement is needed. Barriers to continued improvement include training content, training methods, support from faculty and administrator stakeholders, and resource issues. Strategies derived from implementation science have the potential to address these barriers. Click here to read the article.
Creator: Seattle Children’s Research Institute
Duration: 6:36
Lead author, Jennifer Gerdts, PhD, discusses the rationale for developing a streamlined and efficient interdisciplinary diagnostic evaluation for autism spectrum disorder (ASD) at Seattle Children’s Autism Center (SCAC). Dr. Gerdts compares diagnostic outcomes, follow-up care rates, provider satisfaction, billed time, and reimbursement amounts in interdisciplinary teams to those of more traditional psychology-led and physician-led models. She also suggests benefits of this diagnostic approach for families of children with ASD. Click here to read the article.
Creator: Walter Zahorodny and Justin Smith
Duration: 8:21
This video is a brief summary of the article, "Preliminary Evaluation of a Brief Autism Screener for Young Children." It provides the reasons for undertaking development of a new parent report tool and describes the methodology and initial data assessing the usefulness of the PDQ-1, a brief Autism screener for toddler-age children. Click here to read the article.
Creator: Aleix Cabrera, Barcelona Institute for Global Health (ISGlobal) Video
Duration: 02:43
This study is the first to demonstrate associations between a longer time spent engaging in cognitively stimulating activities and lower scores of both ADHD symptoms and behavior problems, in ADHD-free children at baseline. We also found that sleeping longer was associated with a lower ADHD symptom score. In contrast, time spent watching TV and time spent engaging in physical activity at age 4 years were not associated with ADHD symptoms or behavior problems at age 7 years, nor was there any evidence of interactions between the several exposures considered. Click here to read the article.
Creator: University of Maryland
Duration: 3:17
During toddlerhood, children establish regular sleep patterns, with night awakenings followed by returning to sleep without parental intervention. However, some toddlers experience frequent night awakenings and may require parental intervention to return to sleep. Co-sleeping, meaning sharing the same bed or same room, occurs among many families with toddlers. We found that when parents perceive that their toddler has a sleep problem and they co-sleep, mothers lose almost one hour of sleep and report increased symptoms of stress, depression, and anxiety. Practitioners might consider alternatives to co-sleeping when discussing sleep arrangements with parents.Read the article
Creator: University of Maryland School of Pharmacy
Duration: 5:28
The video abstract highlights the significance and innovation of the research on caregiver preferences for outcomes in youth with mental health multimorbidity. Outcomes were identified in partnership with caregivers to include the range of outcome domains beyond clinical factors that are relevant when making treatment decisions. Best-Worst Scaling is a preference elicitation method where caregivers jointly considered multiple attributes related to treatment outcomes and selected the one most important to them, much as they do real life decisions. This work moves beyond a sole focus on disease-specific outcomes, and provides insight into the outcome priorities that influence treatment decisions. Click here to read the article.
Creator: Melissa Bright, Lindsay Thompson
Duration: 3:22
Adverse childhood experiences (ACEs) and physical, mental, and developmental health conditions Video Creator: Christopher Gomez, University of Florida. Read the article
Creator: Megan Narad, Jessica King
Duration:
We report on the rate need for academic services and academic service utilization among a cohort of children who sustained a traumatic brain injury (TBI) between the ages of 3 and 7 years old, as they transitioned to middle school, approximately 6.8 years after injury. Findings show the need for services among students with a history TBI remains high even years after injury. Rates of unmet need were high across all injury groups (46.2%-63.6%), underscoring the importance of continued monitoring of students with a history of TBI, especially children with less severe injuries who are at risk for being underserved. Read the article
Creator: Natacha Akshoomoff, Ph.D.
Duration: 3:56
We analyzed follow-up data at age 10 years from children who participated in the Extremely Low Gestational Age Newborns Study - also known as a the ELGAN study. Complete data were available from 668 children who were born at less than 28 weeks gestation and who did not have intellectual disability at age 10. We found that about 30% of these children had low achievement in math, reading, or both. As predicted, the rate of having a Math Learning Disability was twice as high as having a Reading Learning Disability. The pattern of deficits on neuropsychological tests varied as a function of learning disability type. Click here to read the article.
Creator: C. Thomas Lewis, IUPUI School of Informatics and Computing
Duration: 5:13
Attention deficit hyperactivity disorder (ADHD) is commonly encountered in primary care practice. Group visits are an alternate way to provide chronic care management while attending to the needs of families. This study examines the acceptability of group visits for ADHD care from the perspectives of caregivers, children and providers and lessons learned in using the group visits across two studies. A brief description of our ADHD group visit model, TEACH-Tailoring Education for ADHD and Children’s Health, is reviewed. Findings suggest that stakeholders find group visits acceptable and increased in satisfaction in ADHD care. Click here to read the article.
Creator: Peter Palumbo
Duration: 4:32
Electronic health record data was collected from 3 DBPNet sites in order to look at variations in prescribing practices and factors associated with Developmental-behavioral pediatricians prescribing psychotropic medication to children with ASD. Click here to read the article.
Creator: Mission Health System Audio-Visual Support
Duration: 6:20
This video describes the initial development of the Clinical Functional Impairment Scale (CFIS). The CFIS was developed because of the lack of an efficient and flexible measure of functional outcomes in Developmental-Behavioral Pediatrics. We describe the importance of shared-decision-making in the clinical use of the CFIS. Focus groups and qualitative methods were used to establish content validity. Inter-rater reliability was assessed with a convenience sample of DBP clinicians who responded to a survey on the SDBP Discussion Board in which case vignettes were presented. The video describes future development and goals for dissemination of the CFIS. Click here to read the article.
Creator: Joe Speer & Chelsey Grasso
Duration: 5:12
We analyzed cross-sectional data from the National Health Interview Survey 2014-2015 to explore the relationship between parental psychological distress and food insecurity by parental status (mothers/fathers). We found that food insecurity was independently associated withserious psychological distress (SPD) among both parents, with this association being especially strong in fathers, who were over four times more likely to have (SPD) if they were food insecure versus food secure. Findings suggest we need to improve screening and treatment for serious mental illness among food insecure parents by targeting both parents to mitigate the adverse effects of parental distress on children’s development. Click here to read the article.
Creator: Wilko Duprez
Duration: 4:51
This longitudinal study assessed the intellectual, academic and executive functioning skills of children diagnosed with ADHD at diagnosis and four years later. Intellectual function was stable over the four-year interval. Reliable change analyses highlighted variability in academic performance, with half the children showing performance declines in at least one academic subject. Executive functions followed a generally stable or improving course. There was some evidence of better neurocognitive performance in those with partial symptom remission at follow up, however early cognitive functioning did not predict symptom outcome over time. Findings emphasize the importance of monitoring academic performance in children with ADHD. Click here to read the article.
Creator: U.S. Centers for Disease Control and Prevention (CDC)
Duration: 5:51
Attention Deficit Hyperactivity Disorder (ADHD) U.S. Centers for Disease Control and Prevention (CDC). Clinical guidelines provide recommendations for diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD), with specific guidance on caring for children younger than 6 years. This exploratory study describes ADHD diagnosis and treatment patterns among young children in the U.S. using two nationally representative parent surveys. Click here to read the article.
Creator: Dori Jenks
Duration: 4:33
In this video abstract, the lead author for the study describes the importance of examining the association between television viewing and parent-child shared book reading, given the implications that each of these activities has on children’s developmental outcomes. The results of the study are presented along with recommendations for policy makers and health care providers on how to communicate with parents regarding structuring screen time and shared book reading in the home. The video concludes with a challenge posed to the audience to reflect on their own experiences with these two activities. Click here to read the article.
Creator: Batya Elbaum
Duration: 6:06
Early intervention programs under Part C of the Individuals with Disability Education Act serve a developmentally heterogeneous population of children ages birth to 36 months,. Applying mixture modeling to developmental assessment data from 1513 children who participated in a large, urban early intervention program, we identified four subgroups of children with distinct developmental profiles. Children's developmental trajectories differed by subgroup; children in the subgroup displaying severe delays in communication, with less severe delays in other areas of functioning, had the highest likelihood of persistent delays. Our study describes the identified subgroups and suggests implications for clinical practice and service planning. Click here to read the article.
Creator: Corinna Jenkins Tucker, Ph.D., C.F.L.E.
Duration: 5:25
This video is a brief summary of the paper, “Victimization by Siblings in Children with Disability or Weight Problems”. Using a national probability sample and controlling for other forms of maltreatment and individual and family characteristics, analyses showed that children with a physical disability and parent-perceived children who are thinner than average and children who are overweight experienced more sibling victimization. Children with an internalizing disorder experienced less sibling victimization. This the first study to highlight the importance of screening for sibling victimization in families of children with a disability and/or non-normative weight status. Click here to read the article.
Creator: Clinton Vadnais, Media Specialist, Baystate Medical Center
Duration: 4:38
We describe a qualitative study of breastfeeding women designed to better understand the decision-making process women undergo regarding infant feeding over time. We conducted interviews at 2 weeks and follow-up interviews at 6 months postpartum. We used the Theory of Planned Behavior (TPB) as a framework for understanding the decision-making process. We found that themes related to perceived insufficient milk supply were strongly related to the perceived behavioral control component of the TPB and that these themes evolved over time. We discuss the clinical implications of these findings with respect to promotion of exclusive breastfeeding and maternal perceptions of control. Click here to read the article.
Creator: Mater Research
Duration: 4:47
The Queensland Flood Study (QF2011) took advantage of a severe flood in Queensland, Australia to investigate the effects of disaster-related prenatal maternal stress on temperament characteristics at 6-months-old. Results showed that mothers’ subjective stress reactions and cognitive appraisal of the disaster while pregnant were associated with easier aspects of temperament in their infants. However, with higher levels of hardship in pregnancy, boys (but not girls) were rated as more irritable. Higher levels of hardship in early pregnancy also predicted more arrhythmic behavior. Finally, mothers whose emotional response to the flood exceeded the hardship they endured reported more active-reactive infants. Click here to read the article.
Creator: Thi-Nhu-Ngoc Nguyen
Duration: 4:12
Children born preterm are at high risk of multiple developmental impairments, including language difficulties across childhood. However, it is unclear as to which biological and socio-environmental factors are reliable predictors of poorer language development, and how the influence of these factors change across childhood in preterm children. This study examined the individual and collective contribution of biological and socioenvironmental factors on language development in a prospective, longitudinal cohort of preterm children (born< 30 weeks' gestation). Results highlight the important and increasing influence of socio-environmental factors on language functioning in preterm children from 2 to 13 years, and points to an important focus on targeting more malleable factors such as parenting behavior and parent education to boost and support preterm children's development.
Creator: Dr. Marisa Toomey
Duration: 3:54
The peer interactions of children with Autism Spectrum Disorder (ASD) are of particular interest to many physicians and researchers who work with children who have ASD. The PROMIS Pediatric Parent-Proxy Peer Relationships Measure was validated in a general pediatric population, but it had not been previously studied in children with ASD. Clinicians from The Children's Hospital of Philadelphia, Boston Children's Hospital, and The Children's Hospital at Montefiore collaborated to evaluate the existing PROMIS Peer Relationships Measure in a population of children with ASD. In this video, Dr. Marisa Toomey highlights the potential significance of the study. Click here to read the article.
Creator: University of Michigan Health System
Duration: 5:08
Dr. Jenny Radesky discusses her qualitative interviews with parents of young children about their mobile device use habits, highlighting the 3 main tensions parents expressed. These included: 1) cognitive tensions, feeling “information overload” and difficulties multitasking between tech and children; 2) emotional tensions, including the feeling that the sometimes “intrusive” nature of mobile media makes it more stress-inducing, but also that they seek it as a way self-regulate when stressed with parenting; 3) dyadic tensions, described as discomfort with how mobile device use during family routines seemed to interrupt moments of connection, but also could act as a peacekeeper.Click here to read the article.
Creator: Nanette Gartrell, MD and Dee Mosbacher MD PhD
Duration: 4:01
Using the 2011-2012 National Survey of Children’s Health dataset, we compared spouse/partner relationships and parent-child relationships (family relationships), parenting stress, and children’s general health, emotional difficulties, coping behavior, and learning behavior (child outcomes) in households of same-sex (female) versus different-sex continuously coupled parents with biological offspring. We assessed whether associations among family relationships, parenting stress, and child outcomes were different in the two household types. We found that children with female same-sex parents and different-sex parents demonstrated no differences in outcomes, despite female same-sex parents reporting more parenting stress. Click here to read the article.
Creator: Deborah Christensen, PhD
Duration: 5:58
Population-based autism spectrum disorder (ASD) surveillance among 4-year old children provides valuable information about the early identification of children with ASD and suggests progression toward lowering the age of first ASD evaluation within participating Autism and Developmental Disabilities Monitoring communities. Click here to read the article.
Creator: Carolyn E. Ievers-Landis, Ph.D
Duration: 1:09
Associate Editor Carolyn E. Ievers-Landis, Ph.D offers commentary on the subject of tanning and the link to unhealthy weight control behaviors.