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1.
Pap. psicol ; 41(3): 228-235, sept.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-197411

RESUMO

Para poder realizar el diagnóstico del trastorno del espectro autista (TEA) se requiere de la evaluación por parte de diferentes informantes. Sin embargo, en ocasiones, se producen ciertas discrepancias entre evaluadores. Con el objetivo de aportar luz a las posibles discrepancias entre informantes, este trabajo incluye una revisión actualizada de la literatura para examinar el grado de acuerdo entre diferentes informantes en lo que respecta a la sintomatología característica del TEA en niños y adolescentes (hasta los 17 años de edad). Se analizaron un total de 20 estudios, en los que los niveles de correlación entre las evaluaciones realizadas por diferentes informantes fueron moderados o bajos. Gran parte de los estudios incluidos en la presente revisión obtuvieron que un mayor grado de acuerdo entre informantes fue asociado con menor sintomatología, mayor CI y mejores resultados en habilidades cognitivas y adaptativas. Considerando estos resultados, es necesario continuar investigando en aspectos contextuales que pueden estar condicionando los resultados de las evaluaciones multi-informantes


In order to establish a diagnosis of autism spectrum disorder (ASD), assessment by different informants is required. Sometimes, however, there are certain discrepancies between evaluators. With the aim of shedding light on possible discrepancies between informants, this work includes an updated review of the literature to examine the degree of agreement between different informants regarding the characteristic symptomatology of ASD in children and adolescents (up to 17 years of age). A total of 20 studies were analyzed, in which the levels of correlation between the evaluations carried out by different informants were moderate or low. A large part of the studies included in this review obtained that a greater degree of agreement among informants was associated with lower symptoms, a higher IQ, and better results in cognitive and adaptive skills. Considering these results, it is necessary to continue investigating contextual aspects that may be conditioning the results of multi-informant evaluations


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Teoria Psicológica , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia
2.
Yonsei Med J ; 61(10): 880-890, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32975063

RESUMO

PURPOSE: The aim of this study was to investigate differences in language ability and emotional-behavioral problems according to the severity of social communication impairments (SCI) and restricted and repetitive behaviors (RRB) in children with autism spectrum disorders (ASD). MATERIALS AND METHODS: We grouped 113 children with ASD aged 3-12 years according to the severity of SCI and RRB, and investigated language differences and emotional-behavioral problems among the severity groups. If differences in language abilities between the groups were observed, they were further subdivided to examine possible predictors of both receptive and expressive language abilities. RESULTS: In cluster analyses using subdomains of the Autism Diagnostic Interview-revised, severe SCI individuals showed lower language ability than their milder counterparts, while RRB showed no differences. Receptive and expressive language in the severe SCI group was negatively predicted by social communication and social motivation, respectively. The severe RRB group showed significantly higher levels of anxiety/distress, somatic complaints, thought problems, attention problems, and aggressive behavior, while the severe SCI group was reported to be more withdrawn. CONCLUSION: The results of this study suggest that the severity of SCI greatly affects language ability. In children with severe SCI, social communication and social motivation negatively predicted receptive language and expressive language, respectively. Children with severe RRB may have more emotional-behavioral problems that require active intervention.


Assuntos
Sintomas Afetivos/diagnóstico , Sintomas Afetivos/psicologia , Transtorno do Espectro Autista/psicologia , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Transtornos do Desenvolvimento da Linguagem/psicologia , Desenvolvimento da Linguagem , Sintomas Afetivos/epidemiologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Emoções , Feminino , Humanos , Idioma , Transtornos do Desenvolvimento da Linguagem/epidemiologia , Masculino , Comportamento Problema , Índice de Gravidade de Doença
3.
J Appl Behav Anal ; 53(3): 1242-1258, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32643811

RESUMO

As the world navigates the COVID-19 health crisis, behavior analysts are considering how best to support families while maintaining services and ensuring the health and safety of everyone involved. Telehealth is one service delivery option that provides families with access to care in their own communities and homes. In this article, we provide a brief summary of the telehealth literature in applied behavior analysis that provided coaching and training to families for individuals who displayed challenging behavior. These studies targeted functional assessment and function-based treatment for challenging behavior. We briefly summarize what is known relative to the assessment and treatment of challenging behavior via telehealth, place these results within a descriptive context of the decisions made by the research team at the University of Iowa, and discuss what we, as behavior analysts, should consider next to advance our understanding and practice of telehealth.


Assuntos
Análise do Comportamento Aplicada , Transtornos do Comportamento Infantil/terapia , Telemedicina , Análise do Comportamento Aplicada/métodos , Criança , Transtornos do Comportamento Infantil/diagnóstico , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
4.
Pediatrics ; 146(1)2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32561612

RESUMO

BACKGROUND AND OBJECTIVES: There is an urgent need to prepare pediatricians to care for children with behavioral and mental health (B/MH) conditions. In this study, we evaluate the perceived competence of pediatric residents and recent graduates in the assessment and treatment of B/MH conditions, characterize variation in competence across residency programs, and identify program characteristics associated with high competence. METHODS: Cross-sectional survey of applicants for the initial certifying examination in pediatrics. Questions were focused on (1) who should be competent in B/MH skills, (2) institutional support around B/MH training, and (3) perceived competence in 7 B/MH assessment skills and 9 treatment skills. Competence was rated on a 5-point scale, and high levels of assessment and treatment competence were defined as scores of ≥4. Composite measures for B/MH assessment and treatment were calculated as mean scores for each domain. We examined variation in residents' self-reported competence across programs and used linear regression to identify factors associated with high levels of competence at the program level. RESULTS: Of applicants, 62.3% responded to the survey (n = 2086). Of these, 32.8% (n = 595) reported high competence in assessment skills and 18.9% (n = 337) in treatment skills. There were large variations in reported competence across programs. Respondents from smaller programs (<30 trainees) reported higher competence in assessment and treatment than those from large programs (P < .001). CONCLUSIONS: Current and recent pediatric trainees do not report high levels of perceived competence in the assessment and treatment of children with B/MH conditions. The substantial variation across programs indicates that the pediatric community should create standards for B/MH training.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Internato e Residência , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Pediatria/educação , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Estudos Transversais , Feminino , Humanos , Masculino , Autorrelato
5.
Epilepsia ; 61(7): 1427-1437, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32557544

RESUMO

OBJECTIVE: To characterize the presence and nature of discrete behavioral phenotypes and their correlates in a cohort of youth with new and recent onset focal and generalized epilepsies. METHODS: The parents of 290 youth (age = 8-18 years) with epilepsy (n = 183) and typically developing participants (n = 107) completed the Child Behavior Checklist for children aged 6-18 from the Achenbach System of Empirically Based Assessment. The eight behavior problem scales were subjected to hierarchical clustering analytics to identify behavioral subgroups. To characterize the external validity and co-occurring comorbidities of the identified subgroups, we examined demographic features (age, gender, handedness), cognition (language, perception, attention, executive function, speed), academic problems (present/absent), clinical epilepsy characteristics (epilepsy syndrome, medications), familial factors (parental intelligence quotient, education, employment), neuroimaging features (cortical thickness), parent-observed day-to-day executive function, and number of lifetime-to-date Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses. RESULTS: Hierarchical clustering identified three behavioral phenotypes, which included no behavioral complications (Cluster 1, 67% of epilepsy cohort [n = 122]), nonexternalizing problems (Cluster 2, 11% of cohort [n = 21]), and combined internalizing and externalizing problems (Cluster 3, 22% of cohort [n = 40]). These behavioral phenotypes were characterized by orderly differences in personal characteristics, neuropsychological status, history of academic problems, parental status, cortical thickness, daily executive function, and number of lifetime-to-date DSM-IV diagnoses. Cluster 1 was most similar to controls across most metrics, whereas Cluster 3 was the most abnormal compared to controls. Epilepsy syndrome was not a predictor of cluster membership. SIGNIFICANCE: Youth with new and recent onset epilepsy fall into three distinct behavioral phenotypes associated with a variety of co-occurring features and comorbidities. This approach identifies important phenotypes of behavior problem presentations and their accompanying factors that serve to advance clinical and theoretical understanding of the behavioral complications of children with epilepsy and the complex conditions with which they co-occur.


Assuntos
Transtornos do Comportamento Infantil/psicologia , Epilepsias Parciais/psicologia , Epilepsia Generalizada/psicologia , Fenótipo , Adolescente , Criança , Transtornos do Comportamento Infantil/diagnóstico , Estudos de Coortes , Estudos Transversais , Epilepsias Parciais/diagnóstico , Epilepsia Generalizada/diagnóstico , Feminino , Humanos , Masculino , Testes Neuropsicológicos
7.
Behav Ther ; 51(2): 283-293, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32138938

RESUMO

Irritability is impairing in youth and is the core feature of disruptive mood dysregulation disorder (DMDD). Currently, there are no established clinician-rated instruments to assess irritability in pediatric research and clinical settings. Clinician-rated measures ensure consistency of assessment across patients and are important specifically for treatment research. Here, we present data on the psychometric properties of the Clinician Affective Reactivity Index (CL-ARI), the first semistructured interview focused on pediatric irritability. The CL-ARI was administered to a transdiagnostic sample of 98 youth (M age = 12.66, SD = 2.47; 41% female). With respect to convergent validity, CL-ARI scores were (a) significantly higher for youth with DMDD than for any other diagnostic group, and (b) showed uniquely strong associations with other clinician-, parent-, and youth-report measures of irritability compared to measures of related constructs, such as anxiety. The three subscales of the CL-ARI (temper outbursts, irritable mood, impairment) showed excellent internal consistency. Test-retest reliability of the CL-ARI was adequate. These data support that irritability can be feasibly, validly, and reliably assessed by clinicians using the CL-ARI. A validated, gold-standard assessment of pediatric irritability is critical in advancing research and treatment efforts.


Assuntos
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtornos do Comportamento Infantil/diagnóstico , Entrevista Psicológica/normas , Humor Irritável , Transtornos do Humor/diagnóstico , Adolescente , Ansiedade/psicologia , Criança , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes
8.
Behav Ther ; 51(2): 294-309, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32138939

RESUMO

Irritability is a substrate of more than one dozen clinical syndromes. Thus, identifying when it is atypical and interfering with functioning is crucial to the prevention of mental disorder in the earliest phase of the clinical sequence. Advances in developmentally based measurement of irritability have enabled differentiation of normative irritable mood and tantrums from indicators of concern, beginning in infancy. However, developmentally sensitive assessments of irritability-related impairment are lacking. We introduce the Early Childhood Irritability-Related Impairment Interview (E-CRI), which assesses impairment associated with irritable mood and tantrums across contexts. Reliability and validity are established across two independent samples varied by developmental period: the Emotional Growth preschool sample (EmoGrow; N = 151, M = 4.82 years) and the When to Worry infant/toddler sample (W2W; N = 330, M = 14 months). We generated a well-fitting two-factor E-CRI model, with tantrum- and irritable mood-related impairment factors. The E-CRI exhibited good interrater, test-retest, and longitudinal reliability. Construct and clinical validity were also demonstrated. In both samples, E-CRI factors showed association to internalizing and externalizing problems, and to caregiver-reported concern in W2W. Tantrum-related impairment demonstrated stronger and more consistent explanatory value across outcomes, while mood-related impairment added explanatory utility for internalizing problems. The E-CRI also showed incremental utility beyond variance explained by the Family Life Impairment Scale (FLIS) survey indicator of developmental impairment. The E-CRI holds promise as an indicator of impairment to inform identification of typical versus atypical patterns reflecting early emerging irritability-related syndromes in the initial phase of the clinical sequence.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Entrevista Psicológica/métodos , Humor Irritável , Agressão/psicologia , Pré-Escolar , Mecanismos de Defesa , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Projetos de Pesquisa
9.
Behav Ther ; 51(2): 310-319, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32138940

RESUMO

Given the prominence of the Aberrant Behavior Checklist (ABC), Irritability Subscale (ABC-I), in treatment outcome studies, we conducted a critical examination of its internal consistency and relationship to other measures of irritability in 758 psychiatrically hospitalized youth with autism spectrum disorder. In exploratory and confirmation samples, we conducted factor and bifactor analyses to describe the internal structure of the ABC-I. Our results suggest that the ABC-I roughly represents a unidimensional construct of irritability, as indicated by a general factor in bifactor analysis. In addition to irritability, subordinate factors are presented that represent tantrums, verbal outbursts, self-harm, and negative affect. Notably, self-harm items explain a large proportion of variance independent of irritability. Therefore, their contribution in analyses of treatment effects should be considered. Further study or revision of the ABC-I may improve convergent validity with transdiagnostic formulations of irritability as well as prevent confound from self-harm in treatment studies for irritability in ASD.


Assuntos
Transtorno do Espectro Autista/psicologia , Lista de Checagem/métodos , Transtornos do Comportamento Infantil/diagnóstico , Humor Irritável , Escalas de Graduação Psiquiátrica , Adolescente , Agressão , Criança , Pré-Escolar , Feminino , Hospitais Psiquiátricos , Humanos , Masculino , Comportamento Autodestrutivo/psicologia
10.
Nord J Psychiatry ; 74(6): 453-460, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32186228

RESUMO

Purpose: The aim of the present study was to investigate the prevalence of specific learning disorder (SLD), comorbid disorders, and risk factors in primary school children for the first time in two-stage design in Turkey.Materials and methods: Participants were 1041 pupils in 28 primary schools and aged from 7 to 11. The Mathematics, Reading, Writing Assessment Scale (MOYA) teacher and parent forms were used in the screening stage and parents and teachers of each child completed MOYA. Ninety-five children were screen positive and eighty-three of these children participated in the interview. SLD diagnoses were based on DSM V criteria. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) was used for the comorbid psychiatric disorders.Results and conclusions: The prevalence rate of the SLD was 6.6%, impairment in reading was 4%, in mathematics was 3.6%, and in written expression was 1.8%. About 62.75% of children with SLD had one or more comorbid diagnoses. ADHD was the most common comorbid mental disorder in SLD (54.9%). SLD prevalence was higher among males. The prevalence of SLD in primary school children in Turkey is consistent with previous studies.


Assuntos
Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/psicologia , Instituições Acadêmicas/tendências , Transtorno de Aprendizagem Específico/epidemiologia , Transtorno de Aprendizagem Específico/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/psicologia , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Transtornos do Neurodesenvolvimento/diagnóstico , Prevalência , Transtorno de Aprendizagem Específico/diagnóstico , Turquia/epidemiologia
11.
Int J Pediatr Otorhinolaryngol ; 133: 109961, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32169775

RESUMO

BACKGROUND: Otitis Media (OM) is one of the most common infections among children in developed countries and may result in temporary conductive hearing loss (HL) if accompanied by middle ear effusion (MEE). Ventilation tube insertion (VTI) is recommended as treatment for recurrent acute OM or chronic MEE with HL. HL may lead to impaired development of psychosocial skills. However, evidence for the developmental consequences of OM and the effect of VTI is inconsistent. The objectives of this study were to investigate 1) whether OM in early childhood is associated with long-term consequences of psychosocial development and 2) if VTI prevents the possible negative consequences of OM. METHODS: This study examined prospectively collected data from 52.877 children registered in the Danish National Birth Cohort (DNBC). Information about previous OM-episodes and VTI was obtained through systematic follow-up interviews at seven years, and The Strength and Difficulties Questionnaire (SDQ) containing questions about psychological wellbeing was completed. Five groups were defined based on OM-exposure and the presence of VTI. Baseline characteristics were analysed, and comparison of mean SDQ-scores for the five exposure groups was conducted. Means were adjusted for à priori defined confounding factors. RESULTS: Data from 52,877 children in the DNBC showed an association between OM and poorer SDQ-scores. VTI was associated with an additional increase, i.e. worsening, of the SDQ-score for boys, and only a slight beneficial effect on the girls' outcome. The groups differed in their baseline characteristics in e.g. maternal education, socio-economic status, breastfeeding, and prematurity. CONCLUSION: Significant associations between parent-reported OM in early childhood and later psychosocial health difficulties were found. VTI did not resolve this association.


Assuntos
Ventilação da Orelha Média/psicologia , Otite Média/psicologia , Otite Média/cirurgia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/etiologia , Desenvolvimento Infantil , Pré-Escolar , Dinamarca , Ajustamento Emocional , Feminino , Seguimentos , Humanos , Lactente , Masculino , Otite Média/complicações , Estudos Prospectivos , Ajustamento Social , Inquéritos e Questionários
12.
Pediatr. aten. prim ; 22(85): 35-37, ene.-mar. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-193438

RESUMO

La epilepsia focal del lóbulo temporal se presenta en la edad pediátrica con manifestaciones clínicas heterogéneas, incluyéndose entre ellas las alteraciones sensoperceptivas y los trastornos de la conducta, pudiendo llegar a ser manejados inicialmente como pacientes psiquiátricos, lo que retrasa el diagnóstico y el inicio del tratamiento


Temporal lobe epilepsy in childhood may present with a wide spectrum of symptoms, including behavioral changes and sensory symptoms. This situation can seem like a psychiatric pathology and can delay the diagnosis and initiation of treatment


Assuntos
Humanos , Masculino , Criança , Transtornos do Comportamento Infantil/diagnóstico , Epilepsia do Lobo Temporal/diagnóstico , Anticonvulsivantes/uso terapêutico , Diagnóstico Diferencial , Avaliação de Sintomas/métodos , Eletroencefalografia/métodos , Transtornos Mentais/diagnóstico
13.
Fertil Steril ; 113(2): 435-443, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32106995

RESUMO

OBJECTIVE: To study the associations between maternal polycystic ovary syndrome (PCOS) and hirsutism with offspring attention-deficit/hyperactivity disorder (ADHD), anxiety, conduct disorder, and behavioral problems. DESIGN: Prospective birth cohort study. SETTING: Not applicable. PATIENT(S): A total of 1,915 mother-child dyads. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Maternal report of offspring ADHD, anxiety, or conduct disorder diagnosis at 7 to 8 years; emotional symptoms, behavioral problems (including peer relationship, conduct, hyperactivity/inattention), and prosocial problems measured with the Strengths and Difficulties Questionnaire (SDQ) at 7 years. RESULT(S): Prevalence of PCOS and hirsutism were 12.0% and 3.9%; 84% of women with hirsutism had PCOS. After adjustment for sociodemographic covariates, prepregnancy body mass index, and parental history of affective disorders, children born to mothers with PCOS had higher risk of anxiety (adjusted risk ratio [aRR] 1.62; 95% confidence interval [CI], 1.02-2.57) and borderline emotional symptoms (aRR 1.66; 95% CI, 1.18-2.33) compared with children born to mothers without PCOS. The associations between maternal PCOS and offspring ADHD were positive but imprecise. Maternal hirsutism was related to a higher risk of children's ADHD (aRR 2.33; 95% CI, 1.28-4.24), conduct disorder (aRR 2.54; 95% CI 1.18-5.47), borderline emotional symptoms, peer relationship problems, and conduct problems (aRRs 2.61; 95% CI, 1.69-4.05; 1.92; 95% CI, 1.16-3.17; and 2.22; 95% CI, 1.30-3.79, respectively). CONCLUSION(S): Maternal PCOS was associated with offspring anxiety, and hirsutism was related to other offspring behavioral problems. These findings should be interpreted with caution as replication is needed in prospective cohort studies that assess PCOS and hirsutism diagnoses using medical records.


Assuntos
Ansiedade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos do Comportamento Infantil/epidemiologia , Comportamento Infantil , Transtorno da Conduta/epidemiologia , Hirsutismo/epidemiologia , Saúde Materna , Síndrome do Ovário Policístico/epidemiologia , Efeitos Tardios da Exposição Pré-Natal , Adulto , Fatores Etários , Ansiedade/diagnóstico , Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/fisiopatologia , Emoções , Feminino , Hirsutismo/diagnóstico , Humanos , Masculino , New York/epidemiologia , Síndrome do Ovário Policístico/diagnóstico , Gravidez , Prevalência , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Comportamento Social
14.
Psychiatry Res ; 284: 112775, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31927302

RESUMO

A meta-analysis was conducted to analyze the literature concerning the effects of paternal perinatal depression (PPND) on socioemotional and behavioral development in children. We assessed the literature using searches in PubMed, Web of Science, the Cochrane Library, and Embase from inception to November 2019 and supplemented it by manual searches. Two authors independently selected the eligible studies and extracted data, and three authors assessed the quality of the studies. To explore the effects of PPND on a child's socioemotional and behavioral development, a random-effects meta-analysis was conducted, followed by the construction of a funnel plot. Nine studies were included for review. The pooled odds ratio (OR) of behavioral problems in children with PPND as compared to non-PPND was 1.209 (95% CI: 1.137-1.285), the pooled OR of emotional problems in children with PPND was 1.265 (95% CI: 1.180-1.356), and the pooled OR of social functions in children with PPND was OR=1.299 (95% CI: 0.972-1.736). PPND may play a significant role in adversely impacting the emotional and behavioral development in children during early childhood. Thus, interventions for PPND should be initiated to make up the negative effect of PPND on a child's emotional and behavioral development.


Assuntos
Transtornos do Comportamento Infantil/psicologia , Desenvolvimento Infantil , Transtorno Depressivo/psicologia , Pai/psicologia , Comportamento Paterno/psicologia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/etiologia , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Transtorno Depressivo/complicações , Transtorno Depressivo/diagnóstico , Feminino , Humanos , Masculino , Estudos Observacionais como Assunto/métodos , Comportamento Paterno/fisiologia , Gravidez , Estudos Prospectivos
15.
Prax Kinderpsychol Kinderpsychiatr ; 69(1): 3-21, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31918650

RESUMO

Parents' and Childcare Teachers' Agreement on Mental Health Problems, Psychosocial Ressources and Need for Action Young Children with mental health problems rarely receive professional help. Recognising a problem is one key factor for mental health care utilisation in kindergarten age. In this study psychosocial problems and ressources of 255 children (age 3,0-6,6 years) were assessed by parents and childcare teachers with the instrument "Verhaltensskalen für das Kindergartenalter" (VSK, Koglin u. Petermann, 2016). Subjective need for action was also measured. Teachers announced a need for action in 19.8 % of the children, while parents did so for 17.3 % of the children, but they agreed only for 18.9 % of these children. So agreement on need for action was low (κ = .16). Agreement was also low for psychosocial problems (Median ICC = .32), and very low with respect to the borderline/clinical range (κ = .13). No agreement was found for psychosocial ressources. Results underline the importance for Early Education and Care professionals to cooperate with institutions like social-pediatric centers to avoid blind spots in the identification of mental health problems in preschool age.


Assuntos
Transtornos do Comportamento Infantil , Saúde Mental , Professores Escolares , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Humanos , Pais
16.
Dev Med Child Neurol ; 62(7): 845-853, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31837010

RESUMO

AIM: To assess the reliability and predictive validity of the developmental and socio-emotional scales of the Standardized Infant NeuroDevelopmental Assessment (SINDA). METHOD: To assess reliability, two sets of three assessors forming eight assessor-pairs independently rated the developmental and socio-emotional scales of 60 infants. To evaluate predictive validity, 223 infants (gestational age 30wks [range 23-41wks]; 117 males, 106 females) attending a non-academic outpatient clinic were assessed by different assessors with SINDA's neurological, developmental, and socio-emotional scales. Atypical neurodevelopmental outcome at a corrected age of 24 months or older implied a Bayley Mental or Psychomotor Developmental Index score of less than 70 or neurological disorder (including cerebral palsy). Behavioural and emotional disorders were classified according to the International Classification of Diseases, 10th Revision. Predictive values were calculated from SINDA (2-12mo corrected age, median 7mo) and typical versus atypical outcome, and for intellectual disability only (Mental Developmental Index <70). RESULTS: Assessors highly agreed on the developmental and socio-emotional assessments (developmental scores: Spearman's rank correlation coefficient ρ=0.972; single socio-emotional behaviour items: Cohen's κ=0.783-0.896). At 24 months or older, 65 children had atypical outcome. Atypical neurological scores predicted atypical outcome (sensitivity 83%, specificity 96%); atypical developmental scores predicted intellectual disability (sensitivity 77%, specificity 92%). Atypical emotionality and atypical self-regulation were associated with behavioural and emotional disorders. INTERPRETATION: SINDA's three scales are reliable, and have a satisfactory predictive validity for atypical developmental outcome at 24 months or older in a non-academic outpatient setting. SINDA's developmental scale has promising predictive validity for intellectual disability. SINDA's socio-emotional scale is a tool for caregiver counselling. WHAT THIS PAPER ADDS: Standardized Infant NeuroDevelopmental Assessment (SINDA)'s developmental and socio-emotional scales have excellent interrater reliability. Replication of the satisfactory validity of SINDA's neurological scale for atypical outcome.


Assuntos
Técnicas de Diagnóstico Neurológico/normas , Transtornos do Neurodesenvolvimento/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Autocontrole , Sintomas Afetivos/diagnóstico , Transtornos do Comportamento Infantil/diagnóstico , Regulação Emocional , Feminino , Humanos , Lactente , Deficiência Intelectual/diagnóstico , Masculino , Valor Preditivo dos Testes , Psicometria/normas , Reprodutibilidade dos Testes
17.
Compr Psychiatry ; 96: 152148, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31756584

RESUMO

OBJECTIVE: The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) is a widely used semi-structured diagnostic interview in child and adolescent psychiatry. However, given the extensive use of the K-SADS-PL in clinical practice and research and its adaptation for use in many languages and cultures, validation studies of the instrument are scarce. This study was designed to examine the inter-rater reliability, criterion validity and construct validity of the updated instrument, the K-SADS-PL for DSM-5, in Japanese outpatients totaling 95 children and adolescents. METHOD: We translated and adapted the updated instrument into Japanese using a standard forward-backward translation procedure. Two of nine experienced clinicians independently made diagnoses using the interview for each patient in a conjoint session. Discrepancies in diagnosis between two clinicians were resolved by consensus, and the consensus diagnosis was compared with a "best-estimate" diagnosis made by five experienced clinicians using all available data sources for patients who were blinded to the diagnosis using the K-SADS-PL for DSM-5. The "best-estimate" diagnosis of ASD was also based on the Diagnostic Interview for Social and Communication Disorders. RESULTS: The inter-rater reliability was very good, as shown by κ ≥ 0.8 for all disorders examined: autism spectrum disorder (ASD), attention-deficit hyperactivity disorder, tic disorders, selective mutism, enuresis and encopresis. The criterion validity was good, as shown by κ ≥ 0.6 for all disorders examined, except for ASD (κ = 0.59). This study also revealed good construct validity of the instrument by confirming the expected associations with each scale from the Social Responsiveness Scale-2nd edition and the Strengths and Difficulties Questionnaire. CONCLUSION: These results suggest that the K-SADS-PL for DSM-5 generates valid diagnoses in child and adolescent psychiatry.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Transtornos do Comportamento Infantil/diagnóstico , Escalas de Graduação Psiquiátrica , Adolescente , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Japão , Masculino , Pacientes Ambulatoriais , Reprodutibilidade dos Testes , Traduções
18.
Nord J Psychiatry ; 74(3): 168-180, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31738631

RESUMO

Aim: Pediatric Anxiety Disorders (AD) are common. Cognitive behavioral therapy (CBT) is one of two first-line treatments of youth AD and it has previously been shown to be superior to wait-list but not placebo therapy. This study consists of a systematic review and meta-analysis of the literature to assess the efficacy of CBT modalities in comparison to control contingencies for pediatric anxiety disorders.Methods: Studies were included if they were randomized controlled trials, and if CBT was manualized or modular, alone or in combination with medication. CBT was required to include behavioral treatment, exposure treatment, or cognitive elements. Eligible studies included participants aged 18 years or younger.Results: Eighty-one studies were included, with 3386 CBT participants and 2527 control participants. The overall results indicated that CBT is an effective treatment for childhood AD. The results showed that individual-based CBT is superior to wait-list and attention control. Group-based CBT is superior to wait-list control and treatment as usual. Remote-based CBT was superior to attention control and wait-list control. Family-based CBT was superior to treatment as usual, wait-list control, and attention control. Selective serotonin reuptake inhibitors were no more effective than individual-based CBT. Combination treatment was, however, more effective than individual-based CBT.Conclusion: To the best of our knowledge, no meta-analysis has thus far disentangled the effects of CBT modalities across various comparisons. This meta-analysis hence provides an important update to the literature on the efficacy of CBT for treating anxiety disorders in young people.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Adolescente , Transtornos de Ansiedade/diagnóstico , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Terapia Combinada/métodos , Humanos , Psicoterapia de Grupo/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Inibidores de Captação de Serotonina/uso terapêutico , Resultado do Tratamento
19.
Clin Pediatr (Phila) ; 59(2): 154-162, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31808350

RESUMO

Using questionnaires, administrative claims, and chart review data, the current study explored the impact of using an electronic medical record system to administer, score, and store the Pediatric Symptom Checklist (PSC-17) during annual pediatric well-child visits. Within a sample of 1773 Medicaid-insured outpatients, the electronic system demonstrated that 90.5% of cases completed a PSC-17 screen electronically, billing codes indicating a screen was administered agreed with the existence of a questionnaire in the chart in 98.8% of cases, the classification of risk based on PSC-17 scores agreed with the classification of risk based on the Current Procedural Terminology code modifiers in 72.9% of cases, and 90.0% of clinicians' progress notes mentioned PSC-17 score in treatment planning. Using an electronic approach to psychosocial screening in pediatrics facilitated the use of screening information gathered during the clinical visit and allowed for enhanced tracking of outcomes and quality monitoring.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Saúde da Criança/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Programas de Rastreamento/organização & administração , Criança , Transtornos do Comportamento Infantil/prevenção & controle , Serviços de Saúde da Criança/organização & administração , Feminino , Humanos , Masculino , Pediatria/organização & administração , Atenção Primária à Saúde/organização & administração , Medição de Risco
20.
Dev Med Child Neurol ; 62(7): 827-832, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31420882

RESUMO

AIM: To determine the nature and frequency of behavioral phenotypes and sleep disturbances in individuals with SATB2-associated syndrome (SAS). METHOD: The Strengths and Difficulties Questionnaire (SDQ) and an age-appropriate sleep questionnaire were distributed to the parents of individuals with SAS. All scores were compared to available normative data. RESULTS: Thirty-one individuals completed the assessment (18 females, 13 males; mean age 7y 4mo [SD 4y 1mo], range 2-16y). Individuals with SAS had significantly higher Total Difficulty scores than the normative sample (14.9 [SD 5.8] vs 7.1 [SD 5.7], p<0.001). A high frequency of emotional problems (22.6% vs 8%, p=0.01), peer problems (48.4% vs 10%, p<0.001), hyperactivity (48.4% vs 9%, p<0.001), and low prosocial behaviors (45.2% vs 9%, p<0.001) contribute to the behavioral profile in SAS. Concurrent sleeping difficulties were also frequently identified. Ten individuals in the 5 to 15 years age range had at least one sleep disorder (mean Sleep Disturbance Scale for Children total score 40.9 [SD 8.4] vs 35.1 [SD 7.7], p<0.001). INTERPRETATION: With previous limited available objective neurobehavioral data on the SAS population, we reported evidence of high-risk for a broad spectrum of burdensome behavioral phenotype and concurrent sleeping difficulties, the latter being particularly prevalent during early childhood. Routine assessment and treatment for behavioral issues and sleep problems is recommended. WHAT THIS PAPER ADDS: Emotional and peer problems, hyperactivity, and low prosocial behavior are common in SATB2-associated syndrome. The Strength and Difficulties Questionnaire Total Difficulty scores are atypical in nearly half of individuals. Behavioral difficulties are perceived as burdensome to over half of the parents. Nearly half of individuals have at least one sleep disorder. Sleep-wake transition disorders were most common.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Proteínas de Ligação à Região de Interação com a Matriz , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Comportamento Social/diagnóstico , Fatores de Transcrição , Anormalidades Múltiplas/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Proteínas de Ligação à Região de Interação com a Matriz/genética , Fenótipo , Distúrbios da Fala/diagnóstico , Síndrome , Fatores de Transcrição/genética
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