Developmental-Behavioral Pediatrics, 5th Edition

cover
Front-matter
Developmental-Behavioral Pediatrics
Copyright
Copyright
Contributors
Contributors
Preface
Preface​
Contents
Contents
1. An Introduction to the Field of Developmental-Behavioral Pediatrics
1
An Introduction to the Field of Developmental-Behavioral Pediatrics
Rationale for the Field of DBP
Definition of DBP
Key Perspectives and Values
Historical Grounding for DBP Perspective
Changing Concepts of Children in Society
The Emergence of Pediatrics
Evolving Conceptualization of Disability
Evolving Concepts of Mental Health Disorders
The Development of Psychology
The Development of Psychiatry
Development of Public Policy and Public Systems
Education
Health
Poverty and Social Risk
Disability
Professional Training and Research
Emergence of the DBP Field
Rise of DBP
Increasing Prevalence
Increased Awareness
Evolving Pediatric Practice
Establishment of Training Programs
Establishment of a Journal and DBP Society
Path to Board Certification
Future Opportunities and Challenges
Conclusion
References
Website References
2. The Biopsychosocial Model- Understanding Multiple, Interactive Influences on Child Development and Behavior
2
The Biopsychosocial Model: Understanding Multiple, Interactive Influences on Child Development and Behavior
Overview
Major Theories
Bronfenbrenner’s Ecological Systems Theory
Sameroff’s Transactional Model
Development of Behavioral Problems and Psychopathology
Diathesis-Stress Model
Differential Susceptibility Theory
Caregiver-Child Relationships
Child Stress and Trauma
Intergenerational Transmission of Risk
Parental Trauma Exposure
Parental Depression
Parental Substance Use Disorders
Interacting Parental Influences on Children’s Behavior
Applications of Theories in the Practice of Developmental-Behavioral Pediatrics
Supporting Parent-Child Relationships in Clinic
Recognizing Your Own Reactions to Patients
Conclusion
References
3. Theories of Human Development11Note- We thank Flavia De Campos Dutra for assisting with the bibliographic research for this chapter during the time of COVID-19.
3
Theories of Human Development1
Overview
Stage theories of universal developmental change
Sigmund Freud: Psychosexual Development
Freudian Stages
Limitations
Erik Erikson: Psychosocial Development
Eriksonian Stages
Limitations
Jean Piaget: Cognitive Development
Sensorimotor Stage
Preoperational Stage
Concrete Operations Stage
Formal Operations Stage
Limitations
Lawrence Kohlberg: Moral Development
Stages
Limitations
John Bowlby: Attachment
Stages
Implications and Limitations
General Implications for Stage Theories During the COVID-19 Pandemic
Sociocultural theories
Lev Vygotsky: Environmental Influences on Language and Thought
Reuven Feuerstein: Social Mediation of Cognition
Urie Bronfenbrenner: Direct and Indirect Environmental Influences
Ann Masten: Resilience in Adverse Environmental Circumstances
General Implications of Sociocultural Theories During the COVID-19 Pandemic
Multisystem probabilistic phase transitions
Dynamic Systems Theory
Implications of the COVID-10 Pandemic
conclusion
References
4. Theories of Learning and Behavior Change
4
Theories of Learning and Behavior Change
Introduction
Classical Conditioning
Operant Conditioning
Social Learning Theories
Cognitive and Constructivist Perspectives
Extensions and Contemporary Applications
Education
Cognitive-Behavioral Therapy
Health Care Contexts
Conclusion
References
5. The Maternal-Fetal Dyad-Challenges and Adaptations
5
The Maternal-Fetal Dyad: Challenges and Adaptations
Introduction
Physiologic and Psychological Challenges in Pregnancy
Perinatal Mental Health
Perinatal Mood and Anxiety Disorders
Depressive Disorders
Risk and Protective Factors for Perinatal Depression
Risks to Child Outcomes Associated With Perinatal Depression
Treatment for Perinatal Depression
Risks to Child Outcomes Associated With Treatment for Perinatal Depression
Bipolar Spectrum Disorders
Postpartum Psychosis
Anxiety Disorders
Posttraumatic Stress Disorder
Panic Attacks and Panic Disorder
Treatment for Perinatal Anxiety Disorders
Pediatric In-Office Interventions for Perinatal Mood and Anxiety Disorders
Traumatic Birth Experiences
Posttraumatic Stress
Traumatic Birth and Disenfranchised Grief
Clinical Implications of Traumatic Birth
Prevention of Traumatic Birth
Prevention of PTSD After Traumatic Childbirth
Fourth Trimester and Beyond
Clinical Pearls for the Fourth Trimester and Beyond
Framework for Interplay of Maternal-Child Health
Conclusion
References
6. Infancy
6
Infancy
Introduction
Neurologic Indicators of Neonatal Maturity
State Organization/Sleep
Clinical Implications
Sensory Maturation
Clinical Implications
SOCIAL-emotional development
Attachment
Clinical Implications
Separation
Cultural Variations of Parenting Related to Social-Emotional Development
Clinical Implications
Social Referencing and Joint Attention
Clinical Implications
Autonomy and Mastery
Clinical Implications
Temperament
Clinical Implications
Consequences/Biologic Embedding of Early Adversity
MOTOR development
Fine Motor Development
Gross Motor Development
Clinical Implications
Cognitive Development
Object Permanence
Causality
Play
Clinical Implications
Communication
Physical Growth
Clinical Implications
Conclusion
References
7. Toddlerhood and the Preschool Years
7
Toddlerhood and the Preschool Years
Introduction
Developmental Domains
Communication
Motor Skills
Gross Motor Skills
Fine Motor Skills
Adaptive Functioning
Autonomy and Fear
Toilet Training
Feeding and Eating
Sleeping
Social-Emotional Development
Nonverbal Communication and Social Reciprocity
Social Skills and Peer Relationships
Play Skills
Emotional and Moral Development
Cognitive Development
Overarching Concepts Important for Toddler-Preschool Development
The Developing Brain
Development of Self-Regulation
Emotion Regulation
Executive Functioning
School Readiness
Clinical Perspectives: Conditions Commonly Presenting in the Toddler and Preschool Years
Developmental Delay
Autism
Behavior and Social-Emotional Problems
Recommendations and Evidence-Based Interventions
Strategies for Increasing Positive Behavior
Managing Challenging Behavior
Therapeutic Referrals for Clinically Significant Concerns
Avoiding and Managing Elopement and Other Threats to Safety
Promoting Social Engagement and Prosocial Behavior
Early Intervention and Transition to School-Based Services
Conclusion
References
8. Middle Childhood
8
Middle Childhood
Introduction
Developmental Progression
Transition From Early Childhood
Physical Changes
Expected Achievements
Cognition (Thinking)
Social
Language
Emotional Development
Academic Learning
Home, Self-Care, and Community Living
Tasks and Challenges
Adaptation to School
Conscience Formation
Achieving Mastery
Social Acceptance
Self-Regulation
Self-Image
Cultural Influences
Readiness for Adolescence
When Things go Awry—Patterns of Dysfunction
Attention Deficits
Learning Differences
Peer Problems and Bullying
Emotional and Behavioral Difficulties
Externalizing Behavior
Anxiety and Internalizing Behavior
Clinical Implications
Approach to the Visit
Sexuality
Trauma and Loss
Collaboration—It Takes a Village
Advising Parents (and Teachers)
Conclusion
References
9. Adolescence
9
Adolescence
Introduction
Developmental Changes During Adolescence
Physical Development
Pubertal and Hormonal Development
Motor Skill Development and Coordination
Brain Development
Cognitive Development
Abstract Thinking
Language Development
Emotional Development and Intensity
Self-Regulation
Psychosocial Development
Personal Identity Development
Autonomy Development
Perspective Taking
Peer Relationships
Family Relationships
Gender
Sexual Orientation
Race/Ethnic Identity
Social Consciousness
Awareness of Social Justice
Contextual Influences
Role of Social Media
Schools
Work
Cultural Influences on Adolescents
Religion
Assessing adolescents’ health and health behaviors
Decision Making During Adolescence
Risk and Benefit Perceptions
Comprehensive Assessments of Health: HEADSS
Drugs/Substances
Sexuality
Sleep
Suicide/Depression
Treating Adolescents
General Considerations
Consent and Confidentiality
Trauma-Informed Care
The Broader Context of Health Management
Engagement of Microsystems and Mesosystems
Exosystems and Macrosystems
Chronosystems
Special Populations and Developmental Considerations
Adolescent Parents
Adolescents in Foster Care
Adolescents and Youth in the Justice System
Adolescents Who Are Immigrants
Mental Health in Adolescence
Anxiety
Mood Disorders
Suicidal Behavior
CONCLUSIONs
References
10. Transition to Adulthood
10
Transition to Adulthood
Introduction
The Developmental Process
Neurologic Processes
Cognitive Processes
Social Processes
Psychosocial Development
Interpersonal and Social Relationships
Family of Origin
Friends
Romantic/Sexual Relationships
Marriage and Parenthood
Education
Work and Finances
Finances
Households and Homeownership
Community Life
Religious and Spiritual Life
Political Life and Civic Engagement
Health Care Needs and Transition
Physical Health Care
Mental Health
Conclusion
References
11. End-of-Life, Death, and Bereavement
11
End-of-Life, Death, and Bereavement
Approaching End of Life
Communication
Culture
Planning for the End of Life
Death
Bereavement
Conclusion
References
12. Understanding Child Development and Behavior in the Context of Family Systems
12
Understanding Child Development and Behavior in the Context of Family Systems
Introduction
A Family Systems Perspective on Child Development and Behavior
Role of the Family System in Development
Parents/Primary Caregivers
Grandparents
Siblings
Extended Relatives and Family of Choice
Family Life Cycle
Developmental Delays and Disabilities in a Family Life cycle Context
Initial Concerns and Diagnosis
Family Management and Organization
Transitions, Adulthood, and Family Life Cycle
Supporting Families: A Summary and Conclusion
References
13. Parenting and Parenting Behavior
13
Parenting and Parenting Behavior
Parenting and Child Development
Parenting Styles and Dimensions
Relational Health
The Role of Fathers
Parenting Across the Lifespan
Parenting in Infancy
Breastfeeding
Infant Sleep
Establishing Routines for Language-Rich Interactions
Parenting in the Toddler and Preschool Years
Supporting Autonomy
Discipline
Parenting in Middle Childhood
Academic Achievement
Screen Time
Parenting Adolescents
Parenting Styles in Adolescence
Adjustment and Peer Relationships
Parenting in Context
Poverty
Racism
Racial Socialization
Colorism
Parenting Children With Developmental Disabilities
Autism Spectrum Disorder
Clinical Implications
References
14. Foster Care and Adoption- Implications for Developmental and Behavioral Pediatrics
14
Foster Care and Adoption: Implications for Developmental and Behavioral Pediatrics
Introduction
Key Terms and Definitions
Epidemiology
Family and Child Preparation
Transition Considerations
Feeding Challenges
Sleep Problems
Need for Control
Developmental and Behavioral Outcomes Within the Context of Adoption
Cognitive and Educational Outcomes Following Adoption
Mental Health Issues and Support Seeking Following Adoption
Impact of Preadoptive Deprivations: Lessons Learned From Studies of Previously Institutionalized Children
Limitations and Current Knowledge Gaps
Identity Development Considerations Postadoption
Ethnic/Racial Identity
Adoption Identity Discussions
Practice and Policy Implications
Conclusion
References
15. Trauma, Resilience, and Child Development
15
Trauma, Resilience, and Child Development
Frameworks: Trauma, Toxic Stress, and Resilience
Trauma
Definition of Trauma
Prevalence
Types of Trauma
Implications of Trauma
Adverse Childhood Experiences, Toxic Stress, and Adversity
The Origin of ACEs
Role of Race in ACEs
Neurobiology of Toxic Stress
Resilience
Defining Resilience
Resilience Factors
Clinical Interventions
Screening, Assessment, and Diagnosis of Trauma
Screening
Assessment
Treatment and Trauma-Informed Care
Definition and Principles of Trauma-Informed Care
Promoting Resilience
Using a Resilience-Building Framework
Building Resilience in Clinical Settings
Secondary Trauma, Resilience, and Self-Care for Clinicians
Systemic Interventions
Addressing Trauma in Schools
Building Resilience in Schools
Building Resilience Through Policy
Further Considerations
Conclusion
References
16. Childcare
16
Childcare
Types of Childcare
Childcare Arrangements
Defining Quality in the Childcare Setting
Clinicians’ Roles
Conclusion
References
17. Peers
17
Peers
Social Development and the Importance of Peer Relationships
Problems in Peer Relationships
Children with Special Health Care Needs as a Potentially Vulnerable Population
Implications for Clinicians
Conclusion
References
18. Schools as a Milieu
18
Schools as a Milieu
Introduction
School Environment
Academic Emphasis
Diversity, Equity, and Inclusion
Teacher Training and Support
Teachers and Peers
Positive Behavior Supports
Extracurricular Activities
Physical Features
Size and Space
Neighborhood Factors
Structure and Technology
The School’s Role in Promoting Physical Health and Wellbeing
Food Insecurity
Child Maltreatment/Abuse
Medication Administration and Health Screening
Role of Clinician as an Advocate
Conclusion
References
19. Neighborhoods and Personal Networks
19
Neighborhoods and Personal Networks
Defining the Neighborhood and the Personal Network
Neighborhood
Personal Network
Neighborhood
Mechanisms of Effect
Recent Trends in Neighborhood Research
Economic Disadvantage
Components of economic disadvantage: Income poverty, material hardship, family health.
Dynamics of disadvantage according to individual and family characteristics.
Restricted Physical Environment (Increased Density, Diminished Green Space)
Geographic Mobility and Residential Instability
Neighborhood Effects on Infants
Neonatal and Infant Mortality
Nutrition and Growth
Neighborhood Effects on Children
Intellectual Development
School Readiness and Achievement
Psychological Wellbeing and Ethnic Density
Neighborhood Effects on Adolescents
Violence-Related Mortality
Involvement in the Criminal Justice System
High School Completion
Personal Networks
Mechanisms of Effect
Recent Trends in Personal Networks Research
Networks Across the Life Span
Neonatal and Infant Health
Children
Adolescents
Network Effects on Health Care
Neighborhoods and Personal Networks: Strategic Activities
Applying Knowledge to Interventions
Engaging Clinicians
Engaging Communities
Engaging Public Health Professionals and Federal Programs
Advancing Research
Conclusion
References
20. Celebrating Sociocultural Diversity in the Exam Room and Addressing Racism and Bias
20
Celebrating Sociocultural Diversity in the Exam Room and Addressing Racism and Bias
Introduction
Defining Racial Terminology
Race
Ethnicity
Racism
Microaggressions
Implicit Racial Bias
Racial/Ethnic Socialization
Racial Literacy
Social Determinants of Health
Racial Awareness and Racial Identity Development in Childhood
Newborn to Toddler (Birth–2 Years)
Preschool and Early Childhood (3–5 Years)
Middle Childhood (6–11 Years)
Adolescence (≥12 Years)
Cultural Humility
Putting Cultural Humility into Practice: A return to Omari’s case
Considerations for Care of Children in Immigrant Families
Conclusion: Promoting Resilience by Celebrating Diversity
References
21. The Influence of Digital Media on Children and Families
21
The Influence of Digital Media on Children and Families
Prevalence of Digital Media
Evolution of Digital Media
Content
Parent Role in Media
Associations with Health Outcomes and Children’s Wellbeing
Overview
Sleep
Obesity
Language Development
Executive Functioning
Children’s Developmental Stages and Associations with Digital Media
Infancy
Infant Development and Screen Media
Relevance for Parents/Clinicians Caring for Infants
Toddlers and Preschoolers
Toddler/Preschooler Development and Screen Media
Relevance for Parents/Clinicians Caring for Toddlers/Preschoolers
School Age
School-Age Children’s Development and Screen Media
Relevance for Parents/Clinicians During School Age
Adolescence
Relevance for Parents/Clinicians During the Adolescent Years
Disparities and Access
Practical Applications
Resources
References
22. Natural and Human Disasters
22 Natural and Human Disasters
The Impact of Disasters on Children
Natural Versus Manmade Disasters
The Vulnerability of Children, Especially Those With Disabilities
Adjustment Reactions of Children Following Disasters
Risk Factors for Adjustment Difficulties
Bereavement in Children
Children’s Conceptual Understanding of Death
Guilt
Secondary and Cumulative Losses and Stressors
Trauma and Grief Triggers and Anniversary Reactions
Effective Communication with Children Following Disasters
Social Support from Caregivers and Other Caring Adults
Psychosocial Support in the Aftermath of a Disaster
Promoting Effective Coping Strategies
Early Interventions—Psychological First Aid
Long-Term Interventions
Use of Psychotropic Medications
Resiliency and Posttraumatic Growth
Consultation to Schools
The Value of Universal Supports
Advice for Educators
Personal Impact of Disasters on Clinicians and Professional Self-care
CONCLUSION
References
23. Biological Mechanisms of Human Development and Behavior
23
Biological Mechanisms of Human Development and Behavior
Introduction
Where does one start when assessing children with developmental disabilities for underlying biologic diagnoses?
History
Physical Examination
Advances in Medical Care
Advances in Genetics
References
24. Genetic Disorders and Their Associated Mechanisms
24
Genetic Disorders and Their Associated Mechanisms
Introduction
Epigenetic Mechanisms of Disease
Epigenetics
Genomic Imprinting
Disorders Associated With Genomic Imprinting
Angelman Syndrome
Prader-Willi Syndrome
Beckwith-Wiedemann syndrome
Silver-Russell Syndrome
Mendelian Disorders of the Epigenetic Machinery
Somatic Mosaicism
Mendelian Genetic Syndromes and Conditions
Rasopathies
Neurofibromatosis Type I
Noonan Syndrome
Costello Syndrome
Cardiofaciocutaneous Syndrome
Connective Tissue Disorders
Marfan Syndrome
Ehlers-Danlos Syndrome
Osteogenesis Imperfecta
Skeletal Dysplasias
Achondroplasia
Multifactorial Conditions
Cleft Lip and Palate
Congenital Heart Disease
CHARGE Syndrome
Neural Tube Defects
Teratogens
Fetal Alcohol Syndrome
Maternal Diabetes
References
25. Chromosome Disorders and Inheritance Patterns
25
Chromosome Disorders and Inheritance Patterns
Introduction
Karyotype
Fluorescence in Situ Hybridization
Comparative Genomic Hybridization and Microarray
Balanced and Unbalanced Translocations
Copy Number Variants
22q11.2 Deletion Syndrome
Williams Syndrome (7q11.23 Deletion)
16p11.2 Deletion
Aneuploidy
Trisomy
Trisomy 21
Trisomy 13
Trisomy 18
Monosomy
Mosaicism
Atypical Chromosome Structure
Isochromosome
Ring Chromosomes
Inversions
Inheritance Patterns
Autosomal Dominant Inheritance
Penetrance
Expressivity
Age of Onset
Allelic Heterogeneity and Locus Heterogeneity
Sex Limited Conditions
Autosomal Recessive Inheritance
Aspects of Autosomal Recessive Inheritance
Consanguinity.
Inbreeding.
Founder effect.
Carrier frequency.
X-Linked Inheritance
X-Linked Recessive Disease
Manifesting heterozygotes.
X-Linked Dominant Disease
References
26. Sex Chromosome Aneuploidy
26
Sex Chromosome Aneuploidy
Introduction
Turner Syndrome
Genetics and Diagnosis of Turner Syndrome
Definition and Prevalence of Turner Syndrome
Genetic Variations and Mechanisms in Turner Syndrome
Genotype-Phenotype Correlations in Turner Syndrome
Clinical Features of Turner Syndrome
Physical and Medical Features of Turner Syndrome
Developmental and Psychological Features of Turner Syndrome
Screening and Treatment Recommendations for Turner Syndrome
Xxy/Klinefelter Syndrome
Genetics and Diagnosis of XXY/Klinefelter Syndrome
Clinical Features of XXY/Klinefelter Syndrome
Medical and Physical Features of XXY/Klinefelter Syndrome
Developmental-Behavioral Features of XXY/Klinefelter Syndrome
Xyy Syndrome
Genetics and Diagnosis of XYY
Clinical Features of XYY
Physical and Medical Features of XYY
Developmental-Behavioral Features of XYY
Trisomy X/47,Xxx
Genetics and Diagnosis of Trisomy X
Clinical Features of Trisomy X
Medical and Physical Features of Trisomy X
Developmental-Behavioral Features of Trisomy X
Tetrasomy And Pentasomy Conditions (Xxyy, Xxxy, Xyyy, Xxxxy, Xxyyy, Tetrasomy X, Pentasomy X)
Genetics of Sex Chromosome Tetrasomy and Pentasomy
Clinical Features of Tetrasomy and Pentasomy Conditions
Genetic Research in Sex Chromosome Aneuploidies
Patient and Professional Resources
Conclusion
References
27. Down Syndrome
27
Down Syndrome
Down Syndrome
History of Down Syndrome
Genetics
Prenatal Screening and Diagnosis
Making the Diagnosis in the Newborn Period
Informing the Family
Health Concerns in Individuals with Down Syndrome
Gastrointestinal Disorders
Ophthalmologic Difficulties
Audiologic and Ear, Nose, and Throat Problems
Sleep Difficulties
Cardiovascular Disease
Endocrinology
Hematology
Infectious Disease and Immunology
Musculoskeletal Disease
Neuropsychiatric Concerns
Intellectual Disability
Autism Spectrum Disorder
Down Syndrome Disintegrative Disorder
Attention-Deficit/Hyperactivity Disorder
Epilepsy
Dementia
Health Care Guidelines for Children and Adults
Growth and Development
Education
Transition
Conclusion
References
28. Fragile X Syndrome and FMR1 Variants
28
Fragile X Syndrome and FMR1 Variants
Introduction
Genetics oF Fragile X
Fragile X Syndrome
Physical, Medical, and Motor Features of FXS
Developmental-Behavioral and Cognitive Features of FXS
Evaluation and Treatment Approaches for FXS
Speech-Language Therapy
Occupational Therapy
Physical Therapy
Special Education
Behavioral Therapies
Psychological and Social Skills Therapies
Medical Evaluations and Treatments in FXS
Medical evaluations.
Psychopharmacologic medications.
Targeted treatment medications.
FMR1 Premutation–Associated Disorders
Fragile X–Associated Tremor Ataxia Syndrome
Fragile X–Associated Primary Ovarian Insufficiency
Fragile X–Associated Neuropsychiatric Disorders
Genetic Counseling and Cascade Testing
Resources for Providers and Families
References
29. Nervous System
29
Nervous System
Prenatal Brain Development
Neuroanatomy
Supratentorial Anatomy
Infratentorial Anatomy
Spinal Cord and Peripheral Nervous System
Meninges
Cerebrovascular Circulation
Cerebrospinal Fluid Circulation
Neurologic History and Physical Examination
History
General Examination
Neurologic Examination
Techniques in Infants
Telehealth
Indications for Imaging
Central Nervous System Malformations
Forebrain and Cerebral Cortex
Holoprosencephaly
Agenesis of Corpus Callosum
Septo-Optic Dysplasia
Lissencephaly
Polymicrogyria
Schizencephaly
Neuronal Heterotopia
Focal Cortical Dysplasia
Posterior Fossa
Dandy-Walker Malformation
Pontocerebellar Hypoplasia
Chiari I to IV
Cerebrospinal Fluid Pathways
Hydrocephalus
Arachnoid Cyst
Brain Size
Megalencephaly
Microcephaly
Neural Tube Defects
Anencephaly
Encephalocele
Spina Bifida and Myelomeningocele
Vascular Disease
Perinatal/Neonatal Stroke
Perinatal Arterial Ischemic Stroke
Neonatal Hemorrhagic Stroke
Cerebral Sinovenous Thrombosis
Periventricular Venous Infarct
Hypoxic Ischemic Encephalopathy
Childhood/Adolescence Stroke
Childhood Arterial Ischemic Stroke
Focal cerebral arteriopathy.
Moyamoya disease.
Vasculitis.
Arterial dissection.
Cerebral Sinovenous Thrombosis
Vascular Malformations
Prognosis
Headache
Migraine
Tension-Type Headache
Trigeminal Autonomic Cephalgias
References
30. Neuromuscular Disorders
30
Neuromuscular Disorders
Overview of Neuromuscular Disorders
What Are the Neuromuscular Disorders?
Diagnostic Workup of Neuromuscular Disorders
Specific Neuromuscular Disorders
Motor Neuron Disorders
Nerve
Neuromuscular Junction
Muscle
Clinical Implications of a Neuromuscular Diagnosis
References
31. Seizures and Epilepsy
31
Seizures and Epilepsy
Background
First-Time Seizure Evaluation and Management
Risk of Recurrent Seizures andFuture Epilepsy
Epilepsy Diagnosis and Classification
Types of Seizures
Types of Epilepsy
Epilepsy Syndromes
Causes of Epilepsy
Epilepsy Evaluation
Treatment of Epilepsy
Status Epilepticus and Acute Treatment Options
Antiseizure Medications
Other Consequences of Epilepsy
Neurocognitive Effects of Epilepsy
Sudden Unexpected Death in Epilepsy Patients
Seizure Safety
Epilepsy Support and Resources
References
32. Diffuse Acquired Brain Injury
32
Diffuse Acquired Brain Injury
Introduction to Diffuse Acquired Brain Injury
Epidemiology
Pathophysiology
Injury Grading/Severity
Neuroimaging/Electroencephalography
Plasticity Versus Development and the Role of Age at Injury
Individual and Contextual Predictors of Outcomes
Moderate and Severe Traumatic Brain Injury
Outcomes
Clinical Management
Rehabilitation
Medication Management
Neuropsychological Monitoring
Psychological and Behavioral Interventions
Cognitive Rehabilitation
Educational Supports
Mild Traumatic Brain Injury
Abusive Head Trauma
Anoxic Brain Injuries
Conclusions and Future Directions
References
33. Congenital Infections
33
Congenital Infections
Introduction
Overview of the Pathophysiology of Congenital Infections
Congenital Infections and Neurodevelopmental Outcomes
Types of Congenital Infections
TORCH Infections
Congenital Cytomegalovirus
Epidemiology
Presentation and Classification of Disease
Neurodevelopmental Outcomes
Congenital Toxoplasmosis
Epidemiology
Presentation and Classification of Disease
Neurodevelopmental Outcomes
Congenital Syphilis
Epidemiology
Presentation and Classification of Disease
Neurodevelopmental Outcomes
Emerging Congenital Infections
Zika Virus
Epidemiology
Presentation and Classification of Disease
Neurodevelopmental Outcomes
Novel Coronavirus Disease 2019 (COVID-19)
Epidemiology
Neurodevelopmental Outcomes
Congenital Infections and Hypothetical Risk of Autism Spectrum Disorder
The Role of the Developmental and Behavioral Pediatrician
References
34. Consequences of Preterm Birth
34
Consequences of Preterm Birth
Introduction
Epidemiology of Preterm Births
Incidence of Preterm Birth
Racial Disparities
Obstetric Dating Practices
Etiology of Preterm Birth
Neonatal Conditions and Assessment of Risk
Preterm Perinatal Brain Injury
Bronchopulmonary Dysplasia
Retinopathy of Prematurity
Necrotizing Enterocolitis
Neurodevelopmental Outcomes
Overview
Cerebral Palsy
Intellectual Disability
Neurosensory Impairments
Neuromotor Abnormality
Language Disorders
Learning
Behavioral Outcomes
Follow-up of the Preterm Infant
Conclusion
References
35. Nutritional Disorders
35
Nutritional Disorders
Overview of the Brain-Nutrient Interaction
High Metabolic Demands
Timing and Dose of the Nutritional Deficiency
Vulnerability and Plasticity
The Role of the Microbiome
Epigenetics
Critical Macronutrients
Protein
Long-Chain Polyunsaturated Fatty Acid
Critical Micronutrients
Iron
Iodine
Vitamin B12 (Cobalamin)
Zinc
Vitamin D
Nutrition Status Assessment in Children with Developmental Disability
Anthropometrics, Body Composition, and Bone Density
Standard Growth Charts
Special Growth Charts
Midupper Arm Circumference
Triceps Skinfold Thickness
Subscapular Skinfold Thickness
Body Composition
Weight Gain Velocity
Arm and Leg Length Measures
Assessment of Bone Mineral Density
Basic Principles for Assessment of Nutritional Requirements in Children With Disabilities
Recommended Dietary Allowance
Resting Energy Expenditure and Total Energy Expenditure
References
36. Inborn Errors of Metabolism
36
Inborn Errors of Metabolism
Background
General Approach
Laboratory Evaluation
Newborn Screening
Disorders Presenting with Hyperammonemia
Overview
Ornithine Transcarbamylase Deficiency
Argininosuccinic Aciduria
Arginase Deficiency
Hyperornithinemia, Hyperammonemia, Homocitrullinuria Syndrome
Amino Acid Disorders
Phenylketonuria
Disorders of Hyperhomocystinemia and Hypermethioninemia
Nonketotic Hyperglycinemia
The Tyrosinemias
Organic Acidemias
Neurometabolic Disorders
Glucose Transporter Type-1 Deficiency
Neurotransmitter Disorders
Creatine Deficiency Syndromes
Vitamin-Responsive Disorders: Disorders of B6 Metabolism
Disorders of Sulfur Amino Acid Metabolism
Isolated Sulfite Oxidase Deficiency
Molybdenum Cofactor Deficiency
Purine and Pyrimidine Disorders
Disorders Of Carbohydrate Metabolism
Galactosemia
Congenital Disorders of Glycosylation
Peroxisomal Disorders
Overview
X-Linked Adrenoleukodystrophy
Peroxisomal Biogenesis Disorders: The Zellweger Spectrum
Mitochondrial Diseases
Overview
Pyruvate Dehydrogenase Deficiency
Lysosomal Storage Disorders
Overview
Mucopolysaccharidoses
Niemann-Pick C
Neuronal Lipofuscinosis
Disorders of Cholesterol Metabolism
Disorders of Cholesterol Synthesis: Smith-Lemli-Opitz Syndrome
Cerebrotendinous Xanthomatosis
Therapeutics
Gene and RNA-Based Therapies
Enzyme Replacement Therapies
Cell-Based Therapies
Small Molecule Therapies
Conclusion
References
37. Prenatal Exposure of Alcohol, Tobacco, and Drugs
37
Prenatal Exposure of Alcohol, Tobacco, and Drugs
Introduction
Alcohol
Syndromes Associated With Prenatal Alcohol Exposure
Epidemiology of Prenatal Alcohol Use
Mechanisms of Prenatal Alcohol Effects
Nicotine
Prescription Medications Affecting Development And Behavior
Antiepileptic Drugs
Valproic Acid
Other Medications
Antineoplastic Agents
Radiotherapy
Chemotherapy
Anticoagulants
Psychotropic Medication
Selective Serotonin Reuptake Inhibitors
Antipsychotics
Tricyclic and Tetracyclic Antidepressants
Mood Stabilizers
Retinoids
Illicit and Recreational Drugs
Cocaine
Opioids
Neonatal Opioid Withdrawal Syndrome
Cannabis
Amphetamines
Screening for Exposure
References
38. The Impact of Environmental Chemicals on the Developing Brain
38
The Impact of Environmental Chemicals on the Developing Brain
Neurodevelopmental Disabilities Caused by Toxic Chemicals in the Environment
Ubiquitous Nature of Environmental Chemicals
Children’s Unique Vulnerabilities to Toxic Chemicals
From Acute Toxicity to Silent Toxicity
Environmental Influences on Development
Lead
Mercury
Organophosphate Pesticides
Additional Developmental Neurotoxicants
Specific Developmental Disabilities: Autism Spectrum Disorder
Environmental Health Disparities
CONCLUSION: Advice for Developmental-Behavioral Clinicians
Conclusion
References
39. Cerebral Palsy and Other Motor Disorders
39
Cerebral Palsy and Other Motor Disorders
Definition of Cerebral Palsy
Etiology
Making the Diagnosis
History
Physical Examination
Neuroimaging
Additional Investigations
Classification of Cerebral Palsy
Movement Disorders in Children with CP
Systemic Medications
Injections
Surgical Management
Orthopedic Issues in CP
Contractures
Scoliosis
Spastic Hip Dysplasia
Evaluation and Management of Pain
Bone Health Evaluation and Management
Growth
Puberty
Growth Attenuation
Gastrointestinal and Nutrition Issues
Pulmonary Concerns
Gynecologic and Urologic Issues
Sexual Health
Vision and Hearing Issues
Mental Health Considerations
Life Expectancy and Quality of Life
Rehabilitation Therapies
Participation
Orthoses and Durable Medical Equipment
Conclusion
References
40. Intellectual Disability
40
Intellectual Disability
Intellectual Disability: Evolution of Terminology
Prevalence
Etiologic Factors
Genetics
Metabolic
Infections
Trauma
Toxins
Evaluation of Intellectual Disability
CoOccurring Conditions
Behavioral and Emotional
Seizures and Epilepsy
Gastrointestinal
Orthopedic
Sensory
Sleep
Outcomes and Disparities
Life Expectancy
Guardianship and Supported Decision Making
Advocacy and Self-Determination
Community Integration
Employment
Postsecondary Education
Sexuality
Poverty
Diversity
Prevention
Immunizations
Nutritional
Safety Laws and Recommendations
Environmental
Neonatal Screening
Social Determinants of Health
Recent and Future therapies and Advances
Resources
Parent Groups
Advocacy Organizations
Youth and Adult Activities
Employment
Professional Organizations
Diversity, Equity, and Inclusion
References
41. Autism Spectrum Disorder
41
Autism Spectrum Disorder
Signs and Symptoms of Autism Spectrum Disorder
Epidemiology
Etiology
Diagnostic Criteria
Social Communication, Social Interaction, and Symbolic Play
Repetitive and Restrictive Patterns of Behaviors
Severity Levels/Support
Accompanying Impairments
Onset and Developmental Course
Infancy/Early Childhood
School-Aged Children
Adolescents
Adults
Historically Understudied Populations
Screening/Assessment/Diagnostic Evaluation
Surveillance and Screening
Comprehensive Assessments and Multimodal Evaluation Methods
Medical Evaluations
Differential Diagnosis Versus Comorbidities
Intellectual Disability
Social Communication Disorder
Selective Mutism
Language Disorders
Attention-Deficit/Hyperactivity Disorder
Anxiety Disorders
Childhood Onset Schizophrenia
Stereotypic Movement Disorder
Co-occurring Medical and Mental Health Conditions
Medical Co-occurring Conditions
Mental Health Co-occurring Conditions
Interventions
Behavioral Interventions for Core Symptoms
Educational Supports
Speech and Language Therapy
Occupational Therapy
Behavioral and Mental Health Interventions
Medical Interventions
Complementary and Alternative Therapies
Family-Centered, Culturally and Linguistically Competent and Equitable Care
Future Directions
References
42. Developmental Considerations in Deafness
42
Developmental Considerations in Deafness
Terminology
Epidemiology
Etiology
Genetic
Developmental Disabilities
Risk Factors for Childhood Hearing Loss
Evaluation
Hearing Screening
Diagnostic Hearing Evaluation
Medical Evaluation
Developmental Evaluation
Developmental and Behavioral Outcomes
Auditory Development
Speech Development
Language Development
Cognitive Development
Social and Emotional Development
Academic
Management
Family-Centered Early Intervention
Medical Management
Audiological Management
Developmental Interventions
Education
Assistive Technology, Transition Services, Vocational Planning
Conclusion
Acknowledgments
References
Resources
43. Blindness and Visual Impairment
43
Blindness and Visual Impairment
Causes of Blindness and Visual Impairment
Diseases of the Orbit
Craniosynostosis Syndromes
Other Orbital Syndromes
Ocular Abnormalities
Microphthalmia
Cornea
Anterior Segment
Lens
Glaucoma
Retina/Vitreous
Neuroophthalmologic Causes of Blindness and Visual Impairment
Optic Nerve
Abusive Head Trauma
Cortical/Cerebral Visual Impairment
Pediatric Screening Responsibilities
Characteristics and Definitions of Blindness and Visual Impairment
Ophthalmologic Interventions and Management
Developmental and Educational Implications of Pediatric Blindness/Visual Impairment
School-Age Children and Adolescents
Conclusion and Recommendations
References
Resources
44. Language and Speech Disorders
44
Language and Speech Disorders
Definitions
Normal Development
Developmental Variations
Developmental Delay
Evaluation Procedures
Screening
Diagnostic Testing
Observational and Interview Assessment Strategies
Norm-Referenced Formal Measures
Criterion-Referenced Measures
Assessment of Speech
Language Disorders
Epidemiology
Known Causes
Unresponsive Social Environment and Impoverished Language Environment
Hearing Loss
Cognitive Impairment
Chromosomal and Genetic Causes of Cognitive Impairment
Autism
Neurologic Conditions
Specific Language Impairment
Management of Language Disorders
Speech Sound Disorders
Articulation Disorders
Phonologic Disorders
Anatomic Disorders
Neurologic Disorders
Stuttering
Voice and Resonance
Management of Speech Sound Disorders
Conclusion
References
45. Sensory Processing Disorders
45
Sensory Processing Disorders
Types of Sensory Processing Disorder
Sensory Modulation Disorder
Sensory-Based Motor Disorders
Vestibular-Based Postural Disorders
Dyspraxia
Sensory Discrimination Disorder
Assessment
History
Intervention
Outcomes of Sensory Integration Intervention
Conclusion
References
46. Attention-Deficit-Hyperactivity Disorder (ADHD)
46
Attention-Deficit/Hyperactivity Disorder (ADHD)
What is ADHD?
Understanding ADHD
Historical Perspective
The Evolving Understanding of the Fundamental Nature of ADHD
Neurobiology
Neurophysiology
Neuropsychological Foundations
Genetics
Other Etiologic Factors.
The Impact of ADHD
Health Disparities and Socioeconomic Costs
Persistence Into Adulthood
Functional Impairment in Children and Adolescents
Medical Comorbidities
Adult Outcomes
Complex ADHD as a Concept and Focus on Improving Functional Outcomes
Diagnosis and Nomenclature
Assessment
Treatment
Psychoeducation and Psychosocial Interventions
Pharmacotherapy
Psychoeducation
Medication Choice
Continuous Versus Intermittent Treatment
When to Consider Stopping Medication
Fostering Understanding and Adherence
Treatment Across the Life span
Conclusion
References
47. Learning Disabilities
47
Learning Disabilities
Background, Definitions, and Symptomatology of Learning Disorders
Specific Learning Disorder/Disability With Impairment in Reading
Specific Learning Disorder/Disability With Impairment in Written Expression
Specific Learning Disorder/Disability With Impairment in Mathematics
Nonverbal Learning Disability
Epidemiology and Etiology
Coexisting Conditions
Attention-Deficit/Hyperactivity Disorder
Speech and Language Disorders
Other Specific Learning Disorders
Autism Spectrum Disorder
Developmental Coordination Disorder
Mental Health Conditions
Social Impairment
Genetic Disorders
Diagnostic Approach
Medical Assessment of Learning Disability
Psychological Assessment of Learning Disability
Treatment
Dyslexia and Reading Disorders
Dyscalculia and Math Disorders
Dysgraphia and Writing Disorders
Laws Impacting Special Education
The Individuals With Disabilities Education Act (IDEA)
Section 504 of the Rehabilitation Act of 1973
Title II of the Americans With Disabilities Act of 1990 (ADA)
Prevention
Response to Intervention
Transition to Postsecondary Education and Adult Life
Postsecondary Education
Employment
Criminal Justice System and Learning Disability
Primary Care Provider Role and Establishing Partnerships
Conclusion
References
48. Talent and Giftedness
48
Talent and Giftedness
Definitions
Gifted and Talented as Ability
Gifted and Talented as Multifactorial
Developmental Concerns
Cognitive Development
Social-Emotional Development
Educational Identification and Programming
Curriculum Alternatives
Ability Grouping
Acceleration
Enrichment
Special Considerations
Identification of Underrepresented Groups
The Underachieving Gifted and Talented Child
Identification of Twice Exceptional Students
Conclusion
References
49. Mood Disorders in Children and Adolescents
49
Mood Disorders in Children and Adolescents
Depressive Spectrum Disorders
Brief Overview
Epidemiology
Clinical Presentation
Comorbid Conditions
Screening and Assessment
Treatment
Psychotherapeutic Interventions
Pharmacotherapy
Prevention
Suicide in Children and Adolescents
Background
Treatment
Bipolar Spectrum Disorder
Brief Overview
Epidemiology
Clinical Presentation
Comorbid Conditions
Screening and Assessment
Treatment of Bipolar Disorder
Acute Manic/Mixed Mania
Bipolar Depression
Maintenance
Treating Comorbid Conditions
Specific Medication Considerations
Second-Generation Antipsychotics
Mood Stabilizers
Antidepressants
Electroconvulsive Therapy
Psychotherapeutic Interventions
Prevention
Conclusion
References
50. Suicide Prevention Care in the Pediatric Setting- A Trauma-Informed Approach
50
Suicide Prevention Care in the Pediatric Setting: A Trauma-Informed Approach
Epidemiology and Presentation of Suicide Risk
Factors Increasing Suicide and Self-Harm Risk
Traumatic Stress, Adversity, and Social Determinants of Health
Care Process Model for Screening, Evaluation, and Management of Suicide/Self-Harm Risk and Traumatic Stress
Screening for Suicide/Self-Harm Risk—Assess (A)
Screening for Traumatic Stress—Assess (A)
SAFETY-A/FISP Overview and Empirical Support
SAFETY-A and ABCD Case Illustration with Carlos
Assess
Build Hope and Reasons for Living
Connect
Develop Plan
Clinical Implications and Conclusions
References
51. Anxiety Disorders in Children and Adolescents
51
Anxiety Disorders in Children and Adolescents
Introduction
Correlates and Risks Factors
Temperament
Genetics
Societal Factors
Parenting and Family Relationships
Stressors and Adverse Childhood Experiences
Comorbidities
Types of Anxiety Disorders
Separation Anxiety Disorder
Social Anxiety Disorder
Generalized Anxiety Disorder
Specific Phobias
Selective Mutism
Panic Disorder and Agoraphobia
Obsessive-Compulsive Disorder
Assessment
Differential Diagnosis
Treatments
Behavior Therapy
Cognitive-Behavioral Therapy
Exposure and Response Prevention
Psychopharmacology
Antidepressant Medications
Benzodiazepines
Other Medications
Medication for OCD
Other Treatments
Combined Treatments
Conclusion and Clinical Implications
References
52. Psychotic-Spectrum Disorders in Children and Adolescents
52
Psychotic-Spectrum Disorders in Children and Adolescents
Clinical High-Risk States for Psychosis
Clinical Description
Differential Diagnosis
Psychotic-Like Experiences
Obsessive-Compulsive Disorder
Autism Spectrum Disorder
Posttraumatic Stress Disorder and Personality Disorders
Assessment
Course and Prognosis
Treatment
Pharmacologic Interventions
Psychosocial Interventions
Multicomponent Interventions
Psychotic-Spectrum Disorders in Children and Adolescents
Clinical Description
Psychotic-Spectrum Disorders
Schizophreniform Disorder
Schizoaffective Disorder
Affective Disorders With Psychosis
Unspecified Schizophrenia
Delusional Disorder
Brief Psychotic Disorder
Other Disorders With Psychosis in Children and Adolescents
Substance-Induced Psychosis
Psychosis Associated With a General Medical Condition
Differential Diagnosis
Neurobiologic and Genetic Risk Factors
Course and Prognosis
Treatment
Pharmacologic Treatment
Psychosocial Interventions
Multicomponent Interventions
Substance Use and Psychosis
Conclusion
References
53. Substance Use Disorders and Other Risk-Taking Behaviors in Youth
53 Substance Use Disorders and Other Risk-Taking Behaviors in Youth
Introduction
Adolescent Development
Substance Use
Epidemiology
Tobacco
Alcohol
Cannabis
Illicit Drugs
Prescription Drugs
Substance Use Progression
Associated Problems
Prevention
Risk Factors
Principles of Effective Prevention
Principles of Effective Parent Guidance
Screening And Assessment
Screening Tools
CRAFFT
NIAAA
S2BI
BSTAD
Assessment
Interventions
Tobacco/Nicotine Dependence
Substance Use Disorder Treatment
Brief Interventions
Treatment Options
Psychosocial/Behavioral Interventions
Medical/Psychiatric Interventions
Detoxification
Medication-Assisted Treatment
Acute Residential Treatment
Long-Term Residential Treatment
Outpatient Treatment
Pediatric Clinicians
Family
ADHD, Psychostimulants, and Substance Use
Intoxication and Withdrawal
Parents/Caregivers Who Use Alcohol and Other Substances
Conclusion
References
54. Dual Diagnosis of Mental Health and Developmental Disorders in Developmental-Behavioral Pediatrics
54
Dual Diagnosis of Mental Health and Developmental Disorders in Developmental-Behavioral Pediatrics
Prevalence and Epidemiology
Diagnostic Considerations
Diagnostic Assessment
Rating Instruments
Diagnosis Of Specific Mental Disorders
Autism Spectrum Disorder
Attention-Deficit/Hyperactivity Disorder
Anxiety
Mood Disorders
Suicide and Suicide Risk Assessment
Gender Diversity and Gender Dysphoria
Conduct Problems and Aggression
Trauma and Posttraumatic Stress Disorder
Schizophrenia Spectrum and Other Psychotic Disorders
Stereotypic Movement Disorder
Pica
Evaluation and Treatment of Medical Conditions
Treatment
Treatment Planning
Psychotherapies and Psychological Interventions
Psychotropic Medications
Care Coordination and Consultation
Conclusion
References
55. Aggression and Disruptive Behavior Disorders
55
Aggression and Disruptive Behavior Disorders
Introduction
Defining Disruptive Behavior Disorders
Prevalence
Role of Aggression in Disruptive Behavior Disorders
Forms of Aggression
Functions of Aggression
How Bullying Relates to Disruptive Behavior Disorders
Etiology of Aggression and Disruptive Behaviors
Biologic Theories
Social Learning Theories
Social Information Processing
Developmental/Ecologic Theories
Assessment of Disruptive Behavior
Treatment of Disruptive Behavior Disorders
Lifestyle Interventions
Empirically Supported Parent Training and Family Therapies for Disruptive Behavior Disorders
Parent-Child Interaction Therapy (PCIT)
Collaborative and Proactive Solutions (CPS)
Multisystemic Treatment (MST)
The Coping Power Program
Medication
Wraparound or Behavioral Health Rehabilitative Services (BHRS)
Outcomes
Conclusion
References
56. Acute Stress Disorder and Posttraumatic Stress Disorder in Youth
Acute Stress Disorder and Posttraumatic Stress Disorder in Youth
57. Adjustment and Adjustment Disorders in Developmental-Behavioral Pediatrics
57
Adjustment and Adjustment Disorders in Developmental-Behavioral Pediatrics
Introduction
Concepts of Stress and Adjustment
Stress Response Systems
Resilience
Ecologic and Cultural Perspectives
Adjustment Disorders
Prevalence
Adjustment Disorders and Medical Illness
Adjustment Disorders and Psychosocial Stressors
Prevention and Treatment
Conclusion
References
58. Impact of Hospitalization and Acute Medical Care on Children and Families
58
Impact of Hospitalization and Acute Medical Care on Children and Families
Impact of Hospitalization on Child and Caregiver Functioning
Conceptual Models
Bioecologic Systems Theory
Pediatric Psychosocial Preventative Health Model
Intervention
Conclusion
References
59. Children with Chronic Illness and Medical Complexity
59
Children with Chronic Illness and Medical Complexity
Definitions of Chronic Illness and Medical Complexity
Etiology
Complexity of Diagnoses and Management
Coordinating the Care Team
Intensity of Care Needs From Medical Clinicians
An Approach to the Child with Medical Complexity
Developmental Concerns
Growth Issues
Nutritional Problems and Gastrointestinal issues
Dysphagia
Gastrointestinal Complications
Gastroesophageal reflux disease.
Gastritis.
Constipation.
Respiratory Issues
Abnormalities of the Airway
Lung Diseases
Ventilatory Support
Ventriculoperitoneal Shunts
Urologic Procedures in Children With Neurogenic Bowel and Bladder
Orthopedic Procedures in CMC
Other Specialized Medical Technologies
Conclusion
References
60. Survivors of Childhood Brain Tumors-Developmental and Behavioral Considerations
60
Survivors of Childhood Brain Tumors: Developmental and Behavioral Considerations
Pediatric Brain Tumors
Types and Frequency
Clinical Suspicion of a Brain Tumor
Tumor Treatments
Late Effects of Brain Tumors and their Treatment
Mechanisms of Injury
Medical Late Effects
Physical Changes
Sensory Impairment: Vision and Hearing
Neurologic Dysfunction: Seizures, Strokes, Balance Impairment
Endocrine Dysfunction
Sleep Disorders
Secondary Malignancy
Neuropsychological Late Effects
Neurocognitive Late Effects
IQ, Working Memory, and Processing Speed
Attention
Interventions for Neurocognitive Functioning
Neurobehavioral Late Effects
Social Competence
Interventions for Social Skills
Survivorship Care
References
61. Neurodevelopment in Children With Congenital Heart Disease
61
Neurodevelopment in Children With Congenital Heart Disease
Etiology of neurodevelopmental deficits in CHD
Neurodevelopment in children with CHD
Intelligence
Speech and Language
Visual-Spatial Skills
Executive Function
Social Cognition
Psychiatric outcomes and quality of life
Guidelines for Neurodevelopmental Screening and Evaluation
Impact of CHD on the Family
Transition to Adult Care
Therapeutic interventions
Conclusion
References
62. Medications With Developmental and Behavioral Side Effects
62
Medications With Developmental and Behavioral Side Effects
Introduction
Antiepileptic Drugs (Anticonvulsants)
Antihistamines
First-Generation Antihistamines (Diphenhydramine, Hydroxyzine, and Cyproheptadine)
Second-Generation Antihistamines (Cetirizine, Loratadine, Fexofenadine)
Corticosteroids (Prednisone, Dexamethasone, Betamethasone, Methylprednisolone)
Corticosteroid Usage in Specific Pediatric Medical Conditions
Corticosteroid Usage in Preterm and Low Birthweight Infants
Conclusion
References
63. Palliative Care for Children With Medical Complexity
63
Palliative Care for Children With Medical Complexity
Overview
Relationship to Primary Care and Developmental-Behavioral Pediatrics
Pain
Signs of Pain
Pain Assessment Tools
Approach to Treatment
Feeding Intolerance
Difficult Conversations
Responsibility for initiating Palliative Care
Recommendations for Positive Difficult Conversation
Team Coordination
Sharing Serious News as a Team
Shared Mental Model
Methods
Understanding Legal and Institutional Policies
Team Flexibility
Barriers to Successful Difficult Conversations
Caregiver Barriers
Clinician Barriers
Health System Barriers
Regoaling
Caregiver Regoaling
Clinician and Health System Regoaling
Conclusion
References
64. Chronic Pain
64
Chronic Pain
The Significance of Childhood Chronic Pain
Definitions and Common Childhood Pain Conditions
Chronic Musculoskeletal Pain
Functional Abdominal Pain Disorder
Headache
Impact of Chronic Pain on Children and Families
Long-Term Course and Outcomes of Childhood Chronic Pain
Understanding Chronic Pain: A Biopsychosocial Framework
Developmental
Biologic
Psychological
Social
Assessment of Chronic Pain in Children
Pain History
Pain Impact
Chronic Pain Management in Children
Counseling Families
Treatment of Chronic Pain in Children
Psychological Interventions
Physical Interventions
Pharmacologic Treatments
CAM Therapies
Interdisciplinary Pediatric Pain Treatment Programs
Telehealth and Digital Health Interventions
Conclusion
References
65. Feeding and Swallowing Disorders
65
Feeding and Swallowing Disorders
Introduction
Typical Feeding Development
Swallowing Disorders
Anatomy and Physiology of Swallowing
Dysphagia and Aspiration
Instrumental Assessments to Evaluate Swallow Function
The International Dysphagia Diet Standardization Initiative
Management Tips
Common Problems
Future Directions
International Association for Pediatric Feeding and Swallowing
Video Appointments
Research
Conclusion
References
66. Growth Faltering
66
Growth Faltering
Medical
Anthropometric Evaluation: Objective Identification of Growth Faltering
Complex Consideration in Addressing Growth Faltering Following Low Birthweight
Laboratory Assessment
Nutritional
Developmental-Behavioral dysfunction
Social-Emotional
Social Determinants of Health in Growth Faltering
Child Protection Considerations in Growth Faltering and Indications for Hospitalization
Psychiatry/Mental Health Support
Conclusion
References
67. Childhood Obesity
67
Childhood Obesity
Epidemiology
Assessment
Screening and Classification
Evaluation
Special Considerations for Children and Youth With Special Health Care Needs
Parenting Styles and Practices
The Role of Pediatric Providers in Weight Management
Taking a Developmental Approach to Prevention and Treatment
Infancy
Early Childhood
School Age
Adolescence
Young Adulthood
Conclusion
References
68. Urinary Incontinence and Nocturnal Enuresis
68
Urinary Incontinence and Nocturnal Enuresis
Overview
Biobehavioral Framework and Contributing Factors
Etiology and Correlates
Clinical Disorders
Externalizing Disorders
Internalizing Disorders
Developmental Disorders
Biopsychosocial Factors and Quality of Life
Evaluation
Medical
Behavioral
Management
First-Line Interventions
Daytime Incontinence
Nocturnal Enuresis
Second-Line Interventions
Daytime Incontinence
Nocturnal Enuresis
Clinical Implications
Future Directions
References
69. Toileting and Encopresis
69
Toileting and Encopresis
Scope of the Problem
Bowel Function and Encopresis
Toilet Training
Toileting Refusal/Stool Withholding
Toilet Training in Special Populations
Encopresis/Functional Fecal Incontinence
Overview
Etiology
Diagnosis
History
Physical Examination
Laboratory Evaluation and Imaging
Treatment
Education
Cleanout
Maintenance
Diet
Behavioral Plan
Relapses/Treatment Failure
Other Therapies
Outcome
Conclusion
References
70. Sleep and Sleep Disorders in Children
70
Sleep and Sleep Disorders in Children
Sleep from A Developmental-Behavioral Perspective
Basic Sleep Mechanisms
The Sleep History
Measuring Sleep
Actigraphy
Polysomnograms and Multiple Sleep Latency Test
Developmental Trajectory of Normal Sleep
Sleep in Newborns
Sleep in Infants (1–12 months)
Sleep in Toddlers (12–36 months)
Sleep in Preschoolers (3–5 years)
Sleep in Middle Childhood (6–12 years)
Sleep in Adolescents (12–18 years)
Neurobehavioral and Neurocognitive Impact of Inadequate and Disrupted Sleep in Children
Good Sleep Hygeine
Common Sleep Disorders in Children
Obstructive Sleep Apnea and Sleep-Disordered Breathing
Parasomnias
Sleep Terrors, Sleep Walking, and Nightmares
Rhythmic Movement Disorders
Bruxism
Restless Legs Syndrome and Periodic Limb Movement Disorder
Narcolepsy
Behavioral Insomnia of Childhood (Sleep Onset Association and Limit Setting Subtypes)
Sleep Issues in Special Populations
Chronic Health Concerns
Anxiety
Attention-Deficit/Hyperactivity Disorder
Autism Spectrum Disorder
Specific Genetic Diagnoses
Medications for Sleep
Sleep-Related Side Effects of Psychopharmacology
Conclusion
References
71. Movement Disorders
71
Movement Disorders
Background
Neurobiology/Pathophysiology
Clinical starting point
Tic Disorders
Definitions
Epidemiology and Natural Course
Phenomenology
Distinctions From Similar Repetitive Behaviors
Secondary Tic Disorders
Genetics
Associated Nontic Neurobehavioral Symptoms
Attention-Deficit/Hyperactivity Disorder
Anxiety and Mood Disorders
Obsessions and Compulsions
Academic Difficulties
Rage Attacks
Autism Spectrum Disorder and Other Social Communication Deficits
Sleep Disorders
Evaluation and Management
Prioritize Most Burdensome Symptoms
Psychoeducation
Behavioral Tic Management
Medication
Brain Electrical Stimulation
Noninvasive.
Surgical.
Nontic Movement Disorders
Stereotypic Behaviors/Stereotypic Movement Disorder (Primary Motor Stereotypies)
Key Similarities to and Differences From Tics
Pathophysiology
Management
Developmental Coordination Disorder
Evaluation and Comorbidity
Management
Chorea
Dystonia
Dopa-Responsive Dystonia
Management
Tremor
Evaluation and Management
Drug-Induced Movement Disorders
Infant/Toddler Specific
Functional Movement Disorders
conclusion
References
72. Habit Disorders in Children and Adolescents
72
Habit Disorders in Children and Adolescents
Classification
Etiology
Stereotypic Movements
Sucking
Banging
Body Rocking
Body-Focused Repetitive Behaviors
Picking
Trichotillomania
Nail Biting
Behavioral Treatment of Stereotypic and Repetitive Behaviors
Behavioral Interventions
Habit Reversal
Other Repetitive Behaviors
Bruxism
Tic Cough (Habit) and Somatic Cough Syndrome (Psychogenic)
Breathholding Spells
Rumination
conclusion
References
73. Sexuality and Its Variations
73
Sexuality and Its Variations
We Are Sexual Beings from Birth to Death
Typical Sexual Development by Age
Fetal Life and Infancy: A Time of Exploration
Toddlerhood: Learning the Self, Learning Others
School-Age Children: Healthy Socializing Builds the Framework for Healthy Sexuality
Preteens: A Moving Target of Developmental Achievement
Adolescence: Asserting the Self
Experiences Impacting/Complicating the Development of Sexuality
Initiation of Sexual Activity/Intercourse
High-Risk Sexual Behavior
Sexual Abuse and Sexual Assault
Conclusion
References
74. Sexuality in Children and Youth With Disabilities
74
Sexuality in Children and Youth With Disabilities
Introduction
General Concepts when Addressing Sexuality Needs of individuals with Disabilities
Physical Disabilities
Intellectual and Developmental Disabilities
Family and Caregivers
Sexual Education
Puberty
Human Papillomavirus Vaccination
Menstruation and Menstrual Management, Contraception, Pregnancy, Reproductive Care, and Sexually Transmitted Infections
Sexual Activity
Adolescents With Intellectual Disabilities
Adolescents With Autism Spectrum Disorders
Adolescents With Spina Bifida or Spinal Cord Injury (Examples of Physical Disability)
Problem Sexual Behaviors
Problem Sexual Behaviors in Children
Individuals With Disabilities Are at Risk for Sexual Abuse and Victimization
The Role of the Developmental Behavioral Clinician
References
75. Gender and Its Variation in Youth
75
Gender and Its Variation in Youth
Gender Dysphoria
Gender Identity Development
Preschool (Ages 3–5 Years)
Childhood (Ages 6–9 Years)
Preteen (Ages 10–12 Years)
Adolescence (Age 13+ Years)
Risk and Resilience
Gender-Affirmative Interventions
Additional Considerations in Providing Gender-Affirmative Care
Neurodiversity in Gender-Diverse Youth
Nonbinary Presentations and Medical Transition
Clinical Implications
References
76. Fundamentals of Developmental, Behavioral, and Psychological Assessment
76
Fundamentals of Developmental, Behavioral, and Psychological Assessment
Introduction to Psychological Assessment
Screening
Psychological Testing
The Purpose of Psychological Assessment
Test Design and Psychometrics
Reliability
Validity
Test Construction
Competencies to Conduct Assessments
Assessment Planning
Sources of Assessment Data
Interview
Observations
Caregiver and Self-Report Measures
Broadband Versus Domain Report Measures
Performance-Based Measures
Integrating Information
Conclusion
References
77. The Interview in Developmental-Behavioral Pediatrics
77
The Interview in Developmental-Behavioral Pediatrics
Initiating and Supporting the Relationship
Meeting and Greeting
Agenda Setting
Potential Challenges for Consideration
Building an Alliance With Children
Family History
Discussing Diagnosis and Treatment
Shared Decision Making
Recognizing the Emotional Needs of the Family
Managing the Challenging Interview
Conclusion
References
78. The Physical Exam- Laying on of Hands…or Not
78
The Physical Exam: Laying on of Hands…or Not
Conducting the physical examination
Behavioral Observation
Relevant physical findings
Growth and Physical Maturity
Abnormal Findings
Neurologic Examination
When We Are Unable to Lay on Hands: Telehealth
General Principles
Advantages of the Telehealth Visit
Limitations of the Telehealth Visit
Examination in the Telehealth Visit
Patient Privacy and Security
The Clinician’s Considerations
The Child and Family Considerations
conclusion
References
79. Evaluation of Children Who Are Nonverbal-Minimally Verbal
79
Evaluation of Children Who Are Nonverbal/Minimally Verbal
Defining the population of children who are minimally verbal
Caregiver interview
Critical observations to make of the child during interaction and play
Psychological assessment
Nonverbal Cognitive Functioning
Communication Skills
Behavioral Rating Scales
Additional Areas for Consideration
Academics
Fine Motor Skills and Visual-Motor Integration
Memory
Conclusion and Clinical Implications
References
80. Assessment of Temperament
80
Assessment of Temperament
Introduction
What Does Temperament Predict?
How Temperament Modifies Experience or Response to Environment
Assessment of Temperament
How And When To Intervene
Conclusion
References
81. Developmental Surveillance and Screening
81
Developmental Surveillance and Screening
Background
Definitions and Chapter Scope
Child Find and the Child Abuse Prevention and Treatment Act
Clinician Screening Rates
Identifying Children at Risk for Delays and Disabilities
Autism Screening
Social-Emotional Screening
Surveillance and Screening Must Be Family Centered
Beyond the United States
Validation and Evidence for Screening
Validation
Evidence for Screening
Implementation of Developmental Screening in Clinical Settings
Components of an Effective Implementation
Common Implementation Challenges
Developmental Care and the Electronic Health Record
Special Populations and Circumstances
Results
Interpretation of Results
Borderline Results
Communicating Results and Forming a Plan
Referral
After Referral
Further Reading
References
82. Evaluation of Emotion and Behavior
82
Evaluation of Emotion and Behavior
Assessment Methods
Broadband Measures
Omnibus Rating Scales
Structured Diagnostic Interviews
Projective Techniques
Narrowband Measures
Implementation of Emotion and Behavior Assessments in Clinical Settings
Instrument Selection
Access/Purchasing Requirements
Administration of Measures
Scoring and Interpretation
Providing Feedback
Financial Considerations
Securing Data
Cultural and Language Considerations
Clinical Implications
References
83. Evaluation of School Readiness-Beyond ABCs
83
Evaluation of School Readiness: Beyond ABCs
Introduction
What is school readiness?
Why should we evaluate school readiness in a child?
How should we assess school readiness in a child?
Use of Culturally Responsive Assessment Tools
Assessing School Readiness in Pediatrics
How should we interpret school readiness assessments?
New Models for Assessing school readiness in Action
Clinical implications
References
84. Observational Assessment in Developmental-Behavioral Pediatrics
84
Observational Assessment in Developmental-Behavioral Pediatrics
Introduction
Observational Assessment Methods
Time Sampling
Event Sampling
Duration Sampling
Latency Sampling
Functional Behavior Assessment
Published instruments for observational assessment
Behavior
Autism Spectrum Disorder
Clinical Implications
References
85. Developmental, Cognitive, and Intelligence Testing
85
Developmental, Cognitive, and Intelligence Testing
History of Intellectual and Developmental Testing
History of Intellectual Testing
History of Theories of Intelligence
History of Developmental Testing
Uses and Limitations of Testing
Uses of Developmental Versus Intellectual Testing
Limitations of Testing
Environmental Influence on Intelligence Scores
Cultural and Linguistic Influence on Test Scores
Reasons for Referring for Developmental, Intellectual, or Cognitive Testing
Integrated Behavioral Health Models
Referral Model
Referrals to Early Intervention
Referrals for Testing in Public Schools
Referrals to Psychology Practices
Framing Referral Questions
Testing Process and Interpretation
Record Review, Clinical Interview, and Rating Scales
Test Selection
Test Administration
Interpretation of Testing Scores
Reporting Scores and Interpretations
Using Testing for Diagnostic Decision Making
Providing Feedback and Recommendations
Conclusion
References
86. Educational Testing and Evaluation of Academic Performance
86
Educational Testing and Evaluation of Academic Performance
Importance of Understanding Educational Testing and Evaluation
Policies Related to Educational Testing and Evaluation
Testing and Laws Focused on Equal Opportunity
Laws Focused on Students With Disabilities
Types of Assessments
Norm-Referenced Assessments
Criterion-Referenced Assessments
Curriculum-Based Evaluation
Portfolio Assessments
A MultiTiered System of Support: A Framework for Assessment and Intervention
Overview of MTSS
Universal (Tier 1)
Targeted (Tier 2)
Intensive (Tier 3)
Physician Contributions Across the Tiers and Overcoming Barriers to Coordination
References
87. Neuropsychology in Developmental-Behavioral Pediatrics Practice
87
Neuropsychology in Developmental-Behavioral Pediatrics Practice
Defining Neuropsychology
Who is a Neuropsychologist?
Neuropsychological Evaluation Differs from Psychological Evaluation
When to Refer for a Neuropsychological Evaluation
Neuropsychology in Practice
Coding and Billing for Neuropsychological Services
Neuropsychological Report
conclusion
References
88. Evaluation of Adaptive Functioning
88
Evaluation of Adaptive Functioning
Introduction
Adaptive Behavior Definitions and Frameworks
Purpose of Adaptive Behavior Assessment
Assessment of Adaptive Functioning
Vineland Adaptive Behavior Scales, Third Edition (Vineland 3)
Adaptive Behavior Assessment System, Third Edition
Scales of Independent Behavior–Revised
Conclusion
References
89. Assessments of the Central Nervous System
89
Assessments of the Central Nervous System
Structural Assessment of the Central Nervous System
Brain Imaging
Head Ultrasound
Mechanism, Advantages, and Limitations
Indications
Computed Tomography
Mechanism, Advantages, and Limitations
Indications
Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy
Mechanism, Advantages, and Limitations
Indications
Considerations When Ordering MRI
Spinal Imaging
Mechanism, Advantages, and Limitations
Indications
Considerations When Ordering Spinal Imaging
Vascular Imaging
Direct Angiography
Mechanism, Advantages, and Limitations
Indications
Computed Tomography Angiography/Venography
Mechanism, Advantages, and Limitations
Indications
Magnetic Resonance Angiography/Venography
Mechanism, Advantages, and Limitations
Indications
Considerations When Ordering MRA/MRV
Functional Assessment of the Central Nervous System
Neurophysiologic Studies
Electroencephalogram
Mechanism, Advantages, and Limitations
Indications
Considerations When Ordering EEG
Magnetoencephalogram
Mechanism, Advantages, and Limitations
Indications
Functional MRI
Mechanism, Advantages, and Limitations
Indications
Direct Assessment of The Central Nervous System
Lumbar Puncture
Mechanism, Advantages, and Limitations
Indications
Conclusion
References
90. Integration of Data Sources and Uncertainty
90
Integration of Data Sources and Uncertainty
Factors Contributing to Uncertainty in Diagnosis and Care
Developmental Changes
Defining Normal
Parent Perspectives
Scientific Advances
Attention-Deficit/Hyperactivity Disorder
Autism Spectrum Disorder
Early Childhood Adversity
Variations Across Disciplines
Methods for Approaching Ambiguity in Care
Data Gathering
Uncertainty Management Theory
Shared Decision Making
conclusion
References
91. Counseling and Readiness to Change
91
Counseling and Readiness to Change
Background: Why Readiness to Change Matters
The Transtheoretical Model
Stages of Change
Stages of Change and Clinical Practice
Limitations of the Transtheoretical Model
Application to Clinical Practice
Assessing Readiness to Change
Facilitating Readiness to Change
Motivational Interviewing
Guiding Principles
OARS (Open-Ended Questions, Affirmations, Reflective Listening, Summary Statements)
Change Talk
Putting it All Together
References
92. Common Factors and Lifestyle Interventions
92
Common Factors and Lifestyle Interventions
Common Factor Skills Derived From Psychotherapy
Identifying Treatment Goals
Essential Skills
Reducing Patient and Parent Levels of Distress and Conflict (At Least Temporarily)
Essential Skills
Immediate Relief
Essential Skills
Agreement on Next Steps
Essential Skills
Using Common Factor Skills in Developing Collaborations That Support Families
Lifestyle Factors Related To Mental Health
Physical Activity
Mood and Anxiety Problems
Attention and Behavior Problems
Neurodevelopmental Disorders
Psychosis and Substance Use Problems
Assessment
Recommendations
Sleep
Diet/Nutrition
Mood and Anxiety Problems
Attention and Hyperactivity Problems
Neurodevelopmental Disabilities
Assessment
Recommendations
Conclusion
References
93. Behavioral Parent Training and Consultation
93
Behavioral Parent Training and Consultation
Evidence-Based Parent Training Packages
Parent-Child Interaction Therapy
Incredible Years
Triple P Positive Parenting Program
Helping the Noncompliant Child and Defiant Children
Community Parent Education Program
Parent Management Training–Oregon Model
Behavioral Counseling During Medical Care
Initiating Counseling
Assessment of Child Characteristics
Developmental Stages
Temperament
Developmental Delays and Disabilities
Selecting the Behavior to Change
Elements of Evidence-Based Parent Training Programs
Modifying the Environment
Effective Instructions
Modeling Appropriate Behavior
Increasing Praise
Differential Attention or Reinforcement
Reward Systems
Punishment
Extensions to Improve Access, Engagement, and Outcomes
Conclusion
References
94. Applied Behavior Analysis for Autism Spectrum Disorder
94
Applied Behavior Analysis for Autism Spectrum Disorder
Introduction to Autism Spectrum Disorder
History of Autism Treatment Approaches
Principles of Applied Behavior Analysis
ABA as an Evidence-based Intervention for ASD
ABA For Challenging Behavior
Qualifications of ABA Providers
Variations in ABA Therapy for ASD
Dosage (Hours of Therapy)
Variations on ABA Modalities
Home-Based Versus Center-Based Approaches
Other Behavioral Models
Developmental, Individual Difference, Relationship-Based/Floortime Play
Relationship Development Intervention
Behavior Therapy and Modified Cognitive- Behavioral Therapy
Conclusion
References
95. Crisis Management in Developmental-Behavioral Pediatrics
95
Crisis Management in Developmental-Behavioral Pediatrics
Introduction
Suicidality and Self-harm
Assessment
Intervention
Violent Outburst and Aggression
Assessment
Intervention
Restraint and Seclusion
Threats of Harm to Others
Assessment
Intervention
Duty to Warn and Duty to Protect
Concerns for Anxiety or Panic
Assessment
Intervention
Concerns for Disclosure of Abuse, Neglect, Sexual Assault, or Domestic Violence
Assessment
Intervention
Acute Presentation of Concerns for Psychosis
Assessment
Intervention
Potentially Intoxicated Child or Caregiver
Assessment
Intervention
Caregiver Mental Health Crisis
Assessment
Intervention
Conclusion
References
96. Individual Therapy for Children and Adolescents- Play Therapy and Interpersonal Therapy as Developmentally Centered Relational Change Modalities
96
Individual Therapy for Children and Adolescents: Play Therapy and Interpersonal Therapy as Developmentally Centered Rel ...
Effectiveness of Therapy with Children and Adolescents
Integrated Behavioral Health
Therapeutic Strategies for Medical Clinicians and Supportive Therapy
Therapeutic Approaches: The Therapeutic Relationship as the Vehicle of Change
Relational Approaches
Play Therapy
Empirical Support
Incorporating Play Therapeutically
Individual Therapy Modalities for Adolescents
Interpersonal Therapy
Empirical Support
Therapeutic Relationship to Process Adolescents’ Experiences
Conclusion
References
97. Family Systems Therapy and Its Importance in Developmental-Behavioral Pediatrics
97
Family Systems Therapy and Its Importance in Developmental-Behavioral Pediatrics
What is Family Therapy?
Defining the Family
Why Family Systems?
Evidence for Family Systems Interventions
Pediatric Psychology
Children With Autism Spectrum Disorder and Other Neurodevelopmental Difficulties
What is involved in family systems therapy?
Key Techniques for Systems Interventions
Interventive Interviewing
Circular Questions Versus Linear Questions
Specific Family Communication Strategies
How do I Help Families, With and Without Family Therapy?
Thinking About Your Client and Family
Using Brief Face-to-Face Time to Maximize Content and Reinforce Relationship
Assessing Need for Family Therapy
Referring for Treatment
Conclusion
References
98. Cognitive-Behavioral Therapy in Developmental-Behavioral Pediatrics
98
Cognitive-Behavioral Therapy in Developmental-Behavioral Pediatrics
Cognitive-Behavioral Therapy
A Brief History of CBT
The B in CBT—Behavior
Examples of Behavioral Strategies
The C in CBT—Cognitive
Examples of Cognitive Strategies
Relaxation-Based Strategies
Typical Format of CBT
Individual and Group Models
An Important Note About Appropriate Training in CBT
Appropriateness of CBT Referral
Common Applications of CBT in Children and Adolescence
Anxiety
Gradual exposure.
Obsessive-Compulsive and Related Disorders
Exposure and Response Prevention and Habit Reversal Training
Depression
CBT for depression.
CBT for Youth With Neurodevelopmental Differences
Common Modifications to CBT for Neurodiverse Youth
In Combination With Pharmacologic Intervention
New Waves of CBT
Dialectical Behavior Therapy
Acceptance and Commitment Therapy
Conclusion
References
99. Psychopharmacology
99
Psychopharmacology
Stimulants
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Clinical Pearls
Alpha-2 Adrenergic Agonists
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Clinical Pearls
Atomoxetine
Mechanism of Action
Efficacy
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Clinical Pearls
Selective Serotonin Reuptake Inhibitors
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Clinical Pearls
Serotonin-Norepinephrine Reuptake Inhibitors
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Tricyclic Antidepressants
Bupropion
Clinical Pearls
Antiepileptics
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Clinical Pearls
Atypical Antipsychotics
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Clinical Pearls
Miscellaneous Medications
Lithium
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Amantadine and Memantine
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Clinical Pearls
N-Acetylcysteine
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Clinical Pearls
Naltrexone
Mechanism of Action
Efficacy
Side Effects
Approved Indications
Off-Label Uses
Dosing
Monitoring
Interactions
Clinical Pearls
Polypharmacy
Conclusion
References
100. Hypnosis, Biofeedback, and Meditation
100
Hypnosis, Biofeedback, and Meditation
Introduction
Therapeutic Language
Diaphragmatic Breathing
Hypnotherapy
Principles and Procedures
Applications of Hypnosis
Biofeedback
Principles and Procedures
Applications of Biofeedback
Meditation
Principles and Procedures
Applications of Mindfulness Meditation
Summary
References
101. Growth Mindset as a Brief Intervention- Research to Practice
101
Growth Mindset as a Brief Intervention: Research to Practice
What is Growth Mindset?
Why is Growth Mindset Important?
Academic Skills
Academic Achievement
Attrition or Dropout
Reading
Language
Social/Interpersonal Skills
Social
Bullying
International Relations
Health
How Do We Promote Growth Mindset in Pediatrics?
What are the Caveats for Implementing Growth Mindset?
How can we apply mindset to public education and public health?
Conclusion
References
102. Treatment of Developmental, Behavioral, and Mental Health Conditions via Technology
102
Treatment of Developmental, Behavioral, and Mental Health Conditions via Technology
Introduction
Telehealth
Phone- and Application-Based Treatments
Wearable Devices
Virtual Reality
VideoGames
Procedural Technologic Intervention
CONCLUSIONS AND Limitations to Treatment with Technology
References
103. Early Intervention
103
Early Intervention
What is Early Intervention?
A Brief History of Part C Early Intervention
Federal Requirements and State Implementation
Federal Requirements
State Implementation
Core Principles
Family-Centered Care
Routine-Based Learning in Natural Environments
Primary Coaching
Evidence Supporting Part C Early Intervention
Process Evaluation
Child Find
Setting
Timeliness
Service Use
Outcome Evaluation
Infant and Toddler Outcomes
Family Outcomes
Early Identification to Intervention Pathway
Early Identification
Referral
Evaluation
Intervention
EI Challenges and Innovations
conclusion
References
104. Special Education Services
104
Special Education Services
Overview of the Individuals With Disabilities Education Act
History of IDEA
IDEA Versus 504
Equity In Special Education
Partnering With Children And Adolescents And Their Families
The Special Education Process
Identification
Identification Process Overview
Child Find.
Response to intervention.
Assessment and Eligibility
Process Overview
Development Of The Iep Or 504 Plan
Overview of the IEP Development Process
The Team and the Meeting
Developing the IEP, Goals, Services, and Accommodations
Present Levels
Goals
Transition
Part C to Part B
Adolescence to Adulthood
Alternative Placements
Implementation of IEP
Quarterly Reporting
IEP Review and Revision
Triennial Reevaluation or Three-Year Review
Developing a 504 Plan
Resources
References
105. Transition to Adulthood for Young Adults With Intellectual and Developmental Disabilities
105
Transition to Adulthood for Young Adults With Intellectual and Developmental Disabilities
Introduction
Transition To Adult-Based Health Care
Health Care Transition Overview
Priority and Goals of Health Care Transition for AYA With IDD
Challenges to Health Care Transition for AYA With IDD
Morbidity and Mortality Associated With Poor Health Care Transition
Differences Between Pediatric- and Adult-Based Approach to Care
Pediatric Versus Adult Provider Approach to Care
Care Coordination and Service Availability
Decision-Making Support
Evidence and Framework for Transitioning to Adult-Based Care
Evidence Base for Transition Planning Practices
Framework for Health Care Transition
Insurance Coverage Changes and Options in Adulthood
Psychosocial Issues During Transition Into Adulthood
Postsecondary Opportunities
Sexuality
Mental Health
Housing Options
References
106. Rehabilitation Services- Occupational Therapy and Physical Therapy
106
Rehabilitation Services: Occupational Therapy and Physical Therapy
Historical Perspective and Evolution of the Professions
Contemporary Practice
Scope of Practice
Occupational Therapy
Physical Therapy
Clinical Implications
References
107. Speech-Language Pathology for Developmental-Behavioral Disorders
107
Speech-Language Pathology for Developmental-Behavioral Disorders
Introduction to Speech-Language Pathology
Settings and Team Members
Assessment methods
Identification of Children at Risk for Language Disorders
Assessment of Speech and Language/Swallowing
Assessment of Swallowing
Service Delivery Models Used in Treatment
Treatment effectiveness
Summary
References
108. Art and Music Therapy
108
Art and Music Therapy
Introduction
Art Therapy
History
Definition
Art Therapy Credentials
Art Therapy Assessments
Art Therapy in Medical and Pediatric Settings
Research on Art Therapy, Brain Functions, and Stress Measures
Music Therapy
Definition
Music Therapy Credentials
Music Therapy Treatment Process
Research on Music Therapy and Brain Function
Music Therapy in Pediatric Medical Care
Music Therapy in the NICU
Conclusion
References
109. Integrative Medicine for Disorders of Development and Behavior
109
Integrative Medicine for Disorders of Development and Behavior
Introduction
Definitions
High Prevalence of Integrative Medicine Use
Principles of Integrative Medical Care
Autism Spectrum Disorder and Integrative Medicine
Gastrointestinal Disturbances
Probiotics
Prebiotics
Gluten-Free and Casein-Free (GFCF) Diet
Impaired Metabolism
Methylated Vitamin B12
Folinic Acid
Minimize Oxidative Stress
Immune Dysregulation
Vitamin D3
Omega-3
Lifestyle Factors
Aberrant Neurobiology
Sensory Integration Therapy
Oxytocin
Acupuncture
Sleep Therapies
Conclusions
Attention-Deficit/Hyperactivity Disorder and Integrative Medicine
Nutrition
Supplements
Omega-3 Fatty Acids
Iron
Mind-Body
Neurofeedback
Mindfulness/Meditation
Nature
Conclusion
Controversial Treatments in Integrative Medicine
Medical Marijuana
Chelation Therapy
Hyperbaric Oxygen Therapy (HBOT)
Conclusion
References
References
110. Community-Based Interventions
110
Community-Based Interventions
Introduction
What is community-based intervention?
Complex Problems
Considerations in Community-Based Interventions
Cultural Humility and Sociocultural Implications
Ethical Standards
Sustainability
Tiered Response to Intervention
Evidence Base
Health System as a Partner for Communities
Community-Based Intervention in Action
Suicide
Bullying
Additional Resources
Programming Framework
Community-Based Participatory Research
Data Sets
Conclusion
References
111. Endocrine and Gynecologic Management of Children With Severe Disabilities
111
Endocrine and Gynecologic Management of Children With Severe Disabilities
Endocrine management of children with developmental disabilities
Bone Density and Preventing Fragility Fractures
Clinical Presentation of Osteoporosis and Fragility Fractures in Children With Developmental Disabilities
The Role of Imaging to Screen for Fracture Risk
Management of Low Bone Mineral Density and Osteoporosis
General Screening and Management Considerations of Endocrine Conditions for Children With Complex Medical Conditions
Hypopituitarism
Overview of the hypothalamic-pituitary-organ axes.
Symptoms of hypopituitarism.
Screening for pituitary dysfunction.
Management of pituitary disorders.
Precocious Puberty
Concerns for Abnormal Growth
Challenges with measuring height.
Interpretation of height and linear growth.
Evaluation of abnormal growth.
Growth Attenuation Treatment
Gynecologic management of adolescents with developmental disabilities
Menstrual Periods: Physiology and Assessment
Menstrual Management
Prescribing Hormonal Therapy and Contraception
Screening Recommendations
Contraception and STD Prevention
Treatments to Avoid
References
112. Social Inclusion
112
Social Inclusion
Social Inclusion
An era of community membership
Legal Foundations
Section 504
The Americans With Disabilities Act
IDEA
Rosa’s Law
Dilemmas of Inclusion
References
113. Education Law- Implications for Developmental-Behavioral Pediatrics
113
Education Law: Implications for Developmental-Behavioral Pediatrics
Overview
Special education: The Individuals with Disabilities Education Act
History of IDEA
Part B of IDEA
Response to Intervention
Part C of IDEA
Accountability: The Every Student Succeeds Act
Civil rights: Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990
Implications for clinicians
References
114. Health Care Systems for Children With Disabilities
114
Health Care Systems for Children With Disabilities
Introduction
Goals of the Health Care System
Quality and Value of Health Care
Achieving the Goals of the Health Care System for Children with Disabilities
Access to Care
Health Insurance and Financing
Private insurance.
Medicare and Medicaid.
Medicaid waivers and demonstrations.
Children’s Health Insurance Program (Chip).
The Affordable Care Act (ACA).
Other Funding Sources That Promote Access to Health Care
Supplemental Security Income (SSI).
Title V Maternal and Child Health (MCH) Program.
Achieving a Better Life Experience (ABLE) savings accounts.
Special needs trusts.
Adequacy of Insurance Coverage for Children With Disabilities
Benefits
Continuity of Coverage
Delivering Health Care
Primary Care Medical Home
Coordination of Care
Innovations in Health Care Delivery for Children With Disabilities
Health Homes and the Medical Neighborhood
Mental Health Integration
Telehealth
Conclusion
References
115. Interprofessional Team-Based Care
115
Interprofessional Team-Based Care
Introduction
Complexity in Clinical Practice
Fragmentation Across Systems
Fragmentation Across Providers
Delivery of Interprofessional Team-Based Care
Models
Coordinated
Colocated
Integrated
Team-Based Strategies
Team Huddles
Debriefs
Barriers to Interprofessional Care
Physical Space
Time
Information Sharing and Security
Hiring and Training
Hiring
Training
Implications for Practice, Payment, and Policy
Conclusion
Resources
References
116. Ethical Considerations
116
Ethical Considerations
Introduction
A Brief Review of Ethical Theories
Principlism
Natural Law Ethics
Virtue Ethics
Utilitarianism
Deontology
Casuistry
Narrative Ethics
Historical Experiences of Individuals with Disabilities
Suggestions for Practical Consideration
A Few Practical Suggestions
Conclusion
References
117. The Pitfalls of Guardianship (Conservatorship) and the Promise of Alternatives
117
The Pitfalls of Guardianship (Conservatorship) and the Promise of Alternatives
Overview
What is a guardianship?
Why be Wary of Guardianships?
The Guardianship Will Outlast the Guardian, in Which Case the Court Holds the Control
Guardianships Do Not Necessarily Make People Safer Self-Determination Can Make People Safer
Guardianship Includes a Harmful Message
What are the Alternatives?
Alternatives for Specific Scenarios
Supported Decision Making
What Choices Need Support?
How Does Supported Decision Making Differ From Guardianship?
What Does a Supported Decision-Making Agreement Look Like?
Conclusion
Additional resources
References
118. The Right to Belong, The Right to be Different
118
The Right to Belong, The Right to be Different
The Right to Belong
The Right to be Different
A Final Word