Children In Pediatric Setting Research Articles

Supporting Migrant Children in Pediatric Settings: Lessons Learned from the US Migrant Humanitarian Crisis Response.

This article examines the influx of migrants to the United States and highlights current global and local immigration trends. The authors focus on migrant children-specifically the effect of migration trauma in the context of humanitarian responses to the intentional movement of migrants to Democrat-led cities across the US to humanize the compounded effects of migration trauma, restrictive immigration policies, and the current resettlement landscape for migrants. The authors are directly involved with supporting migrant arrivals who have relocated to Chicago from the southern border, and apply field knowledge to articulate current barriers to accessing health care and best practices within pediatric settings supporting migrant arrivals. Clinical and practice implications for medical providers in pediatric settings are included. The article also highlights the role of interdisciplinary collaboration in providing health care to asylum-seeking migrants and implications for transdisciplinary workforce development in this area. [Pediatr Ann. 2024;53(5):e171-e177.].

Improving Parenting Skills for Families of Young Children in Pediatric Settings

Disruptive behavior disorders, such as attention-deficient/hyperactivity disorder and oppositional defiant disorder, are common and stable throughout childhood. These disorders cause long-term morbidity but benefit from early intervention. While symptoms are often evident before preschool, few children receive appropriate treatment during this period. Group parent training, such as the Incredible Years program, has been shown to be effective in improving parenting strategies and reducing children's disruptive behaviors. Because they already monitor young children's behavior and development, primary care pediatricians are in a good position to intervene early when indicated. To investigate the feasibility and effectiveness of parent-training groups delivered to parents of toddlers in pediatric primary care settings. This randomized clinical trial was conducted at 11 diverse pediatric practices in the Greater Boston area. A total of 273 parents of children between 2 and 4 years old who acknowledged disruptive behaviors on a 20-item checklist were included. A 10-week Incredible Years parent-training group co-led by a research clinician and a pediatric staff member. Self-reports and structured videotaped observations of parent and child behaviors conducted prior to, immediately after, and 12 months after the intervention. A total of 150 parents were randomly assigned to the intervention or the waiting-list group. An additional 123 parents were assigned to receive intervention without a randomly selected comparison group. Compared with the waiting-list group, greater improvement was observed in both intervention groups (P < .05). No differences were observed between the randomized and the nonrandomized intervention groups. Self-reports and structured observations provided evidence of improvements in parenting practices and child disruptive behaviors that were attributable to participation in the Incredible Years groups. This study demonstrated the feasibility and effectiveness of parent-training groups conducted in pediatric office settings to reduce disruptive behavior in toddlers. clinicaltrials.gov Identifier: NCT00402857.

The role of mental health service providers in protection from child and adolescent abuse and neglect – a Serbian example

Health care professionals are in a position to recognize abused children in pediatric settings. They recognize the importance of improving the physician’s ability to recognize different forms of child abuse and other forms of family violence. The aim of the paper is to present the model of health care activities in protection from and prevention of child abuse and neglect. The Republic of Serbia has made significant efforts in the protection of children from abuse and neglect since the year 2000. A General Protocol for protection of children from abuse and neglect has been adopted, as well as a series of special protocols, including the Special Protocol within the health care system, which was implemented in 2009. The Special Protocol defines the obligation of all healthcare institutions to form a team of experts tasked to recognize, register and intervene in cases of abuse and neglect. The first such team was formed even before the legal obligation in the Institute of Mental Health in 2000. Conclusion – abuse and neglect leaves numerous short and long term consequences detrimental to child development. It is the professional, legal and moral duty of health professionals to react to child abuse and neglect. The role of the health care system in the protection of children is to make sure that every health professional, government agency, or service user (child or parent) take their share of the responsibility, in order to create an environment where each childis protected from abuse or neglect.

Communicating with Children in Healthcare Settings

Children are vulnerable to experiencing stress during clinic visits and hospitalization. Children process information differently than adults due to their cognitive abilities and communication skills. There is paucity of literature on the subject of communicating with children in pediatric settings in India. This article highlights the developmental and theoretical principles which underscore the need for communicating directly with children about their healthcare experiences. Understanding the ongoing interactional influences of developmental perceptions, stress, coping, information processing, parental role, psychological preparation, and the child rights perspective may reinforce the necessity for pediatric caregivers to develop attitudes and skills to communicate with children and their family members in an inclusive and supportive manner. A brief overview of elements influencing the communication process is provided. Practical recommendations for developmentally appropriate, child friendly communication techniques while respecting children's right to participation and expression are highlighted. Collaborating with parents and child development professionals, as well as using relevant educational programs could facilitate clearer child focused communication. Incorporating effective communication practices in pediatric settings could improve the focus on children's holistic health and wellbeing.

Screening for maternal depression in a low education population using a two item questionnaire

To assess a two-question screening tool, the Patient Health Questionnaire-2 (PHQ-2), for identifying depressive symptomatology in economically disadvantaged mothers of children in pediatric settings and to explore risk factors associated with a positive depression screen. A convenience sample of mothers was enrolled at an inner city well-child clinic with children age 3 days to 5 years. The PHQ-2 and Edinburgh Postnatal Depression Scale (EPDS) (as reference scale) were completed. Ninety-four mothers participated. Agreement of the PHQ-2 and EPDS was moderate. The sensitivity of the PHQ-2 for identifying a positive screen on the EPDS was 43.5%; the specificity was 97.2%. The sensitivity of the PHQ-2 was higher for mothers with education beyond high school compared to those with less education. Perceived lack of support with child care and having two or more children were associated with a positive screen. The rate of positive screen was similar for mothers with infants and with older children. Given the low sensitivity of the PHQ-2 in lower educated mothers, additional research in populations with varying sociodemographic characteristics is indicated. Similar rates of symptoms for mothers within and beyond the postpartum period and mothers previously screened support the need for periodic screening.

Accuracy of assessment: the discriminative and predictive power of the Eyberg Child Behavior Inventory

ABSTRACTObjective The discriminative and predictive power of the Eyberg Child Behavior Inventory (ECBI) was assessed using revised clinical cut‐off scores. Sensitivity, specificity, and positive and negative predictive power were calculated to evaluate the effectiveness of the revised score in screening children for treatment of disruptive behavior problems.Sample Participants were drawn from archival samples of 196 children aged 3–6 whose mothers had completed an ECBI. The disruptive behavior group (n = 98) consisted of children referred for psychological treatment who met diagnostic criteria for Oppositional Defiant Disorder or Conduct Disorder. The non‐diagnosed group (n = 98) consisted of children visiting pediatric clinics whose mothers did not check the box on their demographic information questionnaire endorsing the presence of behavior problems.Design Children in the non‐diagnosed group were selected to match the disruptive behavior group on socio‐economic status, age, and sex. The mothers' scores on the ECBI Intensity Scale were used to calculate the sensitivity and specificity, positive and negative predictive power, and kappa of the ECBI.Results The ECBI Intensity Scale correctly classified 91% of the children, with 96% of the diagnosed children correctly classified and 87% of the non‐diagnosed children correctly classified.Implications for practice This study further validates the ECBI for use as a screening measure for children in pediatric settings who require further evaluation or treatment for disruptive behavior problems.

Consultation-Liaison in Child Psychiatry: A Review of the Past 10 Years. Part I: Clinical Findings

To critically review clinical reports on pediatric consultation-liaison psychiatry over the past 10 years. Articles contributing to the understanding of child psychiatric consultation in medical settings were reviewed. Information related to clinical issues was organized into categorical (disease-oriented), noncategorical, and family studies. Newer articles on ethical considerations in caring for medically ill children are summarized. Research has continued to focus on and reflect the importance of the emotional and behavioral needs of children in pediatric settings and the adaptation and stress within families who care for chronically ill children. Given the increased complexity and demands of medical care, the training and skills of a child psychiatrist in pediatric consultation remain a valuable component of comprehensive care for children.

Rights of Children in Pediatric Settings: A Survey of Attitudes

This study compares the attitudes of parents and health care professionals toward the bill of rights for children in pediatric settings of the National Association of Children's Hospitals and Related Institutions (NACHRI) and a locally developed ombudsman committee bill of rights. Parents (N = 64), attending physicians (N = 33), resident physicians (N = 17), nurses (N = 27), nonmedical professionals (N = 35), administrators (N = 18), and clerical workers (N = 17) were surveyed. Each person rated statements derived from the bills from "strongly agree" to "strongly disagree." Analyses of variance indicated a high level of agreement overall for both bills by all groups; however, the local bill was significantly preferred. There were significant differences in agreement between the groups for the local bill and the two bills combined (an overall measure of attitudes about children's rights in pediatric settings). Attending physicians tended to agree significantly less than other groups. On the 32 individual items, attending or resident physicians were significantly lower in agreement than most other groups on 11 items, and nurses were lowest on one other. Disagreement was strongest on items concerning abortion or contraception, the child's right to privacy, the right to consent to care, and the right to have an immediate response from the physician in understandable language.