- Austin J, Manning-Courtney P, Johnson ML, Weber R, Johnson H, Murray D, Ratliff-Schaub K, Tadlock AM, Murray, M. Improving Access to Care at Autism Treatment Centers: A System Analysis Approach. Pediatrics. 2016 Feb;137 Suppl 2:S149-57.
- Access to evaluation for possible autism spectrum disorder (ASD) or other developmental concerns is notoriously challenging. Researchers gained significant improvement in access in two large clinical programs serving children with ASD using quality improvement methodology and employing well described access principles. While demand for these services may be great, through careful system analysis, improvements made will provide children much needed intervention sooner.
- Becker SP, Froehlich TE, Epstein JN. Effects of methylphenidate on sleep functioning in children with attention-deficit/hyperactivity disorder. J Dev Behav Pediatr. 2016 Jun;37:395-404.
- Children with attention-deficit/hyperactivity disorder (ADHD), whether taking ADHD medications or not, experience more sleep problems than their peers. Stimulant medication is the most common treatment for pediatric ADHD, and there has been long-standing concern that stimulant medication use may complicate sleep problems. As a result, some clinicians and families avoid using stimulant medications or increasing stimulant medication doses in children with ADHD who have pre-existing sleep problems. This randomized, double-blind, placebo-controlled trial of 163 stimulant-naïve children with ADHD showed a general association between increased dose of the stimulant medication methylphenidate and increased sleep problems in children with ADHD, particularly for children of lower weight/body mass index. However, a substantial proportion of children with pre-existing sleep difficulties no longer had sleep problems on the highest methylphenidate dose, suggesting that clinicians should not avoid methylphenidate dose titration in the clinical setting solely on the basis of a child’s premorbid sleep problems.
- Lipstein EA, Lindly OJ, Anixt JS, Britto MT, Zuckerman KE. Shared Decision Making in the Care of Children with Developmental and Behavioral Disorders. Matern Child Health J. 2016 Mar;20(3):665-73.
Using data from the National Survey of Children with Special Health Care Needs, this study compared parent perceptions about receipt of Shared Decision Making (SDM) during pediatric medical visits for a physical health condition (asthma) relative to a behavioral condition (Attention Deficit / Hyperactivity Disorder- ADHD).
Parents were less likely to perceive high levels of SDM in the care of their children with more complex developmental behavioral conditions associated with greater diagnostic and treatment complexity as well as greater functional impairments. Compared to parents of children with asthma, those with ADHD had lower odds (0.73) of reporting consistent SDM. Compared to parents of children with ADHD, those with ASD reported even lower odds of consistent SDM (0.59). This study suggests that disease type, complexity, and need for specialty care may present challenges to implementing SDM.
- Sutter C, Nishina A., Adams RE. How you look versus how you feel: Associations between BMI z-score, body dissatisfaction, peer victimization, and self-worth for African American and white adolescents. J Adolesc. 2015 Aug;43:20-8.
- In a diverse sample of 236 youth (ages 10–16 years), body dissatisfaction predicted decreases in self-worth over time even after controlling for BMI z-score. For African American youth, body dissatisfaction directly predicted decreases in self-worth for African American youth and indirectly via peer victimization for white youth. BMI z-scores predicted decreases in self-worth over time only for white adolescents.
- Becker SP, Ciesielski HA, Rood JE, Froehlich TE, Garner AA, Tamm L, Epstein JN. Uncovering a clinical portrait of sluggish cognitive tempo with an evaluation for ADHD: A case report. Clin Child Psychol Psychiatry. 2016 Jan;21(1):81-94.
- There has been long-standing concern that some children with ADHD show a distinct attentional profile that is not captured in the diagnostic criteria for ADHD and is associated with a differential ADHD comorbidity profile and treatment response. This distinct attentional profile, which is characterized by excessive daydreaming as well as slowed behavior and thinking, has been termed “sluggish cognitive tempo” (SCT). Despite the burgeoning scientific literature examining SCT, very little is known about its clinical presentation. This case study provides a clinical description of SCT in a 7-year-old girl, offering a real-life portrait of SCT while also providing an opportunity to qualitatively differentiate between SCT and ADHD, other psychopathologies (e.g., depression, anxiety), and potentially related domains of functioning (e.g., sleep, executive functioning). Preliminary evidence regarding treatment of SCT-related difficulties is also discussed.