Journal of developmental and behavioral pediatrics : JDBP
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J Dev Behav Pediatr · Apr 2010
Chronic hip pain in a boy with mental retardation and cerebral palsy.
Jonny is a 13 year old boy with spastic quadriparesis and severe mental retardation following Haemophilus influenza type B (HIB) meningitis at 2-months of age. Signs of meningitis started on the evening of his 2-month immunizations that included the HIB vaccine. He presented to his pediatrician with left hip pain that occurred intermittently for a few years and more frequently in the past six months. ⋯ The pediatrician called the medical director at the Shriner's Hospital to discuss Jonny's case, but 2 months after the initial visit, the parents had not arranged for an appointment at the Shriner's Hospital. Jonny's hip pain persisted. The pediatrician now wonders how he can more effectively address Jonny's current problems and improve overall care for him and his family.
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J Dev Behav Pediatr · Apr 2010
Psychosocial intervention on procedure-related distress in children being treated for laceration repair.
Research has demonstrated that emergency department visits for injured children are highly stressful experiences, especially when they include a painful procedure. This pilot study explored the impact of an intervention, which included preparation and distraction on procedure-related distress in children treated for laceration repair in the emergency department. ⋯ These findings have significant implications for children's health care and supporting family needs when a child enters the emergency department.
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J Dev Behav Pediatr · Apr 2010
An early male adolescent with externalizing behaviors, school failure, and a colostomy.
Jeff is a 14 1/2 years old ninth grader who presents with his mother, father, and step-father because he is failing in school. Jeff was born with an imperforate anus, and he had several surgical procedures in the first few years of life. He has a colostomy, but it is not clear how well he cares for it independently. ⋯ The parents acknowledge that Jeff always tries to negotiate with them and they often give in. There is no known substance abuse or illegal behavior, although he has demonstrated destructiveness and stealing at home. Jeff's mother remarried a year ago, and her husband backed her in setting more strict limits for Jeff; at Jeff's request, he is currently living with his father most of the time.
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Sophia is a 3-year-old girl who was brought to her pediatrician by her parents who were concerned about inconsolable night-time awakening. Her mother indicated that she has frequent (>6), early nocturnal awakenings accompanied by screaming and crying lasting up to 1 hour since her birth. These episodes increased in intensity and frequency in the past year since the birth of her brother. ⋯ During the office visit, Sophia required 30 minutes to warm up and smile, and over 60 minutes before she spoke her first word. Physical examination was normal (including growth measurements) and the developmental examination was age-appropriate. Upon completion of the assessment, she was engaging, playful, and cooperative with the pediatrician.