Journal of developmental and behavioral pediatrics : JDBP
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J Dev Behav Pediatr · Aug 2003
Case ReportsMalingering by proxy: a form of pediatric condition falsification.
The deliberate production or feigning of signs or symptoms in a child by a caretaker is well recognized as factitious disorder by proxy, a psychiatric condition commonly reported in the pediatric literature. However, it is not as well recognized that the false illness portrayal may also be the result of a parent instructing the child to malinger. ⋯ Physicians are encouraged to make protecting the child from parental or iatrogenic harm a priority. Recommendations for careful confrontation and expedient resolution are made.
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J Dev Behav Pediatr · Jun 2002
Multicenter StudyThe Brigance Infant and Toddler Screen: standardization and validation.
The goal of this study is to present research behind the downward extension of the Brigance Screens into the 0- to 2-year-old age range. Items were selected from the Brigance Inventory of Early Development (standardized on 1156 children) to produce fine motor, receptive language, expressive language, gross motor, self-help, and social-emotional subtests. Sites included 29 pediatric offices, day-care centers, and developmental evaluation centers in 22 states. ⋯ Correlations with diagnostic measures were high (0.46 to 0.91). Specificity ranged from 85% to 86% and sensitivity ranged from 76% to 77%. Accordingly, the Brigance Infant and Toddler Screens are shown to be accurate, valid, and reliable tools that can be administered by a range of professionals using either parent interview or direct elicitation/observation or both.
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J Dev Behav Pediatr · Jun 2002
Comparative StudyChildren's psychological responses after critical illness and exposure to invasive technology.
Children hospitalized in pediatric intensive care units (PICUs) are subjected to highly invasive interventions necessary in overcoming the critical period of their illness, yet little is known about their subsequent psychological adjustment. The purposes of this study were to compare the psychological responses of children hospitalized in a PICU with those of children hospitalized on a general ward and to identify clinically relevant factors that might be associated with psychological outcome. A prospective cohort design was used to follow 120 children for 6 months after PICU and ward discharge. ⋯ No significant group differences were found. However, children who were younger, more severely ill, and who endured more invasive procedures had significantly more medical fears, a lower sense of control over their health, and ongoing posttraumatic stress responses for 6 months postdischarge. Findings indicate that regardless of the hospital setting, invasiveness coupled with length of stay and severity of illness in young children may have adverse long-term effects.
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J Dev Behav Pediatr · Apr 2002
Randomized Controlled Trial Clinical TrialTeaching firearm safety to children: failure of a program.
The present study investigated the effectiveness of a skills-based firearm safety program on reducing children's play with firearms. In a randomized control study, 34 children aged 4 to 7 years participated in a week-long firearm safety program; the Control Group was composed of 36 children. ⋯ Interview data revealed significant discrepancies in parent and child reports of parental gun ownership and inaccurate parental predictions of their children's interest in guns. The results of the current study cast doubt on the potential effectiveness of skills-based gun safety programs for children.
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J Dev Behav Pediatr · Feb 2002
Comparative StudyColicky infants according to maternal reports in telephone interviews and diaries: a large Scandinavian study.
In this population-based study the colic incidence was 9.4%, according to telephone interviews with the parents made when the infants were 5 weeks of age (n = 1628), and parental concern about infant crying was common. However, 7-day diaries of colicky and control infants (n = 116 + 119) revealed low distress amounts in colicky infants in general. ⋯ Even if there may be a reduction in the infantile colic incidence and support for the hypothesis that infantile colic is at least partially "in the eye of the beholder," that is, the concerned parent, a subgroup of infants may be more "genuinely colicky." Women who had stated in late-pregnancy interviews that there is a risk of spoiling an infant with too much physical contact were more likely to have infants with colic, and their infants were more distressed, even when given the same amount of physical contact. This finding warrants further elucidation.