Pediatric anxiety disorders are common and often debilitating conditions.Cognitive is a psychosocial intervention that represents a potentially powerful antidote to these disorders.This article reviews data from treat...Pediatric anxiety disorders are common and often debilitating conditions.Cognitive is a psychosocial intervention that represents a potentially powerful antidote to these disorders.This article reviews data from treatment outcome studies,meta-analyses,and systematic reviews as well as from moderation/mediational investigations.The literature supports the efficacy,effectiveness,and durability of positive treatment outcomes for pediatric anxiety disorders.Recommendations for clinical applications are suggested.展开更多
Background: Behavioral feeding disorders are common among children, which sometimes become progressive, and consequently, children may refuse to eat anything. Parents have lots of difficulties to reset such a disturbe...Background: Behavioral feeding disorders are common among children, which sometimes become progressive, and consequently, children may refuse to eat anything. Parents have lots of difficulties to reset such a disturbed eating pattern. The aim of this study was to perform an analysis of clinical intervention in behavioral feeding disorders in young children. Methods: We conducted a retrospective analysis of data of 28 children aged 1 - 9 years with behavioral feeding disorders. A pediatrician and pediatric social worker conducted the training in two groups: outpatient or inpatient setting. Both groups were treated with parental education and guidance. The inpatient group also had a temporarily (2 weeks) resetting of the pedagogic climate in a pediatric ward of a general hospital under guidance of a pediatric social worker. Results: Almost all parents were inconsistent in applying appropriate behavioral contingencies during meals. Eleven patients followed 8 months of outpatient treatment and 25 patients followed 2 weeks of inpatient treatment. The overall success rate of outpatient treatment after 2 weeks was 18%, and that of inpatient treatment after 8 months was 88%. The corrected relapse rates are 18% and 56% respectively after 6 months. Conclusion: Short clinical intervention in a structured pedagogic environment is a successful treatment in behavioral feeding disorders. Herewith, pediatricians have a powerful tool for treating behavioral feeding disorders by temporarily resetting and changing the pedagogic climate.展开更多
Clinical supervision of cognitive behavioral therapy(CBT) with youth ensures better patient care and fosters trainees' professional development. However,often insufficient attention is directed toward disseminatin...Clinical supervision of cognitive behavioral therapy(CBT) with youth ensures better patient care and fosters trainees' professional development. However,often insufficient attention is directed toward disseminating best practices in supervision of CBT with youth. This Therapeutic Advances contribution aims to communicate the core content of supervision. Additionally, the key supervisory practices associated with CBT with youth are described. Supervisory outcomes are summarized and recommendations for supervisory practices are made.展开更多
Background： Anecdotally, parents often report that children with attention deficit hyperactivity disorder （ADHD） who engage in regular physical activity （PA） experience positive behavioral changes. The purpose of...Background： Anecdotally, parents often report that children with attention deficit hyperactivity disorder （ADHD） who engage in regular physical activity （PA） experience positive behavioral changes. The purpose of this study was to examine this anecdotal relationship to provide preliminary evidence relevant to the potential benefits of PA on ADHD symptoms. Methods： Parents （n = 68） of children diagnosed with ADHD completed an lnternet survey assessing perceptions of how PA influences their child＇s symptoms. Results： A significantly greater percentage of parents reported that regular PA positively impacted symptoms. However, there were no uniform effects for all types of ADHD symptoms. The results indicate that there may be more positive benefits for symptoms of inattention and hyperactivity than for those of impulsivity. Conclusion： This is the first study to empirically document parents＇ perceptions of how PA influences ADHD and suggests that PA can be a viable strategy for reducing symptoms. PA may have greater benefits for specific symptoms of ADHD, providing critical information for developing PA interventions for children and adolescents.展开更多
Functional abdominal pain disorders(FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, ab...Functional abdominal pain disorders(FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, abdominal migraine, and the one not previously present in Rome Ⅲ, functional abdominal pain not otherwise specified. In the absence of sufficiently effective and safe pharmacological treatments for this public problem, non-pharmacological therapies emerge as a viable means of treating these patients, avoiding not only possible side effects, but also unnecessary prescription, since many of the pharmacological treatments prescribed do not have good efficacy when compared to placebo. Thus, the present study provides a review of current and relevant evidence on non-pharmacological management of FAPDs, covering the most commonly indicated treatments, from cognitive behavioral therapy to meditation, acupuncture, yoga, massage, spinal manipulation, moxibustion, and physical activities. In addition, this article also analyzes the quality of publications in the area, assessing whether it is possible to state if non-pharmacological therapies are viable, safe, and sufficiently well-based for an appropriate and effective prescription of these treatments. Finally, it is possible to observe an increase not only in the number of publications on the non-pharmacological treatments for FAPDs in recent years, but also an increase in the quality of these publications. Finally, the sample selection of satisfactory age groups in these studies enables the formulation of specific guidelines for this age group, thus avoiding the need for adaptation of prescriptions initially made for adults, but for children use.展开更多
AIM To examine the extent to which the theory of planned behavior(TPB) predicts academic clinicians' intent to treat pediatric obesity.METHODS A multi-disciplinary panel iteratively devised a Likert scale survey b...AIM To examine the extent to which the theory of planned behavior(TPB) predicts academic clinicians' intent to treat pediatric obesity.METHODS A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes.A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012.Descriptive statistics were used to summarize demographic and item agreement data.A hierarchical linear regression analysis controlling for demographic variables was conducted to examine the extent to which the TPB subscales predicted intent to treat pediatric obesity.RESULTS A total of 198 physicians,surgeons,and allied healthprofessionals across Canada(British Columbia,Alberta,Manitoba,Saskatchewan,Nova Scotia,Ontario and Quebec) completed the survey.On step 1,demographic factors accounted for 7.4% of the variance in intent scores.Together in step 2,demographic variables and TPB subscales predicted 56.9% of the variance in a measure of the intent to treat pediatric obesity.Perceived behavioral control,that is,confidence in one's ability to manage pediatric obesity,and subjective norms,congruent with one's context of practice,were the most significant predictors of the intent to treat pediatric obesity.Attitudes and barriers did not predict the intent to treat pediatric obesity in this context.CONCLUSION Enhancing self-confidence in the ability to treat pediatric obesity and the existence of supportive treatment environments are important to increase clinician's intent to treat pediatric obesity.展开更多
文摘Pediatric anxiety disorders are common and often debilitating conditions.Cognitive is a psychosocial intervention that represents a potentially powerful antidote to these disorders.This article reviews data from treatment outcome studies,meta-analyses,and systematic reviews as well as from moderation/mediational investigations.The literature supports the efficacy,effectiveness,and durability of positive treatment outcomes for pediatric anxiety disorders.Recommendations for clinical applications are suggested.
文摘Background: Behavioral feeding disorders are common among children, which sometimes become progressive, and consequently, children may refuse to eat anything. Parents have lots of difficulties to reset such a disturbed eating pattern. The aim of this study was to perform an analysis of clinical intervention in behavioral feeding disorders in young children. Methods: We conducted a retrospective analysis of data of 28 children aged 1 - 9 years with behavioral feeding disorders. A pediatrician and pediatric social worker conducted the training in two groups: outpatient or inpatient setting. Both groups were treated with parental education and guidance. The inpatient group also had a temporarily (2 weeks) resetting of the pedagogic climate in a pediatric ward of a general hospital under guidance of a pediatric social worker. Results: Almost all parents were inconsistent in applying appropriate behavioral contingencies during meals. Eleven patients followed 8 months of outpatient treatment and 25 patients followed 2 weeks of inpatient treatment. The overall success rate of outpatient treatment after 2 weeks was 18%, and that of inpatient treatment after 8 months was 88%. The corrected relapse rates are 18% and 56% respectively after 6 months. Conclusion: Short clinical intervention in a structured pedagogic environment is a successful treatment in behavioral feeding disorders. Herewith, pediatricians have a powerful tool for treating behavioral feeding disorders by temporarily resetting and changing the pedagogic climate.
文摘Clinical supervision of cognitive behavioral therapy(CBT) with youth ensures better patient care and fosters trainees' professional development. However,often insufficient attention is directed toward disseminating best practices in supervision of CBT with youth. This Therapeutic Advances contribution aims to communicate the core content of supervision. Additionally, the key supervisory practices associated with CBT with youth are described. Supervisory outcomes are summarized and recommendations for supervisory practices are made.
文摘Background： Anecdotally, parents often report that children with attention deficit hyperactivity disorder （ADHD） who engage in regular physical activity （PA） experience positive behavioral changes. The purpose of this study was to examine this anecdotal relationship to provide preliminary evidence relevant to the potential benefits of PA on ADHD symptoms. Methods： Parents （n = 68） of children diagnosed with ADHD completed an lnternet survey assessing perceptions of how PA influences their child＇s symptoms. Results： A significantly greater percentage of parents reported that regular PA positively impacted symptoms. However, there were no uniform effects for all types of ADHD symptoms. The results indicate that there may be more positive benefits for symptoms of inattention and hyperactivity than for those of impulsivity. Conclusion： This is the first study to empirically document parents＇ perceptions of how PA influences ADHD and suggests that PA can be a viable strategy for reducing symptoms. PA may have greater benefits for specific symptoms of ADHD, providing critical information for developing PA interventions for children and adolescents.
文摘Functional abdominal pain disorders(FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, abdominal migraine, and the one not previously present in Rome Ⅲ, functional abdominal pain not otherwise specified. In the absence of sufficiently effective and safe pharmacological treatments for this public problem, non-pharmacological therapies emerge as a viable means of treating these patients, avoiding not only possible side effects, but also unnecessary prescription, since many of the pharmacological treatments prescribed do not have good efficacy when compared to placebo. Thus, the present study provides a review of current and relevant evidence on non-pharmacological management of FAPDs, covering the most commonly indicated treatments, from cognitive behavioral therapy to meditation, acupuncture, yoga, massage, spinal manipulation, moxibustion, and physical activities. In addition, this article also analyzes the quality of publications in the area, assessing whether it is possible to state if non-pharmacological therapies are viable, safe, and sufficiently well-based for an appropriate and effective prescription of these treatments. Finally, it is possible to observe an increase not only in the number of publications on the non-pharmacological treatments for FAPDs in recent years, but also an increase in the quality of these publications. Finally, the sample selection of satisfactory age groups in these studies enables the formulation of specific guidelines for this age group, thus avoiding the need for adaptation of prescriptions initially made for adults, but for children use.
基金Supported by the Hamilton Health Sciences New Investigator Award,No.NIF-N10-240the Mc Master Surgical Associates Innovation Grant+1 种基金the Jack Laidlaw Chair in Patient-Centered Health Carethe Mc Master Children’s Hospital Foundation
文摘AIM To examine the extent to which the theory of planned behavior(TPB) predicts academic clinicians' intent to treat pediatric obesity.METHODS A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes.A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012.Descriptive statistics were used to summarize demographic and item agreement data.A hierarchical linear regression analysis controlling for demographic variables was conducted to examine the extent to which the TPB subscales predicted intent to treat pediatric obesity.RESULTS A total of 198 physicians,surgeons,and allied healthprofessionals across Canada(British Columbia,Alberta,Manitoba,Saskatchewan,Nova Scotia,Ontario and Quebec) completed the survey.On step 1,demographic factors accounted for 7.4% of the variance in intent scores.Together in step 2,demographic variables and TPB subscales predicted 56.9% of the variance in a measure of the intent to treat pediatric obesity.Perceived behavioral control,that is,confidence in one's ability to manage pediatric obesity,and subjective norms,congruent with one's context of practice,were the most significant predictors of the intent to treat pediatric obesity.Attitudes and barriers did not predict the intent to treat pediatric obesity in this context.CONCLUSION Enhancing self-confidence in the ability to treat pediatric obesity and the existence of supportive treatment environments are important to increase clinician's intent to treat pediatric obesity.
