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ABSTRACT: This study reviewed Kentucky Medicaid claims data for children with autism spectrum disorders to determine psychotropic drug (PTD) use in this population. Children with autism spectrum disorders (ICD-9 code 299.XX) in 3 different age-groups from 2005 to 2008 were identified; PTD use was defined as at least 1 prescription per year. PTD use in all age ranges was higher than in previously reported studies. High PTD use in children between 1 and 5 years is particularly of concern and may reflect perceived inadequacies of comprehensive educational/behavioral services for these children.
Clinical Pediatrics 04/2012; 51(10):923-7. · 1.15 Impact Factor
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ABSTRACT: The diagnosis of attention deficit/hyperactivity disorder (ADHD) in children has been steadily increasing over the past 10 years. ADHD is associated with numerous health, behavioral, social, and academic outcomes. The use of medication is common for the treatment of ADHD. However, the evidence base for pharmacological and non-pharmacological treatments for children younger than 6 years of age is limited. Both short-term and long-term studies of efficacy and safety of all interventions are needed in this population, especially the use of psychotropic medications. Understanding the long-term effects of psychotropic medication on the developing brains of preschoolers has important implications for outcomes into adulthood. Nonpharmacologic evidence-based interventions are available and should serve as the first line of treatment in this population. Future research needs include further evidence regarding specific curricula, dose, duration, delivery methods, and staff training to ensure optimal intervention outcomes.
Clinical Pediatrics 02/2011; 50(2):144-52. · 1.15 Impact Factor
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ABSTRACT: Children born prematurely have been shown to have a range of problems that often result in delayed academic achievement.
The current study assessed both attention problem scores (Child Behavior Checklist) and actual performance on tasks tapping three attention networks in a sample of children (n = 94) born with very low birth weights (VLBW; < or = 1500 grams).
Attention problem scores were extremely low and did not predict children's actual attention performance.
A body of research is developing that suggests VLBW children may have specific, yet subtle, attention problems that may differ from those of other children.
Journal of Child and Adolescent Psychiatric Nursing 06/2007; 20(2):74-85.
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ABSTRACT: This study examined the relationship between lead exposure and attention regulation in children from low-income families. Children with lead exposure were expected to have lower attention regulation abilities than children who were not exposed. The 57 participants (39% male, 61% female) were children aged 4 and 5 years (mean age 4y 7mo [SD 5mo]); 24 children were lead-exposed (10-29microg/dl) and 33 were non-exposed comparisons (1-6microg/dl). Both groups qualified to be enrolled in programs for low-income families. A puzzle-matching task was completed in parent-child and child-alone conditions. Attention allocation and puzzle-matching performance were assessed in the two conditions. Children who were lead-exposed demonstrated less self-regulated attention than comparisons and had poorer puzzle performance in the child-alone condition. Attention patterns did not differ in the parent-child condition. This study extends previous knowledge concerning effects of lead exposure on preschool children from disadvantaged environments and suggests that lead exposure affects specific attention regulation abilities.
Developmental Medicine & Child Neurology 01/2005; 46(12):825-31. · 2.92 Impact Factor
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ABSTRACT: This study examined the relationship between lead exposure and attention regulation in children from low-income families. Children with lead exposure were expected to have lower attention regulation abilities than children who were not exposed. The 57 participants (39% male, 61% female) were children aged 4 and 5 years (mean age 4y 7mo [SD5mo]); 24 children were lead-exposed (10–29µg/dl) and 33 were non-exposed comparisons (1–6µg/dl). Both groups qualified to be enrolled in programs for low-income families. A puzzle-matching task was completed in parent–child and child-alone conditions. Attention allocation and puzzle-matching performance were assessed in the two conditions. Children who were lead-exposed demonstrated less self-regulated attention than comparisons and had poorer puzzle performance in the child-alone condition. Attention patterns did not differ in the parent–child condition. This study extends previous knowledge concerning effects of lead exposure on preschool children from disadvantaged environments and suggests that lead exposure affects specific attention regulation abilities.
Developmental Medicine & Child Neurology 11/2004; 46(12):825 - 831. · 2.92 Impact Factor
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ABSTRACT: The ecological model is used as a framework for applying social justice concepts to the care of childbearing women and families. In this model, the environment of childbearing women has 3 distinct levels: macrosystem, mesosystem, and microsystem. Two scenarios are described and examples of nursing actions to promote social justice at each level are provided. This article demonstrates how maternal/infant nursing practice can be expanded to promote health equities, social justice, and support.
Journal of Obstetric Gynecologic & Neonatal Nursing 39(3):339-46; quiz 346-8. · 1.03 Impact Factor
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ABSTRACT: Millions of children in the U.S. suffer from asthma. A disproportionately large number of those children are from low-income and racial minority families. With or without asthma, children from low-income families are at risk for delayed school readiness and less than optimal academic achievement trajectories. The aim of this article was to review the literature on educational interventions for young children with asthma and their families to determine if there was sufficient evidence to guide practice. In addition, a new theoretical model upon which to base new interventions is proposed. Literature was reviewed from Medline, CINAHL, PsycInfo, and the Cochrane Reviews databases. A limited number of randomized, controlled studies of educational interventions for children and their families was found, and only one study was specifically aimed at preschool-age children. Comparisons among studies are difficult because of varying methodologies, and findings are non-conclusive. In conclusion, comprehensive, multidisciplinary, multi-level interventions are needed to minimize the effects of childhood asthma, especially for children from low-income families. Large-scale, randomized, controlled studies are needed to provide empirical evidence for the efficacy of specific interventions for preschoolers prior to school entry to minimize the detrimental effects of uncontrolled asthma on school achievement.
Pediatric nursing 37(1):31-8.
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ABSTRACT: This study examines the relation of maternal scaffolding and children's attention regulation abilities in preschool children from low-income families within the context of a parent–child interaction task and in a child-alone task. Maternal scaffolding behaviors differed for mothers of children with different attention regulation skills. Mothers whose children demonstrated poor attention regulation skills in the parent–child interaction were more likely to verbally engage their children, including more strategic questions, verbal hints, and verbal prompts. Children's level of attention regulation skills interacted with mother's amount of scaffolding to predict performance in the child-alone task. Attention regulation skills were related to independent performance only in the context of high maternal scaffolding. Findings contribute new information important for parent interventions to promote attention regulation skills in children who are at risk for poor academic achievement outcomes.
Journal of Applied Developmental Psychology 30(2):82-91. · 1.85 Impact Factor
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Deborah Winders Davis
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ABSTRACT: Internal and external validity of a study determine the generalizability of its findings. Measurement reliability and validity, which also have an impact on the overall validity of the study, will be discussed in the next column. Although the concepts have been pulled apart for this discussion, all of these factors influence the overall confidence with which researchers can say that they have measured what was intended and that the findings can be applied to a larger population of individuals.
Neonatal network: NN 23(1):54-6.
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Deborah Winders Davis
Neonatal network: NN 24(3):77-9.
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Deborah Winders Davis
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ABSTRACT: Every step of the research process involves decisions that must be made. In almost all cases, there are many possible choices, and none of them is wrong. However, it is up to the researcher to consider all of the options and systematically eliminate possibilities based on a theoretical framework, previous findings and methods described in the literature, or circumstances specific to each research question. When the methods used are less than ideal for some reason, the researcher should identify the problems as limitations to the study. Sometimes the limitations restrict the population to which the data can be generalized. In other instances, the limitations identify new areas of study that the current investigation did not address, but for which the current data provide support.
Neonatal network: NN 24(1):59-62.
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Deborah Winders Davis
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ABSTRACT: Many factors must be considered in planning and implementing research. Scientific reasons for decisions are important, but so are practical considerations. The suggestions made throughout this column are based on experience and may seem to some to be simply "common sense." However, the importance of these practical, common sense considerations cannot be minimized. These practical suggestions are intended to bring into focus the fact that the research process is not that different from other decision-making processes: In research as in life, there are multiple ways to get from point A to point B, and none of them is inherently right or wrong. The choices the researcher makes in designing and implementing a study must be clearly described and must be based on the research goals, the theoretical framework used, and the resources available. Potential nurse researchers should not be intimidated by the task at hand. Rather, they should be comforted by the fact that the same processes they use in making decisions about clinical practice can be employed in designing and implementing research studies.
Neonatal network: NN 23(5):71-3.
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ABSTRACT: A literature review to contrast the role of social and professional support in improving maternal and infant outcomes in pregnant and parenting women. In addition, recommendations are made for future research and policy and program development concerning support needed by pregnant and parenting women.
Data were limited to published studies. Searches of computerized databases, hand searches of journals, and backward searches from reference lists of studies were conducted. Nursing, medicine, psychology, public health, sociology, and social work literatures were searched (CINAHL, Medline, PsychLit, Social Sciences Abstracts, Social Sciences Citation, and Social Work Abstracts).
The studies focused on outcomes of social support and professional support to pregnant and parenting women. The samples of the studies included pregnant women and parenting women up to 2 years postpartum. Studies reviewed were conducted in the United States or Canada and included maternal and/or infant outcomes. All ages and races of pregnant and parenting women were considered.
Data were extracted from each study concerning the theoretical framework, variables, sample, design, measuring instruments, interventions, and outcomes.
Social support outcomes were summarized in paragraphs while a table was used to summarize professional support intervention outcomes.
Outcomes associated with specific support interventions should be clearly identified, informed by theory, and include assisting the pregnant and parenting woman to improve her social support.
MCN The American Journal of Maternal/Child Nursing 28(6):371-6. · 1.12 Impact Factor
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Deborah Winders Davis
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ABSTRACT: An experimental design is necessary for making cause-and-effect judgments about study variables. Although most researchers would agree that the experimental design is desirable, such a design is not possible or appropriate for every study--and even without an experimental design for support of the hypothesis, enough evidence might exist for a researcher to feel somewhat comfortable that variable X causes Y. At the very least, it can be demonstrated that X is always related to Y in some number of settings, with multiple samples of subjects and with controls for as many variables as possible. Before deciding to change a practice based on research findings, however, the clinician must also determine if X is not related to Y in some cases. Without experimental findings, the amount and quality of evidence available must be considered. This column has described three major types of research: experimental, quasi-experimental, and nonexperimental. Each type of research can produce valuable scientific evidence if the study is designed and implemented carefully. The type of research design and its appropriateness for the specific research question is only one consideration in critiquing research findings and making decisions about the application of those findings in practice settings. Future columns will address other considerations.
Neonatal network: NN 22(5):65-7.
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Deborah Winders Davis
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ABSTRACT: The purpose of this article is to discuss findings in the literature regarding long-term developmental outcomes of infants born prematurely, to examine potential causes of individual differences in these outcomes, and to explore directions for future research. An extensive table summarizes recent (1996-2002) international studies of developmental outcomes among children of school age and older who were born with low birth weight, especially as the studies relate to cognitive development and academic performance. The discussion then examines how characteristics of the child and the environment may interact to produce individual differences in outcomes. Processes of attention regulation within the context of the psychosocial environment are examined as an important possible direction for future research. When designing and implementing interventions aimed at improving outcomes in this and other groups of children at risk for delays and deficits, it is important to consider how various factors affect development.
Neonatal network: NN 22(3):27-38.
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ABSTRACT: The goal of this pilot study was to understand attention behaviors in extremely low-birth-weight (ELBW) children within the context of parent-child interactions and their relation to the child's independent performance.
Parent-child and child-alone puzzle matching tasks, demographics, and IQ were measured in a sample of 15 4-year-olds who weighed <1000 g at birth and were free from major disability.
A self-regulated and efficient strategy during the parent-child puzzle was related to using an efficient strategy when working alone. Attention regulation during the parent-child puzzle was related to accuracy in the child-alone task. Parents appeared to be regulating attention appropriately.
Understanding the mechanisms of attention regulation in ELBW children could lead to specific interventions to support parents in strengthening their children's self-regulatory functioning.
Journal for Specialists in Pediatric Nursing 9(3):85-94. · 0.83 Impact Factor
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ABSTRACT: A disproportionate number of very low birth weight (VLBW; < or =1500 g) children require special education services and have school-related problems even when they are free from major disabilities and have average intelligence quotient scores. Visual-perceptual problems have been suggested as contributors to deficits in academic performance, but few data are available describing specific visual-perceptual problems. This study was designed to identify specific visual-perceptual skills in VLBW children.
Participants were 92 VLBW children aged 4 through 5 years who were free from major disability and appropriate for gestational age at birth. The Test of Visual-Perceptual Skills (non-motor)-Revised was used.
Despite intelligent quotient scores in the average range, the majority (63% to 78.3%) of the children performed below age level on all seven subscales of a normed assessment of visual perceptual skills.
Results suggest that visual perceptual screening should be considered as a part of routine evaluations of preschool-aged children born prematurely. Early identification of specific deficits could lead to interventions to improve achievement trajectories for these high-risk children.
Journal of Pediatric Health Care 19(6):363-8. · 1.66 Impact Factor
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ABSTRACT: To review evidence regarding the role of paraprofessional support in improving maternal and infant outcomes in pregnant and parenting women. Although support provided by significant others (social support), by professionals, and by paraprofessionals are frequently considered together in literature reviews, this is inappropriate because the components of the support in each case differ.
Data were limited to published studies. Searches of computerized databases (CINAHL, Medline, PsychLit, Social sciences abstracts, Social sciences citation, and Social work abstracts), hand searches of journals, and backward searches from reference lists of studies were conducted. Nursing, medicine, psychology, public health, sociology, and social work literatures were searched.
The studies included had statistically significant outcomes of paraprofessional support to pregnant and parenting women. Studies were published in 1985 or later, were conducted in the United States or Canada, and included maternal and/or infant outcomes.
Data were extracted from each study concerning the theoretical framework, design, sample, measuring instruments, interventions, and outcomes.
Programs providing paraprofessional support to childbearing women are clearly providing an important service, but empirical evidence is not adequate to determine which specific paraprofessional program works for a specific population of women to achieve the best long-term outcomes for both women and children. Although proponents of paraprofessional support programs for pregnant and parenting women have reported some successes, more data are needed. Researchers should continue to conduct well-designed and controlled studies to compare outcomes from the three types of support. Nurses in practice should build on services provided by paraprofessionals in order to meet women's need for support and to achieve desired outcomes.
MCN The American Journal of Maternal/Child Nursing 29(2):92-7; quiz 98-9. · 1.12 Impact Factor
