Pain Catastrophizing and Functional Disability in Youth with Chronic Pain: An Examination of Indirect Effects.

Pediatric pain conditions are not uncommon and may lead to functional disability. The purpose of this study is to examine indirect effects of pain catastrophizing on functional disability through anxiety, depression, and pain in youth with chronic pain. Participants included 197 youth (144 females, M = 14.

Discrepancies in Assessing Symptoms of Depression in Adolescents With Diabetes Using the Patient Health Questionnaire and Semi-Structured Interviews.

Adolescents with diabetes have a higher prevalence of depression compared with their peers. The American Diabetes Association recommends routine mental health screening for youth with diabetes. This screening is often conducted through accessible and free depression screeners, such as the nine-item Patient Health Questionnaire (PHQ-9).

Multicomponent cognitive-behavioural intervention to improve sleep in adolescents: a multiple baseline design.

Background: Adolescents are prone to sleep problems that have unique developmental aspects and contribute to physical, emotional, and behavioural problems.

Aims: This study evaluated an individualized, multicomponent intervention that considered developmental factors, and promoted age-appropriate autonomy in three adolescent females with disrupted sleep.

Method: Adolescents recorded sleep data on daily logs.

Technical tips: performing EEGs and polysomnograms on children with neurodevelopmental disabilities.

Electroencephalograms (EEGs) and polysomnograms (PSGs) are critical and frequently ordered tests in the care of children with neurodevelopmental disabilities (NDD). Performing studies with this population can be very intimidating, given that the referral reasons and seizure types can be unique, and children with NDD may have any combination of behavioral or sensory challenges that can make it difficult to successfully complete a study. This article presents a variety of strategies that can be used to overcome these challenges through good preparation, patience, caregiver involvement, effective behavioral management techniques, and education about the medical aspects of EEG/ PSG in NDD.

Distraction, exposure therapy, counterconditioning, and topical anesthetic for acute pain management during needle sticks in children with intellectual and developmental disabilities.

A behavior therapy approach for obtaining cooperation during needle sticks was provided to 8 pediatric patients with intellectual and developmental disabilities. Therapy was provided during mock needle sticks. Hand lotion was applied to simulate topical anesthetic.

Using behavioral interventions to assist with routine procedures in children with cystic fibrosis.

Routine cystic fibrosis (CF) medical care includes invasive procedures that may be difficult for young children and adolescents to tolerate because of anxiety, concern with health status, or unfamiliarity with the performed tasks. A growing body of pediatric psychology literature suggests that behavior therapy can effectively increase patient cooperation with stressful medical procedures such as tracheostomy care and needle sticks. Throat cultures are obtained at least quarterly in the outpatient setting or more frequently if a CF patient develops respiratory symptoms.

Behavior management for children and adolescents with acquired brain injury.

Behavioral problems such as disinhibition, irritability, restlessness, distractibility, and aggression are common after acquired brain injury (ABI). The persistence and severity of these problems impair the brain-injured individual's reintegration into family, school, and community life. Since the early 1980s, behavior analysis and therapy have been used to address the behavioral sequelae of ABI.

Interdisciplinary behavioral rehabilitation of pediatric pain-associated disability: retrospective review of an inpatient treatment protocol.

Objective: A biopsychosocial model was used to treat pain-associated disability in children and adolescents. We assessed the clinical outcomes of children and adolescents (8-21 years of age) with pain-associated disability who were treated in an interdisciplinary inpatient rehabilitation program which included physical, occupational, and recreational therapy, medicine, nursing, pediatric psychology, neuropsychology, psychiatry, social work, and education. Psychological treatment emphasized cognitive-behavioral intervention for pain and anxiety management, and behavioral shaping to increase functioning.

Comparison of Two Brief Parent-Training Interventions for Child Distress During Parent-Administered Needle Procedures.

This randomized clinical trial employed a 2-group (general child behavior management training vs. distraction for pain management training) design across repeated parent-administered needle procedures. Forty-seven children with a chronic illness requiring recurrent injections were observed at baseline and 2 intervention sessions.

Interdisciplinary behavioral intervention for life-threatening obesity in an adolescent with Prader-Willi syndrome - a case report.

Objective: To demonstrate interdisciplinary behavioral rehabilitation for life-threatening obesity in an adolescent female with Prader-Willi syndrome.

Methods: Body Mass Index (BMI), supplemental oxygen requirement, mobility, and tantrums were documented. A 600 kcal per day diet, physical therapy, and exercise were implemented in an inpatient setting.

Behavioral intervention to increase compliance with electroencephalographic procedures in children with developmental disabilities.

The EEG, or electroencephalogram, is a neurophysiological technique used to detect and record electrical activity in the brain. It is critical to the diagnosis and management of seizure disorders, such as epilepsy, as well as other neurological conditions. The EEG procedure is often not well tolerated by children with developmental disabilities because of anxiety about unfamiliar equipment, difficulty inhibiting motion, and tactile defensiveness.

Children with seizures exhibit preferences for foods compatible with the ketogenic diet.

Although highly effective for the treatment of intractable epilepsy, the ketogenic diet is not always included in the treatment option hierarchy presented to families, in part due to perceptions that children will find the high-fat/low-carbohydrate regimen unpalatable. This study assessed if children with seizures exhibit food preferences compatible with the diet, as well as if caregivers were accurate in predicting preferences. Children aged 2-17, with (n=29) and without (n=30) a history of seizures, participated in a paired choice food preference assessment while parents estimated child preferences verbally.

Behavioral training for increasing preschool children's adherence with positive airway pressure: a preliminary study.

Behavioral training was implemented to increase adherence with positive airway pressure (PAP) in 4 preschool children. The training employed distraction, counterconditioning, graduated exposure, differential reinforcement, and escape extinction. A non-concurrent multiple baseline experimental design was used to demonstrate program effects.

Social acceptance and facial behavior in children with oral clefts.

Objective: To examine and compare social acceptance, social behavior, and facial movements of children with and without oral clefts in an experimental setting.

Design: Two groups of children (with and without oral clefts) were videotaped in a structured social interaction with a peer confederate, when listening to emotional stories, and when told to pose specific facial expressions.

Participants: Twenty-four children and adolescents ages 7 to 16(1)/(2) years with oral clefts were group matched for gender, grade, and socioeconomic status with 25 noncleft controls.

Behavioural treatment of non-compliance in adolescents with newly acquired spinal cord injuries.

Purpose: To demonstrate the efficacy of using differential reinforcement to treat non-compliance in adolescents with spinal cord injury.

Method: A case series design was used to examine three adolescents (aged 14-16 years) with tetraplegia who received multi-disciplinary rehabilitation treatment and a behavioural contract programme during an in-patient hospital admission. Assessment included collecting data on each patient's weekly percentage of compliance with all rehabilitation goals, weekly percentage of negative affect observed in therapy sessions and scores on a measure of mobility in physical therapy.

Teaching children with attention deficit hyperactivity disorder (ADHD) and autistic disorder (AD) how to swallow pills.

One barrier to medication adherence in pediatric populations is difficulty swallowing pills. Some children may not have prerequisite skills for pill swallowing, while others may have developed conditioned anxiety from repeated negative experiences. Eight children with attention deficit hyperactivity disorder or autistic disorder participated in behavioral training to increase cooperation with pill swallowing.

Behavioral training for pill-swallowing difficulties in young children with autistic disorder.

Introduction: Difficulty with swallowing pills is a common problem, leading to noncompliance with treatment recommendations. Many young children with autistic disorder (AD) who also show comorbid symptoms associated with attention deficit hyperactivity disorder (ADHD) have difficulty swallowing pills. This pilot study describes our experience in teaching pill-swallowing skills to 4 children with AD who also had comorbid symptoms associated with ADHD.

Social interaction patterns of children and adolescents with and without oral clefts during a videotaped analogue social encounter.

Objectives: To examine the social interaction patterns of children with and without oral clefts.

Design: Participants were videotaped while interacting with a peer confederate. Oral cleft and control groups were compared on social behavior and several self- and parent-report measures.

Improving pediatric compliance with positive airway pressure therapy: the impact of behavioral intervention.

Study Objective: The purposes of this study were (1) to describe behavior interventions provided to improve compliance with positive airway pressure (PAP) therapies in children with obstructive sleep apnea, (2) to survey physician and caregiver satisfaction with these interventions, and (3) to present preliminary outcome data on the effects of these interventions.

Design: Retrospective, descriptive analysis.

Setting: Pediatric psychology consultation service at a university-affiliated rehabilitation hospital.

Assessment of facial emotion encoding and decoding skills in children with and without oral clefts.

Purpose: Investigated the facial emotion decoding and encoding skills and perceived social acceptance in children with and without oral clefts.

Patients: 8-15 year-old children with surgically repaired facial clefts (n=19) and non-cleft controls (n=19).

Methods: The children viewed photographs of facial emotions expressed by other children and identified the emotion in each photograph.

Using counterconditioning to treat behavioural distress during subcutaneous injections in a paediatric rehabilitation patient.

A counterconditioning-based intervention was conducted to supplement topical anaesthesia during repeated parent-administered subcutaneous injections performed on a 7-year-old girl for anticoagulation post-stroke. Preferred activities were paired with in vivo exposure to medical stimuli, first during simulated, then actual injections. Differential positive reinforcement was provided contingent on engagement with preferred activities, button pressing in response to an auditory stimulus, and general compliance with adult instructions.

Operant-contingency-based preparation of children for functional magnetic resonance imaging.

Functional magnetic resonance imaging (fMRI) is used to study brain function during behavioral tasks. The participation of pediatric subjects is problematic because reliable task performance and control of head movement are simultaneously required. Differential reinforcement decreased head motion and improved vigilance task performance in 4 children (2 with behavioral disorders) undergoing simulated fMRI scans.

Distraction for children of different ages who undergo repeated needle sticks.

A distraction intervention for pain management and behavioral distress was implemented for six children with chronic illnesses and their parents as the children underwent repeated needle sticks. The children ranged in age from two to eight years. Several different cognitive distractors were used for the children based on their respective developmental levels.