WHAT'S KNOWN ON THIS SUBJECT: Sleep problems are common during childhood, but screening for sleep problems in the clinic setting is often cursory. Moreover, there are few longitudinal studies examining the prevalence and persistence of sleep problems in young children. WHAT THIS STUDY ADDS:Patterns of sleep problems vary across early development, but sleep problems arising in infancy persist in 21% of children through 36 months of age. Parent response to a nonspecific query about sleep problems may overlook relevant sleep symptoms and behaviors. abstract OBJECTIVE: Examine the prevalence, patterns, and persistence of parent-reported sleep problems during the first 3 years of life. METHODS:Three hundred fifty-nine mother/child pairs participated in a prospective birth cohort study. Sleep questionnaires were administered to mothers when children were 6, 12, 24, and 36 months old. Sleep variables included parent response to a nonspecific query about the presence/absence of a sleep problem and 8 specific sleep outcome domains: sleep onset latency, sleep maintenance, 24-hour sleep duration, daytime sleep/naps, sleep location, restlessness/vocalization, nightmares/night terrors, and snoring. RESULTS:Prevalence of a parent-reported sleep problem was 10% at all assessment intervals. Night wakings and shorter sleep duration were associated with a parent-reported sleep problem during infancy and early toddlerhood (6-24 months), whereas nightmares and restless sleep emerged as associations with report of a sleep problem in later developmental periods (24-36 months). Prolonged sleep latency was associated with parent report of a sleep problem throughout the study period. In contrast, napping, sleep location, and snoring were not associated with parent-reported sleep problems. Twenty-one percent of children with sleep problems in infancy (compared with 6% of those without) had sleep problems in the third year of life.CONCLUSIONS: Ten percent of children are reported to have a sleep problem at any given point during early childhood, and these problems persist in a significant minority of children throughout early development. Parent response to a single-item nonspecific sleep query may overlook relevant sleep behaviors and symptoms associated with clinical morbidity. Pediatrics 2012;129:e276-e284 AUTHORS:
OBJECTIVE -This study assessed parent report of mealtime behavior and parenting stress in preschoolers with type 1 diabetes. It was hypothesized that children with type 1 diabetes would be seen as exhibiting more mealtime behavior problems and that their parents would evidence greater parenting stress when compared with healthy subjects. It was also hypothesized that report of mealtime behavior problems would be positively correlated with parenting stress. RESEARCH DESIGN AND METHODS-A total of 40 children (aged 1-6 years) with type 1 diabetes were recruited from a pediatric hospital. Another 40 children matched for age, sex, marital status, and socioeconomic status were used as control subjects. Reliable and valid parent report measures, such as the Behavioral Pediatrics Feeding Assessment Scale and the Parenting Stress Index, were used for data collection.RESULTS -Parents of children with type 1 diabetes reported more behavioral feeding problems than parents of healthy control subjects. Additionally, parents of children with type 1 diabetes reported higher frequencies of parenting behaviors associated with poor nutritional intake and a greater number of parenting problems concerning mealtimes when compared with parents of healthy control subjects. Parents of children with type 1 diabetes also reported higher stress levels than parents of control subjects. A moderate relationship between mealtime behavior problems and general parenting stress was observed for families coping with type 1 diabetes.CONCLUSIONS -Mealtime problems reported in preschool children with type 1 diabetes are appropriate targets for behavioral intervention. Behavioral observation techniques and training in child behavior management skills should be used in future research aimed at assessing and treating barriers to effective nutrition management in young children with type 1 diabetes. Diabetes Care 25:313-318, 2002
Sleep problems in adolescence have been identified as an international public health issue. Over the past few decades, notable advances have been made in our understanding of the patterns and consequences of sleep in adolescence. Despite these important gains, there is much about the role of sleep in adolescence that remains to be understood. This Special Issue brings together studies that examine sleep as it specifically pertains to adolescent development and adjustment. In this introductory article, we argue for the importance of grounding the study of sleep and adolescence in developmental science and a developmental psychopathology framework. First, a review of the literature is used to outline a biopsychosocial and contextual model of sleep in adolescence. Second, attention-deficit/hyperactivity disorder (ADHD) is used as an exemplar of the proposed model given the pervasiveness of sleep problems among youth with ADHD and the likelihood that sleep problems and ADHD symptoms are interconnected in complex ways. Finally, a brief introduction to the empirical articles included in the Special Issue is provided, with particular attention given to how these articles fit within the proposed biopsychosocial and contextual model. Along with the framework proposed in this article, the studies included in this Special Issue advance the current literature and point to critical directions for future research.
Short-term intensive biobehavioral treatment was successful in improving oral intake and weaning from gastrostomy tube feeding in children with Nissen fundoplication and feeding gastrostomy.
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