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Research

1. Reading Aloud, Play, and Social-Emotional Development
Dr. Alan L. Mendelsohn, MD

Dr. Mendelsohn made it onto NYC CBS News last night! The link to the video is here:

Health Watch: New Study Says Reading To Young Children Helps Combat ADD

The peer-reviewed article itself is here:

http://pediatrics.aappublications.org/content/early/2018/04/05/peds.2017-3393

And a few other media articles that picked it up:

http://www.aappublications.org/news/2018/04/09/reading040918

https://health.usnews.com/health-care/articles/2018-04-09/reading-to-your-kids-might-boost-their-social-skills

https://www.doctorslounge.com/index.php/news/hd/79640

ABSTRACT:

OBJECTIVES: To determine impacts on social-emotional development at school entry of a
pediatric primary care intervention (Video Interaction Project [VIP]) promoting positive
parenting through reading aloud and play, delivered in 2 phases: infant through toddler
(VIP birth to 3 years [VIP 0–3]) and preschool-age (VIP 3 to 5 years [VIP 3–5]).
METHODS: Factorial randomized controlled trial with postpartum enrollment and random
assignment to VIP 0-3, control 0 to 3 years, and a third group without school entry
follow-up (Building Blocks) and 3-year second random assignment of VIP 0-3 and control
0 to 3 years to VIP 3-5 or control 3 to 5 years. In the VIP, a bilingual facilitator video
recorded the parent and child reading and/or playing using provided learning materials
and reviewed videos to reinforce positive interactions. Social-emotional development
at 4.5 years was assessed by parent-report Behavior Assessment System for Children,
Second Edition (Social Skills, Attention Problems, Hyperactivity, Aggression, Externalizing
Problems).
RESULTS: VIP 0-3 and VIP 3-5 were independently associated with improved 4.5-year
Behavior Assessment System for Children, Second Edition T-scores, with effect sizes
(Cohen’s d) ∼−0.25 to −0.30. Receipt of combined VIP 0-3 and VIP 3-5 was associated with
d = −0.63 reduction in Hyperactivity (P = .001). VIP 0-3 resulted in reduced “Clinically
Significant” Hyperactivity (relative risk reduction for overall sample: 69.2%; P = .03;
relative risk reduction for increased psychosocial risk: 100%; P = .006). Multilevel models
revealed significant VIP 0-3 linear effects and age × VIP 3-5 interactions.
CONCLUSIONS: Phase VIP 0-3 resulted in sustained impacts on behavior problems 1.5 years
after program completion. VIP 3-5 had additional, independent impacts. With our findings,
we support the use of pediatric primary care to promote reading aloud and play from birth
to 5 years, and the potential for such programs to enhance social-emotional development.

2. Identification of Trauma Exposure and PTSD in Adolescent Psychiatric Inpatients: An Exploratory Study
Jennifer F. Havens,1,2 Omar G. Gudi˜no,1,2 Emily A. Biggs,1,2 Ursula N. Diamond,1,2 J. Rebecca Weis,1,2 and Marylene Cloitre2,3

1Department of Child & Adolescent Psychiatry, Bellevue Hospital Center, New York, New York, USA,

2Department of Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, USA

3National Center for PTSD, Palo Alto, California, USA

ABSTRACT:

Trauma exposure and posttraumatic stress disorder (PTSD), though prevalent among adolescent psychiatric inpatients, are underidentified in standard clinical practice. In a retrospective chart review of 140 adolescents admitted to a psychiatric inpatient unit, we examined associations between probable PTSD identified through the Child PTSD Symptom Scale and adolescents’ service use and clinical characteristics. Results suggest a large discrepancy between rates of probable PTSD identified through standardized assessment and during the emergency room psychiatric evaluation (28.6% vs. 2.2%). Adolescents with probable PTSD had greater clinical severity and service utilization, an increased likelihood of being diagnosed with bipolar disorder (27.5% vs. 9.2%) and being prescribed antipsychotic medications (47.5% vs. 27.6%), and were prescribed more psychotropic medications. Upon discharge, those with probable PTSD were more than those without to be assigned a diagnosis of PTSD (45% vs. 7.1%), a comorbid diagnosis of major depressive disorder (30% vs. 14.3%), to be prescribed an antidepressant medication (52.5% vs. 33.7%), and to be prescribed more medications. The underidentification of trauma exposure and PTSD has important implications for the care of adolescents given that accurate diagnosis is a prerequisite for providing effective care. Improved methods for identifying trauma-related problems in standard clinical practice are needed.

 

3. Randomized Controlled Trial of Primary Care Pediatric Parenting Programs
Alan L. Mendelsohn, MD; Benard P. Dreyer, MD; Carolyn A. Brockmeyer, PhD; Samantha B. Berkule-Silberman, PhD; Harris S. Huberman, MD, MPH; Suzy Tomopoulos, MD

Arch Pediatr Adolesc Med. 2011 Jan;165(1):42-8. doi: 10.1001/archpediatrics.2010.266.

ABSTRACT:

OBJECTIVES:To determine whether pediatric primary care-based programs to enhance parenting and early child development reduce media exposure and whether enhanced parenting mediates the effects.

DESIGN:Randomized controlled trial.

SETTING:Urban public hospital pediatric primary care clinic.

PARTICIPANTS: A total of 410 mother-newborn dyads enrolled after childbirth.

INTERVENTIONS: Patients were randomly assigned to 1 of 2 interventions, the Video Interaction Project (VIP) and Building Blocks (BB) interventions, or to control group. The VIP intervention comprised 1-on-1 sessions with a child development specialist who facilitated interactions in play and shared reading through review of videotapes made of the parent and child on primary care visit days; learning materials and parenting pamphlets were also provided. The BB intervention mailed parenting materials, including age-specific newsletters suggesting activities to facilitate interactions, learning materials, and parent-completed developmental questionnaires (Ages and Stages questionnaires).

OUTCOME MEASURES: Electronic media exposure in the home using a 24-hour recall diary.

RESULTS: The mean (SD) exposure at 6 months was 146.5 (125.0) min/d. Exposure to VIP was associated with reduced total duration of media exposure compared with the BB and control groups (mean [SD] min/d for VIP, 131.6 [118.7]; BB, 151.2 [116.7]; control, 155.4 [138.7]; P = .009). Enhanced parent-child interactions were found to partially mediate relations between VIP and media exposure for families with a ninth grade or higher literacy level (Sobel statistic = 2.49; P = .01).

CONCLUSION: Pediatric primary care may represent an important venue for addressing the public health problem of media exposure in young children at a population level.