ABSTRACT Objective: To evaluate the efficacy and safety of Qigong interventions for school-aged children with attention-deficit hyperactivity disorder (ADHD) and assess the strength and limitations of current evidence. Method: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and was prospectively registered in PROSPERO (CRD420261302013). PubMed, Embase, Web of Science, CNKI, Wanfang, and VIP were searched from inception to March 2025. Eligible studies evaluated traditional Qigong practices, such as Baduanjin or Tai Chi, as interventions for school-aged children with ADHD. Randomized controlled trials, nonrandomized controlled studies, and single-arm pre-post studies were included. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using Cochrane Risk of Bias 2.0 or Risk Of Bias In Non-randomized Studies of Interventions. Findings were synthesized narratively because of heterogeneity. Results: Ten studies involving 389 children met inclusion criteria. Interventions lasted 6 to 16 weeks and primarily involved Baduanjin or Tai Chi. Qigong was more consistently associated with reductions in hyperactivity and impulsivity, whereas effects on inattention were variable. Several studies reported improvements in behavioral problems, sensory integration, and adaptive functioning. Effects were generally comparable to structured exercise and showed incremental benefits when combined with standard treatment. No intervention-related adverse events were reported. Evidence was limited by small samples, methodological weaknesses, outcome heterogeneity, and short follow-up. Conclusion: Qigong may offer modest benefits for hyperactivity and impulsivity in school-aged children with ADHD without identified safety concerns; however, evidence certainty remains low. Current evidence supports further investigation of Qigong as a complementary, not replacement, intervention. Larger, well-designed randomized trials are required.
Objectives: Developmental behavioral concerns comprise a large proportion of referrals in primary care. Access to Developmental Behavioral Pediatrics' (DBP) expertise is limited, with long wait-times to access care. We describe usage of a new DBP phone consult line, regarding diagnostic questions, recommended resources, and to assess contribution to pediatric primary care providers' (PCPs) knowledge and confidence in managing developmental and behavioral issues. Methods: This study has 2 components: (1) A retrospective review of consultation call-records between July 2023 to December 2025, describing utilization of DBP call line, including demographics, diagnostic questions, types of recommendations, and contribution to expediting appropriate interventions. (2) A prospective PCP survey to determine PCP satisfaction with recommendations and perceived learning of new information and skills for the management of DBP concerns. Results: A total of 362 consultations were completed. The average wait time for consultation was 10.7 days, significantly shorter than typical in-person DBP assessment wait times (averaging a year or more). Consultations addressed a broad range of developmental and behavioral concerns, and provided guidance on diagnosis, management, and care coordination. Most patients (85.7%) accessed appropriate interventions without or before referral. PCPs reported high satisfaction (89.7%) and learning new information applicable to future patients (79.3%). Conclusion: A new DBP phone consultation line improves timely access to DBP expertise. It facilitates collaborations between PCPs and DBPs to support PCP clinical decision-making. In addition to decreasing delays in accessing interventions, this model aligns with adult learning principles, to yield high provider satisfaction, enabling PCPs to apply newly acquired knowledge to future patient care.
ABSTRACT Background: Previous satisfaction surveys in a Midwestern developmental-behavioral pediatrics clinic showed suboptimal experiences among Spanish-speaking caregivers, particularly regarding visit length and feeling unsafe during encounters. This study sought to gather detailed information about Spanish-speaking families' experiences with ambulatory developmental-behavioral services and to address a gap in the literature on inequitable health care experiences among caregivers of children with developmental-behavioral disorders. Methods: We collected descriptive, qualitative data on Spanish-speaking families' experiences with developmental-behavioral ambulatory care using Group Level Assessment (GLA) and Participatory Action Research (PAR) methods. Results: Fifteen Spanish-speaking caregivers participated. Although interpreter services were consistently available and often described as excellent, families reported concerns about interpretation accuracy and consistency. Caregivers also noted that providers sometimes appeared rushed, particularly when language barriers led to delays or shortened encounters with non‑Spanish-speaking clinicians. Families proposed several improvements, including expanding bilingual staffing to enhance comfort and communication, strengthening oversight and training for interpreter services—especially in telehealth—and ensuring interpreters actively engage children during therapeutic sessions. Discussion: Addressing these concerns through expanded bilingual staffing, improved interpreter quality, and more culturally responsive communication practices may substantially enhance the care experience for Spanish-speaking families and promote more equitable developmental-behavioral services.
ABSTRACT Objective: To examine the associations between medical conditions and early developmental skills in young children with Down syndrome (DS). Method: Data were drawn from the first timepoint of a longitudinal study of children with DS (n = 114; mean age = 20.6 months). Caregivers completed a comprehensive medical history questionnaire, followed by a structured interview and review by a medical doctor to clarify endorsed conditions. Cognitive, expressive, and receptive communication, and fine and gross motor developments were assessed using the Bayley Scales of Infant and Toddler Development, Fourth edition. Associations between medical condition categories and developmental skills across domains were examined using partial correlations adjusting for age. Dominance analyses assessed the unique contributions of significant medical categories. Results: Vision conditions were associated with lower developmental scores across cognitive, communication, and gross motor domains. Seizure/epilepsy was associated with lower cognitive, expressive communication, and motor domain scores. Length of neonatal intensive care unit stay was associated with lower cognitive and communication scores. Additional factors, including premature birth, structural gastrointestinal conditions, dysphagia, eczema, and thyroid disease, were associated with lower scores in specific developmental domains. Dominance analyses revealed overlapping contributions across significant predictors with each developmental domain. Conclusion: Findings highlight the associations between co-occurring medical conditions and developmental heterogeneity among young children with DS. Results underscore the need for further work, including longitudinal research studies, to clarify the role of medical conditions in shaping neurodevelopment in DS.
