Some of these cognitive findings may be a consequence of chronic pain, and others may reflect subtle neurodevelopmental differences that may predate or be comorbid with pain. Regardless of etiology, with more than half the current sample experiencing some type of learning challenge, often undiagnosed, pediatric psychologists evaluating youth with chronic pain may wish to screen for comorbid learning difficulties.
Attention difficulties commonly found in adolescents and adults with FXS appear to also be characteristic of young boys with FXS, as reflected by lower effortful control. Age-related findings concerning negative affectivity may be particularly significant, leading to improved intervention/preventative efforts.
Although foreign body ingestion (FBI) is a common pediatric referral concern, intentional or recurrent FBI (RFBI) in youth is poorly defined. In adults, several subgroups of patients with psychiatric comorbidities account for a large portion of FBIs. A similar classification system and corresponding management recommendations are yet to be outlined in pediatrics. We report 3 patients with RFBI: a 16-year-old, African American boy with 22 admissions and 27 endoscopic procedures for FBI removal; a 4-year-old, African American boy with autism spectrum disorder admitted twice after delayed presentation of ingestion of magnets; and a 15-year-old Caucasian girl with a complex mental health history who presented twice after intentional ingestion to self-harm. We also present a literature review of pediatric RFBI. Patients with RFBI require a nuanced, multidisciplinary management approach to address acute concerns and reduce subsequent ingestion. A behavioral taxonomy and treatment considerations are presented.
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