BIB is an effective procedure with satisfactory weight loss and improvement in co-morbidities after 6 months. Previous gastric surgery is a contraindication to BIB placement.
The effectiveness of behavior reduction strategies is likely affected by any number of ancillary variables. The purpose of this study was to provide a quantitative review of school‐based behavior reduction interventions and some ancillary variables that may modulate the effectiveness of those interventions. Tau‐U, an effect size statistic for single‐case designs that takes into account level and trend, was calculated across studies, allowing for examination of several moderator variables including type of functional behavior assessment method used. Moderate intervention effects were found across all studies with a small yet insignificant difference between function‐ and nonfunction‐based interventions. The largest difference in a moderator variable was intervention setting, with studies conducted in the natural environment producing larger effects than those in pull‐out settings. Possible explanations for these findings, limitations of the study, and areas of future research are discussed.
Objective: As pediatric behavioral health concerns are increasingly identified and addressed within pediatric primary care and family medicine practices, behavioral health providers (BHPs) in integrated primary care (IPC) are often faced with not only addressing the psychosocial needs of their child patients, but also confronting the needs of those patients' caregivers. Given the extensive body of evidence demonstrating that child mental health is associated with caregiver mental health, continued discussions of addressing caregiver mental health within the integrated care context are warranted. Method: The current paper will discuss obstacles to establishing family-centered comprehensive behavioral care including ethical concerns around informed consent, scope of practice, and dual relations, and various practice considerations. Results: The obstacles are greater for establishing family-centered comprehensive behavioral care within pediatric settings compared to family practice settings due to the additional practice considerations. The potential benefit to children and the broader family system may warrant the effort. Conclusions: By identifying and discussing these issues, BHPs working within pediatric and family medicine settings are encouraged to engage in active dialogue with hospital and clinic administrators to overcome systemic barriers and to think flexibly about how BHPs might expand upon existing approaches in order to utilize the IPC opportunity to address parent mental health concerns that may otherwise impede a child's treatment progress.
Implications for Impact StatementTreating adult caregivers within pediatric primary or family care settings has the potential of vastly improving the mental health of the entire family. Integrated pediatric primary care provides an ideal setting for behavioral health providers to provide holistic family care. To do this effectively, ethical and practical barriers must be discussed and dismantled.
Feeding disorders often present in children with complex medical histories as well as those with neurodevelopmental disabilities. If untreated, feeding problems will likely persist and may lead to additional developmental and medical complications. Treatment of pediatric feeding disorders should involve an interdisciplinary team, but the core intervention should include behavioral feeding techniques as they are the only empirically supported therapy for feeding disorders.
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