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Anticipatory Guidance

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Howard Spivak – 1st expert on this subject based on the ideXlab platform

  • Anticipatory Guidance and violence prevention results from family and pediatrician focus groups
    Pediatrics, 2006
    Co-Authors: Robert D Sege, Elizabeth Hatmakerflanigan, Rebecca Levingoodman, Howard Spivak

    Abstract:

    OBJECTIVES: Anticipatory Guidance is a cornerstone of modern pediatric practice. Recent American Academy of Pediatrics policies related to violence prevention, notably those that advocate firearms safety and the use of alternatives to corporal punishment, seem to be discrepant with common parenting practices. To develop more effective Anticipatory Guidance, we sought the opinions of parents and pediatricians on how best to communicate these messages. DESIGN: Focus groups were conducted to elicit parent and provider opinions. SUBJECTS: Forty-nine parents participated in a total of 9 90-minute focus groups that were held in 3 cities. Twenty-six pediatricians participated in 3 focus groups that were held at a single national meeting. PROCEDURES: Participants were read summaries of current American Academy of Pediatrics policies and led through a systematic discussion of how these policies might best be communicated. The group discussions were audiotaped, transcribed, and analyzed. Common themes heard in multiple groups are reported. RESULTS: Parents provided specific feedback about corporal punishment and firearms and also raised a number of general issues. Pediatricians reported that Anticipatory Guidance was important to them but cited cultural and reimbursement issues as barriers to practice. They also reported the need for additional training and support to make Anticipatory Guidance more effective. DISCUSSION: Focus groups provide insight into doctor-patient communications and can inform efforts to improve primary prevention in the clinical setting. Anticipatory Guidance that consists of authoritative useful information, offered in a supportive manner that communicates respect for parental decision-making, may be effective in improving parenting practices.

  • short term effectiveness of Anticipatory Guidance to reduce early childhood risks for subsequent violence
    JAMA Pediatrics, 1997
    Co-Authors: Robert D Sege, Cary Perry, Luisa Stigol, Lewis M Cohen, John L Griffith, M Cohn, Howard Spivak

    Abstract:

    Objective: To determine whether newly developed Anticipatory Guidance materials designed to teach the use of time-outs and the importance of reductions in childhood television viewing would be recalled by parents and if their use would result in changes in self-reported parental behavior. Subjects and Setting: A total of 559 parents of children aged 14 months to 6 years recruited at the time of routine child health maintenance visits at 2 managed care pediatric departments in eastern Massachusetts. Methods: In-person parent interviews were conducted in the waiting room prior to office visits, with follow-up telephone calls 2 to 3 weeks after the visit. Two groups of families were enrolled: a control group who received usual Anticipatory Guidance and an intervention group who received written materials. Intervention group providers were trained to include study topics during the office visit and to introduce the written materials. Results: Provider training and the provision of written materials increased the parents’ specific recall of Anticipatory Guidance for at least 2 to 3 weeks following the office visit. This effect was specific to the areas of intervention and did not carry over to other commonly used topics of Anticipatory Guidance. Among parents who had never used a time-out prior to the office visit, there was a significant increase in the use of time-outs. Parents who received Anticipatory Guidance regarding the link between exposure to television violence and subsequent violence in children were somewhat more likely to report reductions in weekend television viewing than were parents in the control group, although this change was not statistically significant. Conclusions: Certain parenting behaviors have been associated with subsequent violence. Brief, inexpensive Anticipatory Guidance in relevant areas, provided in the context of routine health supervision visits, appears to result in favorable short-term changes in parenting practices. Arch Pediatr Adolesc Med. 1997;151:392-397

Robert D Sege – 2nd expert on this subject based on the ideXlab platform

  • Anticipatory Guidance and violence prevention results from family and pediatrician focus groups
    Pediatrics, 2006
    Co-Authors: Robert D Sege, Elizabeth Hatmakerflanigan, Rebecca Levingoodman, Howard Spivak

    Abstract:

    OBJECTIVES: Anticipatory Guidance is a cornerstone of modern pediatric practice. Recent American Academy of Pediatrics policies related to violence prevention, notably those that advocate firearms safety and the use of alternatives to corporal punishment, seem to be discrepant with common parenting practices. To develop more effective Anticipatory Guidance, we sought the opinions of parents and pediatricians on how best to communicate these messages. DESIGN: Focus groups were conducted to elicit parent and provider opinions. SUBJECTS: Forty-nine parents participated in a total of 9 90-minute focus groups that were held in 3 cities. Twenty-six pediatricians participated in 3 focus groups that were held at a single national meeting. PROCEDURES: Participants were read summaries of current American Academy of Pediatrics policies and led through a systematic discussion of how these policies might best be communicated. The group discussions were audiotaped, transcribed, and analyzed. Common themes heard in multiple groups are reported. RESULTS: Parents provided specific feedback about corporal punishment and firearms and also raised a number of general issues. Pediatricians reported that Anticipatory Guidance was important to them but cited cultural and reimbursement issues as barriers to practice. They also reported the need for additional training and support to make Anticipatory Guidance more effective. DISCUSSION: Focus groups provide insight into doctor-patient communications and can inform efforts to improve primary prevention in the clinical setting. Anticipatory Guidance that consists of authoritative useful information, offered in a supportive manner that communicates respect for parental decision-making, may be effective in improving parenting practices.

  • short term effectiveness of Anticipatory Guidance to reduce early childhood risks for subsequent violence
    JAMA Pediatrics, 1997
    Co-Authors: Robert D Sege, Cary Perry, Luisa Stigol, Lewis M Cohen, John L Griffith, M Cohn, Howard Spivak

    Abstract:

    Objective: To determine whether newly developed Anticipatory Guidance materials designed to teach the use of time-outs and the importance of reductions in childhood television viewing would be recalled by parents and if their use would result in changes in self-reported parental behavior. Subjects and Setting: A total of 559 parents of children aged 14 months to 6 years recruited at the time of routine child health maintenance visits at 2 managed care pediatric departments in eastern Massachusetts. Methods: In-person parent interviews were conducted in the waiting room prior to office visits, with follow-up telephone calls 2 to 3 weeks after the visit. Two groups of families were enrolled: a control group who received usual Anticipatory Guidance and an intervention group who received written materials. Intervention group providers were trained to include study topics during the office visit and to introduce the written materials. Results: Provider training and the provision of written materials increased the parents’ specific recall of Anticipatory Guidance for at least 2 to 3 weeks following the office visit. This effect was specific to the areas of intervention and did not carry over to other commonly used topics of Anticipatory Guidance. Among parents who had never used a time-out prior to the office visit, there was a significant increase in the use of time-outs. Parents who received Anticipatory Guidance regarding the link between exposure to television violence and subsequent violence in children were somewhat more likely to report reductions in weekend television viewing than were parents in the control group, although this change was not statistically significant. Conclusions: Certain parenting behaviors have been associated with subsequent violence. Brief, inexpensive Anticipatory Guidance in relevant areas, provided in the context of routine health supervision visits, appears to result in favorable short-term changes in parenting practices. Arch Pediatr Adolesc Med. 1997;151:392-397

Angelo Selicorni – 3rd expert on this subject based on the ideXlab platform

  • cornelia de lange syndrome clinical review diagnostic and scoring systems and Anticipatory Guidance
    American Journal of Medical Genetics Part A, 2007
    Co-Authors: Antonie D Kline, Ian D Krantz, Annemarie Sommer, Mark A Kliewer, Laird G Jackson, David Fitzpatrick, Alex V Levin, Angelo Selicorni

    Abstract:

    Cornelia de Lange syndrome (CdLS), also known as Brachmann-de Lange syndrome, is a well-described multiple malformation syndrome typically involving proportionate small stature, developmental delay, specific facial features, major malformations (particularly the cardiac, gastrointestinal and musculoskeletal systems), and behavioral abnormalities. There is a broad spectrum of clinical involvement, with increasing recognition of a much milder phenotype than previously recognized. Significant progress has been made in recent years in the clinical and molecular delineation of CdLS, necessitating a revision of the diagnostic criteria, more inclusive of the milder cases. In addition, a scoring system of severity has been found to correlate with specific brain changes. Thus, a clinical overview and recommendations for Anticipatory Guidance are timely in aiding caretakers and professionals to individualize care decisions and maximize developmental potential for individuals with CdLS. These guidelines are derived from consensus based on collective experience of over 500 patients with CdLS, observations of the natural history in children, adolescents, and adults, a review of the literature, and contacts with national support organizations in North America and Europe. © 2007 Wiley-Liss, Inc.

  • cornelia de lange syndrome clinical review diagnostic and scoring systems and Anticipatory Guidance
    American Journal of Medical Genetics Part A, 2007
    Co-Authors: Antonie D Kline, Ian D Krantz, Annemarie Sommer, Mark A Kliewer, Laird G Jackson, David Fitzpatrick, Alex V Levin, Angelo Selicorni

    Abstract:

    Cornelia de Lange syndrome (CdLS), also known as Brachmann-de Lange syndrome, is a well-described multiple malformation syndrome typically involving proportionate small stature, developmental delay, specific facial features, major malformations (particularly the cardiac, gastrointestinal and musculoskeletal systems), and behavioral abnormalities. There is a broad spectrum of clinical involvement, with increasing recognition of a much milder phenotype than previously recognized. Significant progress has been made in recent years in the clinical and molecular delineation of CdLS, necessitating a revision of the diagnostic criteria, more inclusive of the milder cases. In addition, a scoring system of severity has been found to correlate with specific brain changes. Thus, a clinical overview and recommendations for Anticipatory Guidance are timely in aiding caretakers and professionals to individualize care decisions and maximize developmental potential for individuals with CdLS. These guidelines are derived from consensus based on collective experience of over 500 patients with CdLS, observations of the natural history in children, adolescents, and adults, a review of the literature, and contacts with national support organizations in North America and Europe.