Children with avoidant/restrictive food intake disorder and anorexia nervosa in a tertiary care pediatric eating disorder program: A comparative study.

OBJECTIVE: The purpose of this study was to examine the medical and psychological characteristics of children under the age of 13 years with avoidant restrictive food intake disorder (ARFID) and anorexia nervosa (AN) from a Canadian tertiary care pediatric eating disorders program. METHOD: Participants included 106 children assessed between 2013 and 2017 using the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5). Data were collected through clinical interviews, psychometric questionnaires, and chart review. Information collected included medical variables (e.g., weight, heart rate, need for inpatient admission, and duration of illness from symptom onset); medical comorbidities (e.g., history of food allergies, infection, and abdominal pain preceding the eating disorder); and psychological variables (e.g., psychiatric comorbidity, self-reported depression and anxiety, and eating disorder related behaviors and cognitions). RESULTS: Children with ARFID had a longer length of illness, while those with AN had lower heart rates and were more likely to be admitted as inpatients. Children with ARFID had a history of abdominal pain and infections preceding their diagnoses and were more likely to be diagnosed with a comorbid anxiety disorder. Children with AN had a higher drive for thinness, lower self-esteem, and scored higher on depression. DISCUSSION: This is the first study to look at DSM-5 diagnosis at assessment and include psychometric and interview data with younger children with AN and ARFID. Understanding the medical and psychological profiles of children with AN and ARFID can result in a more timely and accurate diagnosis of eating disorders in younger children.

Social dominance in children with cerebral palsy during a problem-solving task with peers.

PURPOSE: Children with cerebral palsy tend to have poorer social competence outcomes than their peers without a disability in mainstream school settings. To understand their social competence, this study compared children with cerebral palsy with paired children without cerebral palsy with respect to their ability to access resources, defined here as "social dominance", in a problem-solving situation. METHOD: Children with cerebral palsy were randomly paired to a peer (teammate) and put in a competitive context where each team of two children was instructed to solve an impossible problem. To control for social status, a sociometric measure was administered previously in the classroom (Social Preference score). Behaviors related to social dominance (prosocial and coercive behaviors) were coded using an observation scale validated for this study. RESULTS: The results showed that regardless of social status, children with cerebral palsy were less socially dominant than controls without cerebral palsy. Furthermore, their teams seemed to be less dominant than teams composed of two controls. CONCLUSIONS: The lower social competence in children with cerebral palsy could be partly explained by their reduced social dominance behavior in activities requiring speed and fluidity as an expression of executive functions. This might be viewed as a marker for social risks in the integration process at school. Implications for rehabilitation Gross Motor Function Classification System level I or II cerebral palsy is a condition that affects not only motor abilities but also social competence in children. Lower social competence in children with cerebral palsy could be partly explained by reduced social dominance behavior in activities such as problem solving with peers. To improve social competence, rehabilitation interventions should include social participation opportunities in which children with cerebral palsy are encouraged to take an active role in the activity.

Sociometric status and the attribution of intentions in a sample of adolescents with cerebral palsy.

Purpose To examine how cerebral palsy (CP) and sociometric status at age 10 explain the development of a cognitive bias across two groups of adolescents aged 15. Method Children with CP (N = 60) and without CP (N = 57) are part of a follow-up study. Three categories of sociometric status (popular, average, rejected) were obtained by conducting a class-wide interview in the class of the target children at age 10. At 15 years old, the same children (CP and non-CP) were asked to complete the Home Interview With Child questionnaire measuring a cognitive bias (hostile attribution of intentions (AI)). Results Children with CP, especially girls, were significantly more rejected and less popular than controls at age 10. At age 15, among all participants, sociometric rejected and popular children tended to have a higher percentage of hostile AI than sociometric average children. Conclusions There were no significant results for the combined effect of CP and sociometric status on the development of hostile AI at age 15. However, knowing the risk incurred by children with CP of being socially rejected, attention should be paid in the rehabilitation process to opportunities for social participation to facilitate the development of social competence. Implications for Rehabilitation Level I or II cerebral palsy (CP) is a condition that affects not only motor abilities but also social competence in children. Sociometric status in a group tends to affect the development of the ability to interprete intentions of others during adolescence. Sociometric measures in the class of children with CP could be a useful tool in the rehabilitation process in order to better define social participation opportunities. To improve social participation attempts, rehabilitation interventions should target social initiating skills, flexibility in interpreting peers' behaviours, and ability to react effectively to negative peer treatment.