[Sensory food aversion in the context of a modern approach to eating disorders in early childhood]. / A szenzoros ételelutasítás a kora gyermekkori evészavarok korszeru megközelítésének tükrében.

Sensory food aversion, an early childhood eating disorder, is a serious, permanent form of picky eating, in which the infant or the child consistently and persistently refuses certain foods based on specific characteristics, following one or more previous aversive experiences. Biological (sensory processing disorder, taste sensitivity) and environmental factors contribute to its development. Due to limited diet, specific dietary deficiencies may occur but weight gain is usually normal. Behavioral problems, anxiety disorder, autism spectrum disorder are often associated. Diagnosis can usually be made based on a detailed history, but further assessment may include pediatric examination, nutritionist consultation, and psychologic and occupational therapy assessment. Treatment is based on parent education and support in order to minimize mealtime battles and anxiety and to think together about strategies for expanding the child's diet and to help them to accept new foods. As part of the interdisciplinary team, the pediatrician's role is to monitor appropriate growth and development, exclude dietary deficiencies or prescribe supplementation if necessary. In our article, the screening and treatment of sensory processing disorder as part of the assessment of eating problems are introduced as an example of good clinical practice at the Early Childhood Eating and Sleep Disorder Outpatient Clinic at the Heim Pál National Institute of Pediatrics. Orv Hetil. 2023; 164(45): 1767-1777.

Recognizing Early Regulation Disorders in Pediatric Care: The For Healthy Offspring Project.

BACKGROUND Regulation disorders are already apparent in infancy. The For Healthy Offspring Project was the first Hungarian study aimed at building an effective model for screening and examining the prevalence and complex (medical and psychosocial) background of classic behavior regulation disorders (excessive crying, feeding, and sleep problems) in infancy. MATERIAL AND METHODS Data were collected from families of 0- to 3-year-old children in a pediatric hospital and its neighboring areas through questionnaires, medical examinations, and individual and small-group consultations. RESULTS In the questionnaire study about their children's behavior (n=1133), 15% of mothers reported excessive crying, 16% reported feeding problems, and 10% reported sleep problems. In a subsample (n=619) in which medical examinations were also conducted, the prevalence of medical diagnoses was 15.0% for excessive crying, 15.2% for sleep disorders, 10.3% for breastfeeding difficulties, and 14.8% for feeding disorders. Children who were referred to the screening program (n=183) had significantly more behavior regulation disorders than the other children in our study. Regulation disorders were found to be comorbid with other health conditions in some cases. CONCLUSIONS We developed a complex model to screen for regulatory problems in early childhood. This study adds more information about the relationship between regulation problems and other health conditions. The general incidence (5-15%) of early childhood regulation disorders in other countries is likely similar to that found in Hungary. In order to effectively recognize early regulation disorders, diagnostic instruments widely used in the international field should be adapted in general Hungarian pediatric care.

Paediatric tube-feeding: An agenda for care improvement and research.

This article presents an agenda to improve the care and wellbeing of children with paediatric feeding disorder who require tube feeding (PFD-T). PFD-T requires urgent attention in practice and research. Priorities include: routine collection of PFD-T data in health-care records; addressing the tube-feeding lifecycle; and reducing the severity and duration of disruption caused by PFD-T where possible. This work should be underpinned by principles of involving, respecting and connecting families.

[Additional psychometric data for the DS1K mood questionnaire. Experience from a large sample study involving parents of young children]. / Kiegészítö pszichometriai adatok a DS1K hangulati kérdöívhez. Egy kisgyermekes szülöket bevonó nagymintás kutatás tapasztalatai.

AIMS: A new instrument for assessing depressive mood, the first version of Depression Scale Questionnaire (DS1K) was published in 2008 by Halmai et al. This scale was used in our large sample study, in the framework of the For Healthy Offspring project, involving parents of young children. The original questionnaire was developed in small samples, so our aim was to assist further development of the instrument by the psychometric analysis of the data in our large sample (n=1164). METHOD: The DS1K scale was chosen to measure the parents' mood and mental state in the For Healthy Offspring project. The questionnaire was completed by 1063 mothers and 328 fathers, yielding a heterogenous sample with respect to age and socio-demographic status. Analyses included main descriptive statistics, establishing the scales' inner consistency and some comparisons. Results were checked in our original and multiple imputed datasets as well. RESULTS: According to our results the reliability of our scale was much worse than in the original study (Cronbach alpha: 0.61 versus 0.88). During the detailed item-analysis it became clear that two items contributed to the observed decreased coherence. We assumed a problem related to misreading in case of one of these items. This assumption was checked by cross-analysis by the assumed reading level. According to our results the reliability of the scale was increased in both the lower and higher education level groups if we did not include one or both of these problematic items. However, as the number of items decreased, the relative sensitivity of the scale was also reduced, with fewer persons categorized in the risk group compared to the original scale. CONCLUSION: We suggest for the authors as an alternative solution to redefine the problematic items and retest the reliability of the measurement in a sample with diverse socio-demographic characteristics.

[Psychometric parameters of the Hungarian version of Mothers' Object Relations Scales - Short Form (H-MORS-SF) in a large sample]. / A röviditett Szulö-Csecsemö Kapcsolat Skála magyar valtozátnak (H-MORS-SF) pszichometriai mutatói nagy mintán.

INTRODUCTION: The Mothers' Object Relations Scale (MORS) was developed by John M. Oates (Open University, Milton Keynes, UK) in the late 1990s. The MORS is an appropriate instrument for gathering parental perceptions about the child and the parent-infant relationship. The questionnaire and its short form were improved further and validated in British and Hungarian samples in the beginning of the 2000s and the questionnaire was used in several applied studies in the UK where its predictive validity was further confirmed. METHODS: The development and validation phases were based on small samples. The diverse social-demographic characteristics of the For Healthy Offspring project, allowed for further testing the reliability and validity of the Hungarian short-form in a large (n=1164) sample. RESULTS: High internal consistency was found in the original and the imputed data obtained from parents of 0-3-year old children for both of H-MORS-SF dimensions: Invasion and Warmth. The scales had interpretable and systematic cross-correlations with measures of infant temperament (IBQ-R, ECBQ) and mental state (DS1K) of both parents. These results confirm and exceed the previous results based on small samples. CONCLUSION: Given the convincing psychometric indicators and its fast and simple usage, the H-MORS-SF can be considered as an effective preventive screening test for monitoring the developing parent-infant relationship, therefore we suggest its use for professionals working in developmental psychology, child health and social fields.