Pediatrics Commons^™

Evaluation Of Unexplained Bone Fractures In A 3-Month-Old Infant – A Case Report, Hannah Ngo, Rachel Silliman Cohen

Rowan-Virtua Research Day

Child physical abuse is a significant cause of injury in infants and young children and can present in a variety of ways. Failure to recognize abuse in infants and young children can be life-threatening and is often recurrent until safety interventions occur. Consequently, it is of paramount importance that providers strongly consider child physical abuse on the differential, along with metabolic bone disease and accidental traumatic injury, when evaluating fractures in young children and infants. This case report will focus on the evaluation of a 3-month-old male infant who was admitted to the hospital with irritability and decreased right arm …

The Impact Of Stress During Adolescence And The Prevalence Of Pediatric Obesity, Olatunbosun Olakunri, Venkat Venkataraman

Rowan-Virtua Research Day

Obesity is a chronic condition that can be attributed to myriad factors including socioeconomic status, biological risk factors, and various environmental factors. These factors can be considered stress factors, and exposure to various levels of stress can impact the development of stress within the pediatric patients. The purpose of this study is to assess the association between the environmental, mental, social, physical, and psychological stress adolescents are exposed to and how they contribute to the prevalence of pediatric obesity throughout the United States. Understanding these risk factors can help us as a community and most importantly as clinicians develop better …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

Determinants Of Vaccine Hesitancy Among Parents And Caregivers, Priya Srivastava

Rowan-Virtua Research Day

•Vaccination efforts in the United States and globally are one of the largest contributors to pediatric preventative health

•Routine immunizations in the U.S for children ≤ 10 years old cover 14 vaccine-preventable diseases. As a result, an estimated 732,000 deaths, 21 million hospitalizations, and 322 diagnosed cases of diseases have been prevented between 1993 and 2013.

•Vaccines remain a point of contention with pediatricians and their patients' caregivers

•Many parents maintain hesitancy to give vaccines; to a number of reasons. Perceived risk and fear of side effects from vaccines more than the disease itself, can cause out-of-proportion concern

•Misinformation spread …

Cost-Effectiveness And Outcomes Of Utilizing Tisagenlecleucel Therapy (Car T-Cell) In Pediatric Acute Lymphoblastic Leukemia In Comparison To Standard Of Care (Soc) Therapies: A Scoping Review, Andrew Atschinow, Evangeline Attota, Warren Chan, Pooja Kasarapu, Priyal Shah, Karina Vizzoni

Rowan-Virtua Research Day

Aims

This review aims to assess the correlations between outcomes and cost of treatment methods for pediatric acute lymphoblastic leukemia patients, specifically comparing CAR T-cell therapy and Standard-of-Care (SoC) therapy. The socioeconomic background of patients will also be taken into consideration to see if there are differences in their outcomes.

Methods

Peer-reviewed publications were collected from PubMed and Web of Science. The keyword strings used were “acute lymphoblastic leukemia,” “pediatric acute lymphoblastic leukemia,” “pediatric,” “CAR T-cell therapy,” and “cost-effectiveness.” 27 citations were obtained. Titles were screened by 6 authors. Articles met the inclusion criteria including potential Quality-Adjusted Life Year (QALY) …

Ultrasound Versus Radiography For Evaluating Surgical Necrotizing Enterocolitis, Sayed H. Aftab, Santiago Martinez-Correa, Minh-Huy Huynh, Wondwossen T. Lerebo, Jorge Delgado, Rebecca Denis, Misun Hwang

Rowan-Virtua Research Day

Purpose:

Necrotizing enterocolitis (NEC) is an abdominal inflammatory condition that is common in premature neonates. Although abdominal radiograph (AR) remains the imaging standard for NEC, it may miss up to 50% of early signs of NEC and has been described to have a sensitivity as low as 15.4% for detecting pneumoperitoneum. Abdominal ultrasound (US) is portable, non-invasive, and allows real-time bowel integrity, movement, and perfusion assessment. We aim to evaluate the concordance between US and AR in detecting NEC features and the diagnostic performance of both modalities in detecting pneumoperitoneum.

Methods and materials:

We conducted an IRB-approved retrospective, cross-sectional, single-center …

Complications Following Hemivertebrectomy For Congenital Scoliosis, Sanjana Davuluri, Taemin Oh, Kyrillos Akhnoukh, Zachary Weingrad, Michael Lesgart, Terrence Ishmael, Joshua Pahys, Amer Samdani, Steven Hwang

Rowan-Virtua Research Day

Introduction:

Hemivertebrae are rare congenital anomalies that can cause severe scoliosis requiring surgical correction. We aimed to determine whether severity of deformities is associated with more long-term surgical complications following surgical correction.

Methods:

We performed a retrospective, single-institution review on patients who underwent hemivertebrectomy and spinal fusion for congenital scoliosis between 2008-2020. We extracted pertinent data on demographics, radiographic parameters, operative details, and complication rates. Subgroup analyses were also done by complication severity, deformity complexity, and construct length.

Results:

In our series, 30 patients underwent hemivertebrectomy and fusion. Mean age was 9±4.2 years and there was 2:1 male preponderance, with …

How Psychological And Nonpharmacological Treatment Modalities Reduce The Disease Burden Of Amplified Musculoskeletal Pain Syndromes In Pediatrics, Aalia Narvel, Sabrina Gmuca

Rowan-Virtua Research Day

The prevalence of pediatric chronic musculoskeletal pain ranges from 8.5% to 40%.¹ This literature review examined the treatment of amplified musculoskeletal pain syndrome (AMPS), which is a general term that represents a spectrum of pain disorders for patients who may not satisfy specific diagnostic criteria.² Specifically, sources were analyzed to compare the efficacy of individual components in the nonpharmacological, interdisciplinary treatment of AMPS against pain medications. These components included cognitive behavioral psychotherapy (CBT), physical therapy (PT), as well as occupational therapy (OT). There is limited information that assesses these components individually, but there is ample evidence that when …

Bal-A-Vis-X Intervention To Improve Upper Limb Coordination In Children With Disability: A Pilot Study, Marta Boot, Zoe Clark, Kyla Hill, Mckenzie Stefanoff, Betsy Donahoe Fillmore, Trisha Renner, Bo Slutz, Mary I. Fisher

University of Dayton Doctor of Physical Therapy Annual Research Symposium

Purpose/Hypothesis: Balance/Auditory/Vision exercises (Bal-A-Vis-X) consists of a series of exercises using sand-filled bags and racquet balls. Most of the exercises are completed while standing on a rocker board and heavily rooted in rhythm. The rhythmic patterns are utilized to facilitate focused concentration, crossing midline, motor planning, right/left awareness, eye-hand coordination, balance, bilateral coordination, body and spatial awareness. Only a few published studies have explored Bal-A-Vis-X as an intervention in therapy. The purpose of this study was to investigate the use of Bal-A-Vis-X to improve upper limb coordination in children with motor delays.

Number of Subjects: Fifteen children with motor delays …

Barriers And Facilitators To Kinship Care In Texas: A Multi-Stakeholder, Mixed Methods Perspective, Lauren Malthaner, Jill Mcleigh, Hilda Loria, Erinne Conner, Mike Henson-Garcia

Caregiver Needs and Supports

Kinship caregivers face numerous barriers to providing care for children placed with them and limited facilitators to help ensure successful placements. Although the needs of kinship caregivers are being examined and prioritized in the legislature, operational and policy-level interventions are needed. Results from this study allow for interventions tailored to the needs of kinship caregivers in the State of Texas as identified by a multitude of stakeholder groups.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

The Role Of Adverse Childhood Events On The Progression Of Chronic Kidney Disease In Children: A Ckid Study, Ana Cortez, Matthew Matheson, John Cowden, Bradley Warady, Darcy K. Weidemann

Posters

There is a paucity of research on the relationship between adverse childhood events (ACEs) and chronic kidney disease. The effect of ACEs on the long-term health outcomes of cardiovascular disease, cancer, and chronic lung disease first emerged in a paper published in 1998. The National Institutes of Health sponsored the ACE Study, which Kaiser Permanente carried out in California. The study used a 17-question survey addressing seven exposures: psychological, physical, contact-sexual abuse, substance abuse, mental illness, mother being treated violently, and criminal behavior in the household. The results revealed a strong relationship between childhood exposure to ACEs and health outcomes. …

Thyroid Dysfunction In Patients Receiving Immune Checkpoint Inhibitors, Emily Metzinger, Jennifer Boyd, Julia Broussard, Christopher Klockau

Posters

Objectives: The use of immune checkpoint inhibitors (ICIs) in cancer treatment is increasing. Literature about endocrinopathies associated with ICIs in children is limited. This study investigates ICIs and thyroid dysfunction in pediatric patients at one institution.

Methods: Retrospective chart review of patients ages 1 to 19 was completed who received any of the following ICIs between January 2000 and November 2023: PD-1 inhibitors (nivolumab or pembrolizumab), PD-L1 inhibitors (durvalumab or atezolizumab), and CTLA-4 inhibitors (ipilimumab or tremelimumab). Patients were excluded if thyroid function tests (TFTs) were not available to review or if patients passed away within 30 days of ICI …

Family-Centered Care For Lgbtq+ Parents Of Infants In The Neonatal Intensive Care Unit: An Integrative Review, Olivia S. Yinger, Aubrey E. Jones, Keisa Fallin-Bennett, Chelsea Gibbs, Rachel H. Farr

UK CARES Faculty Publications

Background: Having an infant in the Neonatal Intensive Care Unit (NICU) can disrupt parent well-being, the transition to parenthood, and the typical trajectories of infant and child health. For lesbian, gay, bisexual, transgender, queer, or other sexual and gender minority identity (LGBTQ+) parents, this stress may be compounded by health disparities and fear of stigma and discrimination; however, research is lacking about LGBTQ+ parents of infants in the NICU. Objectives: The purpose of this integrative review was to better understand the experiences of LGBTQ+ parents of NICU infants, with a focus on experiences of stigma and discrimination, sources of strength …

Fatty Acid Concentrations In Preterm Infants Fed The Exclusive Human Milk Diet: A Prospective Cohort Study, Lindsay F Holzapfel, Jana P Unger, Pam Gordon, Heeju Yang, Joanne E Cluette-Brown, Laura A Gollins, Amy B Hair, Camilia R Martin

Faculty, Staff and Student Publications

OBJECTIVE: Quantify blood fatty acids and growth outcomes in preterm infants fed the exclusive human milk diet.

METHODS: A prospective cohort study of 30 infants 24-34 weeks gestation and ≤1250 g fed the exclusive human milk diet. Blood fatty acids were quantified at two time points. Comparisons were made using two-sample t-tests and Wilcoxon rank sum.

RESULTS: Donor human milk-fed (n = 12) compared to mother's own milk-fed infants (n = 18) from birth to after 28 days of life, had an increased interval change of linoleic to docosahexaenoic acid ratio (5.5 vs. -1.1 mole percent ratio, p = 0.034). …

The Effect Of Using A Meal Tracking Smartphone Application In Overweight And Obese Adolescents With Prediabetes Or Type 2 Diabetes To Improve Bmi And Hba1c, Lauren Torhorst

Evidence-Based Practice Project Reports

Obesity has become one of the most common chronic pediatric illnesses worldwide and is closely linked to the onset of prediabetes and subsequent Type 2 Diabetes (T2D); therefore, preventing and treating childhood obesity has become a high priority (Hampl et al., 2023). The purpose of this Evidence-Based Practice (EBP) project is to lower Glycosylated Hemoglobin A1c (HbA1C) and Body Mass Index (BMI) in overweight and obese youth with prediabetes and T2D using a meal tracking smartphone application. The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was utilized to pilot this project between two pediatric endocrinology offices located in Southeast Wisconsin. …

Population Pharmacokinetic Analysis Of Atomoxetine And Its Metabolites In Children And Adolescents With Attention-Deficit/Hyperactivity Disorder., Shen Cheng, Mahmoud Al-Kofahi, J Steven Leeder, Jacob T. Brown

Manuscripts, Articles, Book Chapters and Other Papers

Atomoxetine (ATX) is a non-stimulant used to treat attention-deficit/hyperactivity disorder (ADHD) and systemic exposure is highly variable due to polymorphic cytochrome P450 2D6 (CYP2D6) activity. The objective of this study was to characterize the time course of ATX and metabolites (4-hydroxyatomoxetine (4-OH); N-desmethylatomoxetine (NDA); and 2-carboxymethylatomoxetine (2-COOH)) exposure following oral ATX dosing in children with ADHD to support individualized dosing. A nonlinear mixed-effect modeling approach was used to analyze ATX, 4-OH, and NDA plasma and urine, and 2-COOH urine profiles obtained over 24-72 hours from children with ADHD (n = 23) following a single oral ATX dose. Demographics and CYP2D6 …

Safety And Efficacy Of Ivacaftor In Infants Aged 1 To Less Than 4 Months With Cystic Fibrosis., Paul Mcnally, Alvin Singh, Susanna A. Mccolley, Jane C. Davies, Mark Higgins, Meng Liu, Jennifer Lu, Violeta Rodriguez-Romero, Judy L. Shih, Margaret Rosenfeld, Vx15-770-124 Study Group

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Ivacaftor (IVA) has been shown to be safe and efficacious in children aged ≥4 months with cystic fibrosis (CF) and CFTR gating variants. We evaluated safety, pharmacokinetics (PK), and efficacy of IVA in a small cohort of infants aged 1 toCF.

METHODS: In this phase 3, open-label study, infants 1 toinfants, doses were adjusted at day 15 to better match median adult exposures based on individual PK measurements taken on day 4. Primary endpoints were safety and PK measurements.

RESULTS: Seven infants (residual function CFTR variants [n=5]; minimal function CFTR variants [n=2]) received ≥1 dose of IVA. Six infants …

The Effects Of Untreated Reflux On The Incidence Of Feeding Difficulties In Neonates, Anne Grossbauer, Anya Costeloe, Prasad J. Thottam

Posters

• Gastroesophageal reflux (GERD) is the involuntary regurgitation of gastric contents into the esophagus and commonly occurs in infants.
• It is associated with various consequences related to feeding difficulty, such as feeding resistance, oral aversion, dysphagia, laryngomalacia, and failure to thrive.2
• There is a paucity in the literature regarding the incidence rate of feeding difficulties in latepreterm and full-term neonates in the neonatal intensive care unit (NICU).
• Many NICUs employ the use of anti-reflux medications, such as proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2As), to treat GERD.3
• The use of these medications is debated and variable due to perceived …

Rates Of Bronchopulmonary Dysplasia In Very Low Birth Weight Neonates: A Systematic Review And Meta-Analysis, Alvaro Moreira, Michelle Noronha, Jooby Joy, Noah Bierwirth, Aina Tarriela, Aliha Naqvi, Sarah Zoretic, Maxwell Jones, Ali Marotta, Taylor Valarie

MEDI 9331 Scholarly Activities Clinical Years

Importance: Large-scale estimates of bronchopulmonary dysplasia (BPD) are warranted for adequate prevention and treatment. However, systematic approaches to ascertain rates of BPD are lacking.

Objective: To conduct a systematic review and meta-analysis to assess the prevalence of BPD in very low birth weight (≤ 1,500 g) or very low gestational age (< 32 weeks) neonates.

Data sources: A search of MEDLINE from January 1990 until September 2019 using search terms related to BPD and prevalence was performed.

Study selection: Randomized controlled trials and observational studies evaluating rates of BPD in very low birth weight or very low gestational age infants were eligible. Included …

Reproducibility Of Maine Ongoing Outreach Simulation Education (Moose) Program In Level I Rural Delivery Hospitals, Allison Zanno, Jeffrey Holmes, Micheline Chipman, Anya K. Cutler, Leah M. Seften, Mary Ottolini, Alexa Craig, Leah Mallory, Misty Melendi

Costas T. Lambrew Research Retreat 2024

Introduction

• Simulation provides an opportunity to practice neonatal resuscitation program (NRP®) guidelines with high acuity, low occurrence events

• Rural hospitals with low birth volumes have infrequent opportunities to maintain skills needed to adequately perform neonatal resuscitation

• With limited clinical opportunities, it is essential to provide ongoing training and education that allow teams to practice these skills

• Training environment includes a facilitated debrief allowing for feedback on performance and areas of improvement

Improving Adherence To The American Academy Of Pediatrics (Aap) Clinical Practice Guideline (Cpg) For The Evaluation And Management Of Well Appearing Febrile Infants At Maine Medical Center: A Quality Improvement Initiative, Gabriela Deoliveira Md, Meredith Jackson Md, Laura J. Faherty Md, Mph, Mshp, Sarah M. Gabrielson Mph, Bsn, Anya K. Cutler Ms

Costas T. Lambrew Research Retreat 2024

Educational interventions aid in adherence to MaineHealth febrile infant guidelines with a positive shift seen in the evaluation of infants 29-60 days of age.

Statewide Needs Assessment Of Neonatal Readiness At Delivery Hospitals In Maine, Allison Zanno, Jay Kerecman, Ann Boomer, Leah M. Seften, Anya K. Cutler, Alexa Craig, Misty Melendi

Costas T. Lambrew Research Retreat 2024

Background

• Neonatal mortality is higher in hospitals with low birth rates

• More than two-thirds of hospitals deliver less than one neonate per day in Maine

• Identification of neonatal preparedness is lacking and will assist in prioritization of education and outreach initiatives to delivery hospitals

• Our objective was to engage stakeholders to understand current neonatal readiness at delivery hospitals across the state and identify barriers to and helpful resources for improving neonatal care delivery

Increasing Equitable Access To Pediatric Specialty Care In Maine Through Implementation Of Econsults, David Ireland, Rachel Rockers, Sarah M. Gabrielson, Anya K. Cutler, Laura J. Faherty, Genevieve Whiting

Costas T. Lambrew Research Retreat 2024

Introduction

•Barriers to accessing pediatric specialty care exist for many and are not experienced equally by all.

•eConsults are an asynchronous provider-provider referral modality to obtain low-barrier specialist input in place of some face-to-face (F2F) visits.

•We evaluated sociodemographic factors associated with referral to and receipt of specialist input before and after eConsult implementation at MaineHealth to examine equity implications.

Improving And Standardizing Pediatric Asthma Care Across Mainehealth Using The Validated Hospital Asthma Severity Scoring (Hass) Tool, Sean Patterson, Leah Marie Seften, Anya Cutler, Alexa Craig, Anne Coates, Noah Diminick

Costas T. Lambrew Research Retreat 2024

Objective: To assess if an inter-professional educational intervention can improve the accuracy and inter-rater reliability of the HASS.

An Assessment Of The Needs Of Maine Primary Care Providers Relating To Tobacco Prevention, Assessment, And Treatment Of Lgbtqia+ Youth And Young Adults, Logan Gerchman, Sarah M. Gabrielson, Toni Eimicke, Brandy Brown

Costas T. Lambrew Research Retreat 2024

Most primary care providers in Maine ask youth about tobacco use but don’t adjust strategies for LGBTQIA+ youth.

Most want LGBTQIA+ specific resources for smoking prevention and cessation.

Understanding Inpatient Diagnostic Imaging Use In Children’S Hospitals To Prioritize Stewardship Efforts, Megan Collins, Matt Hall, John R. Stephens, Jessica Markham

Posters

Background: Healthcare waste, including overuse of treatments or testing such as unnecessary diagnostic imaging, has estimated annual costs of over $760 billion in the United States. The most prevalent and costly imaging studies among hospitalized children are not known. Objective: To describe diagnostic imaging studies among hospitalized children with the highest prevalence, cost, rates of repetition, and hospital variation to help inform de-implementation efforts. Design/Methods: We performed a retrospective cohort study of children <18 years of age hospitalized from 1/1/2021 to 12/31/2022 across 45 hospitals in the Pediatric Health Information System. We identified all radiologic imaging for inpatient and observation encounters using billing codes. We grouped images by modality and body location, and excluded images classified as other/unspecified body location. The intraclass correlation coefficient was used to measure variation across hospitals in imaging use after adjusting for age and severity. Higher numbers indicate a higher degree of variation. Results: We identified 1,523,343 encounters; 59.1% had diagnostic imaging (Table 1). The most prevalent diagnostic imaging studies were chest x-ray (XR), abdominal XR, and echocardiogram. The images most frequently repeated were chest XR, echocardiogram, and abdominal XR. The costliest individual diagnostic imaging studies were echocardiogram, chest XR, and head/brain MRI (Table 2). Although chest XR was among the least expensive imaging modalities per unit cost, given the high prevalence of use and repeat use it was one of the costliest tests overall. Head US, interventional XR, and abdominal US had the highest variability of use between hospitals (Table 2, Figure). Conclusion(s): Chest XR and echocardiograms were among the most prevalent, costly, and frequently repeated imaging studies. Abdominal XR, abdominal ultrasound, bone/joint XR, head/brain CT, and head/brain MRI were high in both prevalence and cost among hospitalized children. Five of the 10 most commonly used imaging techniques and four of the 10 most commonly repeated imaging techniques expose children to ionizing radiation. These results could help identify areas that should be targeted to reduce radiation exposure, improve care, and decrease costs for hospitalized children.

The Impact Of Birth Volume On Neonatal Resuscitation Practices In Neonates Treated With Therapeutic Hypothermia, Allison Zanno, Matthew Ryzewski, Leah M. Seften, Anya K. Cutler, Whittney Barkhuff, Deirdre O Reilly, Jay Kerecman, Alexa Craig, Misty Melendi

Costas T. Lambrew Research Retreat 2024

Background

• Neonatal resuscitation is a high acuity, low-occurrence (HALO) event

• Clinicians in hospitals with low birth volumes lack regular opportunities to maintain Neonatal Resuscitation Program (NRP®) skills due to low birth volumes

• Data used for this analysis was provided through the Northeast Regional Hypothermia Consortium of neonates who received therapeutic hypothermia at four northern New England tertiary care centers

• We investigated differences in resuscitative practices in hospitals with varied birth volumes.

Perioperative Antibiotic Use In Neonatal General Surgery: A Survey Of Apsa Membership, Samuel K. Osei, Ashley Williams, Diane Studzinski, Patrick Karabon, Begum Akay, Pavan Brahmamdam

Posters

• Guidelines for antibiotic prophylaxis for surgical site infection (SSI) are widely used for adult patients.
• There is limited data on prophylaxis in pediatrics, and there are no standardized guidelines for neonates.
• Perioperative antibiotic use in neonates based on the surgeon’s preference.

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

Family Accommodation In Children And Adolescents With Misophonia, Eric A Storch, Andrew G Guzick, Johann D'Souza, Jane Clinger, Daphne Ayton, Minjee Kook, Conor Rork, Eleanor E Smith, Isabel A Draper, Nasim Khalfe, Catherine E Rast, Nicholas Murphy, Marijn Lijfijjt, Wayne K Goodman, Matti Cervin

Center for Medical Ethics and Health Policy Staff Publications

Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared …