{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T08:42:21Z","timestamp":1784018541911,"version":"3.55.0"},"reference-count":63,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Brown University Warren Alpert Medical School Women & Infants Hospital of Rhode Island","award":["U10 DA24119"],"award-info":[{"award-number":["U10 DA24119"]}]},{"name":"Brown University Warren Alpert Medical School Women & Infants Hospital of Rhode Island","award":["U10 HD27904"],"award-info":[{"award-number":["U10 HD27904"]}]},{"name":"Brown University Warren Alpert Medical School Women & Infants Hospital of Rhode Island","award":["N01 HD23159"],"award-info":[{"award-number":["N01 HD23159"]}]},{"DOI":"10.13039\/100008199","name":"RTI International","doi-asserted-by":"crossref","award":["U10 HD36790"],"award-info":[{"award-number":["U10 HD36790"]}],"id":[{"id":"10.13039\/100008199","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of Miami Holtz Children\u2019s Hospital","award":["U10 DA24118"],"award-info":[{"award-number":["U10 DA24118"]}]},{"name":"University of Miami Holtz Children\u2019s Hospital","award":["U10 HD21397"],"award-info":[{"award-number":["U10 HD21397"]}]},{"name":"University of Tennessee","award":["U10 DA24128"],"award-info":[{"award-number":["U10 DA24128"]}]},{"name":"University of Tennessee","award":["U10 HD21415"],"award-info":[{"award-number":["U10 HD21415"]}]},{"name":"University of Tennessee","award":["U10 HD42638"],"award-info":[{"award-number":["U10 HD42638"]}]},{"name":"Wayne State University Hutzel Women\u2019s Hospital and Children\u2019s Hospital of Michigan","award":["U10 DA24117"],"award-info":[{"award-number":["U10 DA24117"]}]},{"name":"Wayne State University Hutzel Women\u2019s Hospital and Children\u2019s Hospital of Michigan","award":["U10 HD21385"],"award-info":[{"award-number":["U10 HD21385"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Attention-deficit\/hyperactivity disorder (ADHD) is the most common behavioral problem in children. Multiple risk factors, including prenatal substance exposure, have been associated with this disorder. Objectives: We determined (1) the rate of ADHD in children with prenatal cocaine exposure (PCE) as compared to those non-exposed, (2) the association of ADHD with the infant\u2019s sex, race, and birth weight, maternal age and education, and other known risk factors, and factors that may mediate the relationship between these risk factors and ADHD. Methods: This was a secondary analysis of data from the Maternal Lifestyle Study for a long-term follow-up. ADHD was defined as any diagnosis of attention deficit, hyperactivity disorder, or the combination, from the National Institute of Mental Health Diagnostic Interview Schedule for Children (NIMH DISC) administered to children, ages 11 or 14 years. The main exposure variable was PCE. Independent variables included infant and maternal characteristics, caretaker psychopathology, and maternal\u2013child conflict. Mediators evaluated were the child\u2019s impulsivity at 4 years of age and attention problems at 5 years from the Child Behavior Checklist. Results: Path analysis revealed that the effects of risk variables, including PCE, were mediated through the child\u2019s attention problems at age 5 years. Child\u2019s impulsivity, which was significantly associated with attention problems, was also a mediator between PCE and ADHD. Male sex had a direct path to ADHD. Conclusions: Our findings lend support to early screening before 4 years of age in children with PCE or other risk factors for ADHD. Behavioral interventions provided during early childhood may mitigate the later diagnosis or severity of ADHD.<\/jats:p>","DOI":"10.3390\/children12111570","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T08:50:07Z","timestamp":1763542207000},"page":"1570","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prenatal Cocaine Exposure, Perinatal Risks, and Mediators to Preadolescent Attention Deficit Hyperactivity Disorder (ADHD)"],"prefix":"10.3390","volume":"12","author":[{"given":"Thitinart","family":"Sithisarn","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Kentucky, Lexington, KY 40508, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M.","family":"Bann","sequence":"additional","affiliation":[{"name":"Statistics and Epidemiology, Research Triangle Institute, RTI International, Durham, NC 27709, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Lester","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02903, USA"},{"name":"Center for the Study of Children at Risk, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seetha","family":"Shankaran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI 48201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toni","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary D.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Office of Research, Florida Gulf Coast University, Fort Myers, FL 33965, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrietta","family":"Bada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Kentucky, Lexington, KY 40508, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1017\/S003329170500471X","article-title":"The age-dependent decline of attention deficit hyperactivity disorder: A meta-analysis of follow-up studies","volume":"36","author":"Faraone","year":"2006","journal-title":"Psychol. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Hartman, C.A., Larsson, H., Vos, M., Bellato, A., Libutzki, B., Solberg, B.S., Chen, Q., Du Rietz, E., Mostert, J.C., and Kittel-Schneider, S. (2023). Anxiety, mood, and substance use disorders in adult men and women with and without attention-deficit\/hyperactivity disorder: A substantive and methodological overview. Neurosci. Biobehav. Rev., 151.","DOI":"10.1016\/j.neubiorev.2023.105209"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4823","DOI":"10.1038\/s41380-023-02228-3","article-title":"Incidence, prevalence, and global burden of ADHD from 1990 to 2019 across 204 countries: Data, with critical re-analysis, from the Global Burden of Disease study","volume":"28","author":"Cortese","year":"2023","journal-title":"Mol. Psychiatry"},{"key":"ref_4","unstructured":"NSCH (2025, May 01). National Survey of Children\u2019s Health: Indicator 2.7a: Severity of ADD\/ADHD, Age 3\u201317 Years. Available online: https:\/\/www.childhealthdata.org\/browse\/survey\/results?q=11077&r=1."},{"key":"ref_5","unstructured":"NSCH (2025, May 01). National Survey of Children\u2019s Health: Indicator 2.7: Prevalence of ADD\/ADHD, Age 3\u201317 Years. Available online: https:\/\/www.childhealthdata.org\/browse\/survey\/results?q=11076&r=1."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1080\/15374416.2024.2335625","article-title":"ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment","volume":"53","author":"Danielson","year":"2024","journal-title":"J. Clin. Child Adolesc. Psychol."},{"key":"ref_7","unstructured":"CDC (2025, May 01). Data and Statistics on ADHD, Available online: https:\/\/www.cdc.gov\/adhd\/data\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/ncbddd\/adhd\/data.html."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.psychres.2019.02.003","article-title":"Are subsyndromal manifestations of attention deficit hyperactivity disorder morbid in children? A systematic qualitative review of the literature with meta-analysis","volume":"274","author":"Kirova","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/s41572-024-00495-0","article-title":"Attention-deficit\/hyperactivity disorder","volume":"10","author":"Faraone","year":"2024","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1093\/jpepsy\/jsv162","article-title":"Topical Review: ADHD and Health-Risk Behaviors: Toward Prevention and Health Promotion","volume":"41","author":"Schoenfelder","year":"2016","journal-title":"J. Pediatr. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/dmcn.15401","article-title":"Preterm postnatal complications and risk of attention-deficit\/hyperactivity disorder","volume":"65","author":"Tso","year":"2023","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/S2215-0366(20)30312-6","article-title":"Environmental risk factors, protective factors, and peripheral biomarkers for ADHD: An umbrella review","volume":"7","author":"Kim","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s40291-022-00609-y","article-title":"Epigenetics and ADHD: Reflections on Current Knowledge, Research Priorities and Translational Potential","volume":"26","author":"Cecil","year":"2022","journal-title":"Mol. Diagn. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e221957","DOI":"10.1001\/jamanetworkopen.2022.1957","article-title":"Individual and Combined Association Between Prenatal Polysubstance Exposure and Childhood Risk of Attention-Deficit\/Hyperactivity Disorder","volume":"5","author":"Hong","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e348","DOI":"10.1542\/peds.2006-1404","article-title":"Impact of prenatal cocaine exposure on child behavior problems through school age","volume":"119","author":"Bada","year":"2007","journal-title":"Pediatrics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.ntt.2010.06.005","article-title":"Preadolescent behavior problems after prenatal cocaine exposure: Relationship between teacher and caretaker ratings (Maternal Lifestyle Study)","volume":"33","author":"Bada","year":"2011","journal-title":"Neurotoxicol. Teratol."},{"key":"ref_17","first-page":"1153","article-title":"Screening for psychosocial disorders in pediatric practice","volume":"142","author":"Jellinek","year":"1988","journal-title":"Am. J. Dis. Child."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1001\/archpedi.153.3.254","article-title":"Use of the Pediatric Symptom Checklist to screen for psychosocial problems in pediatric primary care: A national feasibility study","volume":"153","author":"Jellinek","year":"1999","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/DBP.0b013e318208ee3c","article-title":"Serial pediatric symptom checklist screening in children with prenatal drug exposure","volume":"32","author":"Whitaker","year":"2011","journal-title":"J. Dev. Behav. Pediatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e12358","DOI":"10.1111\/jspn.12358","article-title":"Factors in children with a history of neonatal abstinence syndrome at 10 years of age: Evidence from the maternal lifestyle study","volume":"27","author":"Miller","year":"2022","journal-title":"J. Spec. Pediatr. Nurs."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/00004583-200001000-00014","article-title":"NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, Differences from Previous Versions, and Reliability of Some Common Diagnoses","volume":"39","author":"Shaffer","year":"2000","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1542\/peds.110.6.1182","article-title":"The maternal lifestyle study: Effects of substance exposure during pregnancy on neurodevelopmental outcome in 1-month-old infants","volume":"110","author":"Lester","year":"2002","journal-title":"Pediatrics"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e1479","DOI":"10.1542\/peds.2011-3306","article-title":"Protective factors can mitigate behavior problems after prenatal cocaine and other drug exposures","volume":"130","author":"Bada","year":"2012","journal-title":"Pediatrics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1017\/S0954579499002011","article-title":"Effects of prenatal alcohol and cocaine exposure on infant cortisol levels","volume":"11","author":"Jacobson","year":"1999","journal-title":"Dev. Psychopathol."},{"key":"ref_25","unstructured":"Derogatis, L.R. (1993). BSI Brief Symptom Inventory, Administration, Scoring, Procedures Manual, National Computer Systems."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/0022-4405(94)90026-4","article-title":"Patterns of Relationships Between Children and Kindergarten Teachers","volume":"32","author":"Pianta","year":"1994","journal-title":"J. Sch. Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1037\/0003-066X.34.10.834","article-title":"The Coherence of Individual Development: Early Care, Attachment, and Subsequent Developmental Issues","volume":"34","author":"Sroufe","year":"1979","journal-title":"Am. Psychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"569","DOI":"10.2307\/1129176","article-title":"Measurement of temperament in infancy","volume":"52","author":"Rothbart","year":"1981","journal-title":"Child Dev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1111\/1467-8624.00355","article-title":"Investigations of temperament at three to seven years: The Children\u2019s Behavior Questionnaire","volume":"72","author":"Rothbart","year":"2001","journal-title":"Child Dev."},{"key":"ref_30","unstructured":"Achenbach, T.M. (1991). Manual for the Child Behavior Checklist\/4-18 and 1991 Profile, Department of Psychiatry, University of Vermont."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Pauli-Pott, U., and Becker, K. (2021). Impulsivity as Early Emerging Vulnerability Factor-Prediction of ADHD by a Preschool Neuropsychological Measure. Brain Sci., 11.","DOI":"10.3390\/brainsci11010060"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.jpsychires.2021.04.028","article-title":"The child behavior checklist can aid in characterizing suspected comorbid psychopathology in clinically referred youth with ADHD","volume":"138","author":"Biederman","year":"2021","journal-title":"J. Psychiatr. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/01.DBP.0000268560.72580.f9","article-title":"Impact of prenatal cocaine exposure on attention and response inhibition as assessed by continuous performance tests","volume":"28","author":"Accornero","year":"2007","journal-title":"J. Dev. Behav. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/S0892-0362(96)00121-3","article-title":"Prenatal cocaine exposure: Effects on the development of school-age children","volume":"18","author":"Richardson","year":"1996","journal-title":"Neurotoxicol. Teratol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Nygaard, E., Slinning, K., Moe, V., and Walhovd, K.B. (2016). Behavior and Attention Problems in Eight-Year-Old Children with Prenatal Opiate and Poly-Substance Exposure: A Longitudinal Study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158054"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ntt.2010.06.003","article-title":"Prenatal cocaine exposure: Effects on mother- and teacher-rated behavior problems and growth in school-age children","volume":"33","author":"Richardson","year":"2011","journal-title":"Neurotoxicol. Teratol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1038\/npp.2014.147","article-title":"Developmental consequences of fetal exposure to drugs: What we know and what we still must learn","volume":"40","author":"Ross","year":"2015","journal-title":"Neuropsychopharmacology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e12436","DOI":"10.1111\/gbb.12436","article-title":"Prenatal cocaine exposure disrupts the dopaminergic system and its postnatal responses to cocaine","volume":"17","author":"Riley","year":"2018","journal-title":"Genes Brain Behav."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.neuroscience.2007.04.036","article-title":"Prenatal cocaine exposure enhances responsivity of locus coeruleus norepinephrine neurons: Role of autoreceptors","volume":"147","author":"Elsworth","year":"2007","journal-title":"Neuroscience"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.biopsych.2013.04.030","article-title":"Prenatal cocaine exposure and gray matter volume in adolescent boys and girls: Relationship to substance use initiation","volume":"74","author":"Rando","year":"2013","journal-title":"Biol. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1001\/jamapediatrics.2013.550","article-title":"Regional brain morphometry and impulsivity in adolescents following prenatal exposure to cocaine and tobacco","volume":"167","author":"Liu","year":"2013","journal-title":"JAMA Pediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1542\/peds.2006-0003","article-title":"Diffusion tensor imaging of frontal white matter and executive functioning in cocaine-exposed children","volume":"118","author":"Warner","year":"2006","journal-title":"Pediatrics"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"983","DOI":"10.3390\/pediatric16040084","article-title":"Trends in Childhood Behavioral, Mental, and Developmental Problems (2019\u20132022) Using the National Survey of Children\u2019s Health","volume":"16","author":"Lent","year":"2024","journal-title":"Pediatr. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1037\/0022-006X.72.2.218","article-title":"Does maternal warmth moderate the effects of birth weight on twins\u2019 attention-deficit\/hyperactivity disorder (ADHD) symptoms and low IQ?","volume":"72","author":"Tully","year":"2004","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/00004703-200202000-00004","article-title":"Impact of low birth weight on attention-deficit hyperactivity disorder","volume":"23","author":"Mick","year":"2002","journal-title":"J. Dev. Behav. Pediatr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.psychres.2015.01.025","article-title":"Sibling differences in low birth weight, dopaminergic polymorphisms, and ADHD symptomatology: Evidence of GxE","volume":"226","author":"Jackson","year":"2015","journal-title":"Psychiatry Res."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Stanford, C., and Tannock, R. (2012). Sexual Differentiation of the Brain and ADHD: What Is a Sex Difference in Prevalence Telling Us?. Behavioral Neuroscience of Attention Deficit Hyperactivity Disorder and Its Treatment, Springer.","DOI":"10.1007\/978-3-642-24612-8"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S2215-0366(24)00010-5","article-title":"Why are females less likely to be diagnosed with ADHD in childhood than males?","volume":"11","author":"Martin","year":"2024","journal-title":"Lancet Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1111\/jcpp.13920","article-title":"Time after time: Failure to identify and support females with ADHD\u2014A Swedish population register study","volume":"65","author":"Skoglund","year":"2024","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1111\/jcpp.13987","article-title":"Sex differences in attention-deficit hyperactivity disorder diagnosis and clinical care: A national study of population healthcare records in Wales","volume":"65","author":"Martin","year":"2024","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e20192528","DOI":"10.1542\/peds.2019-2528","article-title":"Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit\/Hyperactivity Disorder in Children and Adolescents","volume":"144","author":"Wolraich","year":"2019","journal-title":"Pediatrics"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Shaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A.G., and Arnold, L.E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: Effects of treatment and non-treatment. BMC Med., 10.","DOI":"10.1186\/1741-7015-10-99"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.1016\/j.jped.2016.01.007","article-title":"Evaluation of child development: Beyond the neuromotor aspect","volume":"92","author":"Eickmann","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1046\/j.0021-9630.2003.00316.x","article-title":"Assessment of young children\u2019s social-emotional development and psychopathology: Recent advances and recommendations for practice","volume":"45","author":"Carter","year":"2004","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Sim, F., Thompson, L., Marryat, L., Ramparsad, N., and Wilson, P. (2019). Predictive validity of preschool screening tools for language and behavioural difficulties: A PRISMA systematic review. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0211409"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e13694","DOI":"10.1111\/obr.13694","article-title":"Screening tools used in primary health care settings to identify health behaviours in children (birth-16 years); A systematic review of their effectiveness, feasibility and acceptability","volume":"25","author":"Dutch","year":"2024","journal-title":"Obes. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1177\/0009922811406263","article-title":"Enhancing the algorithm for developmental-behavioral surveillance and screening in children 0 to 5 years","volume":"50","author":"Marks","year":"2011","journal-title":"Clin. Pediatr."},{"key":"ref_58","unstructured":"Achenbach, T.M., and Resorla, L.A. (2000). The Child Behavior Checklist (CBCL\/1.5-5), Research Center for Children, Youth, & Families, Univeristy of Vermont."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.chc.2014.05.008","article-title":"Behavior management for preschool-aged children","volume":"23","author":"Williford","year":"2014","journal-title":"Child Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1023\/A:1005131131159","article-title":"Parenting and family stress treatment outcomes in attention deficit hyperactivity disorder (ADHD): An empirical analysis in the MTA study","volume":"28","author":"Wells","year":"2000","journal-title":"J. Abnorm. Child Psychol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.chc.2014.05.014","article-title":"Behavior management for school-aged children with ADHD","volume":"23","author":"Pfiffner","year":"2014","journal-title":"Child Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e12196","DOI":"10.1002\/jcv2.12196","article-title":"Sustained improvements by behavioural parent training for children with attention-deficit\/hyperactivity disorder: A meta-analytic review of longer-term child and parental outcomes","volume":"3","author":"Doffer","year":"2023","journal-title":"JCPP Adv."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/002204269902900203","article-title":"Accuracy in Detecting Prenatal Drug Exposure","volume":"29","author":"Arendt","year":"1999","journal-title":"J. Drug Issues"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/11\/1570\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:16:46Z","timestamp":1763702206000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/11\/1570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,19]]},"references-count":63,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["children12111570"],"URL":"https:\/\/doi.org\/10.3390\/children12111570","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,19]]}}}