Search

Aim: This study re-evaluated the classification accuracy of language screening. This is because the new Swedish child health programme moved this screening from 3 to 2.5 years of age. Another aim was to investigate the stability of diagnoses between these two time points., Methods: Children were recruited consecutively during 2016-2017 from three Child Health Services in Gävle, Sweden. Forty-eight monolingual children (31 boys) and 93 bilingual children (38 boys) underwent language screening and a clinical examination by a speech and language pathologist at 2.5 years of age. They were re-examined after 6 months (at 36-38 months) for clinical diagnosis., Results: Of the 48 monolingual children, 45 retained their status at both 2.5 and 3 years of age, while three no longer met the criteria for development language disorder. Among the 93 bilingual children, 87 retained their 2.5-year status at age 3, two no longer met the criteria, and four new cases were diagnosed. These differences were not statistically significant. All changes in screening parameters between 2.5 and 3 years were within the 95% Confidence Interval, indicating stable classification., Conclusion: Screening accuracy and language status were robust between 2.5 and 3 years, providing no support for a wait-and-see approach., (© 2024 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: The aim of this study was to describe parental concerns about child health and behaviour and their sociodemographic predictors in 3-year-olds, in relation to the national guidelines of well-baby clinics., Methods: The study included parents of 33 526 children in Stockholm who had completed a questionnaire prior to a routine visit to a well-baby clinic at age 3 years. Multivariate regression was used to analyse predictors for concerns., Results: Child behaviour problems, defined as defiance and problem with adherence to daily routines, were the most common parental concerns (36.4%), with poor social skills and relations being second (21.8%). Regarding development, 9.6% had concerns about speech and 4.7% about motor development. Screen use (9.5%) and being underweight (6.3%) were other common parental concerns, while lifestyle concerns regarding physical activity and overweight were rare. Parents raised about twice as many concerns for first-born children compared with younger siblings. Child behaviour and developmental concerns were more frequent in families where the mother had primary education only and attended a well-baby clinic with a high Care Need Index., Conclusion: Parents' concerns reflected the national guidelines about child development and behaviour, but not its emphasis on a healthy lifestyle., (© 2024 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: To explore the perceptions of the COVID-19 pandemic, as expressed in the drawings of Swedish children aged 4-6 years., Methods: We analysed 91 drawings with associated descriptions submitted to the Swedish Archive of Children's Art from April 2020 to February 2021., Results: The visual and text analysis resulted in three themes. First, illustrating the virus and embodying the danger showed that young children understood the invisible enemy, combining realistic elements of the virus particle with fantasies of the 'virus monster' that needs to be fought off. Second, life has changed for the worse describes the profound effect the pandemic had on young children's lives also in Sweden, with comparatively mild restrictions and no school closures. Third, the virus spreads across the world, affects people and infects their bodies conveys young children's understanding of the pandemic as an existential challenge affecting the whole world. Children displayed surprisingly high levels of health literacy related to COVID-19, including contagion routes and the importance of hand hygiene., Conclusion: The drawings of Swedish children aged 4-6 years demonstrated the profound, practical and emotional effects of the pandemic on their lives. Drawings also illuminated young children's level of health literacy regarding COVID-19., (© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: To test the method of engaging co-researcher adolescents in data collection and explore stated motives for their selection of social media material related to COVID-19., Methods: Twenty-three adolescents, 13-19-years old, in Sweden participated as co-researchers collecting material from their social media related to COVID-19. Specifically, they motivated their selection of social media material in field notes. Their motives were explored using content analysis., Results: Adolescent co-researchers understood and performed the task well, providing insight into the social media exchanges of adolescents during the pandemic. An overarching theme for the motivation for their selection emerged: Social media is an important tool for adolescents' communication and information exchange during COVID-19. Four categories were identified: Keeping track of the talk of the town; Recognition of personally relevant topics; Adolescents as information consumers; Social media as a means for expressing feelings, advice and existential reflections. Co-researchers reported challenges relating to the quality of pandemic-related information available to adolescents., Conclusion: Including young people as co-researchers on matters relevant to them was successful. This study also underlines the need to consider the role of social media in information exchange during crises and to co-produce health communication with adolescents to meet their specific needs., (© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: To explore the relations between asthma, allergies and mental health problems in preschool children, aged 3-5 years., Methods: In this cross-sectional Swedish study, we used data on 4649 children in Uppsala municipality whose parents and preschool teachers had responded to questions measuring asthma and allergies, and the Strengths and Difficulties Questionnaire (SDQ) for assessment of mental health problems. Logistic regression models were used to explore the relations between asthma and allergies and mental health problems., Results: Children with asthma (8.5%) had elevated odds of having emotional symptoms as rated by parents (OR: 1.34; 1.02-1.76) and teachers (OR: 1.44; 1.09-1.91). According to parents' ratings, these children also had elevated odds of showing mental health problems in general according to the SDQ total score (OR: 1.42; 1.05-1.94). Children with food allergies or intolerance (4.4%) only had elevated odds of having emotional symptoms (OR: 1.64; 1.16-2.33), as reported by parents. These results remained significant after adjustment for parental background factors., Conclusion: Preschool children with asthma and food allergies or intolerance are at risk of having concurrent mental health problems. Mental health problems should be assessed in children with these disorders. Adequate support and/or referral to specialised services should be offered when needed., (© 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: Bilingual children are at risk of being overlooked for early identification of language difficulties. We investigated the accuracy of four screening models for children aged 2.5. The first model screened the child using their mother tongue, the second screened in Swedish, and the third screened in both languages used by the child. The fourth model consisted of direct screening in Swedish and using parental information about the child's language development in their mother tongue., Methods: Overall, 111 bilingual children (51% girls), 29-33 months, were recruited from three child health centres in Gävle, Sweden, from November 2015 to June 2017. All children were consecutively assessed by a speech and language pathologist, blinded to the screening outcomes., Results: Developmental language disorder was confirmed in 32 children (29%). Only the third model, based on direct assessment using the two languages used by the child, attained adequate accuracy; 88% sensitivity, 82% specificity, 67% positive and 94% negative predictive values., Conclusion: Bilingual children should be screened directly in both their languages in order to achieve adequate accuracy. Such screening procedure is particularly important for children from families with low socio-economic status living in complex linguistic environments., (© 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: The aim of this narrative review was to evaluate the evidence for interventions for children's secure attachment relationships and parents' caregiving sensitivity that could potentially be implemented in the context of a well-baby clinic., Methods: Literature search on programmes for parental caregiving sensitivity and secure attachment for infants aged 0-24 months. Randomised controlled trials (RCTs) published 1995-2018 with interventions starting from one week postpartum, and with a maximum of 12 sessions (plus potential booster session) were included., Results: We identified 25 studies, of which 22 studied effects of home-based programmes using video feedback techniques. Positive effects of these interventions in families at risk were found on parental caregiving sensitivity and to a lesser extent also on children's secure or disorganised attachment. The effects of two of these programmes were supported by several RCTs. Three intervention studies based on group and individual psychotherapy showed no significant positive effects. Most of the interventions targeted mothers only., Conclusion: The review found some evidence for positive effects of selective interventions with video feedback techniques for children's secure attachment and strong evidence for positive effects on parental caregiving sensitivity. Important knowledge gaps were identified for universal interventions and interventions for fathers and parents with a non-Western background., (© 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: We examined if routine Swedish language screening for developmental language disorder (DLD) carried out at three years of age could be performed as effectively six months earlier., Methods: This study observed 105 monolingual Swedish-speaking children (53% boys) aged 29-31 months at three Swedish child health centres. We compared their ability to combine three words, as per the existing protocol, and two words. They also underwent a comprehension task. Speech and language pathologists clinically assessed the children for DLD and their results were compared with the nurse-led screening., Results: The results for the three-word and two-word criterion were the following: sensitivity (100% versus 91%) specificity (81% versus 91%), positive predictive (38% versus 56%) and negative predictive value (100% versus 99%). The three-word criterion identified 29 children with possible DLD, including 11 cases later confirmed, and the two-word criterion identified 18 possible cases, including 10 confirmed cases. DLD was overrepresented in the 10% of children who did not cooperate with the nurse-led screening., Conclusion: Changing the required word combinations from three to two words worked well. The three-word test identified one extra confirmed case, but resulted in 10 more false positives. Lack of cooperation during screening constituted an increased risk for DLD., (©2019 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Aim: Joint physical custody (JPC), where children spend about equal time in both parent's homes after parental separation, is increasing. The suitability of this practice for preschool children, with a need for predictability and continuity, has been questioned., Methods: In this cross-sectional study, we used data on 3656 Swedish children aged three to five years living in intact families, JPC, mostly with one parent or single care. Linear regression analyses were conducted with the Strengths and Difficulties Questionnaire, completed by parents and preschool teachers, as the outcome measure., Results: Children in JPC showed less psychological problems than those living mostly (adjusted B 1.81; 95% CI [0.66 to 2.95]) or only with one parent (adjusted B 1.94; 95% CI [0.75 to 3.13]), in parental reports. In preschool teacher reports, the adjusted Betas were 1.27, 95% CI [0.14 to 2.40] and 1.41, 95% CI [0.24 to 2.58], respectively. In parental reports, children in JPC and those in intact families had similar outcomes, while teachers reported lower unadjusted symptom scores for children in intact families., Conclusion: Joint physical custody arrangements were not associated with more psychological symptoms in children aged 3-5, but longitudinal studies are needed to account for potential preseparation differences., (©2017 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: Little is known about the organisation of child maltreatment practice in Europe. We therefore explored medical child protection systems and training across Europe., Methods: An online survey was completed by physicians working in child maltreatment, identified through professional organisations in 28 member countries of the European Union, Iceland, Norway and Switzerland in 2012-2013. Respondents were questioned regarding management of suspected child maltreatment, mandatory reporting, professional training, patient referral and physician roles in multidisciplinary investigations. Responses underwent a narrative synthesis and descriptive enumerations., Results: The survey was completed by 88 individuals, unevenly distributed in 22 of 31 countries. Physicians were mandated to report child maltreatment in 16 of 22 countries. All of 88 responding physicians described multidisciplinary involvement in the clinical and forensic management of suspected child maltreatment. Practitioners involved in physical examinations included general physicians, paediatricians, forensic medical examiners, gynaecologists and paediatric surgeons. Paediatricians were required to undergo child protection training according to 30 of 86 respondents in 14 of 22 countries., Conclusion: This survey demonstrates that there were wide variations in the organisation of child maltreatment paediatrics in Europe. The differing legislative frameworks and models of care are pertinent to consider when comparing epidemiology of maltreatment reported from across European countries., (©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Aim: A significant number of children living in Sweden are bilingual, but how language screening is performed in this group is unknown. We investigated child healthcare nurses' perceptions of the language screening of bilingual children aged 30-36 months, together with their clinical practices., Methods: An online questionnaire was completed by 863 nurses who performed language screening of bilingual children in Sweden at least once a month, corresponding to 89% of the target population. Cox regression identified predictors of the nurses' tendency to simplify the screening of bilingual children., Results: The nurses reported a greater lack of confidence and more difficulties in interpreting screening outcomes for bilingual than monolingual children (p < 0.001). Half of the nurses simplified the screening processes for bilingual children and 74% postponed referrals to speech and language services, basing these adaptations on their perceptions of the children's Swedish language skills (p < 0.001). Most nurses (82%) believed that language development was slower in bilingual children, and this was the strongest predictor of simplified screening practices (RR=2.00, 95% CI 1.44-2.77)., Conclusion: Child healthcare nurses need easily accessible information and clear guidelines on the language development of bilingual children to ensure that bilingual and monolingual children receive equitable language screening services., (©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Aim: To explore Swedish child health nurses' views on their role of involving fathers at the Child Health Centres (CHCs)., Methods: Interviews with 17 experienced Swedish Child Health nurses were recorded, transcribed and analysed using systematic text condensation. Following the first analysis, the transtheoretical model of behavioural change was used to interpret the results., Results: Four themes emerged during the analysis: (1) the nurses' own agenda; (2) nurses' opinion about the father's role; (3) nurses' gatekeeping; and (4) wanting more father involvement. Most nurses were in the precontemplation stage according to the transtheoretical model when they expressed their roles as nurses (Theme 1), how they perceived the father's role within the family (Theme 2) and how they actively encouraged mothers, but not fathers, to visit the CHCs (Theme 3/Mothers are our priority). Nurses in the contemplation stage started to consider involving fathers in the CHCs (Theme 3/The gate is closed...). Still others were in the preparation (Theme 4/Fathers are worthy of change) and action stages (Theme 4/Active in involving fathers), respectively., Conclusion: Child Health nurses place more emphasis on engaging mothers than fathers in the services. To increase father involvement, nurses need support to become aware, initiate and maintain action., (©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Objective: This systematic review aims to describe longitudinal evidence on the effects of father involvement on children's developmental outcomes., Methods: Father involvement was conceptualized as accessibility (cohabitation), engagement, responsibility or other complex measures of involvement. Both biological fathers and father figures were included. We searched all major databases from the first dates. Data on father involvement had to be generated at least 1 year before measuring offspring outcomes., Results: N = 24 publications were included in the overview: 22 of these described positive effects of father involvement, whereof 16 studies had controlled for SES and 11 concerned the study population as a whole [five socio-economic status (SES)-controlled]. There is certain evidence that cohabitation with the mother and her male partner is associated with less externalising behavioural problems. Active and regular engagement with the child predicts a range of positive outcomes, although no specific form of engagement has been shown to yield better outcomes than another. Father engagement seems to have differential effects on desirable outcomes by reducing the frequency of behavioural problems in boys and psychological problems in young women, and enhancing cognitive development, while decreasing delinquency and economic disadvantage in low SES families., Conclusions: There is evidence to support the positive influence of father engagement on offspring social, behavioural and psychological outcomes. Although the literature only provides sufficient basis for engagement (direct interaction with the child) as the specific form of 'effective' father involvement, there is enough support to urge both professionals and policy makers to improve circumstances for involved fathering.