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Background Prevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is identified with overweight, yet cost‐effective interventions for children aged 2–6 years and their caregivers in Child Health Services are lacking. Objectives To evaluate the effects and cost‐effectiveness of a child‐centered health dialogue in the Child Health Services in Sweden on 4‐year‐old children with normal weight and overweight. Methods Thirty‐seven Child Health Centers were randomly assigned to deliver intervention or usual care. The primary outcome was zBMI‐change. Results A total of 4598 children with normal weight (zBMI: 0.1 [SD = 0.6] and 490 children with overweight (zBMI: 1.6 [SD = 0.3]) (mean age: 4.1 years [SD = 0.1]; 49% females) were included. At follow‐up, at a mean age of 5.1 years [SD = 0.1], there was no intervention effect on zBMI‐change for children with normal weight. Children with overweight in the control group increased zBMI by 0.01 ± 0.50, while children in the intervention group decreased zBMI by 0.08 ± 0.52. The intervention effect on zBMI‐change for children with overweight was –0.11, with a 95% confidence interval of –0.24 to 0.01 (p = 0.07). The estimated additional costs of the Child‐Centered Health Dialogue for children with overweight were 167 euros per child with overweight and the incremental cost‐effectiveness ratio was 183 euros per 0.1 zBMI unit prevented. Conclusions This low‐intensive multicomponent child‐centered intervention for the primary prevention of child obesity did not show statistical significant effects on zBMI, but is suggested to be cost‐effective with the potential to be implemented universally in the Child Health Services. Future studies should investigate the impact of socio‐economic factors in universally implemented obesity prevention programs.

Information is scarce on Early Childhood Caries (ECC) in Mexican preschool children and its impact on quality of life.To evaluate the ECC prevalence and its impact on OHRQoL in 3-5 years-old Mexican children according to disease severity.Caries was determined at two thresholds: (1) children with at least one caries lesion (ICDAS-1-6) and (2) children with at least one lesion in dentin (ICDAS-3-6). OHRQoL was assessed through the Mexican Early Childhood Oral Health Impact Scale (M-ECOHIS). Associations among caries severity, M-ECOHIS, and other variables were assessed by ordinal logistic regression.A total of 409 children participated (53.8% girls, 46.2% boys). Caries prevalence was 82.2% considering all lesions, and 45.0% for dentinal lesions. Significant linear trends (p .05) among caries levels and categories of exposure were found for socioeconomic variables, dietary habits, and toothbrushing habits. Attending rural private schools (OR = 1.39, 95%CI = 1.11-1.72; p .01), two main meals/day (OR = 2.75, 95%CI = 1.26-6.03; p = .01) and unsupervised toothbrushing (OR = 3.20, 95%CI = 1.96-5.24; p .01) increased the risk to have high caries severity levels. M-ECOHIS scores were statistically significant associated with caries levels (χM-ECOHIS was significantly associated with caries severity. Type of school, age groups, parents' educational level, family income, and living conditions were correlated with caries, showing how distinctive risk indicators were associated with different caries stages.

Children with Down syndrome (DS) show delayed acquisition of cognitive and functional skills compared to typically developing children. The objective of this study was to accurately describe early development of infants and young children (children hereafter) with DS based on a large recent sample. We carried out repeated measure analysis of the global development quotient (GDQ) and developmental age using data from the Assessment of Systematic Treatment with Folinic Acid and Thyroid Hormone on Psychomotor Development of Down Syndrome Young Children (ACTHYF) study (NCT01576705). Because there was no statistically significant difference in the primary endpoint between active treatment and placebo, data from all treatment groups were pooled for post-hoc analysis. Data of 141 children with DS aged 6-18 months at inclusion were analyzed. Mean GDQ decreased over the study period, especially in the youngest age classes ([6-9] and [9-12] months), indicating that acquisition of skills occurred at a slower pace compared to typically developing children. Strongest deficits were observed for motor and hearing and language skills. Only GDQ at baseline correlated significantly with evolution of GDQ. Future studies should aim at elucidating the mechanisms underlying motor and language development. Early pharmacological interventions together with early childhood therapies might be necessary to improve the developmental trajectory of children with DS.

OBJECTIVES Dental caries remains a complex childhood condition often requiring preventable hospital admissions. There are limited population-based epidemiological studies that use large and linked data sets to quantify the clinical, socio-demographic and familial risk factors related to hospital admissions for dental caries. The aim of this study was to describe and quantify the rates, socio-demographic, clinical characteristics and familial factors including repeat admissions associated with young children admitted to hospital for dental caries. METHODS This cohort study (n = 33,438) used longitudinally linked hospital admission data among all children aged

OBJECTIVES The management of early childhood caries is challenging and the impacts of its treatment on child oral health-related quality of life (COHRQoL) and dental anxiety among Australian Aboriginal children is relatively unknown. The aim of the study was to compare the impact on COHRQoL and dental anxiety after approximately 12 months among Aboriginal children treated for early childhood caries (ECC) using the Atraumatic Restorative Treatment and the Hall Technique (ART/HT: test) or standard care (control). METHODS Consenting Aboriginal communities in the North-West of Western Australia were randomized into early (test) or delayed (control) intervention for the management of ECC. Children and parents/carers completed a questionnaire at baseline and at follow-up. The questionnaire sought information on COHRQoL using the proxy-reported Early Childhood Oral Health Impact Scale (ECOHIS) and the self-reported Caries Impacts and Experiences Questionnaire for Children (CARIES-QC). The test group was provided with the ART/HT care at baseline while the control group was advised to seek care through the usual care options available within the community. At follow-up, both groups were offered care using the ART/HT approach. Changes in the mean scores from baseline to follow-up within groups were evaluated using appropriate paired (t-test, Wilcoxon paired test), and between groups with unpaired tests (t-test). Multivariate regression analysis after multiple imputations of missing data used generalized estimating equation (GEE) controlling for clustering within communities. RESULTS Twenty-five communities and 338 children (mean age = 3.6 years, sd 1.7) participated in the study (test = 177). One child was excluded from the analysis because of a missing questionnaire and clinical data at baseline and follow-up. At baseline, test group children were older (test = 3.8 years, 95% CI 3.6-4.1;control = 3.3 years, 95% CI 3.1-3.6) and had higher caries experience (test dmft = 4.4, 95% CI 3.8-5.0;control dmft = 3.1, 95% CI 2.5-3.7), but there was no significant difference in COHRQoL or anxiety levels between the groups. At follow-up, parents in the delayed intervention reported worsening of COHRQoL (70% worsening of the family impact section of the ECOHIS and 37% worsening of the total ECOHIS scale), and there was an 8% reduction in child dental anxiety among the early treatment group. CONCLUSIONS The application of the ART/HT approaches was feasible, effective, and impacted positively on child oral health-related quality of life and child dental anxiety among Aboriginal children in remote communities. The model of care as tested in this study should be further developed for inclusion in main-stream service delivery programmes.

BACKGROUND The cost of socioeconomic inequality in health service use among Australian children with chronic health conditions is poorly understood. OBJECTIVES To quantify the cost of socioeconomic inequality in health service use among Australian children with chronic health conditions. METHODS Cohort study using a whole-of-population linked administrative data for all births in Queensland, Australia, between July 2015 and July 2018. Socioeconomic status was defined by an areas-based measure, grouping children into quintiles from most disadvantaged (Q1) to least disadvantaged (Q5) based on their postcode at birth. Study outcomes included health service utilisation (inpatient, emergency department, outpatient, general practitioner, specialist, pathology and diagnostic imaging services) and healthcare costs. RESULTS Of the 238,600 children included in the analysis, 10.4% had at least one chronic health condition. Children with chronic health conditions in Q1 had higher rates of inpatient (6.6, 95% confidence interval [CI] 6.4, 6.7), emergency department (7.2, 95% CI 7.0, 7.5) and outpatient (20.3, 95% CI 19.4, 21.3) service use compared to children with chronic health conditions in Q5. They also had lower rates of general practitioner (37.5, 95% CI 36.7, 38.4), specialist (8.9, 95% CI 8.5, 9.3), pathology (10.7, 95% CI 10.2, 11.3), and diagnostic imaging (4.3, 95% CI 4.2,4.5) service use. Children with any chronic health condition in Q1 incurred lower median out-of-pocket fees than children in Q5 ($0 vs $741, respectively), lower median Medicare funding ($2710, vs $3408, respectively), and higher median public hospital funding ($31, 052 vs $23, 017, respectively). CONCLUSIONS Children of most disadvantage are more likely to access public hospital provided services, which are accessible free of charge to patients. These children are less likely to access general practitioner, specialist, pathology and diagnostic imaging services; all of which are critical to the ongoing management of chronic health conditions, but often attract an out-of-pocket fee.

PURPOSE Mild to moderate vision loss affects many children and can negatively impact a child's early literacy and academic achievement. Nevertheless, there is no consensus on which factors present in early childhood indicate the need for long-term ophthalmic follow up, particularly in children with a history of perinatal adversity. This study identified the relationship between visual, cognitive, motor and demographic factors at 2 years of age and visual acuity (VA) and stereoacuity at 4.5 years of age. METHODS Five hundred sixteen children identified as being at risk of neonatal hypoglycaemia were recruited soon after birth. At 2 years of age, binocular VA, stereoacuity and non-cycloplegic refraction were measured and a clinical neuro-developmental assessment with the Bayley Scales of Infant Development III (BSID-III) was conducted by a trained examiner. Monocular VA and stereoacuity were measured at 4.5 years of age. RESULTS Three hundred twenty-eight children completed both the 2 and 4.5 year vision and neurodevelopmental assessments. Multiple linear regression showed oblique astigmatism and motor function at 2 years were significantly associated with VA at 4.5 years of age, while spherical equivalent refraction, motor scores and stereoacuity at 2 years were significantly associated with stereoacuity at 4.5 years of age. BSID-III motor scores had the best sensitivity (81.8%) and specificity (51.5%) for identifying impaired stereoacuity at 4.5 years. However, all measures at 2 years were poorly associated with VA at 4.5 years old. CONCLUSION Vision and neurodevelopmental measures at 2 years were poorly associated with visual function at 4.5 years of age. However, lower scores on tests of motor function at 2 years may be associated with vision abnormalities, particularly reduced stereopsis, at 4.5 years of age and referral for comprehensive vision assessment for these children may be warranted.

TARAMAWOS WOS:000715077800001 TARAMASCOPUS In this study, the primary purpose is to analyse early childhood children's and their parents’ perceptions towards ‘children's participation rights. Accordingly, this study applies a phenomenology model pattern which is one of the qualitative research approaches. Fifteen children between 48 and 72 months and one of the parents (mother or father) participated in this study. The semi-structured interview technique was selected to collect data. Content analysis was applied to analyse the data, and specific codes and themes were created. The findings obtained from data analysis were discussed with the participation ladder proposed by Roger Hart.

The Infant Mental Health Journal is committed to ending systemic racism and promoting diversity, equity, and inclusion in academic publishing. IMHJ unequivocally denounces all forms of racism and white supremacy, including systemic racism in academic publishing. We commit to investigating and working to terminate the ways in which systemic racism has become normalized in academic publishing, including examining our practices and processes at IMHJ. We invite you to join us in intentional, anti-racist work through your scholarship. As part of this effort, IMHJ has updated the author guidelines to include new information regarding how authors can express the ways in which they are engaging with intention in diverse, anti-racist research. These guidelines are available under the author guidelines section on the IMHJ website (https://onlinelibrary.wiley.com/journal/10970355). As a second immediate response relative to promoting diverse, equitable, and inclusive research, IMHJ is releasing the following Call to Action, focusing on centering Blackness in infant and early childhood mental health research. This call is designed as a first step in our efforts, and IMHJ looks forward to coming initiatives aimed at disrupting systemic racism in infant and early childhood mental health research for the many scholars studying and working with diverse populations marginalized by racism and systemic inequities.La Revista de Salud Mental Infantil está comprometida a terminar el racismo sistémico y promover la diversidad, la equidad y la inclusividad en las publicaciones académicas. La Revista IMHJ censura categóricamente toda forma de racismo y supremacía de la raza blanca, incluyendo el racismo sistémico en publicaciones académicas. Estamos comprometidos a investigar y trabajar para erradicar los medios por los cuales el racismo sistémico se ha convertido en la norma en las publicaciones académicas, incluyendo el examinar nuestras prácticas y procesos dentro de la Revista IMHJ. Les invitamos a que se nos unan en nuestro esfuerzo intencional, antirracista, por medio de sus investigaciones profesionales. Como parte de este esfuerzo, la Revista IMHJ ha actualizado los parámetros para los autores para incluir nueva información acerca de cómo los autores pueden expresar de qué maneras están trabajando con intención en investigaciones diversas, antirracistas. Estos parámetros se encuentran disponibles bajo la sección de parámetros de autor en la página electrónica de la Revista IMHJ (https://onlinelibrary.wiley.com/journal/10970355). Como una segunda respuesta inmediata en relación con el fomento de la investigación diversa, igualitaria e incluyente, la Revista IMHJ presenta esta Llamada a la Acción, la cual se enfoca en centralizar la Negritud en la investigación de salud mental en infantes y la temprana niñez. Esta llamada está diseñada como un primer paso en nuestros esfuerzos y la Revista IMHJ anticipa próximas iniciativas dedicadas a poner fin al racismo sistémico en la investigación sobre salud mental en infantes y la temprana niñez para los muchos investigadores profesionales que estudian y trabajan con grupos diversos de población marginalizados por el racismo y las desigualdades sistémicas.Le Infant Mental Health Journal s'engage à mettre fin au racisme endémique et à promouvoir la diversité, l’équité, et l'inclusion dans les publications académiques. L'IMHJ dénonce sans équivoque toutes les formes de racisme et de suprématie de la race blanche, y compris le racisme systémique dans les publications académiques. Nous nous engageons à déterminer comment le racisme systémique s'est normalisé dans les publications académiques et nous nous engageons à travailler à éradiquer cette normalisation ainsi qu’à examiner et à disséquer les pratiques et les processus de l'IMHJ. Nous vous invitons à nous rejoindre dans ce travail intentionnel, délibéré et anti-raciste à travers vos recherches. Dans cette optique l'IMHJ a mis à jour les directives pour les auteurs afin d'inclure plus d'informations sur la manière dont les auteurs peuvent exprimer les façons dont ils s'engagent délibérément dans des recherches diverses et anti-racistes. Ces directives sont disponibles dans la section « directives pour auteurs » dans le site de IMHJ (https://onlinelibrary.wiley.com/journal/10970355). De plus, en tant que deuxième réaction immédiate liée à la promotion de recherches diverses, équitables et inclusives, l'IMHJ rend publique l'Appel à l'Action suivant, mettant l'accent sur la nécessité de centrer la condition noire dans les recherches sur la santé mentale du nourrisson et de la petite enfance. Cet appel est le premier pas de nos efforts et l'IMHJ attend avec intérêt les initiatives à venir se donnant pour but de contrecarrer le racisme systémique dans les recherches sur la santé mentale du nourrisson et de la petite enfance pour les nombreux chercheurs étudiant et travaillant avec des populations diverses marginalisées par le racisme et les inéquités systémiques.Aufruf zum Handeln: Schwarzsein in den Mittelpunkt rücken und den strukturellen Rassismus in der Forschung zur psychischen Gesundheit von Kindern und in der akademischen Publizistik durchbrechen Das Infant Mental Health Journal setzt sich für das Ende von strukturellem Rassismus und für die Förderung von Vielfalt, Gleichberechtigung und Inklusion im akademischen Publikationswesen ein. Das IMHJ prangert unmissverständlich alle Formen von Rassismus und weißer Vorherrschaft an, einschließlich des strukturellen Rassismus im akademischen Verlagswesen. Wir verpflichten uns, die Art und Weise, in der struktureller Rassismus im akademischen Verlagswesen normalisiert wurde, zu untersuchen und daran zu arbeiten, ihn zu beenden. Dies schließt die Überprüfung unserer Praktiken und Prozesse beim IMHJ ein. Wir laden Sie ein, sich uns mit ihrer Forschung bei der bewussten, antirassistischen Arbeit anzuschließen. Als Teil dieser Bemühungen hat das IMHJ die Autor:innenrichtlinien aktualisiert. Es wurden neue Informationen darüber aufgenommen, wie Autor:innen zum Ausdruck bringen können, wie sie sich explizit für eine vielfältige, antirassistische Forschung einsetzen. Diese Richtlinien sind auf der IMHJ-Website unter dem Abschnitt Autor:innenrichtlinien zu finden (https://emea01.safelinks.protection.outlook.com/?url = https%3A%2F%2Fonlinelibrary.wiley. com%2Fjournal%2F10970355data = 04%7C01%7C%7C04fcb2ce91b44348abfe08d9958a88dd%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637705244491301364%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000sdata = kPRKcHYbAwvFHz1JT4QOX4igY7VelpdZoRcynlhJI4w%3Dreserved = 0). Als zweite unmittelbare Reaktion bzgl. der Förderung einer vielfältigen, gerechten und inklusiven Forschung veröffentlicht das IMHJ den folgenden Aufruf zum Handeln, der Schwarzsein in den Mittelpunkt der Forschung zur psychischen Gesundheit von Säuglingen und Kleinkindern rücken will. Dieser Aufruf soll ein erster Schritt in unseren Bemühungen sein. Das IMHJ freut sich auf kommende Initiativen, die darauf abzielen, den strukturellen Rassismus in der Forschung zur psychischen Gesundheit von Säuglingen und Kleinkindern für die vielen Wissenschaftler:innen zu durchbrechen, die mit verschiedenen Bevölkerungsgruppen arbeiten, die durch Rassismus und strukturelle Ungleichheiten marginalisiert werden.行動喚起:乳幼児精神保健研究及び学術出版において、Blacknessを中心に置き、制度的人種差別を止める 乳幼児精神保健ジャーナル(IMHJ)は、学術出版において、制度的人種差別を終わりにし、多様性・公平性・包括性を促進することに全力を注ぐ。IMHJ は明確に、学術出版における制度的人種差別を含めた、あらゆる形態の人種差別と白人至上主義を非難する。我々は、IMHJでの実践と過程を調査することを含め、制度的人種差別が学術出版において常態となることを終結させるために、調査し取り組むことに全力を注ぐ。是非、あなた方も研究を通じて、意図的で反人種差別の取り組みに参加してほしい。この取り組みの一環として、IMHJは著者が意図をもって、多様性と反人種差別の研究に取り組んでいることを表現できる仕方に関する新しい情報を含めるために著者ガイドラインを更新した。これらのガイドラインは、IMHJのホームページ(https://urldefense.com/v3/__https://onlinelibrary.wiley.com/journal/10970355)**f__;44Gu6JGX6ICF44Ks44Kk44OJ44Op44Kk44Oz44Gu44K7!!HXCxUKc!ht5w9WS1VrQQFy9SI4HWUAtrMwPyYhW_DVUgwdRcA6WwVEqIKIONvSQ97ePUYa1R$ クションの下から入手できる。多様性、公平かつ包括的な研究の促進に関連する２番目の即時対応として、IMHJは、乳幼児精神保健の研究においてBlacknessを中心に置くことに焦点を当て、後述の行動喚起を公表している。この喚起は、我々の取り組みの第一歩としてデザインされている。そしてIMHJは、人種差別と制度的不平等によって阻害された多様な人々と共に研究し活動している多くの研究者にとって、乳幼児精神保健研究における制度的人種差別を止めることを目的とした新機軸となることを期待する。.摘 要:《婴儿心理健康杂志》致力于结束系统性种族主义, 促进学术出版的多样性、公平性和包容性。IMHJ明确谴责所有形式的种族主义和白人至上主义, 包括学术出版中的系统性种族主义。我们致力于调查并努力终止学术出版中系统性种族主义的常态化, 包括审查我们在IMHJ的做法和流程。我们邀请您通过学术研究加入我们有意识的反种族主义工作。作为这项工作的一部分, IMHJ更新了作者指南, 纳入了有关作者如何表达他们主动参与各种反种族主义研究的新信息。这些指南可在IMHJ网站的作者指南部分找到 (https://onlinelibrary.wiley.com/journal/10970355 )。作为促进多样性、公平性和包容性研究的第二个直接回应, IMHJ发布以下行动呼吁:重点关注婴幼儿心理健康研究中“以黑人为中心”的问题。这一呼吁是我们努力的第一步, 对于那些与因种族主义和系统性不平等而被边缘化的不同人群学习工作共事的学者来说, IMHJ期待着未来推出更多旨在消除婴幼儿心理健康研究中系统性种族主义的举措。.دعوة للعمل: تسليط الضوء على قضايا السود ووقفالعنصرية المنهجية في أبحاث الصحة النفسية للرضع والنشر الأكاديمي الملخص جريدة الصحة النفسية للأمهات والرضع ملتزمة بإنهاء العنصرية النظامية وتعزيز التنوع والمساواه والشمول في النشر الأكاديمي.وتدين الجريدة بشكل قاطع جميع أشكال العنصرية واستعلاء البيض ، بما في ذلك العنصرية الممنهجة في النشر الأكاديمي. نلتزم بالتحقيق والعمل على إنهاء الطرق التي أصبحت بها العنصرية الممنهجة من الأمور البديهية في النشر الأكاديمي ، بما في ذلك فحص ممارساتنا وعملياتنا في الجريدة. ندعوكم للانضمام إلينا في العمل الذي يستهدف مناهضة العنصرية من خلال أعمالكم البحثية. كجزء من هذا الجهد ، قامت الجريدة بتحديث إرشادات المؤلفين لتشمل معلومات جديدة تتعلق بكيفية تعبير المؤلفين عن الطرق التي يستطيعون بها أن يساهموا في بحث متنوع مناهض للعنصرية. تتوفر هذه الإرشادات ضمن قسم إرشادات المؤلف على موقع الجريدة على الانترنت. (https://urldefense.com/v3/__https://onlinelibrary.wiley.com/journal/10970355__;!!HXCxUKc!hyF7qF-DmF3dFfiOpsPozODIYhPA-gI6zgEstSsNmHtjzYL7TjBEIwLMRX6bxSGA$) وكاستجابة فورية ثانية فيما يتعلق بترويج البحوث المتنوعة والعادلة والشاملة ، تطلق جريدة الصحة النفسية للأطفال والرضع هذه الدعوة للعمل ، مع التوجه لتسليط الضوء على قضايا السود في أبحاث الصحة النفسية للرضع والأطفال في مرحلة الطفولة المبكرة. تم تصميم هذه الدعوة كخطوة أولى في جهودنا ، وتتطلع الجريدة إلى المبادرات القادمة التي تهدف إلى تعطيل العنصرية المنهجية في أبحاث الصحة النفسية للرضع والأطفال في مرحلة الطفولة المبكرة للعديد من الباحثين الذين يدرسون ويعملون مع مجموعات سكانية متنوعة مهمشة بسبب العنصرية وعدم المساواة المنهجية.

AIM To evaluate and describe results of aetiological investigations offered to a population level cohort of babies who had confirmed permanent hearing loss after they either (i) failed universal neonatal hearing screening or (ii) passed newborn screening but were detected with a permanent hearing loss in early childhood. METHODS Descriptive analysis of results of investigations offered to neonates and young children in whom permanent hearing loss was detected as part of a statewide newborn hearing screening programme. A total of 306 285 newborns were screened between 2013 and 2017. The failed screening results were confirmed by a diagnostic audiological assessment battery. Medical evaluation for the identification of the cause of the hearing loss was performed by a paediatrician or otolaryngologist, investigations were ordered using a stepwise approach, and aetiology was assigned using a coding scheme. RESULTS Permanent hearing loss was confirmed in 967 children (0.3%). Data were available for 873. An aetiological factor was identified or presumed in 61.3% of cases. Genetic causes were present in 26.8% and structural causes were present in 24.9% of cases. Congenital cytomegalovirus was present in 4.4%. CONCLUSIONS Use of a coding scheme is feasible at a population level and allows collation of data from multiple sites and will allow outcome mapping and service planning.

Autism spectrum disorder (ASD) comprises a group of multifactorial neurodevelopmental disorders primarily characterized by deficits in social interaction and repetitive behavior. Although the onset is typically in early childhood, ASD poses a lifelong challenge for both patients and caretakers. Adult neurogenesis (AN) is the process by which new functional neurons are created from neural stem cells existing in the post-natal brain. The entire event is based on a sequence of cellular processes, such as proliferation, specification of cell fate, maturation, and ultimately, synaptic integration into the existing neural circuits. Hence, AN is implicated in structural and functional brain plasticity throughout life. Accumulating evidence shows that impaired AN may underlie some of the abnormal behavioral phenotypes seen in ASD. In this review, we approach the interconnections between the molecular pathways related to AN and ASD. We also discuss existing therapeutic approaches targeting such pathways both in preclinical and clinical studies. A deeper understanding of how ASD and AN reciprocally affect one another could reveal important converging pathways leading to the emergence of psychiatric disorders.

OBJECTIVE To compare the effect of using an educational booklet and a video alone or together in promoting maternal self-efficacy to prevent childhood diarrhea. DESIGN AND SAMPLE Randomized multicenter clinical trial with 522 mothers of children under 5 years of age from northeastern Brazil. They were allocated into eight groups, according to the city: metropolis - video alone (N = 61), booklet alone (N = 60), booklet and video along (N = 60), without intervention (N = 60); countryside - booklet alone (N = 70), video alone (N = 70), booklet and video along (N = 71), without intervention (N = 70). MEASUREMENTS A sociodemographic form and the Maternal Self-Efficacy Scale for preventing early childhood diarrhea. RESULTS Increases in self-efficacy scores were observed in all experimental groups after the educational intervention. Urban mothers living had greater self-efficacy than rural mothers. This result was verified in the video alone group (p = .036) and without intervention group (p = .003). Mothers in all intervention groups, regardless of the educational intervention used, had higher self-efficacy scores than the comparison group mothers (p

Aim: The aim of this cohort study was to evaluate doctor-diagnosed and self-reported asthma in young adults after early-childhood hospitalisation for wheezing. Methods: In this prospective-controlled follow-up, questionnaires were sent to 95 subjects aged 24–28 years, who had been hospitalised for their first episodes of wheezing under 24 months of age. Fifty-eight cases and 100 controls returned the questionnaires. Results: The risk of doctor-diagnosed asthma was 2.14-fold (95% confidence interval 0.61–7.41), and the risk of self-reported asthma 2.39-fold (1.14–4.99) in cases compared to controls. The increased risk of self-reported asthma remained as statistically significant in analyses adjusted for current smoking, overweight and allergic rhinitis. Study subjects presented with wheezing symptoms, use of bronchodilators and inhaled corticosteroids, and with seasonal symptoms presumptive for allergic rhinitis during the last 12 months, more often than controls. The identification of a respiratory syncytial virus or rhinovirus during hospitalisation in early childhood was not anymore associated with asthma risk in adulthood. As expected, previous asthma during early childhood was a strong risk factor for asthma in young adulthood. Conclusion: In this controlled questionnaire study, early-childhood hospitalisation for lower respiratory infection with wheezing was an independently significant risk factor of asthma in young adults. publishedVersion

Background Empathic concern is an important component of children's social competence. Yet, little is known about the role of the development of concern for others during infancy as a predictor of social competence in early childhood. Methods Israeli infants (N = 165, 50% girls) were observed five times, from 3 to 36 months. Empathic concern was assessed at ages 3-18 months using observations, and four components of social competence were assessed at 36 months using observations and teacher reports. Results Four groups with distinct developmental trajectories of empathic concern from 3 to 18 months were identified: early-onset (starting high and increasing), low-empathy (starting low with minimal increase), rising (starting low and increasing considerably), and a very small group with a negative slope (decreasing). The first three trajectories differed on aspects of social competence at 36 months. Early-onset children continued to exhibit the highest empathic concern. Both the early-onset and rising groups had greater affective knowledge than the low-empathy group. Moreover, the rising group had better peer relations compared with low-empathy trajectory children. Conclusions Children who exhibit high levels of empathy early in infancy are likely to show high social competence later on. However, even when initial empathy levels are low, subsequent growth in empathy from 3 to 18 months can occur, with positive consequences for children's social competence at 36 months. Only children with low initial empathic concern and minimal growth across infancy are at increased risk of having poorer socioemotional capabilities in early childhood.

Item does not contain fulltext Background: There is empirical evidence that a developmental language disorder (DLD) in early childhood leads to behaviour problems. However, it is still not clear how changes in language proficiency in these children influence the presence of behaviour problems. Aims: The aim of this study is to examine if changes in language proficiency are related to changes in behaviour problems in toddlers indicated to have DLD. Methods & Procedures: This study included 185 toddlers indicated to have DLD (mean age 38 months at pretest). Scores on receptive and expressive language domains and internalizing and externalizing behaviour were gathered on Wave 1 and Wave 2 using Routine Outcome Monitoring. The Reliable Change Index was used to categorize children into two groups: children improving in receptive and expressive language domains and children not improving. Outcomes & Results: For receptive syntax, receptive vocabulary and expressive syntax, 30% or less of the children improved. Only for expressive vocabulary, most children improved (63%). Behaviour problems were present in 17% (internalizing) and 23% (externalizing) of the children. Changes in language proficiency did not lead to changes in internalizing or externalizing behaviour problems, not for the total sample, nor for children displaying behaviour problems at Wave 1. Conclusions & Implications: Professionals working with toddlers indicated to have DLD need to be aware of the co-occurrence of language problems and behaviour problems, and have to realize that behaviour problems might not immediately decrease when language proficiency improves. If behaviour problems are present in toddlers indicated to have DLD, interventions should not only focus on language, but also on behaviour problems. What this paper adds What is already known on the subject There is empirical evidence that a developmental language disorder (DLD) in early childhood leads to behaviour problems. However, it is still not clear how changes in language proficiency in children with DLD influence the presence of behaviour problems. What this paper adds to existing knowledge This study addresses if a change in language proficiency is related to changes in child behaviour problems in toddlers indicated to have DLD. The results of our study showed that most of the children did not show a positive reliable change in receptive syntax, receptive vocabulary and expressive syntax at this young age, but most of the children did in expressive vocabulary. Furthermore, changes in language proficiency did not lead to changes in the presence of internalizing or externalizing behaviour problems. What are the potential or actual clinical implications of this work? Therefore, professionals working with toddlers indicated to have DLD should be aware of the co-occurrence of language problems and behaviour problems, and have to realize that behaviour problems might not decrease as a result of improved language proficiency. If behaviour problems are present and need to be treated, other interventions, apart from the language intervention, might be necessary. 14 p.

Inhibitory control (IC) is a core executive function integral to self-regulation and cognitive control, yet is itself multi-componential. Directed global inhibition entails stopping an action on demand. Competitive inhibition is engaged when an alternative response must also be produced. Related, but not an executive function, is temperamentally-driven wariness of novelty, known as behavioural inhibition. Understanding early development of these components has been hampered by a shortage of suitable measures. We combine established and novel measures to capture directed global inhibition (Toy Prohibition, Touchscreen Prohibition), competitive inhibition (A-not-B, Early Childhood Inhibitory Touchscreen Task; ECITT) and behavioural inhibition (Touchscreen Approach) in 113 10- and 16-month-olds (73 seen longitudinally). ECITT performance shows good 1-week test-retest reliability at 10-months (r = .30-.60) but little stability to 16-months. Directed global inhibition performance shows developmental progression but little stability of individual differences from 10-16 months. Performance on measures targeting similar IC components shows greater coherence at 16-months (r = .23-.59) compared with 10-months (r = .09-.35). Probing of ECITT condition effects indicates toddlers are more able, compared with infants, to override immediate prepotencies; indicative of increasingly flexible control over behaviour. However, exerting IC over cumulative prepotencies appears just as challenging for toddlers as infants. Exploratory analyses show little evidence for cross-sectional or longitudinal associations between behavioural, directed global and competitive inhibition. In combination, these findings indicate that IC is not yet a stable, unidimensional construct during the transition between infancy and toddlerhood, and highlight the need for careful selection of multiple measures for those interested in capturing early variation in IC. This article is protected by copyright. All rights reserved.

BACKGROUND There is little evidence on adult benefits from early childhood interventions in low and middle-income countries. We assessed adult cognition, psychosocial skills and behaviour from a stimulation trial conducted in Jamaica. METHODS Children with stunted growth (height-for age

Policy Points Investments in early childhood education can have long-lasting influence on health and well-being at later stages of the life course. Widespread public support and strategies to counter opposition will be critical to the future political feasibility of enhancing early childhood policies and programs. Simple advocacy messages emphasizing the need for affordable, accessible, high-quality childcare for all can increase public support for state investments in these policies. Policy narratives (short stories with a setting, characters, and a plot that unfolds over time and offers a policy solution to a social problem) that describe structural barriers to childcare and policy solutions to address these barriers may be particularly effective to persuade individuals inclined to oppose such policies to become supportive. Inoculation messages (messages designed to prepare audiences for encountering and building resistance to opposing messages) may protect favorable childcare policy attitudes in the face of oppositional messaging. CONTEXT Early childhood education (ECE) programs enhance the health and social well-being of children and families. This preregistered, randomized, controlled study tested the effectiveness of communication strategies to increase public support for state investments in affordable, accessible, and high-quality childcare for all. METHODS At time 1 (August-September 2019), we randomly assigned members of an online research panel (n = 4,363) to read one of four messages promoting state investment in childcare policies and programs, or to a no-exposure control group. Messages included an argument-based message ("simple pro-policy"), a message preparing audiences for encountering and building resistance to opposing messages ("inoculation"), a story illustrating the structural nature of the problem and solution ("narrative"), and both inoculation and narrative messages ("combined"). At time 2 (two weeks later) a subset of respondents (n = 1,436) read an oppositional anti-policy message and, in two conditions, another narrative or inoculation message. Ordinary least squares regression compared groups' levels of support for state investment in childcare policies and programs. FINDINGS As hypothesized, respondents who read the narrative message had higher support for state investment in childcare policies than those who read the inoculation message or those in the no-exposure control group at time 1. Among respondents who were initially opposed to such investments, those who read the narrative had greater support than respondents who read the simple pro-policy message. Those who received the inoculation message at time 2 were more resistant to the anti-policy message than respondents who did not receive such a message, but effects from exposures to strategic messages at time 1 did not persist at follow-up. CONCLUSIONS Results offer guidance for policy advocates seeking to increase public support for early childhood policies and programs and could inform broader efforts to promote high-value policies with potential to improve population health.

Background Executive functioning (EF) varies in children with autism spectrum disorder (ASD) and is associated with clinical symptoms, academic, and adaptive functioning. Here, we examined whether middle-childhood EF mediates associations between early-childhood autism symptoms and adolescent outcomes in children with ASD. Methods The Pathways in ASD Cohort comprising children recruited at the time of ASD diagnosis (at 2-4 years-of-age) and followed prospectively across eight subsequent timepoints over ˜10 years was used. A subset of Pathways participants (n = 250) with Behavior Rating Inventory of Executive Function (BRIEF)-Parent Form data from at least one timepoint when participants were school-aged was analyzed. A mediation framework was used to examine whether BRIEF-measured EF across age 7-10 years (middle-childhood) mediated associations between early-childhood autism symptoms (measured using the parent-report Social Responsiveness Scale across age 2-6 years) and clinical, academic, and functional outcomes, indexed at age >10-11.8 years (early-adolescence) using the Child Behavior Checklist (CBCL)-Internalizing and Externalizing Scales, Academic Performance from the Teacher's Report Form, and Vineland Adaptive Behavior Scales. Models were rerun substituting clinician-rated and teacher-rated measures, where possible. Results Mediation models indicated a significant indirect effect of middle-childhood EF on associations between early-childhood autism symptoms and externalizing behavior, academic performance, or adaptive functioning in early adolescence; kappa squared (κ2 ) effect sizes ranged from large to small. Model findings were stable across raters. Middle-childhood EF did not mediate associations between early-childhood autism symptoms and adolescent internalizing behavior. Conclusions Among children with an ASD diagnosis, middle-childhood EF may be one pathway through which early-childhood autism symptoms influence a variety of outcomes in early-adolescence. An experimental study targeting middle-childhood EF to improve adolescent academic, emotional/behavioral, and adaptive functioning is needed to evaluate the clinical meaningfulness of these findings.

Background Nutrition has significant importance in the course of growth and development in early childhood. Selective and fussy eating is prevalent among children with autism spectrum disorder and can have a profound impact on parents' mealtime actions. Aims The study aimed to investigate the relationship between parental mealtime actions and the eating behaviours of children aged 3-5 years with typical development (TD) and autism spectrum disorder (ASD). Methods A total of 180 parents of children between 3-5 years in Ankara participated in the study; 90 were parents of children with TD, and 90 were parents of children with ASD. We measured the variables using the Brief Assessment of Mealtime Behaviour in Children (BAMBIC), Children's Eating Behaviour Questionnaire (CEBQ), and Parent Mealtime Action Scale (PMAS). Results The results revealed that food refusal, disruptive behaviours, and limited variety in TD children were related to parental actions, such as the use of rewards. We also found a negative correlation between enjoyment of food and the use of rewards. Children with ASD displayed differences concerning food refusal, and their parents were found to prepare more special meals for them compared to children with TD. Conclusion Despite differences, the eating behaviours of children with TD and ASD show similarities in some cases. If a child has a low interest in eating, then their parents tend to be more insistent, use more rewards, and offer special meals. On the contrary, a child's high interest in eating harms such parental behaviours. Since an acknowledgment that a relationship exists between the eating behaviours of children and parental actions would make intervening to shape parental attitudes easier, it is recommended that future studies should be carried out to respond to the eating problems of children by working with parents.

BACKGROUND The rate of various anxiety disorders in early childhood and whether they continue into middle childhood or adolescence is not known. We therefore report on the prevalence and stability of DSM-5-defined anxiety disorders and their symptoms, capturing the period from preschool to adolescence. METHODS By means of interviewer-based clinical interviews, anxiety was measured in a sample of Norwegian children at six measurement points from age 4 to 14 (n = 1,041). To adjust for time-invariant factors, we applied random intercept cross-lagged panel models (RI-CLPMs) capturing within-person changes. RESULTS Nearly 10% (95% CI = 7.29, 12.63) had an anxiety disorder at some timepoint. Specific phobia was the most prevalent disorder in early and middle childhood, whereas generalized anxiety disorder (GAD) increased in prevalence and became the most common anxiety disorder at age 14 (4.51%, 95% CI = 2.78, 6.23). When time-invariant confounding was adjusted for, homotypic continuity in anxiety symptoms typically first emerged in late middle childhood or adolescence. Even so, such within-person analyses revealed a heterotypic path from increased number of early childhood symptoms of specific phobia to increased number of GAD symptoms in middle childhood (B = .41, 95% CI = .06, .75). Increased separation anxiety in middle childhood predicted increased symptoms of GAD in adolescence (B = .38, 95% CI = .14, .62), and vice versa (B = .05, 95% CI = .00, .09). Only minor gender differences were revealed. CONCLUSIONS Anxiety disorders are prevalent in childhood. In early childhood, anxiety symptoms generally do not predict later anxiety symptoms. In middle childhood, however, such symptoms are less likely to vanish, indicating this developmental period to be particularly important for preventive and treatment efforts.

Atopic dermatitis (AD) mostly develops in early childhood and tends to resolve with age. However, its time course in severity before and after adolescence varies widely among patients. To investigate the course of disease severity from birth to 19 years old of adult patients with AD, we conducted a nationwide Web-based survey of 3090 Japanese adult subjects diagnosed with AD, using a questionnaire to choose a pattern that most resembled their own out of 10 courses of AD severity. Patients in the 20s and 30s age groups tended to choose the option "gradually improved" or "improved by the age of 12", but patients in the 40s or older age group tended to choose the option "aggravation between the age of 12 and 19". Those who chose "AD development at age 20 or older" increased as the generation was older. This survey revealed that the time course of AD severity from birth to 19 years old varies depending on the generation targeted in this study. It is presumed that the acquired factors affecting the natural history of AD have changed over the past 50 years in Japan.

Background Early obesity prevention research interventions in Australia generally expect participants to be able to communicate in English, but do not account for other languages. This study aimed to investigate engagement, satisfaction, retention and behavioural outcomes of linguistically diverse participants from a mainstream early childhood obesity prevention trial. Methods Healthy Beginnings is a nurse-led intervention based in Sydney, supporting families with optimal infant feeding and active play via telephone. This secondary analysis assessed participant engagement in the nurse telephone calls (call completions), satisfaction and behavioural outcomes (6 and 12 month survey data) and retention (survey completions), in the first year of life according to participants' language spoken at home (English or other language). Results Of 1155 mothers, 533 (46.1%) spoke a language other than English at home. Significantly fewer mothers speaking a language other than English completed the 6-month survey (79%) compared to those speaking English (84%), yet mothers speaking a language other than English who completed the program were more satisfied with the program overall. Significantly fewer mothers speaking a language other than English completed the final four nurse calls (of six) (56-65%) compared to those speaking English (70-80%). Adjusted odds ratios showed selected behavioural outcomes were significantly more positive for participants speaking English at home. Conclusions Healthy Beginnings trial participants who spoke a language other than English at home had less favourable engagement, retention, and behavioural outcomes compared to those who spoke English. SO WHAT?: Early obesity prevention interventions should consider cultural adaptations to improve engagement and effectiveness among culturally and linguistically diverse families.

Executive functioning (EF) and self-regulated learning (SRL) are established predictors of academic achievement, both concurrent and future. Although it has been theorized that EF development enables SRL in early childhood, this directional model remains empirically untested against plausible alternatives. Thus, this study investigated the longitudinal relations between children's EF and SRL during the transition from kindergarten to Year 1 in an Australian sample to determine the direction and strength of the association between EF and SRL. We compared four directional models and also tested whether EF and SRL can be construed as manifestations of a common factor. Children's EF was assessed using a battery of tasks tapping working memory, inhibition, and shifting, and their SRL was assessed by teachers using the Checklist of Independent Learning Development. Cross-lagged structural equation modelling analyses were conducted on a longitudinal dataset of 176 children at the end of kindergarten (age M = 5 years, 8 months; SD = 4.02 months), and 1 year later (age M = 6 years, 5 months; SD = 3.65 months). EF predicted SRL longitudinally (β= .58, controlling for kindergarten SRL), consistent with common assumptions, whereas SRL did not predict EF. However, the common factor model also fit the data very well. We concluded that EF and SRL are indeed related concurrently and longitudinally but that further evidence is needed to disambiguate whether EF is best understood as a necessary antecedent of SRL development in early childhood, or whether they reflect the same general construct.

Background Higher body mass index (BMI) and internalizing symptoms often codevelop with each other, and both of them have been widely linked to child later maladjustment. However, existing studies on the association between BMI and internalizing symptoms predominantly focus on the between-person association (i.e., the average association for a given group) and use continuous measures of BMI. To address these gaps, using approaches that can effectively partition within-person from between-person variation, this study aimed to delineate temporal dynamics (i.e., directionality) of the associations between BMI and internalizing symptoms (as continuous and clinical cut-off categorical measures for both of them). The trend of codevelopment between BMI and internalizing symptoms is also investigated. Methods This study used data from the Early Childhood Longitudinal Studies, Kindergarten Class of 2010-2011 (ECLS:2011), a nationally representative birth cohort study in the United States. Participants were 17,552 children (48.78% female, Mage = 5.6 years old at the first wave) who were assessed seven times from kindergarten through Grade 5. Results Results of the random intercept, cross-lagged panel model suggested reciprocal within-person associations between BMI and internalizing symptoms from child 7.1 to 11.1 years old. Conclusions Our findings highlight both the necessity of disaggregating between-person and within-person effects in cross-lagged associations between BMI and internalizing symptoms and the importance of interventions that target body weight and mental health issues in middle childhood to reduce the negative impact of both in the long run.

BACKGROUND Good quality parenting in early childhood is reliably associated with positive mental and physical health over the lifespan. The hypothesis that early parenting quality has significant long-term financial benefits has not been previously tested. METHODS Design: Longitudinal study with follow-up from 2012 to 2016. SETTING UK multicentre study cohort (London, South-East England). PARTICIPANTS 174 young people drawn from 2 samples, one at moderate risk of poor outcomes and one at high risk, assessed aged 4-6 years then followed up in early adolescence (mean age 12.1 years). MEASURES The primary outcome was total costs: health, social care, extra school support, out-of-home placements and family-born expenditure, determined through semistructured economic interviews. Early parenting quality was independently assessed through direct observation of parent-child interaction. RESULTS Costs were lower for youths exposed to more sensitive parenting (most sensitive quartile mean £1,619, least sensitive quartile mean £21,763; p

Various studies outline the ‘digital disconnect’ that exists between the digital experiences that children have with technologies at home and at school. It is however important to document the increasingly multimodal technological world that young children are inhabiting. Framed by socio-cultural and ecological theoretical perspectives, this case study of a 4-year old girl investigates how the contexts surrounding the child impact the use of digital technologies and the differences, if any, between the two contexts. Participatory methods are used to gather data from the child participant in relation to her experiences, preferences and interactions with technology, which was triangulated with the views of one parent and her current educator. Qualitative data were analysed using thematic analysis. Four themes emerged as follows: technological uses and competences, child agency and participation, individual and collective funds of knowledge and bridging of children's lifeworlds. Findings indicated that the differences or digital disconnect between the home and the school are not necessarily perceived as negative or limiting, yet there is also room for fluidity and openness to explore these technological spaces as possibilities or bridges for children's participation, engagement and agency in the two lifeworlds. Practitioner notes What is already known about the topic The notion of digital disconnect between the home and the school characterises children's encounters with technology. Learning is culturally, historically and socially situated, and a result of participation and immersion in the cultural milieu through the mediation of social and cultural tools. What this paper adds Empirical evidence of young children's experiences of their multimodal lifeworlds through case study research. Understanding of a young child's perceptions on the use of digital technologies in the home and the school from her own lens using participatory methods with children. Realisation that at age 4, a child may already have developed clear distinctions between formal and informal spaces. Implications for practice and/or policy Implications regarding the ways early childhood settings may respond in light of findings related to how young children may regard the existence of a digital disconnect from a positive or neutral lens. Considerations around the need to give young children a voice before effecting changes to their learning spaces through participatory, child-friendly methods, in concordance with a rights-based approach. Suggestions on the role of the adults (parents and educators) in ensuring that young children are provided with opportunities to experience and use digital technologies for multiple purposes through modelling, scaffolding and creativity. © 2021 British Educational Research Association

OBJECTIVE: The study examined whether mother–child reciprocity across increasingly challenging contexts moderated the association between household chaos and early childhood behavior problems. BACKGROUND: Living in a chaotic household is associated with behavioral dysregulation in childhood. An important goal in discordant household contexts is to establish positive aspects of relationships that are associated with more favorable developmental outcomes. METHOD: The study analyzed data from 127 mother–child dyads participating in the 3-year visit in a study of primarily low-income, African American/Black families in urban areas. Dyads were videotaped during three successive, increasingly challenging, interaction tasks. Multiple regression analyses examined household chaos, dyadic reciprocity, and the interplay of those as predictors of behavior problems. RESULTS: Greater household chaos was associated with more internalizing and externalizing behavior problems. Moderation analyses indicated that dyadic reciprocity during two challenging interaction tasks (but not during free play) attenuated the association between household chaos and internalizing problems. CONCLUSIONS: Household chaos was not associated with internalizing problems among dyads who had a connected, supportive relationship in more challenging interactive contexts. IMPLICATIONS: Improving shared positive affect and dyadic harmony in the parent–child relationship may help protect young children against the negative influence of chaotic contexts.