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Objective: The objective of the study was to identify distinct trajectories of delayed communicative development from 12 to 36 months and examine differences in risk factors and developmental outcomes for each trajectory., Methods: Participants were 2192 children drawn from a prospective longitudinal pregnancy cohort in a large Canadian city. Maternal pregnancy medical records were used to determine perinatal risk factors. The Ages and Stages Questionnaire Communication subscale was administered at 12, 24, and 36 months. At 36 months, mothers reported on the child's health, cognitive, and behavioral development., Results: Using growth mixture modeling, we identified 4 trajectories of communicative development. Most children (81.1%) were characterized by high and stable scores from 12 to 36 months. The remaining children fell into a low-increasing class (13.0%), a moderate-stable class (4.5%), and a low-decreasing class (1.4%). At 36 months, the low-increasing class had caught up to the high-stable group. However, by 36 months, the low-decreasing class fell under the recommended "referral" cutoff, and the moderate-stable class fell under the "monitoring" cutoff criteria. Children with continued communication problems at 36 months were more likely to have a congenital anomaly and lower family income than late-talking children who had caught up., Conclusion: Repeated assessments of a brief screening tool were able to differentiate patterns of communicative development over time, each with unique risk factors and developmental outcomes. Results highlight the potential for risk factors and repeated screenings to help identify children most at risk for persistent communication delays and in need of early support services.

Importance: Excessive screen time is associated with delays in development; however, it is unclear if greater screen time predicts lower performance scores on developmental screening tests or if children with poor developmental performance receive added screen time as a way to modulate challenging behavior., Objective: To assess the directional association between screen time and child development in a population of mothers and children., Design, Setting, and Participants: This longitudinal cohort study used a 3-wave, cross-lagged panel model in 2441 mothers and children in Calgary, Alberta, Canada, drawn from the All Our Families study. Data were available when children were aged 24, 36, and 60 months. Data were collected between October 20, 2011, and October 6, 2016. Statistical analyses were conducted from July 31 to November 15, 2018., Exposures: Media., Main Outcomes and Measures: At age 24, 36, and 60 months, children's screen-time behavior (total hours per week) and developmental outcomes (Ages and Stages Questionnaire, Third Edition) were assessed via maternal report., Results: Of the 2441 children included in the analysis, 1227 (50.2%) were boys. A random-intercepts, cross-lagged panel model revealed that higher levels of screen time at 24 and 36 months were significantly associated with poorer performance on developmental screening tests at 36 months (β, -0.06; 95% CI, -0.10 to -0.01) and 60 months (β, -0.08; 95% CI, -0.13 to -0.02), respectively. These within-person (time-varying) associations statistically controlled for between-person (stable) differences., Conclusions and Relevance: The results of this study support the directional association between screen time and child development. Recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use.

Objectives: To examine the prenatal and postnatal mechanisms by which maternal adverse childhood experiences (ACEs) predict the early development of their offspring, specifically via biological (maternal health risk in pregnancy, infant health risk at birth) and psychosocial risk (maternal stress during and after pregnancy, as well as hostile behavior in early infancy)., Methods: Participants were 1994 women (mean age = 31 years) and their infants, who were recruited in pregnancy as part of a prospective longitudinal cohort from 2008 to 2010. Pregnant women completed self-report questionnaires in pregnancy and postpartum related to psychosocial risk and a questionnaire about hostile behavior when their infant was 4 months of age. Health risk in pregnancy and infant health risk at birth were obtained from health records. Mothers completed the Ages and Stages Questionnaire when infants were 12 months of age., Results: Path analysis revealed that the association between maternal ACEs and infant development outcomes at 12 months operated through 2 indirect pathways: biological health risk (pregnancy health risk and infant health risk at birth) and psychosocial risk (maternal psychosocial risk in pregnancy and maternal hostile behavior in infancy)., Conclusions: Psychosocial risks in pregnancy, but not in early infancy, contribute to the transmission of vulnerability from maternal ACEs to child development outcomes in infancy via maternal behavior. Maternal health risk in pregnancy indirectly confers risk from maternal ACEs to child development outcomes at 12 months of age through infant health risk. Maternal health and psychosocial well-being in pregnancy may be key targets for intervention., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2018 by the American Academy of Pediatrics.)

Objective: To identify the combination of factors most protective of developmental delay at age 2 among children exposed to poor maternal mental health., Design: Observational cohort study., Setting: Pregnant women were recruited from primary healthcare offices, the public health laboratory service and community posters in Calgary, Alberta, Canada., Participants: 1596 mother-child dyads who participated in the All Our Babies study and who completed a follow-up questionnaire when their child was 2 years old. Among participants who completed the 2-year questionnaire and had complete mental health data (n=1146), 305 women (27%) were classified as high maternal mental health risk., Primary Measures: Child development at age 2 was described and a resilience analysis was performed among a subgroup of families at maternal mental health risk. The primary outcome was child development problems. Protective factors were identified among families at risk, defined as maternal mental health risk, a composite measure created from participants' responses to mental health life course questions and standardised mental health measures., Results: At age 2, 18% of children were classified as having development problems, 15% with behavioural problems and 13% with delayed social-emotional competencies. Among children living in a family with maternal mental health risk, protective factors against development problems included higher social support, higher optimism, more relationship happiness, less difficulty balancing work and family responsibilities, limiting the child's screen time to <1 hour per day and the child being able to fall asleep in <30 min and sleeping through the night by age 2., Conclusions: Among families where the mother has poor mental health, public health and early intervention strategies that support interpersonal relationships, social support, optimism, work-life balance, limiting children's screen time and establishing good sleep habits in the child's first 2 years show promise to positively influence early child development., Competing Interests: Conflicts of Interest: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Background: Late preterm (34(0/7) to 36(6/7)weeks gestation) infants may experience developmental delays greater than those found in term (≥ 37(0/7)weeks gestation) infants., Aim: The aim of this study was to compare the risk of developmental delay between late preterm and full-term Canadian born infants at age 12months, and to determine infant and maternal factors associated with risk of delay., Methods: A descriptive comparative study was conducted from data available from the All Our Babies community-based, prospective, pregnancy cohort in Calgary, Alberta. Participants were a sample of mothers of 52 infants born late preterm and 156 randomly selected mothers of term infants, matched for infant sex; eligible infants were singleton births. Mothers completed a developmental screening tool, the Ages and Stages Questionnaire, version 3 (ASQ-3), when their infant was age 12months. Corrected age (CA) was used for preterm infants., Results: Both late preterm and term infants who required neonatal intensive care (NICU) were more likely to demonstrate risk of developmental delay. Compared to term infants, there was a trend for late preterm infants to be at risk of communication and gross motor delay at age 12months CA that was attenuated to the null when adjustments were made for NICU admission and other covariates., Conclusions: Infants born between 34 and 41weeks who are admitted to NICU are at increased risk of developmental delay. Early identification of risk provides an opportunity for referral for developmental assessment and early intervention programming., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Purpose: Maternal psychological distress is one of the most common perinatal complications, affecting up to 25% of pregnant and postpartum women. Research exploring the association between prenatal and postnatal distress and toddler cognitive development has not been systematically compiled. The objective of this systematic review was to determine the association between prenatal and postnatal psychological distress and toddler cognitive development., Methods: Articles were included if: a) they were observational studies published in English; b) the exposure was prenatal or postnatal psychological distress; c) cognitive development was assessed from 13 to 36 months; d) the sample was recruited in developed countries; and e) exposed and unexposed women were included. A university-based librarian conducted a search of electronic databases (Embase, CINAHL, Eric, PsycInfo, Medline) (January, 1990-March, 2014). We searched gray literature, reference lists, and relevant journals. Two reviewers independently evaluated titles/abstracts for inclusion, and quality using the Scottish Intercollegiate Guideline Network appraisal tool for observational studies. One reviewer extracted data using a standardized form., Results: Thirteen of 2448 studies were included. There is evidence of an association between prenatal and postnatal distress and cognitive development. While variable effect sizes were reported for postnatal associations, most studies reported medium effect sizes for the association between prenatal psychological distress and cognitive development. Too few studies were available to determine the influence of the timing of prenatal exposure on cognitive outcomes., Conclusion: Findings support the need for early identification and treatment of perinatal mental health problems as a potential strategy for optimizing toddler cognitive development.

One in six children entering school experiences developmental delay. Maternal mental health represents one of the earliest, modifiable influences in a child's life. The objective of the review was to evaluate the association between maternal mental health and school-age child development, and we hypothesized there would be a negative association. Five databases were searched (Embase, CINAHL, Eric, PsycInfo, Medline). Key journals and reference lists were hand-searched. Two reviewers assessed studies based on inclusion criteria: (1) the exposure was any form of maternal mental health occurring during pregnancy or postpartum periods; (2) the outcome was child development (>48 months to 8 years); (3) the study recruited participants from developed countries; and (4) publication was in English between January, 1990 and December, 2012. Disagreements were resolved by consensus. Study quality was assessed by two reviewers using the Scottish Intercollegiate Guideline Network and disagreements were resolved by consensus. Data extraction was conducted by one reviewer using standardized forms. Maternal mental health problems in pregnancy and/or the postpartum period increased the likelihood that school-age children experienced suboptimal global, behavioral, cognitive, and socio-emotional development. The findings highlight the need for maternal mental health assessment during the prenatal, postnatal, and early childhood periods.

Infant development plays a foundational role in optimal child development and health. Some studies have demonstrated an association between maternal psychological distress and infant outcomes, although the main emphasis has been on postpartum depression and infant-maternal attachment. Prevention and early intervention strategies would benefit from an understanding of the influence of both prenatal and postpartum maternal distress on a broader spectrum of infant developmental outcomes. We conducted a systematic review of studies assessing the effect of prenatal and postpartum maternal psychological distress on five aspects of infant development: global; cognitive; behavioral; socio-emotional; and psychomotor. These findings suggest that prenatal distress can have an adverse effect on cognitive, behavioral, and psychomotor development, and that postpartum distress contributes to cognitive and socio-emotional development.

Background: Parental knowledge of child development has been associated with more effective parenting strategies and better child outcomes. However, little is known about what adults who interact with children under the age of 14 years know about child development., Methods: Between September 2007 and March 2008, computer assisted telephone interviews were completed with 1443 randomly selected adults. Adults were eligible if they had interacted with a child less than 14 years of age in the past six months and lived in Alberta, Canada., Results: Sixty three percent of respondents answered two (or more) out of four questions on physical development correctly. Fifteen percent of respondents answered two (or more) out of three questions on cognitive development correctly. Seven percent of respondents answered three (or more) out of five questions on social development correctly. Two percent of respondents answered three (or more) out of five questions on emotional development correctly. Parents and females were better able to identify physical developmental milestones compared to non-parents and males. 81% of adults correctly responded that a child's experience in the first year of life has an important impact on later school performance, 70% correctly responded that a child's ability to learn is not set from birth, 50% of adults correctly responded that children learn more from hearing someone speak than from television, and 45% recognized that parents' emotional closeness with a baby influences later achievement. Parents were most likely to use doctors/paediatricians, books, and nurses as resources. Among parents, there was no relationship between knowledge and parenting morale., Conclusions: The majority of adults were unable to correctly answer questions related to when children under six years of age typically achieve developmental milestones. Knowledge of physical development exceeded knowledge about cognitive, emotional and social development. Adults were aware of the importance of positive experiences in influencing children's development. Strategies to improve awareness of developmental milestones combined with information on how to support optimal development may improve child development outcomes. Given that parents seek information about child development from health care providers there is an opportunity to ensure that providers are well informed about child development.

Using data from the All Our Families study, a longitudinal study of 1992 mother-child dyads in Canada (47.7% female; 81.9% White), we examined the developmental pathways between infant gestures and symbolic actions and communicative skills at age 5. Communicative gestures at age 12 months (e.g., pointing, nodding head "yes"), obtained via parental report, predicted stronger general communicative skills at age 5 years. Moreover, greater use of symbolic actions (e.g., "feeding" a stuffed animal with a bottle) indirectly predicted increased communicative skills at age 5 via increased productive vocabulary at 24 months. These pathways support the hypothesis that children's communicative skills during the transition to kindergarten emerge from a chain of developmental abilities starting with gestures and symbolic actions during infancy.

Parents and non-parental adults who interact with children influence child development. This study evaluates the knowledge of child development in two large and diverse samples of adults from Alberta in 2007 and 2013. Telephone interviews were completed by two random samples (1,443 in 2007; 1,451 in 2013). Participants were asked when specific milestones in physical, cognitive, emotional and social domains typically occur (age birth to six years). Data were analysed using univariate and multivariate techniques. Linear logistic regression models were used to examine factors associated with knowledge and differences between the two samples while adjusting for differences and covariates. Adults' knowledge was overall poor (<25% correct responses), but notably higher for physical (48% in 2007, 44% in 2013) than social, cognitive or emotional milestones (=21% in all cases). Knowledge was lower in the 2013 than the 2007 sample (23% in 2007, 21% in 2013), and in particular for mothers after adjusting for location and income (24% in 2007, 22% in 2013). Evidence of low knowledge may have important education and policy implications. Factors such as availability of child development evidence-based information, parental stress and access to quality childcare might play a role in the low levels of knowledge.

Mothers experiencing psychological distress in the postpartum period may have difficulties parenting their children. Inconsistent and unresponsive parenting may increase the risk of later emotional and behavioural problems in children. The purpose of this study was to identify how maternal psychological characteristics cluster at eight weeks postpartum, and whether these clusters were associated with maternal-reported child emotional and behavioural problems at the age of three years, as measured by the Parents' Evaluation of Developmental Status (PEDS) questionnaire. In a longitudinal pregnancy cohort (N?=?647), three clusters of postpartum psychological characteristics were identified. Contrary to expectations, mothers with the greatest psychological distress did not report concerns about their child's emotional and behavioural problems; rather, they reported concerns about global developmental delay. These findings suggest that infants of mothers experiencing postpartum psychological distress should receive additional follow-up to reduce the risk for global developmental delay.

Research Findings: This study assessed public perceptions of child care and its providers in a Canadian province where government funding for child care includes subsidies and a voluntary accreditation process. In 2007-2008, 1,443 randomly selected adults in Alberta, Canada, completed a telephone survey. Individuals were eligible to participate if they had had interactions with a child younger than 14 years of age in the past 6 months. A total of 52% indicated that the government should cover about half of child care costs, and 72% indicated that child care providers at day care centers should have at least a college diploma. Between 80% and 90% indicated that child care providers were as central to children's development as elementary school teachers. One third of parents sought information on child development from child care providers. These parents were more likely to have children in care for more than 6 hr per week, have children younger than 6 years old, and be unmarried. Practice or Policy: The majority of Alberta adults were in favor of substantial public funding of child care. Adults who interacted with children valued the role of child care providers in supporting children's development, which may be encouraging news for providers. Because parents sought information about child development from child care providers, it is important to ensure that providers have both the training and the content expertise to provide parents with current information that will optimize development and support parents in their role. Policymakers, educators, and program planners may consider this information useful in allocating resources to promote child development. (Contains 5 tables and 1 figure.)

Background: Like infants born very preterm (<32 weeks), late preterm (≥34 and <37 weeks) and early term (≥37 and <39 weeks) births have been associated with increased risk of developmental delay (DD); yet, the evidence remains heterogeneous across the continuum of gestational ages, hindering early identification and intervention. Objective: To estimate the association of gestational age at birth with early childhood trajectories of DD in early childhood for infants born ≥34 and <41 weeks, and determine how various maternal, pregnancy and infant characteristics relate to these trajectory groups. Methods: Analysis of mother–child dyad data with infants born ≥34 and <41 weeks gestational age within an observational pregnancy cohort in Alberta, Canada, from 2008 to 2011 (n = 2644). The association between gestational age and trajectories of the total number of Ages and Stages Questionnaire domains indicating risk of DD from 1 through 5 years of age were estimated using group‐based trajectory modelling along with other perinatal risk factors. Results: Three distinct trajectory groups were identified: low‐risk, moderate‐risk (transiently at risk of DD in one domain over time) and high‐risk (consistently at risk of delay in ≥2 domains over time). Per week of decreasing gestational age, the risk ratio of membership in the high‐risk group increases by 1.77 (95% confidence interval [CI] 1.43, 2.20) or 1.84 (95% CI 1.49, 2.27) relative to the moderate‐risk and low‐risk respectively. Increasing maternal age, identifying as Black, indigenous or a person of colour, elevated maternal depressive symptoms in pregnancy, and male infant sex were associated with high‐ and moderate‐risk trajectories compared to the low‐risk trajectory. Conclusions: In combination with decreasing gestational age, poor maternal mental health and social determinants of health increase the probability of membership in trajectories with increased risk of DD, suggesting that additional monitoring of children born late preterm and early term is warranted. [ABSTRACT FROM AUTHOR]

Hypertensive disorders in pregnancy (HDP) are associated with increased risk of offspring neurodevelopmental disorders, suggesting long-term adverse impacts on fetal brain development. However, the relationship between HDP and deficits in general child development is unclear. Our objective was to assess the association between HDP and motor and cognitive developmental delay in children at 36 months of age. We analyzed data from the All Our Families community-based cohort study (n = 1554). Diagnosis of HDP–gestational or chronic hypertension, preeclampsia, or eclampsia–was measured through medical records. Child development was measured by maternal-report on five domains of the Ages and Stages Questionnaire (ASQ-3). Standardized cut-off scores were used to operationalize binary variables for any delay, motor delay, and cognitive delay. We calculated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) using logistic regression, sequentially controlling for potential confounders followed by factors suspected to lie on the causal pathway. Overall, 8.0% of women had HDP and hypertension-exposed children had higher prevalence of delay than unexposed children. Hypertension-exposed children had elevated risk for developmental delay, but CIs crossed the null. The aRRs quantifying the fully adjusted effect of HDP on child development were 1.19 (95% CI 0.92, 1.53) for any delay, 1.18 (95% CI 0.86, 1.61) for motor delay, and 1.24 (95% CI 0.83, 1.85) for cognitive delay. We did not find a statistically significant association between HDP and developmental delay. Confidence intervals suggest that children exposed to HDP in utero have either similar or slightly elevated risk of any, motor, and cognitive delay at 36 months after controlling for maternal and obstetric characteristics. The observed direction of association aligns with evidence of biological mechanisms whereby hypertensive pathology can disrupt fetal neurodevelopment; however, more evidence is needed. Findings may have implications for early developmental monitoring and intervention following prenatal hypertension exposure. [ABSTRACT FROM AUTHOR]

Using data from the All Our Families study, a longitudinal study of 1992 mother-child dyads in Canada (47.7% female; 81.9% White), we examined the developmental pathways between infant gestures and symbolic actions and communicative skills at age 5. Communicative gestures at age 12 months (e.g., pointing, nodding head "yes"), obtained via parental report, predicted stronger general communicative skills at age 5 years. Moreover, greater use of symbolic actions (e.g., "feeding" a stuffed animal with a bottle) indirectly predicted increased communicative skills at age 5 via increased productive vocabulary at 24 months. These pathways support the hypothesis that children's communicative skills during the transition to kindergarten emerge from a chain of developmental abilities starting with gestures and symbolic actions during infancy. [ABSTRACT FROM AUTHOR]

Self-regulation is the ability to manage emotions, modulate behaviors, and focus attention. This critical skill begins to develop in infancy, improves substantially in early childhood and continues through adolescence, and has been linked to long-term health and well-being. The objectives of this study were to determine risk factors and moderators associated with the three elements of self-regulation (i.e., inattention, emotional control, or behavioral control) as well as overall self-regulation, among children at age 5. Participants were mother–child dyads from the All Our Families study (n = 1644). Self-regulation was assessed at age 5. Risk factors included income, maternal mental health, child sex, and screen time, and potential moderation by parenting and childcare. Adjusted odds ratios of children being at risk for poor self were estimated using multivariable logistic regression. Twenty-one percent of children had poor self-regulation skills. Risk factors for poor self-regulation included lower income, maternal mental health difficulties, and male sex. Childcare and poor parenting did not moderate these associations and hostile and ineffective parenting was independently associated with poor self-regulation. Excess screen time (>1 h per day) was associated with poor self-regulation. Self-regulation involves a complex and overlapping set of skills and risk factors that operate differently on different elements. Parenting and participation in childcare do not appear to moderate the associations between lower income, maternal mental health, male sex, and screen time with child self-regulation. [ABSTRACT FROM AUTHOR]

Background: Maternal depression and anxiety have been associated with deleterious child outcomes. It is, however, unclear how the chronicity and timing of maternal mental health problems predict child development outcomes. The aim of the current study was to assess the effect of both chronicity and timing of maternal anxiety and depression in pregnancy, infancy, and the toddler period on children's internalizing and externalizing symptoms, as well as social and communication skills at age 5.Method: Participants were 1,992 mother-child pairs drawn from a large prospective pregnancy cohort. Mothers reported on anxiety and depression symptoms with clinical screening tools at six time points between <25 weeks gestation and 3 years postpartum. Child outcomes were assessed at age 5.Results: Effect sizes were small for brief incidents of depression/anxiety and increased for intermittent and chronic problems (i.e., three or more timepoints) compared with mothers who had never experienced clinical-level anxiety or depression. Maternal anxiety/depression during pregnancy, infancy, and toddlerhood predicted all child outcomes, even after controlling for depression/anxiety during the other timepoints. However, maternal anxiety and depression during toddlerhood had a stronger association with child internalizing/externalizing symptoms and communication skills than either prenatal or postpartum depression/anxiety.Conclusions: Increasing number of exposures to clinical-level anxiety and depression is related to poorer child outcomes. Neither prenatal nor postpartum periods emerged as "sensitive" periods. Rather, maternal depression and anxiety during toddlerhood was more strongly associated with child outcomes at age 5. Results highlight the need for continued support for maternal mental health across early childhood. [ABSTRACT FROM AUTHOR]

Exposure to a natural disaster in childhood can have serious, long-lasting consequences, impacting physical and mental health, development, and learning. Although many children experience negative effects after a disaster, the majority do not, and what differentiates these groups is not well understood. Some of the factors that influence disaster-related outcomes in the midst of adversity include parents' mental health, the home environment, and socioeconomic status. Furthermore, genetics has also a role to play in how children respond to stressors. We had the opportunity to conduct a natural experiment of disaster recovery following the Alberta 2013 Flood. This paper presents the detailed protocol on prediction of resilience in Albertan families, and validation with cortisol data. In addition, data collection procedures, developing resiliency screening tools, candidate gene identification, genotyping, DNA methylation, and genomic analyses are described to achieve the research objectives. This study produced new knowledge by using pre- and post-disaster information on children's health and development, including children's genetics and responses to stress. This information has been identified as important to governments and other organizations invested in early child development. Our comprehensive research plan generates evidence that can be mobilized population-based approaches to improve child and family resiliency. [ABSTRACT FROM AUTHOR]

Parents and non-parental adults who interact with children influence child development. This study evaluates the knowledge of child development in two large and diverse samples of adults from Alberta in 2007 and 2013. Telephone interviews were completed by two random samples (1,443 in 2007; 1,451 in 2013). Participants were asked when specific milestones in physical, cognitive, emotional and social domains typically occur (age birth to six years). Data were analysed using univariate and multivariate techniques. Linear logistic regression models were used to examine factors associated with knowledge and differences between the two samples while adjusting for differences and covariates. Adults’ knowledge was overall poor (<25% correct responses), but notably higher for physical (48% in 2007, 44% in 2013) than social, cognitive or emotional milestones (≤21% in all cases). Knowledge was lower in the 2013 than the 2007 sample (23% in 2007, 21% in 2013), and in particular for mothers after adjusting for location and income (24% in 2007, 22% in 2013). Evidence of low knowledge may have important education and policy implications. Factors such as availability of child development evidence-based information, parental stress and access to quality childcare might play a role in the low levels of knowledge. [ABSTRACT FROM AUTHOR]

Mothers experiencing psychological distress in the postpartum period may have difficulties parenting their children. Inconsistent and unresponsive parenting may increase the risk of later emotional and behavioural problems in children. The purpose of this study was to identify how maternal psychological characteristics cluster at eight weeks postpartum, and whether these clusters were associated with maternal-reported child emotional and behavioural problems at the age of three years, as measured by the Parents' Evaluation of Developmental Status (PEDS) questionnaire. In a longitudinal pregnancy cohort (N = 647), three clusters of postpartum psychological characteristics were identified. Contrary to expectations, mothers with the greatest psychological distress did not report concerns about their child's emotional and behavioural problems; rather, they reported concerns about global developmental delay. These findings suggest that infants of mothers experiencing postpartum psychological distress should receive additional follow-up to reduce the risk for global developmental delay. [ABSTRACT FROM PUBLISHER]

Preschool children living in low-income families are at increased risk for poor outcomes; early intervention programmes mitigate these risks. While there is considerable evidence of the effectiveness of centre-based programmes in other jurisdictions, there is limited research about Canadian programmes, specifically programmes that include children and parents. The purpose of this study was to evaluate a single-site, two-generation preschool demonstration programme for low-income families in Canada. A single group, pre-test (programme intake) /post-test (programme exit) design with a 7-year-old follow-up was used. Between intake and exit, significant improvements in receptive language and global development were found among the children, and significant improvements in self-esteem, use of community resources, parenting stress and risk for child maltreatment were found among the parents. These positive improvements were sustained until the children were 7 years old. Public investment in two-generation preschool programmes may mitigate risks for suboptimal child development and improve parental psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Research Findings:This study assessed public perceptions of child care and its providers in a Canadian province where government funding for child care includes subsidies and a voluntary accreditation process. In 2007–2008, 1,443 randomly selected adults in Alberta, Canada, completed a telephone survey. Individuals were eligible to participate if they had had interactions with a child younger than 14 years of age in the past 6 months. A total of 52% indicated that the government should cover about half of child care costs, and 72% indicated that child care providers at day care centers should have at least a college diploma. Between 80% and 90% indicated that child care providers were as central to children's development as elementary school teachers. One third of parents sought information on child development from child care providers. These parents were more likely to have children in care for more than 6 hr per week, have children younger than 6 years old, and be unmarried.Practice or Policy:The majority of Alberta adults were in favor of substantial public funding of child care. Adults who interacted with children valued the role of child care providers in supporting children's development, which may be encouraging news for providers. Because parents sought information about child development from child care providers, it is important to ensure that providers have both the training and the content expertise to provide parents with current information that will optimize development and support parents in their role. Policymakers, educators, and program planners may consider this information useful in allocating resources to promote child development. [ABSTRACT FROM PUBLISHER]

Background: Research has shown that exposure to interpersonal violence is associated with poorer mental health outcomes. Understanding the impact of interpersonal violence on mental health in the early postpartum period has important implications for parenting, child development, and delivery of health services. The objective of the present study was to determine the impact of interpersonal violence on depression, anxiety, stress, and parenting morale in the early postpartum. Methods: Women participating in a community-based prospective cohort study (n = 1319) completed questionnaires prior to 25 weeks gestation, between 34-36 weeks gestation, and at 4 months postpartum. Women were asked about current and past abuse at the late pregnancy data collection time point. Postpartum depression, anxiety, stress, and parenting morale were assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale, the Spielberger State Anxiety Index, the Cohen Perceived Stress Scale, and the Parenting Morale Index, respectively. The relationship between interpersonal violence and postpartum psychosocial health status was examined using Chi-square analysis (p < 0.05) and multivariable logistic regression. Results: Approximately 30% of women reported one or more experience of interpersonal violence. Sixteen percent of women reported exposure to child maltreatment, 12% reported intimate partner violence, and 12% reported other abuse. Multivariable logistic regression analysis found that a history of child maltreatment had an independent effect on depression in the postpartum, while both child maltreatment and intimate partner violence were associated with low parenting morale. Interpersonal violence did not have an independent effect on anxiety or stress in the postpartum. Conclusion: The most robust relationships were seen for the influence of child maltreatment on postpartum depression and low parenting morale. By identifying women at risk for depression and low parenting morale, screening and treatment in the prenatal period could have far-reaching effects on postpartum mental health thus benefiting new mothers and their families in the long term. [ABSTRACT FROM AUTHOR]

Background: Parental knowledge of child development has been associated with more effective parenting strategies and better child outcomes. However, little is known about what adults who interact with children under the age of 14 years know about child development. Methods: Between September 2007 and March 2008, computer assisted telephone interviews were completed with 1443 randomly selected adults. Adults were eligible if they had interacted with a child less than 14 years of age in the past six months and lived in Alberta, Canada. Results: Sixty three percent of respondents answered two (or more) out of four questions on physical development correctly. Fifteen percent of respondents answered two (or more) out of three questions on cognitive development correctly. Seven percent of respondents answered three (or more) out of five questions on social development correctly. Two percent of respondents answered three (or more) out of five questions on emotional development correctly. Parents and females were better able to identify physical developmental milestones compared to non-parents and males. 81% of adults correctly responded that a child's experience in the first year of life has an important impact on later school performance, 70% correctly responded that a child's ability to learn is not set from birth, 50% of adults correctly responded that children learn more from hearing someone speak than from television, and 45% recognized that parents' emotional closeness with a baby influences later achievement. Parents were most likely to use doctors/paediatricians, books, and nurses as resources. Among parents, there was no relationship between knowledge and parenting morale. Conclusions: The majority of adults were unable to correctly answer questions related to when children under six years of age typically achieve developmental milestones. Knowledge of physical development exceeded knowledge about cognitive, emotional and social development. Adults were aware of the importance of positive experiences in influencing children's development. Strategies to improve awareness of developmental milestones combined with information on how to support optimal development may improve child development outcomes. Given that parents seek information about child development from health care providers there is an opportunity to ensure that providers are well informed about child development. [ABSTRACT FROM AUTHOR]

Background: Children at highest risk of developmental problems benefit from early identification and intervention. Investigating factors affecting child development at the time of transition to school may reveal opportunities to tailor early intervention programs for the greatest effectiveness, social benefit and economic gain. The primary objective of this study was to identify child and maternal factors associated with children who screened at risk of developmental problems at school entry. Methods: An existing cohort of 791 mothers who had been followed since early pregnancy was mailed a questionnaire when the children were aged four to six years. The questionnaire included a screening tool for developmental problems, an assessment of the child's social competence, health care utilization and referrals, and maternal factors, including physical health, mental health, social support, parenting morale and sense of competence, and parenting support/resources. Results: Of the 491 mothers (62%) who responded, 15% had children who were screened at high risk of developmental problems. Based on a logistic regression model, independent predictors of screening at high risk for developmental problems at age 5 were male gender (OR: 2.3; 95% CI: 1.3, 4.1), maternal history of abuse at pregnancy (OR: 2.4; 95% CI: 1.3, 4.4), and poor parenting morale when the child was 3 years old (OR: 3.9; 95% CI: 2.1, 7.3). A child with all of these risk factors had a 35% predicted probability of screening at high risk of developmental problems, which was reduced to 13% if maternal factors were favourable. Conclusions: Risk factors for developmental problems at school entry are related to maternal well being and history of abuse, which can be identified in the prenatal period or when children are preschool age. [ABSTRACT FROM AUTHOR]

Background: Undetected and untreated developmental problems can have a significant economic and social impact on society. Intervention to ameliorate potential developmental problems requires early identification of children at risk of future learning and behaviour difficulties. The objective of this study was to estimate the prevalence of risk for developmental problems among preschool children born to medically low risk women and identify factors that influence outcomes. Methods: Mothers who had participated in a prenatal trial were followed up three years post partum to answer a telephone questionnaire. Questions were related to child health and development, child care, medical care, mother's lifestyle, well-being, and parenting style. The main outcome measure was risk for developmental problems using the Parents' Evaluation of Developmental Status (PEDS). Results: Of 791 children, 11% were screened by the PEDS to be at high risk for developmental problems at age three. Of these, 43% had previously been referred for assessment. Children most likely to have been referred were those born preterm. Risk factors for delay included: male gender, history of ear infections, a low income environment, and a mother with poor emotional health and a history of abuse. A child with these risk factors was predicted to have a 53% chance of screening at high risk for developmental problems. This predicted probability was reduced to 19% if the child had a mother with good emotional health and no history of abuse. Conclusion: Over 10% of children were identified as high risk for developmental problems by the screening, and more than half of those had not received a specialist referral. Risk factors for problems included prenatal and perinatal maternal and child factors. Assessment of maternal health and effective screening of child development may increase detection of children at high risk who would benefit from early intervention. Trial registration: Current Controlled Trials ISRCTN64070727 [ABSTRACT FROM AUTHOR]

The impact of in utero and early childhood experiences on health, well-being, literacy and competence has been well described by economists, governments, researchers and healthcare providers, and engagement of all women in appropriate prenatal care is a vehicle to improve the chances of optimal child development. Prenatal strategies that meet the needs of low-resource (young, single, of lower educational achievement and/or lower income) pregnant women have the potential to alter the trajectory for vulnerable mothers and children. This review examines factors that distinguish women with limited resources who are retained in prenatal care from those who are not retained. Services that acknowledge and address mental health and social well-being may result in greater retention in prenatal care and improved outcomes. Measuring the outcomes of an intervention among only those who are retained in the program leads to an overestimate of the benefit and potential complacency with regard to addressing the needs of our most complex and vulnerable women. It is imperative that we continue to develop strategies for those women who are at highest risk of not being retained in prenatal care to fulfill the aims of the United Nations Convention on the Rights of the Child. [ABSTRACT FROM AUTHOR]

The current study examined the interaction between maternal depressive symptoms and child temperament in predicting subsequent child language skills. Participants were 252 mother-child dyads recruited from the All Our Families longitudinal cohort, a primarily middle-class sample (62.9% completed postsecondary education) from Alberta, Canada (90.5% White, 6% Asian, 3.5% other). Maternal depressive symptoms at age 3, controlling for pretiatal depressive symptoms, did not evidence a direct effect on child language skills at age 5 (49.6% males; mean [M] = 5.12 years old, standard deviation [SD] =.11). However, both child surgency and effortful control interacted with maternal depression at age 3 to predict later language skills. Low effortful control was a risk factor for poorer language abilities in contexts of high maternal depressive symptoms. High child surgency emerged as a differential susceptibility marker, predicting poorer language skills in contexts of high maternal depressive symptoms but better language sialls in contexts of low depressive symptoms. Negative affect did not interact with maternal depressive symptoms in predicting language skills. These findings highlight the complex interaction between maternal and child characteristics in predicting language development during a developmental period in which language skills are a prime indicator of school readiness and a predictor of future academic achievement and socioemotional adjustment. [ABSTRACT FROM AUTHOR]

Little is known about the development of early screen use patterns. Using data from 1949 families in Calgary, Alberta, drawn from the All Our Families cohort, this study examined patterns of screen use across 3 time points (24, 36, 60 months) to identify trajectories of screen use, socio-demographic factors that predict trajectory membership, and whether high use trajectories relate to suboptimal child behavior and learning outcomes. Mothers reported on children's screen use (hours per day), children's behavior problems (Behavior Assessment System for Children) and developmental milestones (Ages and Stages Questionnaire). Using latent class growth modeling, two trajectories were identified: low to moderate screen use (90.5% of sample; 2.16, 3.28, and 1.34 h/day, respectively) and high-persistent screen use (9.5% of sample; 3.91, 5.26, and 3.31 h/day, respectively). A number of socio-demographic factors were associated with the high-persistent screen use trajectory. Additionally, the high-persistent screen use trajectory was associated with higher levels of externalizing behavior (e.g., inattention, aggression), poor adaptive skills (e.g., social, life skills), and less likelihood of achievement of developmental milestones (e.g., language, motor skills), at 60 months of age. Findings support that screen use patterns are formed early in childhood, emphasizing the need for prevention and early intervention. • Screen use patterns are formed early in childhood. • Many factors in the family environment relate to screen use patterns. • High screen users across early childhood have poorer developmental outcomes. • Families are encouraged to engage with technology in an age-appropriate way. [ABSTRACT FROM AUTHOR]

Background: Understanding factors that protect against early developmental delay among children who are experiencing adversity can inform prevention and early intervention strategies.Aims: To identify risk factors for development delay at one year and protective factors for developmental delay in 'at risk' environments (poor maternal mental health and socio-demographic risk).Methods and Procedures: Data was analyzed from 3360 mother-child dyads who participated in the All Our Babies (AOB) pregnancy cohort. Participants completed four questionnaires spanning pregnancy to one year postpartum and provided access to medical records. Risk factors for developmental delay at age one were identified using bivariate methods and multivariable modeling. Protective factors for child development in 'at risk' family environments were identified using bivariate analyses.Outcomes and Results: At one year, 17% of children were developmentally delayed, defined as scoring in the monitoring zone on at least 2 of the 5 developmental domains of the Ages and Stages Questionnaire. Prenatal depression, preterm birth, low community engagement, and non-daily parent-child interaction increased the risk of delay. Protective factors for children in 'at risk' environments included relationship happiness, parenting self-efficacy, community engagement, higher social support, and daily parent-child interaction.Conclusions and Implications: The study results suggest that maternal and infant outcomes would be improved, even for vulnerable women, through identification and intervention to address poor mental health and through normalizing engagement with low cost, accessible community resources that can also support parent-child interaction. [ABSTRACT FROM AUTHOR]