Search

It remains uncertain as to whether nutrient supplementation for the general population considered healthy could be useful in the prevention of RTIs, such as COVID-19. In this systematic review and meta-analysis, the evidence was evaluated for primary prevention of any viral respiratory tract infection (RTI) such as SARS-CoV-2, through supplementation of nutrients with a recognized role in immune function: multiple micronutrients, vitamin A, folic acid, vitamin B12, C, D, E, beta-carotene, zinc, iron and long-chain polyunsaturated fatty acids. The search produced 15,163 records of which 93 papers (based on 115 studies) met the inclusion criteria, resulting in 199,055 subjects (191,636 children and 7,419 adults) from 37 countries. Sixty-three studies were included in the meta-analyses, which was performed for children and adults separately. By stratifying the meta-analysis by world regions, only studies performed in Asia showed a significant but heterogeneous protective effect of zinc supplementation on RTIs (RR 0.86, 95% CI 0.7-0.96, I-2 = 79.1%, p = .000). Vitamin D supplementation in adults significantly decreased the incidence of RTI (RR 0.89, 95% CI 0.79-0.99, p = .272), particularly in North America (RR 0.82 95% CI 0.68-0.97), but not in Europe or Oceania. Supplementation of nutrients in the general population has either no or at most a very limited effect on prevention of RTIs. Zinc supplementation appears protective for children in Asia, whilst vitamin D may protect adults in the USA and Canada. In 10/115 (8.7%) studies post-hoc analyses based on stratification for nutritional status was performed. In only one study zinc supplementation was found to be more effective in children with low zinc serum as compared to children with normal zinc serum levels.

This study aimed to investigate the predictive effect of problematic behaviours on cognitive tempo and attention level of 60-66 months old children attending preschool education institutions. The research data were obtained from 155 children between 60 and 66 months old attending independent kindergartens affiliated to the Ministry of National Education in Malatya city centre in 2018-2019 academic year. Regression analysis was performed to examine the mediating role; Bootstrap analysis was used in order to determine direct and indirect path coefficients in regression models. As a result of the findings obtained from the study, while the cognitive tempo of the children included in the sample had a significant effect on attention, there was no significant effect of the cognitive effect on the mediating variables, and the mediating variables on the attention. Therefore, it is seen that behavioural problems do not have a significant role in the effect of cognitive tempo on attention.

Very preterm (VPT) children and adolescents show executive, behavioural and socio-emotional difficulties that persists into adulthood. This study aims to assess the effectiveness of a mindfulness-based intervention (MBI) in improving these competencies in VPT young adolescents using a randomised controlled trial design. 56 young adolescents aged 10–14 years, born before 32 gestational weeks, were randomly assigned to an “intervention” or a “waiting” group and completed an 8-week MBI in a cross-over design. Executive, behavioural and socio-emotional competencies were assessed at three different time points via parent and self-reported questionnaires, neuropsychological testing and computerised tasks. The data were analysed using an intention-to-treat approach with linear regression modelling. Our findings show a beneficial effect of MBI on executive, behavioural and socio-emotional competencies in VPT young adolescents measured by parent questionnaires. Increased executive competencies were also observed on computerised task with enhanced speed of processing after MBI. Two subgroups of participants were created based on measures of prematurity, which revealed increased long-term benefits in the moderate-risk that were not observed in the high-risk subgroups of VPT young adolescents. MBI seems a valuable tool for reducing detrimental consequences of prematurity in young adolescents, especially regarding executive, behavioural and socio-emotional difficulties.Clinical Trial Registration ClinicalTrials, NCT04638101. Registered 20 November 2020—Retrospectively registered, https://clinicaltrials.gov/show/NCT04638101.

Background: Pediatric patients admitted for acute lung disease are treated and monitored in the hospital, after which full recovery is achieved at home. Many studies report in-hospital recovery, but little is known regarding the time to full recovery after hospital discharge. Technological innovations have led to increased interest in home-monitoring and digital biomarkers. The aim of this study was to describe at-home recovery of 3 common pediatric respiratory diseases using a questionnaire and wearable device. Methods: In this study, patients admitted due to pneumonia (n = 30), preschool wheezing (n = 30), and asthma exacerbation (AE; n = 11) were included. Patients were monitored with a smartwatch and a questionnaire during admission, with a 14-day recovery period and a 10-day “healthy” period. Median compliance was calculated, and a mixed-effects model was fitted for physical activity and heart rate (HR) to describe the recovery period, and the physical activity recovery trajectory was correlated to respiratory symptom scores. Results: Median compliance was 47% (interquartile range [IQR] 33–81%) during the entire study period, 68% (IQR 54–91%) during the recovery period, and 28% (IQR 0–74%) during the healthy period. Patients with pneumonia reached normal physical activity 12 days postdischarge, while subjects with wheezing and AE reached this level after 5 and 6 days, respectively. Estimated mean physical activity was closely correlated with the estimated mean symptom score. HR measured by the smartwatch showed a similar recovery trajectory for subjects with wheezing and asthma, but not for subjects with pneumonia. Conclusions: The digital biomarkers, physical activity, and HR obtained via smartwatch show promise for quantifying postdischarge recovery in a noninvasive manner, which can be useful in pediatric clinical trials and clinical care.

Objective To investigate the traumatic effects of the COVID-19 pandemic on middle-school students and their parents. Methods This epidemiological cross-sectional study was conducted with middle-school students in Denizli. A questionnaire consisting of the IES-R, CRIES-13 and a sociodemographic data form was delivered online. A total of 1059 participants who fully completed the questionnaire were included for analysis. Results The IES-R total and subdimension scores and the CRIES-13 scores were found to be significantly higher in families with an income level of ≤2,500 TL. The CRIES-13 scores of children were found to be significantly higher in divorced families. No statistically significant difference was determined between the IES-R total and subdimension scores of the parents who were healthcare workers and the CRIES-13 scale scores of their children. Conclusion A statistically significant, positive, moderate relationship was found between the IES-R scale total and subdimension scores of parents and the CRIES-13 scale scores of children. A low socioeconomic level was seen to increase the prevalence of anxiety in adults and adolescents. The children of divorced families were found to be at higher risk of PTSD. Successful management of mental health symptoms in parents will reflect positively on the mental health status of their children.

ObjectiveTo explore how parents judge disease severity of their febrile child and to identify symptoms they associate with serious illness, minor illness or health.DesignSemistructured interviews were conducted. Interviews were audio taped, transcribed verbatim and analysed thematically.ParticipantsParents of children aged 0–5 years with a febrile illness.SettingParticipants were recruited at the paediatric ward and the emergency department.ResultsTwenty-six interviews were conducted, in which 37 parents participated. Parents described disease severity of their child mainly in terms of changes in their child’s normal characteristics (behaviour and physical features). They found it harder to describe specific disease symptoms such as dyspnoea or dehydration. Their child being active, eating and drinking well, and smiling were perceived as reassuring, whereas high fever, moving very little and uncertainty about the type of infections were mentioned as alarming symptoms. Previous experience with febrile illnesses in their children was of great influence on the number and accuracy of symptoms they reported.ConclusionParents used the normal behaviour and physical features of their child as a reference frame for judging disease severity. With a larger deviation from the child’s normal characteristics, parents considered the illness more serious. They were less able to describe specific symptoms of disease such as dyspnoea or dehydration. This knowledge is important for clinicians in their communication with parents of children with febrile illness.

PURPOSE: To identify determinants of spoken language comprehension (SLC) in children with cerebral palsy (CP).MATERIALS AND METHODS: Cross-sectional data of 207 children with CP were included: 82 toddlers (18 months-3;11 years), 59 preschool children (4;0-5;11 years), and 66 schoolchildren (6;0-8;11 years), across all Gross Motor Function Classification System (GMFCS) levels. SLC was assessed using the Computer-Based instrument for Low motor Language Testing (C-BiLLT). Potential determinants were retrieved from medical files and through parental questionnaires. Per developmental stage, multivariable regression analyses were used to assess determinants of SLC.RESULTS: Fifty-nine percent of the children showed below average SLC. Significant determinants for SLC differed per developmental stage. In toddlers: age, motor type, functional communication and speech function (R2 = 0.637); in preschool children: functional communication, speech function and language activities (R2 = 0.820), and in schoolchildren: functional communication, intellectual functioning and arm-hand functioning (R2 = 0.807). For all developmental stages, functional mobility was not a significant determinant.CONCLUSIONS: A large proportion of children with CP across all GMFCS levels have SLC impairments. Findings indicate that SLC is strongly determined by functional communication classified with CFCS. We recommend standardized assessment and monitoring of SLC in all children with CP. IMPLICATIONS FOR REHABILITATIONChildren across all GMFCS levels can experience difficulties in spoken language comprehension.At all developmental stages, functional communication (classified with CFCS) is an important determinant of spoken language comprehension.Standardized assessment and monitoring of spoken language comprehension, language production, speech, and communication of all children with CP, is strongly recommended.When children show below average performances, especially in spoken language comprehension, intervening with speech and language therapy and guidance for parents, is advised.

It remains uncertain as to whether nutrient supplementation for the general population considered healthy could be useful in the prevention of RTIs, such as COVID-19. In this systematic review and meta-analysis, the evidence was evaluated for primary prevention of any viral respiratory tract infection (RTI) such as SARS-CoV-2, through supplementation of nutrients with a recognized role in immune function: multiple micronutrients, vitamin A, folic acid, vitamin B12, C, D, E, beta-carotene, zinc, iron and long-chain polyunsaturated fatty acids. The search produced 15,163 records of which 93 papers (based on 115 studies) met the inclusion criteria, resulting in 199,055 subjects (191,636 children and 7,419 adults) from 37 countries. Sixty-three studies were included in the meta-analyses, which was performed for children and adults separately. By stratifying the meta-analysis by world regions, only studies performed in Asia showed a significant but heterogeneous protective effect of zinc supplementation on RTIs (RR 0.86, 95% CI 0.7-0.96, I2 = 79.1%, p = .000). Vitamin D supplementation in adults significantly decreased the incidence of RTI (RR 0.89, 95% CI 0.79-0.99, p = .272), particularly in North America (RR 0.82 95% CI 0.68-0.97), but not in Europe or Oceania. Supplementation of nutrients in the general population has either no or at most a very limited effect on prevention of RTIs. Zinc supplementation appears protective for children in Asia, whilst vitamin D may protect adults in the USA and Canada. In 10/115 (8.7%) studies post-hoc analyses based on stratification for nutritional status was performed. In only one study zinc supplementation was found to be more effective in children with low zinc serum as compared to children with normal zinc serum levels.

Whereas in adults, physical inactivity is strongly related to obesity and hypertension, in young children the evidence is inconsistent and scarce. We examined the association between physical activity (PA) behaviours at 5&ndash, 6 years of age and adiposity and blood pressure (BP) at 10&ndash, 11 years in 947 children (51% boys) from the Groningen Expert Center for Kids with Obesity (GECKO) Drenthe cohort. Sedentary time (ST) and light, moderate, and vigorous PA were assessed using accelerometry (ActiGraph GT3X, wear time &gt, 600 min/day, &ge, 3 days). Body mass index (BMI), waist circumference (WC), and systolic and diastolic BP were measured at 5&ndash, 6 and 10&ndash, 11 years of age and standardized as age- and sex-adjusted (and height-adjusted, for BP) z-scores. Adjusted linear and logistic regression models showed that most PA behaviours were not related to standardized BMI or WC, overweightness/obesity, abdominal overweightness/obesity, standardized systolic or diastolic BP, pulse pressure, or prehypertension at 10&ndash, 11 years of age. Only if children spent more time in vigorous PA was WC slightly lower (B (95% CI) = &minus, 0.08 (&minus, 0.16, &minus, 0.01) SD, std&beta, = &minus, 0.068) and the increase in WC over the years was less (B (95% CI) = &minus, 0.10 (&minus, 0.18, &minus, 0.01) SD, std&beta, 0.083). To conclude, at this very young age, PA behaviours are not a strong predictor for overweightness/obesity or hypertension later in childhood.

Aim To identify factors that are relevant for spoken language comprehension in children with cerebral palsy (CP), following the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY) framework. Method A systematic literature search was conducted using the electronic literature databases PubMed, Embase, PsycInfo, and Cochrane Library, from January 1967 to December 2019. Included studies involved children with CP, results regarding spoken language comprehension, and analysis of at least one associated factor. Factors were classified within ICF-CY domains. Results Twenty-one studies met inclusion criteria. Factors in the ICF-CY domains of body functions and structure were most frequently reported. White brain matter abnormalities, motor type, functional mobility, and intellectual functioning appear to be relevant factors in spoken language comprehension in CP. Factors in the domain of activities and participation, as well as contextual factors, have rarely been studied in the context of spoken language comprehension in CP. Interpretation Most factors known to be important for spoken language comprehension in typically developing children and/or known to be susceptible to change by interventions are understudied in CP.

Objective:The objective was to examine the association between parenting practices, toddler’s dietary intake and BMI. In addition, potential moderation of these associations by general parenting and child temperament was examined.Design:The current cross-sectional study assessed parenting practices using the Comprehensive Feeding Practices Questionnaire, general parenting using the Comprehensive General Parenting Questionnaire, child temperament using the Child Behavior Check List, and children’s dietary intake through parental questionnaires. Children’s weight and length were objectively measured to determine BMI z-scores. Associations were examined using multiple linear regression analyses. Moderation was examined using interaction terms.Setting:Home setting.Participants:393 Dutch toddlers (age 1–3 years) and their parents recruited through fifty childcare centres and preschools in the Netherlands.Results:Various practices were related to children’s diet and BMI. For instance, the availability of healthy foods is the most important predictor of healthy dietary intake (e.g. β = –0·35 for sweets; β = 0·18 for fruit). The association of availability with a healthier diet was strongest when parents scored low on the positive parenting style dimensions, including nurturance, structure and/or behavioural control. In addition, it seemed that a high availability of healthy foods and low availability of unhealthy foods is especially beneficial for children showing withdrawal/depressive, anxious or overactive behaviour, while encouraging balance and variety is not beneficial for these children. All other practices were related to children’s diet and/or BMI as well.Conclusions:The findings underline the importance of viewing the impact of parenting practices in the context of general parenting and child temperament.

AIM: To identify factors that are relevant for spoken language comprehension in children with cerebral palsy (CP), following the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY) framework.METHOD: A systematic literature search was conducted using the electronic literature databases PubMed, Embase, PsycInfo, and Cochrane Library, from January 1967 to December 2019. Included studies involved children with CP, results regarding spoken language comprehension, and analysis of at least one associated factor. Factors were classified within ICF-CY domains.RESULTS: Twenty-one studies met inclusion criteria. Factors in the ICF-CY domains of body functions and structure were most frequently reported. White brain matter abnormalities, motor type, functional mobility, and intellectual functioning appear to be relevant factors in spoken language comprehension in CP. Factors in the domain of activities and participation, as well as contextual factors, have rarely been studied in the context of spoken language comprehension in CP.INTERPRETATION: Most factors known to be important for spoken language comprehension in typically developing children and/or known to be susceptible to change by interventions are understudied in CP.

Aim To determine development curves of communication and social interaction from childhood into adulthood for individuals with cerebral palsy (CP). Method This Pediatric Rehabilitation Research in the Netherlands (PERRIN)‐DECADE study longitudinally assessed 421 individuals with CP, aged from 1 to 20 years at baseline, after 13 years (n=121 at follow‐up). Communication and social interactions were assessed using the Vineland Adaptive Behavior Scales. We estimated the average maximum performance limit (level) and age at which 90% of the limit was reached (age90) using nonlinear mixed‐effects modeling. Results One‐hundred individuals without intellectual disability were aged 21 to 34 years at follow‐up (39 females, 61 males) (mean age [SD] 28y 5mo [3y 11mo]). Limits of individuals without intellectual disability, regardless of Gross Motor Function Classification System (GMFCS) level, approached the maximum score and were significantly higher than those of individuals with intellectual disability. Ages90 ranged between 3 and 4 years for receptive communication, 6 and 7 years for expressive communication and interrelationships, 12 and 16 years for written communication, 13 and 16 years for play and leisure, and 14 and 16 years for coping. Twenty‐one individuals with intellectual disability were between 21 and 27 years at follow‐up (8 females, 13 males) (mean age [SD] 24y 7mo [1y 8mo]). Individuals with intellectual disability in GMFCS level V showed the least favourable development, but variation between individuals with intellectual disability was large. Interpretation Individuals with CP and without intellectual disability show developmental curves of communication and social interactions similar to typically developing individuals, regardless of their level of motor function. Those with intellectual disability reach lower performance levels and vary largely in individual development. What this paper adds Communication and social interactions in individuals with cerebral palsy without intellectual disability develop similarly to typically developing individuals.Communication and social interactions of individuals with intellectual disability develop less favourably and show large variation., What this paper adds Communication and social interactions in individuals with cerebral palsy without intellectual disability develop similarly to typically developing individuals.Communication and social interactions of individuals with intellectual disability develop less favourably and show large variation. This article's abstract has been translated into Spanish and Portuguese. Follow the links from the http://onlinelibrary.wiley.com/doi/10.1111/dmcn.14351/abstract to view the translations.

Background Accurate proxy-report questionnaires, adapted to the child's developmental stage, are required to monitor 24-h movement behaviors in young children, especially for large samples and low-resource settings. Objectives This review aimed to summarize available studies evaluating measurement properties of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in children aged 0-5 years. Methods Systematic literature searches were carried out in the PubMed, Embase and SPORTDiscus databases, up to January 2021. For physical activity and sedentary behavior questionnaires this is a review update, whereas for sleep questionnaires we included all relevant studies published up to now. Studies had to evaluate at least one of the measurement properties of a proxy-report questionnaire assessing at least duration and/or frequency of physical activity, sedentary behavior and/or sleep in 0- to 5-year-old children. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was used to evaluate the quality of evidence. Results Thirty-three studies were included, examining a total of 37 questionnaires. Ten questionnaires were designed for infants, two for toddlers, 11 for preschoolers, and 14 for a broader age range targeting multiple of these age groups. Twenty questionnaires assessed constructs of sleep, four assessed constructs of physical activity, two assessed screen behavior, five assessed constructs of both physical activity and sedentary behavior, and six assessed constructs of all 24-h movement behaviors. Content validity was evaluated for six questionnaires, structural validity for two, internal consistency for three, test-retest reliability for 16, measurement error for one, criterion validity for one, and construct validity for 26 questionnaires. None of the questionnaires were considered sufficiently valid and/or reliable for assessing one or more movement behaviors in 0- to 5-year-old children, and the quality of evidence was mostly low or very low. Conclusions Valid and/or reliable questionnaires assessing 24-h movement behaviors in 0- to 5-year-olds are lacking. High-quality studies are therefore required, to develop proxy-report questionnaires and evaluate their measurement properties. PROSPERO registration number CRD42020169268.

Background Accurate proxy-report questionnaires, adapted to the child’s developmental stage, are required to monitor 24-h movement behaviors in young children, especially for large samples and low-resource settings. Objectives This review aimed to summarize available studies evaluating measurement properties of proxy-report questionnaires assessing physical activity, sedentary behavior and/or sleep in children aged 0–5 years. Methods Systematic literature searches were carried out in the PubMed, Embase and SPORTDiscus databases, up to January 2021. For physical activity and sedentary behavior questionnaires this is a review update, whereas for sleep questionnaires we included all relevant studies published up to now. Studies had to evaluate at least one of the measurement properties of a proxy-report questionnaire assessing at least duration and/or frequency of physical activity, sedentary behavior and/or sleep in 0- to 5-year-old children. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was used to evaluate the quality of evidence. Results Thirty-three studies were included, examining a total of 37 questionnaires. Ten questionnaires were designed for infants, two for toddlers, 11 for preschoolers, and 14 for a broader age range targeting multiple of these age groups. Twenty questionnaires assessed constructs of sleep, four assessed constructs of physical activity, two assessed screen behavior, five assessed constructs of both physical activity and sedentary behavior, and six assessed constructs of all 24-h movement behaviors. Content validity was evaluated for six questionnaires, structural validity for two, internal consistency for three, test-retest reliability for 16, measurement error for one, criterion validity for one, and construct validity for 26 questionnaires. None of the questionnaires were considered sufficiently valid and/or reliable for assessing one or more movement behaviors in 0- to 5-year-old children, and the quality of evidence was mostly low or very low. Conclusions Valid and/or reliable questionnaires assessing 24-h movement behaviors in 0- to 5-year-olds are lacking. High-quality studies are therefore required, to develop proxy-report questionnaires and evaluate their measurement properties. PROSPERO registration number CRD42020169268.

Background: Substantial evidence acknowledges the complex gene-environment interplay impacting brain development and learning. Intergenerational neuroimaging allows the assessment of familial transfer effects on brain structure, function and behavior by investigating neural similarity in caregiver-child dyads. Methods: Neural similarity in the human reading network was assessed through well-used measures of brain structure (i.e., surface area (SA), gyrification (lG), sulcal morphology, gray matter volume (GMV) and cortical thickness (CT)) in 69 mother-child dyads (children's age~11 y). Regions of interest for the reading network included left-hemispheric inferior frontal gyrus, inferior parietal lobe and fusiform gyrus. Mother-child similarity was quantified by correlation coefficients and familial specificity was tested by comparison to random adult-child dyads. Sulcal morphology analyses focused on occipitotemporal sulcus interruptions and similarity was assessed by chi-square goodness of fit. Results: Significant structural brain similarity was observed for mother-child dyads in the reading network for lG, SA and GMV (r = 0.349/0.534/0.542, respectively), but not CT. Sulcal morphology associations were non-significant. Structural brain similarity in lG, SA and GMV were specific to mother-child pairs. Furthermore, structural brain similarity for SA and GMV was higher compared to CT. Conclusion: Intergenerational neuroimaging techniques promise to enhance our knowledge of familial transfer effects on brain development and disorders., Developmental Cognitive Neuroscience, 53, ISSN:1878-9293, ISSN:1878-9307

The detection of motor developmental problems, especially developmental coordination disorder, at age 5-6 contributes to early interventions. Here, we summarize evidence on (1) criterion validity of screening instruments for motor developmental problems at age 5-6, and (2) their applicability. We systematically searched seven databases for studies assessing criterion validity of these screening instruments using the M-ABC as reference standard. We applied COSMIN criteria for systematic reviews of screening instruments to describe the correlation between the tests and the M-ABC. We extracted information on correlation coefficients or area under the receiver operating curve, sensitivity and specificity, and applicability in practice. We included eleven studies, assessing eight instruments: three performance-based tests (MAND, MOT 4-6, BFMT) and five questionnaires (DCD-Q, PQ, ASQ-3, MOQ-T-FI, M-ABC-2-C). The quality of seven studies was fair, one was good, and three were excellent. Seven studies reported low correlation coefficients or AUC (

Parental emotion regulation plays a vital role in the parent-child relationship. This study examines the mediating role of mindful parenting in the relationship between parental emotion regulation difficulties and problem behaviors of children with autism spectrum disorder (ASD). The study was conducted with 273 parents of children with ASD in Istanbul. The study findings revealed a significant yet negative correlation between mindful parenting and emotion regulation difficulty and problem behaviors. The study model highlighted that emotion regulation difficulties significantly predicted mindful parenting and the child\"s problem behavior, whereas mindful parenting significantly predicted the child\"s problem behavior. Additionally, the study findings indicated that mindful parenting was a partial mediator.

This study examines preschool children's play tendency and their prosocial behavior. The screening method was used in the study, and it was carried out with a total of 319 four- to six-year-old children who attended state kindergartens. Children's Playfulness Scale and Child Prosocialness Scale were used as data collection tools. According to the results, no significant difference was found in the play tendency and prosocial behavior scores in relation with gender and parent's employment status. However, a significant difference was found in the play tendency and prosocial behavior scores in relation with age and family income. In terms of the number of siblings, while there was no significant difference in prosocial behavior scores, a significant difference was found in the play tendency. A significant positive relationship was found between the play tendency and prosocial behavior scores. The findings are discussed with regard to the relevant literature.

INTRODUCTION: Over the past decades, children have been increasingly using screen devices, while at the same time their sleep duration has decreased. Both behaviors have been associated with excess weight, and it is possible they act as mutually reinforcing behaviors for weight gain. The aim of the study was to explore independent, prospective associations of screen time and sleep duration with incident overweight in a sample of European children. METHODS: Data from 4,285 children of the IDEFICS/I.Family cohort who were followed up from 2009/2010 to 2013/2014 were analyzed. Hours per day of screen time and of sleep duration were reported by parents at baseline. Logistic regression analyses were carried out in separate and mutually adjusted models controlled for sex, age, European country region, parental level of education, and baseline BMI z-scores. RESULTS: Among normal weight children at baseline (N = 3,734), separate models suggest that every hour increase in screen time and every hour decrease in sleep duration were associated with higher odds of the child becoming overweight or obese at follow-up (OR = 1.16, 95% CI: 1.02-1.32 and OR = 1.23, 95% CI: 1.05-1.43, respectively). In the mutually adjusted model, both associations were attenuated slightly ( screen time OR = 1.13, 95% CI: 0.99-1.28; sleep duration OR = 1.20, 95% CI: 1.03-1.40), being consistently somewhat stronger for sleep duration. DISCUSSION/CONCLUSION: Both screen time and sleep duration increased the incidence of overweight or obesity by 13-20%. Interventions that include an emphasis on adequate sleep and minimal screen time are needed to establish their causal role in the prevention of overweight and obesity among European children. CC BY-NC 4.0https://www.karger.com/open-access/types-licences-copyright-costsPublished online: November 1, 2021Correspondence to: Monica Hunsberger, monica.hunsberger@gu.seFunding SourcesV.G.’s contribution to this study was supported by the Swedish Institute. The Swedish section of this study was co-financed by the Swedish Research Council for Environment, Agricultural Sciences, and Spatial Planning (2012-00038), the Swedish Research Council (2015-02508), the ALF-agreement for western Sweden (ALFGBG-722441), and the Swedish Research Council for Health, Working Life and Welfare (FORTE Grant 2014-01994).

Nature visits and nature exposure have been shown to be favorably associated with children’s health and development, but the research regarding their associations with children’s lifestyle habits is limited. The current study aimed to investigate the associations between the frequency of parent–child nature visits and sleep, moderate-to-vigorous physical activity (MVPA) and weight status among three- to six-year-old Finnish preschoolers. Parents and their children (n = 864) participated in a cross-sectional DAGIS (increased health and wellbeing in preschools) study, which was conducted between 2015 and 2016 in Finland. In total, 798 parents answered a questionnaire on the frequency of parent–child nature visits, which also included questions on sociodemographic factors and their children’s sleep habits. Parents also reported children’s bedtimes and wake-up times and children wore an accelerometer for seven days. Trained researchers measured children’s weight and height. Linear and logistic regression analyses were conducted. More frequent parent–child nature visits were associated with children’s longer sleep duration at night, higher amounts of MVPA outside preschool time and, among girls, good sleep consistency. The frequency of parent–child nature visits was not significantly associated with whether children were overweight or obese or not. Promoting parent–child nature visits could be a cost-effective way to increase young children’s MVPA and enhance night-time sleep.

BackgroundThe early years are a crucial period to promote healthy energy balance-related behaviours in children and prevent overweight and obesity. The childcare setting is important for health-promoting interventions. Increasingly, attention has been paid to parental involvement in childcare-based interventions. The aim of this systematic review is to evaluate the effectiveness of these interventions with direct parental involvement on the children’s weight status and behavioural outcomes.MethodsA systematic search was conducted in four electronic databases to include studies up until January 2019. Studies written in English, describing results on relevant outcomes (weight status, physical activity, sedentary behaviour and/or nutrition-related behaviour) of childcare-based interventions with direct parental involvement were included. Studies not adopting a pre-post-test design or reporting on pilot studies were excluded. To improve comparability, effect sizes (Cohen’s d) were calculated. Information on different types of environment targeted (e.g., social, physical, political and economic) was extracted in order to narratively examine potential working principles of effective interventions.ResultsA total of 22 studies, describing 17 different interventions, were included. With regard to the intervention group, 61.1% found some favourable results on weight status, 73.3% on physical activity, 88.9% on sedentary behaviour, and all on nutrition-related behaviour. There were studies that also showed unfavourable results. Only a small number of studies was able to show significant differences between the intervention and control group (22.2% weight status, 60.0% physical activity, 66.6% sedentary behaviour, 76.9% nutrition behaviour). Effect sizes, if available, were predominantly small to moderate, with some exceptions with large effect sizes. The interventions predominantly targeted the socio-cultural and physical environments in both the childcare and home settings. Including changes in the political environment in the intervention and a higher level of intensity of parental involvement appeared to positively impact intervention effectiveness.ConclusionChildcare-based interventions with direct parental involvement show promising effects on the children’s energy balance-related behaviours. However, evidence on effectiveness is limited, particularly for weight-related outcomes. Better understanding of how to reach and involve parents may be essential for strengthening intervention effectiveness.

OBJECTIVES: A major issue in the rehabilitation of children with cochlear implants (CIs) is unexplained variance in their language skills, where many of them lag behind children with normal hearing (NH). Here, we assess links between generative language skills and the perception of prosodic stress, and with musical and parental activities in children with CIs and NH. Understanding these links is expected to guide future research and toward supporting language development in children with a CI. DESIGN: Twenty-one unilaterally and early-implanted children and 31 children with NH, aged 5 to 13, were classified as musically active or nonactive by a questionnaire recording regularity of musical activities, in particular singing, and reading and other activities shared with parents. Perception of word and sentence stress, performance in word finding, verbal intelligence (Wechsler Intelligence Scale for Children (WISC) vocabulary), and phonological awareness (production of rhymes) were measured in all children. Comparisons between children with a CI and NH were made against a subset of 21 of the children with NH who were matched to children with CIs by age, gender, socioeconomic background, and musical activity. Regression analyses, run separately for children with CIs and NH, assessed how much variance in each language task was shared with each of prosodic perception, the child's own music activity, and activities with parents, including singing and reading. All statistical analyses were conducted both with and without control for age and maternal education. RESULTS: Musically active children with CIs performed similarly to NH controls in all language tasks, while those who were not musically active performed more poorly. Only musically nonactive children with CIs made more phonological and semantic errors in word finding than NH controls, and word finding correlated with other language skills. Regression analysis results for word finding and VIQ were similar for children with CIs and NH. These language skills shared considerable variance with the perception of prosodic stress and musical activities. When age and maternal education were controlled for, strong links remained between perception of prosodic stress and VIQ (shared variance: CI, 32%/NH, 16%) and between musical activities and word finding (shared variance: CI, 53%/NH, 20%). Links were always stronger for children with CIs, for whom better phonological awareness was also linked to improved stress perception and more musical activity, and parental activities altogether shared significantly variance with word finding and VIQ. CONCLUSIONS: For children with CIs and NH, better perception of prosodic stress and musical activities with singing are associated with improved generative language skills. In addition, for children with CIs, parental singing has a stronger positive association to word finding and VIQ than parental reading. These results cannot address causality, but they suggest that good perception of prosodic stress, musical activities involving singing, and parental singing and reading may all be beneficial for word finding and other generative language skills in implanted children.

What are the implications of a lower than expected forced expiratory volume in one second (FEV1) in childhood on respiratory health later in adulthood? Lung function is known to track with age, and there is evidence from recent epidemiologic studies that impaired lung function early in life is associated with later chronic airflow limitation, or even chronic obstructive pulmonary disease, COPD. This risk seems particularly strong in subjects with persistent and severe forms of childhood asthma. Can we translate findings from longitudinal cohort studies to individual risk predictions and preventive guidelines in our pediatric care? In this review, we discuss the clinical implementations of recent epidemiological respiratory studies and the importance of preserved lung health across the life course. Also, we evaluate available clinical tools, primarily lung function measures, and profiles of risk factors, including biomarkers, that may help identifying children at risk of chronic airway disease in adulthood. We conclude that translating population level results to the individual patient in the pediatric care setting is not straight forward, and that there is a need for studies specifically designed to evaluate performance of prediction of risk profiles for long-term sequelae of childhood asthma and lung function impairment.

Background Respiratory tract infections (RTIs) are a common reason for children to consult in general practice. Antibiotics are often prescribed, in part due to miscommunication between parents and GPs. The duration of specific respiratory symptoms has been widely studied. Less is known about illness-related symptoms and the impact of these symptoms on family life, including parental production loss. Better understanding of the natural course of illness-related symptoms in RTI in children and impact on family life may improve GP–parent communication during RTI consultations. Objective To describe the general impact of RTI on children and parents regarding illness-related symptoms, absenteeism from childcare, school and work, use of health care facilities, and the use of over-the-counter (OTC) medication. Methods Prospectively collected diary data from two randomized clinical trials in children with RTI in primary care (n = 149). Duration of symptoms was analysed using survival analysis. Results Disturbed sleep, decreased intake of food and/or fluid, feeling ill and/or disturbance at play or other daily activities are very common during RTI episodes, with disturbed sleep lasting longest. Fifty-two percent of the children were absent for one or more days from childcare or school, and 28% of mothers and 20% of fathers reported absence from work the first week after GP consultation. Re-consultation occurred in 48% of the children. OTC medication was given frequently, particularly paracetamol and nasal sprays. Conclusion Appreciation of, and communication about the general burden of disease on children and their parents, may improve understanding between GPs and parents consulting with their child.

Studies have strongly suggested a disturbed regulation of dopaminergic neurotransmission in attention-deficit/hyperactivity disorder (ADHD) and Parkinson's disease (PD). A genetic and phenotypic overlap between both disorders is discussed. A well-studied risk gene for PD is the gene coding for -synuclein (SNCA). -Synuclein, a protein located primarily in the presynaptic vesicles, has been suggested to play a role in the modulation of dopamine transporter (DAT) function. DAT is the target of psychostimulants for the treatment of ADHD and plays a key role in regulating the dopamine concentrations in the synaptic cleft. In our sample consisting of German families with children affected by ADHD, we tested for association of allelic variants of two functionally relevant polymorphisms of the -synuclein gene (NACP-Rep1: 156 families, 232 children; rs356219: 195 families, 284 children) with ADHD. Transmission disequilibrium test analysis revealed no over-transmission for NACP-Rep1 (OR 1, p(nom)=1 p(adj)=1) and rs356219 (OR 1.28; p(nom)=0288) in affected siblings. However, a subanalysis on trios with index children showed a nominal association of rs356219 with ADHD (OR 1.43, p(nom)=0.020), which survived Bonferroni correction (p(adj)=0.039); again, no association for NACP-Rep1 (OR 0.8, p=0.317, p(adj)=0.634) was found. In conclusion, we found in our pilot study a trend for an association of the rs356219 genotype in SNCA that may affect -synuclein function and contribute to the aetiology of ADHD. In light of the small sample size of our study, the link between PD and ADHD through dopamine-related neurobiology warrants further investigations. Future studies on SNCA in large ADHD samples should focus on specified symptoms and traits, e.g. attentional capacities or emotional dysregulation.

Background: Although studies showed that an adverse intrauterine environment increases the obesity risk in adulthood, little is known about consequences of fetal growth and birth size for eating behaviour. We examined whether fetal and birth size are associated with childhood eating behaviour.Methods: Participants were 4350 mother-child dyads of the prospective cohort study Generation R. We assessed the relation between fetal and birth size measurements with child eating behaviour at age 4 years by maternal report on the Child Eating Behaviour Questionnaire. Child body mass index (BMI) was measured at age 2 years.Results: Per one standard deviation (SD) larger birthweight, children scored lower on Satiety Responsiveness [-0.29 points; 95% confidence interval (CI): -0.39; -0.18], higher on Food Responsiveness (0.28 points; 95% CI: 0.17; 0.39) and on Enjoyment of Food (0.21 points; 95% CI: 0.12; 0.31) at age 4 years. Similar associations were found in late pregnancy. Per one SD increase in fetal growth from late pregnancy to birth, children scored lower on Satiety Responsiveness (-0.15 points; 95% CI: -0.26; -0.04). Children within the 10% highest birthweight scored higher on food approach and lower on food avoidant scales, whereas associations in children within the 10% lowest birthweights were absent. Although child BMI partly mediated the association, direct effects of birthweight on appetitive traits remained.Conclusions: This study indicates that fetal size, especially being large in utero, is associated with obesity-inducing eating behaviour. Our findings point to intrauterine influences on appetite and satiety, and contribute to understanding the complex aetiology of obesity.

The main aim of this study was to determine the agreement in classification between the modified KörperKoordinations Test für Kinder (KTK3+) and the Athletic Skills Track (AST) for measuring fundamental movement skill levels (FMS) in 6- to 12-year old children. 3,107 Dutch children (of which 1,625 are girls) between 6 and 12 years of age (9.1 ± 1.8 years) were tested with the KTK3+ and the AST. The KTK3+ consists of three items from the KTK and the Faber hand-eye coordination test. Raw scores from each subtest were transformed into percentile scores based on all the data of each grade. The AST is an obstacle course consisting of 5 (grades 3 till 5, 6–9 years) or 7 (grades 6 till 8, 9–12 years) concatenated FMS that should be performed as quickly as possible. The outcome measure is the time needed to complete the track. A significant bivariate Pearson correlation coefficient of 0.51 was found between the percentile sum score of the KTK3+ and the time to complete the AST, indicating that both tests measure a similar construct to some extent. Based on their scores, children were classified into one of five categories: 95%. Cross tabs revealed an agreement of 58.8% with a Kappa value of 0.15 between both tests. Less than 1% of the children were classified more than two categories higher or lower. The moderate correlation between the KTK3+ and the AST and the low classification agreement into five categories of FMS stress the importance to further investigate the test choice and the measurement properties (i.e., validity and reliability) of both tools. PE teachers needs to be aware of the context in which the test will be conducted, know which construct of motor competence they want to measure and know what the purpose of testing is (e.g., screening or monitoring). Based on these considerations, the most appropriate assessment tool can be chosen.

This study aims to review the scientific papers on Early Childhood Education for Sustainability (ECEfS) published between 2008 and 2020 and reveal changes in the area. This systematic review was carried out in two stages. In the first stage, a systematic review of papers on ECEfS was conducted according to the specified criteria, and all identified studies were evaluated descriptively. In the second stage, interventional research was evaluated, and their results were reviewed. It was seen that qualitative research methods were mostly preferred in the reviewed studies and most of them were conducted with children. It was determined that the most frequently discussed pillar is environmental. Moreover, the number of interventional research studies is limited. The research findings, it is thought that there is a need for future studies that use interventional, experimental and action research methods, holistically addressing pillars of sustainability

Background Various parent training interventions have been shown to have some effect on the symptoms of children with autism. We carried out a systematic review and meta-analyses to assess effectiveness of parental training for children with autism on their symptoms and parental stress. Methods Four electronic databases, CINAHL, EMBASE, MEDLINE and PsycINFO were searched until March 2020 for relevant literature. Two reviewers independently screened bibliographies using an eligibility checklist and extracted data using a structured proforma. We have also carried out meta-analyses when data were available for pooling. Results Seventeen papers from 15 studies were included for data analysis. Fifteen papers showed a positive treatment effect when compared with the control group, although not always significant. Meta-analysis based on pooled data from only two studies in each respective intervention, showed small to moderate treatment effects for three interventions, DIR/Floortime, Pivotal Response and Parent focused training respectively. Conclusions As in previous systematic reviews there was a mild to moderate treatment effects of three specific types of interventions respectively. However, it was difficult to draw any definitive conclusion about the effectiveness and generalisability of any intervention because of the wide variation in the interventions, control groups, outcome measures, small sample size, small number of studies in meta-analysis, overlap between the intervention and control procedures used in the included studies. There is an urgent need for experts in various international centres to jointly standardise a parent training intervention for children with autism and carry out a large scale RCT to assess its clinical and economic effectiveness. Research Registry Unique Identifying Number: reviewregistry915.

This study used Latent Class Analysis to identify groups of children exposed to similar Home Language and Literacy Environments (HLLE) and explored whether belonging to a given HLLE group was related to children's language and early literacy growth from prekindergarten to kindergarten. Participants were 1,425 Chilean mothers and their children (M-age = 52.52 months at baseline) from low-socioeconomic status households. Four HLLE groups were identified, which were associated with different trajectories of language and early literacy development. Children from groups whose mothers either read and talk about past events with them or teach them letters in addition to reading and talking about past events, showed higher relative vocabulary and letter knowledge. Implications for research and interventions are discussed.

Background Current options for temperature measurement in children presenting to primary care include either electronic axillary or infrared tympanic thermometers. Non-contact infrared thermometers could reduce both the distress of the child and the risk of cross-infection. Objectives The objective of this study was to compare the use of non-contact thermometers with the use of electronic axillary and infrared tympanic thermometers in children presenting to primary care. Design Method comparison study with a nested qualitative study. Setting Primary care in Oxfordshire. Participants Children aged ≤ 5 years attending with an acute illness. Interventions Two types of non-contact infrared thermometers [i.e. Thermofocus (Tecnimed, Varese, Italy) and Firhealth (Firhealth, Shenzhen, China)] were compared with an electronic axillary thermometer and an infrared tympanic thermometer. Main outcome measures The primary outcome was agreement between the Thermofocus non-contact infrared thermometer and the axillary thermometer. Secondary outcomes included agreement between all other sets of thermometers, diagnostic accuracy for detecting fever, parental and child ratings of acceptability and discomfort, and themes arising from our qualitative interviews with parents. Results A total of 401 children (203 boys) were recruited, with a median age of 1.6 years (interquartile range 0.79–3.38 years). The readings of the Thermofocus non-contact infrared thermometer differed from those of the axillary thermometer by –0.14 °C (95% confidence interval –0.21 to –0.06 °C) on average with the lower limit of agreement being –1.57 °C (95% confidence interval –1.69 to –1.44 °C) and the upper limit being 1.29 °C (95% confidence interval 1.16 to 1.42 °C). The readings of the Firhealth non-contact infrared thermometer differed from those of the axillary thermometer by –0.16 °C (95% confidence interval –0.23 to –0.09 °C) on average, with the lower limit of agreement being –1.54 °C (95% confidence interval –1.66 to –1.41 °C) and the upper limit being 1.22 °C (95% confidence interval 1.10 to 1.34 °C). The difference between the first and second readings of the Thermofocus was –0.04 °C (95% confidence interval –0.07 to –0.01 °C); the lower limit was –0.56 °C (95% confidence interval –0.60 to –0.51 °C) and the upper limit was 0.47 °C (95% confidence interval 0.43 to 0.52 °C). The difference between the first and second readings of the Firhealth thermometer was 0.01 °C (95% confidence interval –0.02 to 0.04 °C); the lower limit was –0.60 °C (95% confidence interval –0.65 to –0.54 °C) and the upper limit was 0.61 °C (95% confidence interval 0.56 to 0.67 °C). Sensitivity and specificity for the Thermofocus non-contact infrared thermometer were 66.7% (95% confidence interval 38.4% to 88.2%) and 98.0% (95% confidence interval 96.0% to 99.2%), respectively. For the Firhealth non-contact infrared thermometer, sensitivity was 12.5% (95% confidence interval 1.6% to 38.3%) and specificity was 99.4% (95% confidence interval 98.0% to 99.9%). The majority of parents found all methods to be acceptable, although discomfort ratings were highest for the axillary thermometer. The non-contact thermometers required fewer readings than the comparator thermometers. Limitations A method comparison study does not compare new methods against a reference standard, which in this case would be central thermometry requiring the placement of a central line, which is not feasible or acceptable in primary care. Electronic axillary and infrared tympanic thermometers have been found to have moderate agreement themselves with central temperature measurements. Conclusions The 95% limits of agreement are > 1 °C for both non-contact infrared thermometers compared with electronic axillary and infrared tympanic thermometers, which could affect clinical decision-making. Sensitivity for fever was low to moderate for both non-contact thermometers. Future work Better methods for peripheral temperature measurement that agree well with central thermometry are needed. Trial registration Current Controlled Trials ISRCTN15413321. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 53. See the NIHR Journals Library website for further project information.

Background and aims: The most severe problems in language manifest as difficulties in comprehending oral language. These difficulties are persistent and expose individuals to several risk factors. There is a lack of intervention research in the area of oral language comprehension, and no reviews have focused solely on oral language comprehension interventions in young children. The aim of this review was to identify interventions targeting oral language comprehension in children 8 years or younger with language disorders or difficulties. The review also examined the possible intervention foci, efficacy, and level of evidence of these interventions. Methods: A systematic scoping review of eight databases was carried out. Twenty of 2399 articles met the inclusion criteria and a further six articles were identified through reference lists of sourced articles. These 26 articles described 25 studies. Altogether 2460 children aged 1-8 years participated in the 25 studies. The data from these studies were extracted and analysed, and the intervention foci, efficacy, and level of evidence were evaluated. Main contribution: The reviewed interventions focused on three aspects: modifying the communicative environment of the child; targeting aspects of the child's language; or targeting the child's language processing. Of the included studies, 80% indicated positive effects on participants' oral language comprehension. The level of evidence of the included studies varied. With few exceptions, researchers and practitioners can have moderate confidence in the results of the included studies indicating that it is possible to ameliorate difficulties in oral language comprehension. Conclusions: This review summarises the existing evidence on oral language comprehension interventions in young children with language disorders or difficulties. The evidence base is still limited, and more research is urgently needed. The results suggest that though not all interventions seem to provide desired outcomes, there are several interventions indicating efficacy to target problems in oral language comprehension in 1-8-year-old children with language disorders or difficulties. A careful choice of therapy technique and collaboration with people in the child's environment is required to maximize outcomes. Implications: The results suggest that young children's oral language comprehension skills can be improved by guiding parents and clinicians in their communication strategies, and by clinician-implemented interventions targeting aspects of the child's language. The research on interventions targeting children's language processing is limited, and the results mixed. The present study provides information on different oral language comprehension interventions and their outcomes. The findings are readily applicable for clinical use.

Background: There is a need for interdisciplinary research to better understand how pedagogical approaches in primary physical education (PE) can support the linked development of physical, cognitive and affective aspects of physical literacy and physical activity behaviors in young children living in deprived areas. The Skill Acquisition Methods fostering Physical Literacy in Early-Physical Education (SAMPLE-PE) study aims to examine the efficacy of two different pedagogies for PE, underpinned by theories of motor learning, to foster physical literacy.\ud \ud Methods: SAMPLE-PE will be evaluated through a cluster-randomized controlled trial targeting 5–6 year old children from schools located in areas of high deprivation in Merseyside, North-West England. Schools will be randomly allocated to one of three conditions: Linear Pedagogy, Non-linear Pedagogy, or Control. Non-linear and Linear Pedagogy intervention primary schools will receive a PE curriculum delivered by trained coaches over 15 weeks, while control schools will follow their usual practice. Data will be collected at baseline (T0), immediately post-intervention (T1), and 6 months after the intervention has finished (T2). Children’s movement competence is the primary outcome in this trial. Secondary outcomes include physical activity, perceived competence, motivation, executive functions, and self-regulation. An extensive process evaluation will also examine implementation factors such as intervention context, reach, dose, fidelity and acceptability.\ud \ud Discussion: The SAMPLE-PE project will enable better understanding surrounding how to operationalise physical literacy through enrichment of PE practices in early PE. The study will provide robust scientific evidence regarding the efficacy of underpinning PE pedagogy with theories of motor learning to promote the development of physical literacy.\ud \ud Trial Registration: Retrospectively registered on 5th September 2018 at ClinicalTrials.gov, a resource provided by the U.S. National Library of Medicine (Identifier: NCT03551366).

Environmental lead (Pb) exposure can induce dysbacteriosis, impair oral health, and is associated with the development of dental caries. However, the mechanism is unclear. The aim of this study was to explore the effects of Pb toxicity on oral antimicrobial activity in children in an e-waste area. Results showed higher blood Pb levels in e-waste-exposed group children, accompanied by decreased saliva SAG (salivary agglutinin) concentrations, increased peripheral WBC (white blood cell) counts and monocyte counts, and elevated peripheral monocyte percentage. LnPb (natural logarithmic transformation of blood Pb level) was negatively correlated with saliva SAG concentration, while positively correlated with peripheral monocyte percentage. Saliva SAG concentration played a complete mediating role in the correlation of LnPb to peripheral monocyte percentage. To our knowledge, this is the first study on the relationship of environmental Pb exposure and oral antimicrobial activity in children, showing that environmental Pb exposure may weaken oral antimicrobial activity through reducing saliva SAG concentration, which may raise the risk of oral dysbacteriosis and ultimately pathogen infection.

Physical activity and motor competence (MC) have been considered to be closely related and prevent childhood obesity. The aim of the study was two-fold: to examine MC measured with two different tools in relation to individual, family, and environmental correlates and to investigate gender differences in MC. The Test of Gross Motor Development-Third Edition (TGMD-3) was administered to three- to seven-year-old children (n = 945), while the K&ouml, rperkoordinationstest f&uuml, r Kinder (KTK) was also used for five- to seven-year-old children (n = 444). The parent questionnaire (n = 936) included questions about individual (e.g., participation in organized sports), family (e.g., parents&rsquo, education level), and environmental (e.g., access to sports facilities) correlates. The children&rsquo, s temperament was assessed using the Colorado Childhood Temperament Inventory (CCTI) questionnaire. Data were analyzed using one-way analysis of variance and linear mixed-effects regression models. The regression models explained 57% and 38% of the variance in TGMD-3 and KTK, respectively. Individual correlates, including older age, more frequent participation in sports, and specific temperament traits of activity and attention span-persistence, were the strongest predictors for better MC. Small gender differences were found in both assessment tools, albeit in a different manner. In conclusion, socioecological correlates of MC in young children are multidimensional, and individual correlates appear to be the most important predictors of MC. Importantly, the correlates can differ according to the MC assessment tools.

Physical activity and motor competence (MC) have been considered to be closely related and prevent childhood obesity. The aim of the study was two-fold: to examine MC measured with two different tools in relation to individual, family, and environmental correlates and to investigate gender differences in MC. The Test of Gross Motor Development-Third Edition (TGMD-3) was administered to three- to seven-year-old children (n = 945), while the Körperkoordinationstest für Kinder (KTK) was also used for five- to seven-year-old children (n = 444). The parent questionnaire (n = 936) included questions about individual (e.g., participation in organized sports), family (e.g., parents’ education level), and environmental (e.g., access to sports facilities) correlates. The children’s temperament was assessed using the Colorado Childhood Temperament Inventory (CCTI) questionnaire. Data were analyzed using one-way analysis of variance and linear mixed-effects regression models. The regression models explained 57% and 38% of the variance in TGMD-3 and KTK, respectively. Individual correlates, including older age, more frequent participation in sports, and specific temperament traits of activity and attention span-persistence, were the strongest predictors for better MC. Small gender differences were found in both assessment tools, albeit in a different manner. In conclusion, socioecological correlates of MC in young children are multidimensional, and individual correlates appear to be the most important predictors of MC. Importantly, the correlates can differ according to the MC assessment tools.

Background: 22q11.2 deletion syndrome (22q) is a chromosome disorder, where a segment of chromosome 22, located at 811.2, is missing. This study aims to investigate the relationship between a number of parent-reported comorbid conditions including gastrointestinal symptoms, sleep problems, autism spectrum disorder (ASD) symptoms and behavior problems in children and adolescents with 22q deletion syndrome.Method: The Gastrointestinal Symptom Inventory, Children's Sleep Habits Questionnaire, Behavior Problem Inventory-Short Form and the Social Communication Questionnaire were completed by parents of 149 children and adolescents aged 3-18 years with a diagnosis of 22q.Results: A series of correlations and hierarchical multiple regressions were conducted to examine the relationships between GI symptoms, sleep problems and behavior problems in children and adolescents with 22q deletion syndrome. A significant moderate relationship was found between GI symptoms and sleep problems. Gender and ASD symptoms predicted GI symptoms. Significant small relationships were found between GI symptoms and self-injurious behavior. Significant small to moderate relationships were found between sleep problems and self-injurious behavior, aggressive/destructive behavior, and sterotyped behavior. Sleep problems predicted challenging behavior.Conclusions: This research demonstrated the importance of studying the relationship between comorbidities, including gastrointestinal symptoms, sleep problems, and behavior problems and how they shape the phenotype of 22q deletion syndrome. peer-reviewed 2021-05-28

This study investigated reliability and validity evidence regarding the Early Numeracy test (EN-test) in a sample of 1139 Swedish-speaking children (587 girls) in kindergarten (n = 361), first grade (n = 321), and second grade (n = 457). Structural validity evidence was established through confirmatory factor analysis (CFA), which showed that a four-factor model fit the data significantly better than a one-factor or two-factor model. The known-group and cross-cultural validity were established through multigroup CFAs, finding that the four-factor model fit the gender, age and language groups equally well. Internal consistency for the test and sub-skills varied from good to excellent. The EN-test can be considered as an appropriate assessment to identify children at risk for mathematical learning difficulties.

Adequate gross motor skills are an essential aspect of a child's healthy development. Where physical education (PE) is part of the primary school curriculum, a strong curriculum-based emphasis on evaluation and support of motor skill development in PE is apparent. Monitoring motor development is then a task for the PE teacher. To fulfill this task, teachers need adequate tools. The 4-Skills Scan is a quick and easily manageable gross motor skill instrument; however, its validity has never been assessed. Therefore, the purpose of this study was to assess the construct and concurrent validity of both 4-Skills Scans (version 2007 and version 2015). A total of 212 primary school children (6-12 years old) was requested to participate in both versions of the 4-Skills Scan. For assessing construct validity, children covered an obstacle course with video recordings for observation by an expert panel. For concurrent validity, a comparison was made with the M-ABC-2, by calculating Pearson correlations. Multivariable linear regression analyses were performed to determine the contribution of each subscale to the construct of gross motor skills, according to the M-ABC-2 and the expert panel. Correlations between the 4-Skills Scans and expert valuations were moderate, with coefficients of .47 (version 2007) and .46 (version 2015). Correlations between the 4-Skills Scans and the M-ABC-2 (gross) were moderate (.56) for version 2007 and high (.64) for version 2015. It is concluded that both versions of the 4-Skills Scans are satisfactory valid instruments for assessing gross motor skills during PE lessons.

The diagnosis of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents has increased considerably over the past decades. Scholars and health professionals alike have expressed concern about the role of screen media in the rise in ADHD diagnosis. However, the extent to which screen media use and ADHD are linked remains a point of debate. To understand the current state of the field and, ultimately, move the field forward, we provide a systematic review of the literature on the relationship between children and adolescents' screen media use and ADHD-related behaviors (i.e., attention problems, hyperactivity, and impulsivity). Using the Differential Susceptibility to Media effects Model as a theoretical lens, we systematically organize the existing literature, identify potential shortcomings in this literature, and provide directions for future research. The available evidence suggests a statistically small relationship between media and ADHD-related behaviors. Evidence also suggests that individual child differences, such as gender and trait aggression, may moderate this relationship. There is a clear need for future research that investigates causality, underlying mechanisms, and differential susceptibility to the effects of screen media use on ADHD-related behaviors. It is only through a richer empirical body that we will be able to fully understand the media-ADHD relationship. ispartof: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA vol:115 issue:40 pages:9875-9881 ispartof: location:United States status: published

Objective: This study aimed to investigate possible early childhood caries (ECC) risk indicators in preschoolers who applied for examination/treatment at the Government University Pediatric Dentistry Clinic, Istanbul, Turkey. Material and Methods: Children aged 36-71 months and their mothers who applied for examination/treatment and consented were enrolled in this cross-sectional survey during a 3-month period. Mother-child pairs were examined intraorally, and caries experience was recorded using (dmft/DMFT) an index. A structured questionnaire inquiring oral hygiene habits and diet history of the children was employed to interview the mothers. Categorical data from children with no clinical caries (NC), ECC, Severe ECC (S-ECC) were compared using Chi-square test and correlation of caries experience in mother-child pairs and were tested with Spearman rho. Statistical significance was set p

Objectives: To determine the role of physical activity intensity and bout-duration in modulating associations between physical activity and cardiometabolic risk markers.Methods: A cross-sectional study using the International Children’s Accelerometry Database (ICAD) including 38,306 observations (in 29,734 individuals aged 4–18 years). Accelerometry data was summarized as time accumulated in 16 combinations of intensity thresholds (≥500 to ≥3000 counts/min) and bout-durations (≥1 to ≥10 min). Outcomes were body mass index (BMI, kg/m2), waist circumference, biochemical markers, blood pressure, and a composite score of these metabolic markers. A second composite score excluded the adiposity component. Linear mixed models were applied to elucidate the associations and expressed per 10 min difference in daily activity above the intensity/bout-duration combination. Estimates (and variance) from each of the 16 combinations of intensity and bout-duration examined in the linear mixed models were analyzed in meta-regression to investigate trends in the association.Results: Each 10 min positive difference in physical activity was significantly and inversely associated with the risk factors irrespective of the combination of intensity and bout-duration. In meta-regression, each 1000 counts/min increase in intensity threshold was associated with a −0.027 (95% CI: −0.039 to −0.014) standard deviations lower composite risk score, and a −0.064 (95% CI: −0.09 to −0.038) kg/m2 lower BMI. Conversely, meta-regression suggested bout-duration was not significantly associated with effect-sizes (per 1 min increase in bout-duration: −0.002 (95% CI: −0.005 to 0.0005) standard deviations for the composite risk score, and −0.005 (95% CI: −0.012 to 0.002) kg/m2 for BMI).Conclusions: Time spent at higher intensity physical activity was the main determinant of variation in cardiometabolic risk factors, not bout-duration. Greater magnitude of associations was consistently observed with higher intensities. These results suggest that, in children and adolescents, physical activity, preferably at higher intensities, of any bout-duration should be promoted.

Inadequate sleep is highly prevalent and known to decline both physical- and mental health. Literature suggests that altered functioning of the hypothalamic-pituitary-adrenal (HPA) axis might underlie this association. This assumption is mainly based on changes in basal neuroendocrine activity and it is of equal importance to elucidate whether sleep may also influence HPA stress responsiveness. The present review provides a complete outline of recent human studies that have investigated how different aspects of sleep influence cortisol reactivity to laboratory stress. From the available data it can be concluded that both objective and subjective decrements in sleep quality potentiate the stress reactivity of the HPA axis. On the contrary, normal variations in sleep duration do not seem to influence cortisol stress responsiveness whereas excessive daytime sleepiness is associated with a blunting of the cortisol response. Given its well-established health consequences, sensitization of the HPA axis might well be a crucial component linking inadequate sleep to stress-related pathology.

Chronic exposure to heavy metals could affect cell-mediated immunity. The aim of this study was to explore the status of memory T cell development in preschool children from an e-waste recycling area. Blood lead (Pb) levels, peripheral T cell subpopulations, and serum levels of cytokines (IL-2/IL-7/IL-15), relevant to generation and homeostasis of memory T cells were evaluated in preschool children from Guiyu (e-waste-exposed group) and Haojiang (reference group). The correlations between blood Pb levels and percentages of memory T cell subpopulations were also evaluated. Guiyu children had higher blood Pb levels and increased percentages of CD4+ central memory T cells and CD8+ central memory T cells than in the Haojiang group. Moreover, blood Pb levels were positively associated with the percentages of CD4+ central memory T cells. In contrast, Pb exposure contributed marginally in the change of percentages of CD8+ central memory T cells in children. There was no significant difference in the serum cytokine levels between the e-waste-exposed and reference children. Taken together, preschool children from an e-waste recycling area suffer from relatively higher levels of Pb exposure, which might facilitate the development of CD4+ central memory T cells in these children. (c) 2017 Published by Elsevier B.V.