•Consumption of formula reconstituted with fluoridated water can lead to excessive fluoride intake.•Breastfed infants receive very low intake of fluoride.•We compared IQ scores in 398 children who ...were formula-fed versus breastfed during infancy.•IQ scores were lower with higher levels of fluoride in tap water.•The effect was more pronounced among formula-fed children, especially for nonverbal skills.
Infant consumption of formula reconstituted with fluoridated water can lead to excessive fluoride intake. We examined the association between fluoride exposure in infancy and intellectual ability in children who lived in fluoridated or non-fluoridated cities in Canada.
We examined 398 mother-child dyads in the Maternal-Infant Research on Environmental Chemicals cohort who reported drinking tap water. We estimated water fluoride concentration using municipal water reports. We used linear regression to analyze the association between fluoride exposure and IQ scores, measured by the Wechsler Primary and Preschool Scale of Intelligence-III at 3–4 years. We examined whether feeding status (breast-fed versus formula-fed) modified the impact of water fluoride and if fluoride exposure during fetal development attenuated this effect. A second model estimated the association between fluoride intake from formula and child IQ.
Thirty-eight percent of mother-child dyads lived in fluoridated communities. An increase of 0.5 mg/L in water fluoride concentration (approximately equaling the difference between fluoridated and non-fluoridated regions) corresponded to a 9.3- and 6.2-point decrement in Performance IQ among formula-fed (95% CI: −13.77, −4.76) and breast-fed children (95% CI: −10.45, −1.94). The association between water fluoride concentration and Performance IQ remained significant after controlling for fetal fluoride exposure among formula-fed (B = −7.93, 95% CI: −12.84, −3.01) and breastfed children (B = −6.30, 95% CI: −10.92, −1.68). A 0.5 mg increase in fluoride intake from infant formula corresponded to an 8.8-point decrement in Performance IQ (95% CI: −14.18, −3.34) and this association remained significant after controlling for fetal fluoride exposure (B = −7.62, 95% CI: −13.64, −1.60).
Exposure to increasing levels of fluoride in tap water was associated with diminished non-verbal intellectual abilities; the effect was more pronounced among formula-fed children.
The flipped classroom (FC) inverts the traditional classroom by having students participate in passive aspects of learning at home and active aspects of learning in class with the guide of an ...instructor. The introductory statistics course for nonmath majors may be especially suited to the FC model given its unique challenges as a required course for students with varying mathematical skills and background. For example, these students often have low interest and high statistics-related anxiety. Recent studies suggest the FC for introductory statistics courses leads to increased performance relative to a traditional lecture-based classroom (LC). This meta-analysis compared the academic performance of students in introductory statistics courses for nonmath majors who were taught in a FC versus those taught in a LC. Results indicate that students in the FC had statistically discernibly higher final performance outcomes compared to the LC delivery with an average difference of 6.9% in performance (Hedge's g = 0.43), though there was evidence of moderation by the presence of weekly in-class quizzes. These findings suggest that implementing the FC within the introductory statistics classroom at the undergraduate level may improve learning achievement, but more research is needed to explore the role of regular class quizzes.
Supplementary materials
for this article are available online.
Researchers are often interested in exploring predictors of change, and commonly use a regression based model or a gain score analysis to compare degree of change across groups. Methodologists have ...cautioned against the use of the regression based model when there are non-random group differences at baseline because this model inappropriately corrects for baseline differences. Less research has addressed the issues that arise when exploring continuous predictors of change (e.g., a regression model with posttest as the outcome and pretest as a covariate). If continuous predictors of change correlate with pretest scores, the modeled relationship between predictors and change may be an artifact. This two-part study explored the statistical artifact, or overestimation of effect estimates, that may arise when continuous predictors of change are included in pretest-posttest regression based models. Study 1 revealed that the problematic regression based model that covaries out pretest scores is currently being applied in psychology literature more often than models that do not covary pretest scores, and that the conditions leading to the artifact (i.e., spurious effects) were met in a significant amount of studies reviewed. Study 2 demonstrated that the artifact arises in conditions common within psychological research, and directly impacts Type I error rates. Recommendations are provided regarding which regression based models are appropriate when pretest scores are correlated with continuous predictors.
Fluoride has been associated with IQ deficits during early brain development, but the period in which children are most sensitive is unknown.
We assessed effects of fluoride on IQ scores across ...prenatal and postnatal exposure windows.
We used repeated exposures from 596 mother-child pairs in the Maternal-Infant Research on Environmental Chemicals pregnancy and birth cohort. Fluoride was measured in urine (mg/L) collected from women during pregnancy and in their children between 1.9 and 4.4 years; urinary fluoride was adjusted for specific gravity. We estimated infant fluoride exposure (mg/day) using water fluoride concentration and duration of formula-feeding over the first year of life. Intelligence was assessed at 3–4 years using the Wechsler Preschool and Primary Scale of Intelligence-III. We used generalized estimating equations to examine the associations between fluoride exposures and IQ, adjusting for covariates. We report results based on standardized exposures given their varying units of measurement.
The association between fluoride and performance IQ (PIQ) significantly differed across prenatal, infancy, and childhood exposure windows collapsing across child sex (p = .001). The strongest association between fluoride and PIQ was during the prenatal window, B = −2.36, 95% CI: −3.63, −1.08; the association was also significant during infancy, B = −2.11, 95% CI: −3.45, −0.76, but weaker in childhood, B = −1.51, 95% CI: −2.90, −0.12. Within sex, the association between fluoride and PIQ significantly differed across the three exposure windows (boys: p = .01; girls: p = .01); among boys, the strongest association was during the prenatal window, B = −3.01, 95% CI: −4.60, −1.42, whereas among girls, the strongest association was during infancy, B = −2.71, 95% CI: −4.59, −0.83. Full-scale IQ estimates were weaker than PIQ estimates for every window. Fluoride was not significantly associated with Verbal IQ across any exposure window.
Associations between fluoride exposure and PIQ differed based on timing of exposure. The prenatal window may be critical for boys, whereas infancy may be a critical window for girls.
•The association between fluoride and performance IQ significantly differed across exposure windows.•The strongest association between fluoride and PIQ was during the prenatal window.•Within sex, the association between fluoride and PIQ significantly differed across exposure windows. Among boys, the prenatal window appeared critical, while for girls, infancy was critical.•Full-scale IQ estimates were weaker than PIQ estimates for every window.•Fluoride was not significantly associated with Verbal IQ across any exposure window.
There is demand for valid risk assessment of individuals with child sexual exploitation material (CSEM) offenses. We compared the predictive performance of the Risk Matrix 2000/Sex (RM2000/S) and the ...Child Pornography Offender Risk Tool (CPORT) among 365 men convicted of CSEM offenses. In fixed 5-year follow-up analyses, the CPORT (area under the curve AUC = .73) had significantly higher predictive accuracy than the RM2000/S (AUC = .66) for any sexual recidivism. The predictive difference for CSEM recidivism was not statistically significant. A meta-analysis found the CPORT had large effects in predicting sexual recidivism (AUC = .75) and moderate accuracy for CSEM recidivism (AUCs = .65 and .66), while the RM2000/S had moderate accuracy in predicting any sexual recidivism (AUC = .66; insufficient studies of CSEM recidivism). Results suggest a tool developed specifically for CSEM offending, such as CPORT, may perform better at predicting any sexual recidivism than adapting a general sexual offending risk tool.
Background
Many youth with neurodevelopmental disorders (NDDs) experience mental health problems such as anxiety, depression or anger, and these are often associated with impairments of cognition and ...emotion regulation. The mechanisms that may be linking cognitive difficulties, emotion regulation and mental health are not known.
Aims
The current study examined whether adaptive and maladaptive (dysregulated) emotion regulation mediated the link between different cognitive control processes (working memory, inhibition and shifting) and internalizing/externalizing symptoms in children with NDDs.
Methods
Participants included 48 children (8–13 years of age) with one or more diagnoses of autism, attention deficit hyperactivity disorder, cerebral palsy and learning disability, who were enrolled in a larger study of cognitive behaviour therapy targeting emotion regulation. Multiple mediation analyses were implemented using the PROCESS macro. The mediation effects of adaptive and maladaptive emotion regulation were examined on the relationships between (1) working memory and internalizing/externalizing symptoms, (2) inhibition and internalizing/externalizing symptoms and (3) shifting and internalizing/externalizing symptoms. All data were collected prior to intervention, at baseline.
Results
Shifting, inhibitory control and working memory predicted increased emotion dysregulation, which functioned as a full mediator to both internalizing and externalizing problems in children with NDDs.
Conclusions
In the presence of emotionally triggering situations, children with greater cognitive challenges experience greater maladaptive emotion regulation, which results in both internalizing and externalizing problems. For youth with NDDs, therapeutic plans that include strengthening of working memory, inhibition and shifting abilities in addition to emotion regulation skills training may be helpful in alleviating externalizing and internalizing behaviour.
Difficulties with emotion regulation are common in children with autism. Although interventions targeting emotion regulation show promise, children’s individual treatment responses vary, and it is ...important to understand the factors that contribute to treatment change. The present study aimed to identify pre-treatment child characteristics and parent psychopathology that predict treatment response in a 10-week manualized cognitive behaviour therapy intervention for children with autism, 8–12 years of age. Exploratory best-subset regression analyses were first carried out to identify the optimal set of predictors. Logistic regressions were then conducted to determine whether these variables predicted reliable improvement. Outcome variables consisted of the lability/negativity and the emotion regulation subscales of the Emotion Regulation Checklist. Predictors included pre-treatment developmental, clinical, and parent psychopathology variables. Analyses revealed that youth who started the treatment with higher verbal reasoning, higher impairment in social motivation, and more anxious parents were more likely to show reliable improvements in emotion regulation. Youth who started the treatment with higher internalizing scores had lower odds of showing reliable improvement. Implications of our findings include facilitation of active involvement, avoidance of complex language, and the provision of additional supports. Further suggestions to inform clinical practice are discussed.
Lay abstract
Children with autism commonly experience difficulty controlling their emotions. Although existing treatments are successful in teaching critical emotion regulation skills, not all children improve. It is important to identify the factors that influence treatment response to be able to reach more children. This study aimed to identify child and parent characteristics that predict treatment response in a 10-week cognitive behaviour therapy treatment for children with autism, 8–12 years of age, and their parents. We found that youth who started the treatment with higher verbal abilities, who were more anxious in social situations, and had parents who were more anxious, were more likely to improve in learning new emotion regulation skills. We also found that children who had more physical discomforts or complaints before starting the treatment were less likely to improve in their negative expressions of emotion. Our study suggests that it is important for clinicians to promote active involvement and learning by avoiding complex language and to use more visual materials to supplement the learning process, and make sure that sessions are sensitive to the individual needs of participants.
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