Questionnaires to detect emotional and behavioral (EB) problems in preventive child healthcare (PCH) should be short; this potentially affects their validity and reliability. Computerized adaptive ...testing (CAT) could overcome this weakness. The aim of this study was to (1) develop a CAT to measure EB problems among pre-school children and (2) assess the efficiency and validity of this CAT. We used a Dutch national dataset obtained from parents of pre-school children undergoing a well-child care assessment by PCH (
n
= 2192, response 70%). Data regarded 197 items on EB problems, based on four questionnaires, the Strengths and Difficulties Questionnaire (SDQ), the Child Behavior Checklist (CBCL), the Ages and Stages Questionnaire: Social Emotional (ASQ:SE), and the Brief Infant–Toddler Social and Emotional Assessment (BITSEA). Using 80% of the sample, we calculated item parameters necessary for a CAT and defined a cutoff for EB problems. With the remaining part of the sample, we used simulation techniques to determine the validity and efficiency of this CAT, using as criterion a total clinical score on the CBCL. Item criteria were met by 193 items. This CAT needed, on average, 16 items to identify children with EB problems. Sensitivity and specificity compared to a clinical score on the CBCL were 0.89 and 0.91, respectively, for total problems; 0.80 and 0.93 for emotional problems; and 0.94 and 0.91 for behavioral problems.
Conclusion
: A CAT is very promising for the identification of EB problems in pre-school children, as it seems to yield an efficient, yet high-quality identification. This conclusion should be confirmed by real-life administration of this CAT.
What is Known:
• Studies indicate the validity of using computerized adaptive test (CAT) applications to identify emotional and behavioral problems in school-aged children.
• Evidence is as yet limited on whether CAT applications can also be used with pre-school children.
What is New:
• The results of this study show that a computerized adaptive test is very promising for the identification of emotional and behavior problems in pre-school children, as it appears to yield an efficient and high-quality identification.
Aim
The aim of this study is to determine the most useful diagnostic tools to differentiate appendicitis from non‐specific abdominal pain (NSAP) in pre‐school children.
Methods
We prospectively ...evaluated all children aged 5 years or younger admitted for suspected appendicitis at a paediatric emergency department during 5 years. Cases of NSAP and appendicitis were enrolled according to inclusion and exclusion criteria. The different variables collected were assessed by statistic and diagnostic accuracy studies.
Results
A total of 82 patients were studied: 27 cases of NSAP and 55 cases of appendicitis. We found no symptoms or signs with a high power of discrimination between both processes. Complicated cases of appendicitis begin to appear when the duration of symptoms exceeds 12 h. Among laboratory tests, C‐reactive protein (CRP) value >34 mg/L was the variable with a greater association to appendicitis (odds ratio 9.8). Abdominal ultrasound (US) had high sensitivity and specificity to differentiate appendicitis, significantly improving its diagnostic accuracy when the duration of symptoms exceeds 12 h.
Conclusions
A good history and physical examination are important in the diagnostic process, but reliable physical signs can be difficult to elicit in pre‐school children. CRP and abdominal US are useful investigations that can improve diagnostic accuracy. According to our results, abdominal pain duration longer than 12 h or CRP value >34 mg/L should be an indication to perform an abdominal US in pre‐school children with right lower quadrant tenderness.
The present study aimed to analyze the differences between maternal and paternal parenting stress and children’s behavioral functioning, as determined by teacher and parent reports. In addition, it ...sought to evaluate the presence of clusters based on parenting stress and to determine whether perceptions of children’s behavioral functioning varied across these clusters. The sample was composed of the parents and teachers of N = 201 children. Parents completed a self-report questionnaire on parenting stress and parents and teachers filled out report-form questionnaires assessing children’s emotional and behavioral functioning. The results showed that mothers had higher levels of parenting stress than fathers, and both parents reported more prosocial behavior in children than did teachers. Furthermore, middle stressed parents had children who expressed more prosocial behavior than did parents in other clusters. The findings also showed that parenting stress influenced partners’ perceptions of children’s behavioral functioning. The multiplicity of child observers facilitated a better understanding of how parenting stress, linked to parent–child interactions, may play an important role in shaping parents’ perceptions of their children.
Alterations in the development of attention control and learning have been associated with autism and can be measured using the ‘antisaccade task’, which assesses a child’s ability to make an ...oculomotor response away from a distracting stimulus, and learn to instead anticipate a later reward. We aimed to assess these cognitive processes using portable eye-tracking in an understudied population of pre-school children with and without a diagnosis of autism spectrum disorder in community settings in New Delhi, India. The eye-tracking antisaccade task was presented to children in three groups (n = 104) (children with a clinical diagnosis of autism spectrum disorder or intellectual disability and children meeting developmental milestones). In accordance with findings from high-income, laboratory-based environments, children learnt to anticipate looks towards a reward, as well as inhibit eye-movements towards a distractor stimulus. We also provide novel evidence that while differences in inhibition responses might be applicable to multiple developmental conditions, a reduced learning to anticipate looks towards a target in this age group may be specific to autism. This eye-tracking task may, therefore, have the potential to identify and assess autism specific traits across development, and be used in longitudinal research studies such as investigating response to intervention in low-resource settings.
Lay abstract
The development of cognitive processes, such as attention control and learning, has been suggested to be altered in children with a diagnosis of autism spectrum disorder. However, nearly all of our understanding of the development of these cognitive processes comes from studies with school-aged or older children in high-income countries, and from research conducted in a controlled laboratory environment, thereby restricting the potential generalisability of results and away from the majority of the world’s population. We need to expand our research to investigate abilities beyond these limited settings. We address shortcomings in the literature by (1) studying attention control and learning in an understudied population of children in a low- and middle-income country setting in India, (2) focusing research on a critical younger age group of children and (3) using portable eye-tracking technology that can be taken into communities and healthcare settings to increase the accessibility of research in hard-to-reach populations. Our results provide novel evidence on differences in attention control and learning responses in groups of children with and without a diagnosis of autism spectrum disorder. We show that learning responses in children that we assessed through a portable eye-tracking task, called the ‘antisaccade task’, may be specific to autism. This suggests that the methods we use may have the potential to identify and assess autism-specific traits across development, and be used in research in low-resource settings.
Background: Methodological challenges such as confounding have made the study of the early determinants of mental health morbidity problematic. This study aims to address these challenges in ...investigating antenatal, perinatal and postnatal risk factors for the development of mental health problems in pre‐school children in a cohort of Western Australian children.
Methods: The Raine Study is a prospective cohort study of 2,868 live born children involving 2,979 pregnant women recruited at 18 weeks gestation. Children were followed up at age two and five years. The Child Behaviour Checklist (CBCL) was used to measure child mental health with clinical cut‐points, including internalising (withdrawn/depressed) and externalising (aggressive/destructive) behaviours (n = 1707).
Results: Multinomial logistic regression analysis showed that the significant risk factors for behaviour problems at age two were the maternal experience of multiple stress events in pregnancy (OR = 1.20, 95% CI = 1.06, 1.37), smoking during pregnancy (OR = 1.30, 95% CI = 1.06, 1.59) and maternal ethnicity (OR = 3.34, 95% CI = 1.61, 6.96). At age five the experience of multiple stress events (OR = 1.17, 95% CI = 1.08, 1.27), cigarette smoking (OR = 1.19, 95% CI = 1.03, 1.37), male gender (OR = 1.43, 95% CI = 1.02, 2.00), breastfeeding for a shorter time (OR = .97, 95% CI = .94, .99) and multiple baby blues symptoms (OR = 1.08, 95% CI = 1.02, 1.14) were significant predictors of mental health problems.
Conclusions: Early childhood mental health is significantly affected by prenatal events in addition to the child’s later environment. Interventions targeting adverse prenatal, perinatal and postnatal influences can be expected to improve mental health outcomes for children in the early years.
Aim
The aim of this study was to describe sociodemographic and family predictors for behavioural and emotional problems in pre‐schoolers.
Methods
This was a cross‐sectional study including 30,795 ...children in the Stockholm region whose parents had completed the Strength and Difficulties Questionnaire (SDQ) prior to a routine visit to a well‐baby clinic at age 3 years. Multivariate logistic regression was used to analyse predictors for having a high total SDQ difficulties score.
Results
Young parental age and a low level of parental education predicted high total SDQ score in a stepwise pattern. Being a first‐born child was associated with a high SDQ score with an adjusted odds ratio of 2.10 (95% C.I. 1.84–2.41), compared with having older siblings. A sole physical custody arrangement predicted a high total SDQ score after parental separation. The percentage of children with a high total SDQ score increased with the Care Need Index (CNI) of the well‐baby clinic.
Conclusions
This study identified socioeconomic disadvantage and being the first‐born child as the main predictors of poor mental health at age 3 years. Well‐baby clinics with socioeconomically disadvantaged catchment areas should be provided with adequate resources and methods for equitable prevention.
Linear growth is controlled by several factors, malnutrition is one of the leading causes of stunted child growth. The objective of this study was to determine the dietary intakes associated with ...stunting among pre-school children in rural Upper Egypt.
Community-based cross-sectional study.
Data were collected by interviewing the children's caregivers in the rural household setting.
The study included 497 pre-school children aged 2-5 years in rural Upper Egypt. Food intake data were estimated using 24-h recall method. Anthropometric measurements of children were taken and then converted to z-scores for weight-for-age Z-score, height-for-age Z-score and weight-for-height Z-score.
The study included 497 children of which 19·1 % were stunted, 76·3 % did not meet recommended energetic intake and 13·7 % did not meet recommended protein intake and this was significantly higher than non-stunted children. Children who were stunted significantly consumed poultry, eggs and fruits less often than non-stunted children, by regression; male sex (adjusted odds ratio (aOR) = 1·91), mother's age (0·93), lower socio-economic status (SES); and not meeting recommended protein intake (aOR = 2·26) were found to be associated with stunting.
Male sex, younger mothers, lower SES and not meeting recommended energy and protein were statistically associated with stunting. Nutrition education messages encouraging adequate and healthy eating are recommended.
Background
Screen time, defined as time spent watching television, DVDs, or videos or playing computer or video games, has been related to serious health consequences in children, such as impaired ...language acquisition, violent behaviour, tobacco smoking and obesity. Our aim was to determine if a simple intervention aimed at preschool‐aged children, applied at the health maintenance visits, in the primary care setting, would be effective in reducing screen time.
Methods
We used a two group randomized controlled trial design. Two‐ to 6‐year‐old children and their parents were randomly assigned to receive an intervention to reduce their screen time, BMI and parental report of aggressive behaviour. At the end of the intervention we made home visits at 2, 6 and 9 months and the parents completed questionnaire.
Results
Parents in the intervention group reported less screen time and less aggressive behaviour than those in the control group but there were no differences in BMI z scores.
Conclusions
This study shows that a preschool‐based intervention can lead to reductions in young children's television/video viewing.
Background
Current research investigating collaboration between parents and speech and language therapists (SLTs) indicates that the SLT role is characterized by therapist‐led practice. Co‐working ...with parents of children with speech and language difficulties is less frequently described. In order to embrace co‐working during intervention, the SLT role may need to be reframed, focusing on acquiring skills in the role of coach as well as the role of planning intervention and treating children.
Aims
To report (1) SLTs’ conceptions about their own roles during intervention for pre‐school children with speech and language difficulties; and (2) SLTs’ conceptions of parents’ roles during intervention.
Methods & Procedures
A qualitative study used individual, semi‐structured interviews with 12 SLTs working with pre‐school children. Open‐ended questions investigated SLTs’ expectation of parents, experience of working with families, and the SLTs’ conception of their roles during assessment, intervention and decision‐making. Thematic network analysis was used to identify basic, organizational and global themes.
Results & Outcomes
SLTs had three conceptions about their own role during intervention: treating, planning and coaching. The roles of treating and planning were clearly formulated, but the conception of their role as coach was more implicit in their discourse. SLTs’ conception of parents’ roles focused on parents as implementers of activities and only occasionally as change agents.
Conclusions & Implications
Collaboration that reflects co‐working may necessitate changes in the conception about the role for both SLTs and parents. SLTs and parents may need to negotiate roles, with parents assuming learner and adaptor roles and SLTs adopting a coaching role to activate greater involvement of parents. Applying conceptual change theory offers new possibilities for understanding and enabling changes in SLTs’ conception of roles, potentially initiating a deeper understanding of how to achieve co‐working during speech and language intervention.
To investigate the association between eating behaviours (eating speed and energy intake of main meals) and overweight in pre-school children.
Cross-sectional study. Data consisted of measurements ...(height and weight), questionnaire information (eating behaviours of eating speed and overeating) and on-site observation data (meal duration and energy intake of main meals).
Seven kindergartens in Beijing, China.
Pre-school children (n 1138; age range 3·1-6·7 years old) from seven kindergartens participated in the study.
The multivariate-adjusted odds ratio of overweight in participants with parent-reported 'more than needed food intake' was 3·02 (95 % CI 2·06, 4·44) compared with the 'medium food intake' participants, and higher eating speed was associated with childhood overweight. For the two observed eating behaviours, each 418·7 kJ (100 kcal) increase of lunch energy intake significantly increased the likelihood for overweight by a factor of 1·445, and each 5-min increase in meal duration significantly decreased the likelihood for overweight by a factor of 0·861. Increased portions of rice and cooked dishes were significantly associated with overweight status (OR = 2·274; 95 % CI 1·360, 3·804 and OR = 1·378; 95 % CI 1·010, 1·881, respectively).
Eating speed and excess energy intake of main meals are associated with overweight in pre-school children.
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