Child Background Characteristics Research Articles

Characteristics of and cost of care for children with impaired development and acute appendicitis: A study of two national databases

BackgroundCharacteristics of children with impaired development who have acute appendicitis are not well described in the literature. MethodsWe reviewed the National Surgical Quality Improvement Program-Pediatric and the multicenter Pediatric Health Information System for patients with acute appendicitis. Comparisons for demographics, clinical outcomes, and hospital charges between children with impaired development versus neurotypical children were made using independent t test or Wilcoxon rank sum tests. The multivariable logistic regression model estimated the odds of complicated acute appendicitis in impaired development patients. Based on correlation analyses, hierarchical linear modeling was used to examine the extent to which impaired development influenced resource use. ResultsPatients with impaired development were younger, had higher comorbidities, and were more commonly male sex. In the National Surgical Quality Improvement Program-Pediatric database, impaired development was associated with higher rates of complicated acute appendicitis (33.6% vs 27.5, P < .001), particularly in older children, and higher usage of computed tomography at National Surgical Quality Improvement Program-Pediatric hospitals (23.1% vs 15.1%, P < .001). In the Pediatric Health Information System database, the adjusted odds of complicated acute appendicitis were significantly higher in patients with impaired development (1.20 [1.09–1.31]), low childhood opportunity level (1.39 [95% confidence interval: 1.31–1.47]), and Black race (1.25 [1.17–1.33]). Hierarchical adjusted linear modeling showed that impaired development was associated with significantly higher hospital charges (9% increase). ConclusionManagement of acute appendicitis in children with impaired development remains a challenge to clinicians, as evidenced by the higher rate of perforated appendicitis in older children, diagnostic computed tomography use at National Surgical Quality Improvement Program-Pediatric hospitals, postoperative computed tomography use, and increased costs.

A glass ceiling at the playhouse? Gender gaps in public and private preschool enrollment in India

India has reduced male-biased gender gaps in primary school enrollment and progression rates in recent years. However, patterns of early childhood education enrollment, selection of preschool, and related gender gaps remain inadequately studied. This study uses data from India’s National Family Health Survey (2019–2021), which collected preschool information for children aged 2–4 years, to examine female-male gaps in preschool enrollment. An estimated 40% of children were enrolled in preschools, and among them, 28% were enrolled in private preschools, with substantial variation across states. State, district, and household fixed-effects regressions, which accounted for a wide range of background characteristics of children, show that while preschool enrollment rates were 3.6–4.1% higher among girls than boys, girls were 9.3–16.7% less likely to be enrolled in higher quality private preschools. Using a mother fixed-effects regression, we found that while there was no gender gap in siblings’ preschool enrolment rates, girls were 18.6% less likely to be enrolled in private preschool than their brothers. The relative bias towards males in private preschool enrollment decreased with standard of living and maternal schooling levels. The findings indicate gender discrimination in enrollment in higher quality private preschool against young girls.

The impact of the Covid-19 pandemic on children who become looked after in Derby City

This article compares the needs and background characteristics of children who became looked after by an English local authority between April and July in 2019 and the same three months in 2020, with the aim of identifying any impact of the Covid-19 pandemic which broke out in March 2020 and continued for some months thereafter. It scrutinises the two cohorts, comparing children's age, gender, ethnicity, entry to care with siblings and reasons for admission. Differences attributable to the pandemic were found.

Predictors of Treatment Response for Preschool Children With Developmental Language Disorder.

Purpose Enhanced Conversational Recast treatment is an effective intervention for remediating expressive grammatical deficits in preschool-age children with developmental language disorder, but not all children respond equally well. In this study, we sought to identify which child-level variables predict response to treatment of morphological deficits. Method Predictor variables of interest, including pre-intervention test scores and target morpheme production, age, and mother's level of education (proxy for socio-economic status) were included in analyses. The sample included 105 children (M = 5;1 [years;months]) with developmental language disorder who participated in 5 weeks of daily Enhanced Conversational Recast treatment. Classification and regression tree analysis was used to identify covariates that predicted children's generalization of their trained grammatical morpheme, as measured by treatment effect size d. Results Our analysis indicates that the Structured Photographic Expressive Language Test-Preschool 2 (SPELT-P 2) scores and the Peabody Picture Vocabulary Test-Fourth Edition scores significantly predicted the degree of benefit a child derived from Enhanced Conversational Recast treatment. Specifically, a SPELT-P 2 score above 75 (but still in the impaired range, < 87) combined with a high Peabody Picture Vocabulary Test-Fourth Edition score (> 100) yielded the largest treatment effect size, whereas a SPELT-P 2 score below 75 predicted the smallest treatment effect size. Other variables included in the model did not significantly predict treatment outcomes. Conclusions Understanding individual differences in response to treatment will allow service providers to make evidence-based decisions regarding how likely a child is to benefit from Enhanced Conversational Recast treatment and the expected magnitude of the response based on the child's background characteristics.

Factors associated with child neglect in Indonesia: Findings from National Socio-Economic Survey

This study aimed to identify the factors that affect the incidence rate of neglected children in Indonesia by considering the household effect. Neglect is a form of child abuse by not fulfilling or ignoring their basic needs. Neglected children are a complex social problem. This is a multidimensional problem, since the cause cannot be seen only based on individual characteristics, but it must also consider the household variation effect. The data was collected from a secondary source, namely the Socio-Culture and Education Module of the 2012 National Socio-Economic Survey (NSES-SCEM) that consisted of 75,000 households' data. The response variable was the child status of neglect, while the explanatory variables included a child's background characteristics at individual and household level. Two-level binary logistic regression with a random effect was applied. The regression model results show that neglected children were more commonly boys, had one or both parents dead, were younger in age, have another neglected child in the households, have disabilities, live in an uninhabitable house, headed by young and/or lower educated adults, had lower economic status, have higher underage family members, had unemployed parents, and lived with one of her/his parents. The current study found that the individual and household level remains an important aspect of child neglect in Indonesia. Policies in Indonesia should be directed to improve household welfare and to create a specific intervention to identify and assist vulnerable children in society.

Preschoolers' school readiness profiles and the teacher-child relationship: A latent transition approach

This study used latent profile analysis to identify subgroups of children who displayed similar underlying school readiness skills at the beginning of the school year, as well as to examine whether these children transitioned across readiness profiles over the course of the school year. The sample included 899 preschool children (mean age = 53.91 months). Measures consisted of fall and spring assessments of children's math, science, executive functioning, behavior, and approaches to learning. Latent profile analyses yielded a three-profile solution at both time points. Within each profile, children performed similarly across math, science, and executive functioning assessments. Ratings of behavior and approaches to learning differentiated from the other assessments in two of the profiles. Latent transition analyses indicated that profiles were moderately stable over the course of the year. Logistic regression analyses revealed that child background characteristics and the teacher-child relationship were associated with profile transition.

Determinants of childhood morbidity in Bangladesh: evidence from the Demographic and Health Survey 2011

ObjectivesThe present study aims to estimate the incidence of preventable infectious diseases or associated symptoms among young children in Bangladesh and also determine the factors affecting these conditions. The study...

Patterns of Food Parenting Practices and Children's Intake of Energy-Dense Snack Foods.

Most previous studies of parental influences on children’s diets included just a single or a few types of food parenting practices, while parents actually employ multiple types of practices. Our objective was to investigate the clustering of parents regarding food parenting practices and to characterize the clusters in terms of background characteristics and children’s intake of energy-dense snack foods. A sample of Dutch parents of children aged 4–12 was recruited by a research agency to fill out an online questionnaire. A hierarchical cluster analysis (n = 888) was performed, followed by k-means clustering. ANOVAs, ANCOVAs and chi-square tests were used to investigate associations between cluster membership, parental and child background characteristics, as well as children’s intake of energy-dense snack foods. Four distinct patterns were discovered: “high covert control and rewarding”, “low covert control and non-rewarding”, “high involvement and supportive” and “low involvement and indulgent”. The “high involvement and supportive” cluster was found to be most favorable in terms of children’s intake. Several background factors characterized cluster membership. This study expands the current knowledge about parental influences on children’s diets. Interventions should focus on increasing parental involvement in food parenting.

Child care quality and children's cognitive and socio-emotional development: an Australian longitudinal study

There is growing evidence that high-quality non-parental child care can contribute to children's learning, development and successful transition to school. Research examining the quality of child care and the effect on children's development is not well documented outside the USA. We used data from the Longitudinal Study of Australian Children to examine the association between domain-specific aspects of child care quality at ages two to three and children's cognitive (receptive vocabulary, literacy, maths proficiency) and socio-emotional development (internalising, externalising behaviours) at ages four to five and six to seven (n = 772–1136, depending on outcome). After extensive controls for parent, family and child background characteristics, higher quality relationships were associated with higher receptive vocabulary, literacy and maths scores and lower internalising and externalising problem behaviour scores at four to five and these effects although weaker, were still evident at ages six to seven. Activities in child care and provider/programme characteristics of care were not associated with children's developmental outcomes.

Factors related to dietary habits and body mass index among Turkish school children: a Cox's interaction model‐based study

To report a study conducted to describe the determinants of Turkish school-aged children's dietary habits and body mass index. Over the past two decades, children's unhealthy dietary habits and obesity have increased rapidly. Nurses have an essential role in minimizing health-risk behaviours and promoting healthy lifestyles. Using the Interaction Model of Client Health Behavior to measure children's dietary habits and body mass index values helps to prepare health-promotion interventions. A descriptive, correlational study. The study was conducted, based on a sample of 420 fifth-grade students and their parents in one city in Turkey. The data were collected during 2007 using a questionnaire designed to assess the dietary habits and anthropometric indices. Data were analysed using quantitative analysis to identify key variables. The girls scored healthier on dietary habits than did the boys. Although dietary self-efficacy was statistically significant as an explanatory variable of dietary habits for both genders, the dietary attitude was the only explanatory variable of dietary habits for the girls. No difference was detected in the prevalence of overweight between boys and girls. Nurses are well-situated to give children dietary self-efficacy improvement, dietary attitude enhancement, and family-centred and school-based intervention programmes to reduce their unhealthy dietary habits. The model guides researchers to identify the background characteristics of children that result in the body mass index.

Clustering of energy balance-related behaviors in 5-year-old children: Lifestyle patterns and their longitudinal association with weight status development in early childhood

BackgroundThis study identified lifestyle patterns by examining the clustering of eating routines (e.g. eating together as a family, having the television on during meals, duration of meals) and various activity-related behaviors (i.e. physical activity (PA) and sedentary screen-based behavior) in 5-year-old children, as well as the longitudinal association of these patterns with weight status (BMI and overweight) development up to age 8.MethodsData originated from the KOALA Birth Cohort Study (N = 2074 at age 5). Principal component analysis (PCA) was used to identify lifestyle patterns. Backward regression analyses were used to examine the association of lifestyle patterns with parent and child background characteristics, as well as the longitudinal associations between the patterns and weight status development.ResultsFour lifestyle patterns emerged from the PCA: a ‘Television–Snacking’ pattern, a ‘Sports–Computer’ pattern, a ‘Traditional Family’ pattern, and a “Fast’ Food’ pattern. Child gender and parental educational level, working hours and body mass index were significantly associated with the scores for the patterns. The Television–Snacking pattern was positively associated with BMI (standardized regression coefficient β = 0.05; p < 0.05), and children with this pattern showed a positive tendency toward being overweight at age 8 (Odds ratio (OR) = 1.27, p = 0.06). In addition, the Sports–Computer pattern was significantly positively associated with an increased risk of becoming overweight at age 7 (OR = 1.28, p < 0.05).ConclusionsThe current study showed the added value of including eating routines in cross-behavioral clustering analyses. The findings indicate that future interventions to prevent childhood overweight should address eating routines and activity/inactivity simultaneously, using the synergy between clustered behaviors (e.g. between television viewing and snacking).

Behavioral Competence and Academic Functioning Among Early Elementary Children With Externalizing Problems

.The positive effect of competent behaviors on academic functioning may outweigh the negative effect of externalizing problems. The current study examined this premise among children with externalizing problems in the early elementary years. Participants were 207 kindergarten through third-grade children and their parents and teachers. Results suggested that children's behavioral competence made a unique contribution to all aspects of academic functioning examined (i.e., academic problems, reading and math achievement) over and above a variety of child background characteristics, including externalizing problems. Furthermore, children's behavioral competence buffered the negative effects of limited parental education on children's reading achievement. That is, among children of parents with less than a college degree, children's reading achievement was higher for those whose behavioral competence was average than for those whose behavioral competence was at risk. Findings highlight the significance of identifying and promoting behavioral competencies when working with children with behavior problems.

Energy balance-related behavioural patterns in 5-year-old children and the longitudinal association with weight status development in early childhood

The current study examined clustering of dietary intake and activity behaviours (i.e. physical activity (PA) and sedentary behaviour) in 5-year-old children, as well as the longitudinal association with BMI and overweight development. Principal component analysis (PCA) was used to identify behavioural patterns. Backward regression analyses were used to examine the association of behavioural patterns with parent and child background characteristics, as well as the association of the patterns with BMI Z-score and overweight development up to ages 7 and 8 years. The Netherlands. Data originated from the KOALA Birth Cohort Study (n 2074 at age 5 years). Four patterns emerged: a 'sedentary-snacking' pattern (including television viewing and snack consumption), a 'healthy intake' pattern (including healthy items such as fruit, vegetables and fish), a 'sandwich' pattern (including bread and sandwich fillings) and a 'sporty-traditional meal' pattern (including sports, meat and potatoes). The patterns were related to child gender, general appetite and various parental characteristics. The sedentary-snacking pattern was positively associated with longitudinal BMI development. Cross-behavioural energy balance-related behavioural patterns exist at age 5 years. Different activity types (e.g. sports, television viewing) clustered differently with the behavioural patterns, indicating the need to incorporate these different types instead of one general PA measure in energy balance-related pattern analyses. The clustering and potential synergy between activity behaviours and dietary intake, as well as the associations with weight status development, stress the importance of an integrated approach to PA and healthy nutrition promotion in preventing childhood overweight.

A question of class: On the heterogeneous relationship between background characteristics and a child's placement risk

While a range of studies investigate how a child's background characteristics affects his or her placement risk, only few have considered the possible stratified influence of these characteristics. This study contributes to this small literature by investigating if the influence from background characteristics varies by the child's social class membership. The analysis shows that this is the case: background characteristics matter less for preschool children from higher classes compared to low class preschool children, however, they matter more for high class teenagers than for low class teenagers.

Clinical characteristics and outcome of children with Burkitt lymphoma in Uganda according to HIV infection

Characteristics of children with Burkitt lymphoma (BL) and HIV infection have not been described in Uganda before. We reviewed records at Uganda Cancer Institute (UCI) for years 1994-2004, to compare clinical features and outcome of BL in children who are HIV positive and negative (HIV+, HIV-). As statistical methods we used Student's t-test, Chi-square and Kaplan-Meier's to compare both groups. Of 1,462 records of children retrieved, 228 met the eligibility criteria and were reviewed (158 HIV-, 70 HIV+). There were 139 (61%) males and 89 (39%) females. The mean age was 6.9 years (HIV+ 6.7, HIV- 7.1). One hundred seventy-one cases (75%) had facial tumor (HIV+ 71.4%, HIV- 76.6%). HIV positive children presented significantly with extrafacial disease (lymphadenopathy 67%, hepatic masses 51%, and thoracic masses 10%). Presentation with advanced stage disease occurred more frequently in HIV positive patients compared to HIV negative patients. Treatment response rates to chemotherapy were similar irrespective of HIV status. However, overall survival was poorer in HIV positive patients with a median survival of 11.79 months (P-value < 0.000, 95% CI 8.65-14.92). BL in Uganda presents frequently with facial disease irrespective of HIV status. However HIV+ BL also presents commonly with extra facial sites, mainly lymphadenopathy. There is no difference in response to treatment with chemotherapy, but HIV+ BL patients have poorer survival. There is need for further characterization of BL in Uganda to understand the role of HIV in disease process and outcome.

Child Characteristics and Receipt of Stimulant Medications: A Population-Based Study

Predictive factors associated with prescription of psychostimulant drugs to children remain poorly understood. We aimed to identify child-related factors that predict receipt of methylphenidate (MPH: Ritalin) by children in a large population-based study. With data from time 1 (1994-1995) and time 2 (1996-1997) of the National Longitudinal Survey of Children and Youth, we analyzed the role of child background, and behavioral and functional characteristics, all measured at time 1, in predicting receipt of MPH at time 2 in a series of logistic regression models. Parent- and teacher-reported attention-deficit/hyperactivity disorder (ADHD) symptoms were consistent and significant predictors of receipt of MPH (odds ratios [ORs] ranging from 5.3-7.0, and from 3.2-4.1, respectively), particularly when concordant. Parent-reported aggressive behaviors (OR 1.91, 95% confidence interval [CI], 1.24-2.96) and teacher-reported internalizing symptoms (OR 3.01, 95% CI, 1.74-5.54) also predicted receipt of MPH, whereas higher levels of academic functioning predicted lower likelihood of receiving MPH (OR 0.54, 95% CI, 0.34-0.85), even after controlling for child background characteristics, ADHD symptoms, and prior receipt of MPH. Across models, male gender predicted a higher likelihood of receiving MPH (ORs ranging from 3.5-4.5) over and above ADHD and other behavioral symptoms. The strongest predictor of MPH receipt across models was prior receipt of MPH (ORs ranging from 83.7-128.3). Child characteristics and behavioral symptoms other than ADHD symptoms predict prescription and uptake of MPH, possibly attributable to their serving as clinically convenient indicators of impairment. Gender effects in receipt of stimulant medications among children with ADHD symptoms warrant further investigation.

Ethnic Social Milieu and Black Children's Intelligence Test Achievement

Family background characteristics of children have been shown to be significantly related to their school success. Race and family socioeconomic status (SES) are particularly strong correlates of scholastic achievement. White children generally show higher achievement than black children, and high-SES children tend to be more successful than their low-SES peers.1 However, researchers in this area continue to search for the mechanisms by which variations in these family characteristics affect educational outcomes. The fact that black children generally show lower scholastic attainment than their white peers within SES strata2 indicates that educational outcomes are influenced independently by the race of the family of rearing as well as by family SES. Findings of this sort have caused some theorists to suspect that a significant genetic component is involved in the differential scholastic achievement of children from different racial groups.3 The assumption that black children are deficient in cognitive skills necessary for school success is based, in large part, upon the consistent finding that black children achieve lower average scores on standardized tests of intelligence than their white peers. A sig-