Characteristics Of Children Research Articles

Pediatric Emergency Medicine Physicians' Perspectives of Concussion in Young Children.

Traumatic brain injury (TBI) during early childhood (before 6 years) is prevalent, accounting for rising rates of emergency department visits. These injuries may lead to postconcussive symptoms, which may be subtle and difficult to diagnose in young children. Inadequate discharge counseling may lead to prolonged duration of symptoms and possible developmental delays. We aimed to explore pediatric emergency medicine (PEM) physicians' perspectives on "concussion" terminology, diagnosis, and management, specifically in a young child with mild TBI. We conducted semistructured interviews using open-ended questions involving a hypothetical scenario. We recruited currently practicing PEM physicians by a snowball sampling method. A research team recorded, transcribed, and analyzed the interviews. Using social constructionism as the philosophical framework, we developed and refined codes and derived themes until reaching thematic saturation. Peer debriefing with an expert collaborator aided with revisions of themes. A single PEM researcher interviewed 13 participants. Three primary themes emerged. Our first theme identified the role of guidelines and tools in the diagnostic workup. Most participants utilized a clinical prediction tool for neuroimaging but no clinical symptom scales. Our second theme described the difficulties and inconsistencies in the approach to diagnosis of concussion, largely due to young age, lack of verbal skills and unreliable examinations. Our last theme focused on the difficulty in providing clear discharge instructions to parents. Many participants described difficulty providing activity restrictions, instead allowing self-modulation, and lack of counseling for educational tasks. Variability exists among PEM physicians in diagnosis and management of concussions in young children. Discomfort with lack of reliability of symptoms and underappreciation of typical early childhood characteristics may account for findings. Educational initiatives, age-appropriate clinical tools and treatment-guided outcomes research are needed to guide PEM physicians in the care of young children with head injuries.

At the Interface Between Parasympathetic Activity and Self‐Regulation in Young Children: Introduction to the Special Issue

ABSTRACTThe parasympathetic nervous system (PNS) is highly responsive to changes in environmental conditions and serves an essential role in mobilising the metabolic resources required for young children to regulate their thoughts, emotions and behaviours. According to polyvagal theory, the PNS evolved to play a leading role in the neurophysiological response to situations that range from modestly challenging to engaging, and many situations in which young children must exercise volitional processes of self‐regulation conform to this description. Children's phasic parasympathetic activity during measures of volitional self‐regulation is often associated with their performance on those measures or with their performance on other assessments of self‐regulation, but the nature of the associations between PNS activity and performance on measures of volitional self‐regulation is highly variable. This heterogeneity complicates the interpretation of results obtained across different studies and inhibits our ability to formulate directional hypotheses about what patterns of phasic parasympathetic activity we would expect to observe as young children exercise volitional processes of self‐regulation in different situations. This special issue presents a set of papers that addressed these challenges by administering multiple measures of volitional self‐regulation to the same sample of children or by examining how children's characteristics and experience in their developmental environments may account for observed differences in their phasic PNS activity.

Rate and setting of neurodevelopmental and psychosocial encounters for children with CHD.

In North America, less than 30% of children with complex CHD receive recommended follow-up for neurodevelopmental and psychosocial care. While rates of follow-up care at surgical centres have been described, little is known about similar services outside of surgical centres. This cohort study used Maine Health Data Organization's All Payer Claims Data from 2015 to 2019 to identify developmental and psychosocial-related encounters received by children 0-18 years of age with complex CHD. Encounters were classified as developmental, psychological, and neuropsychological testing, mental health assessment interventions, and health and behaviour assessments and interventions. We analysed the association of demographic and clinical characteristics of children and the receipt of any encounter. Of 799 unique children with complex CHD (57% male, 56% Medicaid, and 64% rural), 185 (23%) had at least one developmental or psychosocial encounter. Only 13 children (1.6%) received such care at a surgical centre. Developmental testing took place at a mix of community clinics/private practices (39%), state-based programmes (31%), and hospital-affiliated clinics (28%) with most encounters billing Medicaid (86%). Health and behavioural assessments occurred exclusively at hospital-affiliated clinics, predominately with Medicaid claims (82%). Encounters for mental health interventions, however, occurred in mostly community clinics/private practices (80%) with the majority of encounters billing commercial insurance (64%). Children with complex CHD in Maine access developmental and psychosocial services in locations beyond surgical centres. To better support the neurodevelopmental outcomes of their patients, CHD centres should build partnerships with these external providers.

Adoption of Children with “hard-to-place” Characteristics in Romania during 2016-2022

Aim: This article examines adoption trends for children with "hard-to-place" characteristics in Romania from 2016 to 2022. The central research question is whether recent legislative changes, designed to boost the adoption process, have positively affected the adoption of these children, who are often considered difficult to place due to factors such as age, health conditions, being part of a sibling group, or belonging to an ethnic minority. Method: A secondary data analysis was conducted using official statistics from the National Authority for the Protection of Child’s Rights and Adoption (ANPDCA). The data included adoption trends and characteristics of children awaiting adoption over the study period. Results: While the number of adoptable children continued to increase over the last seven years, there was no significant increase in adoption rates for children with "hard-to-place" characteristics. Many of these children remain in the system, highlighting the ongoing challenges in finding adoptive families able and willing to meet their unique needs. Conclusions and Recommendations: The findings suggest that legislative changes alone have not been enough to improve adoption rates for this vulnerable group of children. A multidimensional education program is essential to prepare prospective adoptive parents, equipping them with the skills and knowledge needed to care for children with complex needs, thereby facilitating more successful adoptions.

Predicting Papiamento and Dutch reading comprehension development in a post-colonial context

Abstract The current research aims to predict L1 Papiamento and L2 Dutch reading comprehension development in 180 children in the upper primary grades (4–6) in a post-colonial Caribbean context from initial language of decoding instruction, cognitive and linguistic child characteristics, and linguistic transfer. Overall, children showed better reading comprehension proficiency in L1 as compared to L2 Dutch. Over the grades, strong autoregression effects in reading comprehension development in both languages were evidenced. Language of decoding instruction was found to predict L2 reading comprehension, but not L1 reading comprehension. The development of L2 reading comprehension showed better outcomes in the case of initial decoding instruction in L2. Word decoding, reading vocabulary, and grammar in respectively L1 and L2 were related to L1 and L2 reading comprehension in Grade 4, while L2 reading comprehension was additionally related to L2 basic oral vocabulary. Moreover, only reading vocabulary was related to L1 and L2 reading comprehension development across the grades. Finally, evidence of cross-linguistic interdependencies in the development of reading comprehension in L1 and L2 was found.

Impact of HIV exposure without infection on hospital course and mortality among young children in sub-Saharan Africa: a multi-site cohort study

BackgroundAlthough mortality risk associated with HIV is well described, HIV-exposed uninfected (HEU) young children are also at increased risk of hospitalization and death as compared to HIV-unexposed uninfected (HUU) children. The drivers of poor outcomes among HEU children remain unknown, limiting the development of interventions to support this vulnerable population.MethodsWe performed a secondary analysis of data from a large multi-country prospective cohort [Childhood Acute Illness and Nutrition (CHAIN) Network] study. Data from 5 sites in Uganda, Kenya, and Malawi were included. Hospitalized children aged 2–23 months were followed from an index admission for 6 months after discharge to determine acute and long-term outcomes. Using perinatal HIV exposure (HEU and HUU) as the primary exposure and adjusting for child, caregiver, and household characteristics, we compared inpatient and 30-day survival outcomes, nutritional status, hospital length of stay, illness severity, and utilization of inpatient resources.ResultsWe included 1486 children: 217 HEU and 1269 HUU. HEU children had an increased risk of mortality both during hospitalization [adjusted OR 1.96, 95% CI (1.14–3.37)] and in the 30 days following hospital admission [adjusted hazard ratio 2.20, 95% CI (1.10–4.42)]. Wasting and stunting were more frequent in HEU than HUU children, with adjusted OR 1.41, 95% CI (1.03–1.95) and adjusted OR 1.91, 95% CI (1.34–2.70), respectively. HEU children were also more likely to have a prolonged hospital stay compared to HUU children [adjusted OR 1.58, 95% CI (1.08–2.29)], although admission diagnoses, illness severity at admission, and use of inpatient resources (supplemental oxygen, nasogastric tube, and second-line antibiotics) did not differ significantly between groups.ConclusionsHEU children are more likely to die during hospitalization and within 30 days of admission, to be wasted and stunted upon hospital admission, and to require a prolonged hospital stay, as compared to HUU children. Hospitals in settings with a high prevalence of women-living-with-HIV should ensure that maternal HIV status is established among children requiring admission and build capacity to provide additional hospital monitoring and early post-discharge support for HEU children.

Abuse and neglect as indicators of unhealthy behaviours among 15-year-old schoolchildren in Albania

ObjectiveWe assessed the independent associations of lifetime child abuse and neglect indices with behavioural characteristics of children. Study designA cross-sectional study was conducted in Albania in 2022. MethodsParticipants consisted of a nationwide representative sample of 1877 schoolchildren aged 15 years (55 % girls; response: 96 %). Data on lifetime child abuse and neglect were collected, along with behavioural factors and sociodemographic characteristics. Binary logistic regression was used to assess the independent associations of child abuse and neglect with behavioural factors of schoolchildren. ResultsIrrespective of sociodemographic characteristics, lifetime physical abuse was positively related to lifetime smoking (OR = 1.8, 95%CI = 1.4–2.3), lifetime alcohol consumption (OR = 2.4, 95%CI = 1.9–2.9), and breakfast skipping (OR = 1.3, 95%CI = 1.0–1.6). Furthermore, positive independent factors associated with emotional abuse included lifetime alcohol intake (OR = 1.7, 95%CI = 1.3–2.1) and breakfast skipping (OR = 1.4, 95%CI = 1.0–1.8). Additionally, positive factors associated with lifetime emotional neglect consisted of lifetime smoking (OR = 2.2, 95%CI = 1.6–3.0) and alcohol intake (OR = 2.0, 95%CI = 1.5–2.6), and a lower fruit consumption (OR = 1.7, 95%CI = 1.3–2.3). Positive factors associated with lifetime sexual abuse included lifetime alcohol consumption (OR = 2.4, 95%CI = 1.4–4.1) and especially smoking (OR = 4.3, 95%CI = 2.6–7.3). Also, lifetime witnessing of family violence was positively related to lifetime smoking (OR = 2.7, 95%CI = 1.8–4.1) and alcohol intake (OR = 1.7, 95%CI = 1.2–2.6). ConclusionsWe evidenced strong and consistent links between child maltreatment indices and unhealthy behavioural practices among 15-year-old children in Albania. These findings underscore the potential impact of early trauma on developmental trajectories. The association between child abuse and the adoption of detrimental behaviours highlights the urgent need for comprehensive support and intervention strategies to break the cycle of harm.

Healthcare Practitioners’ perspectives on paediatric burns management at Korle Bu Teaching Hospital, Ghana

BackgroundPaediatric burns pose significant challenges in healthcare management. Paediatric burns require specialized care due to the distinct anatomical and physiological characteristics of children, which make them more vulnerable to complications. In resource-limited settings like Ghana, the absence of adequate supplies and standardized protocols can exacerbate these challenges, necessitating the need for a comprehensive understanding of the perspectives of healthcare practitioners involved in their care.Study Objective.To explore healthcare practitioners’ perspectives on paediatric burns management at a tertiary hospital, Ghana, covering current practices, barriers, impacts on patients and families, and recommendations for improvement. MethodologyThis study employed a qualitative research approach utilizing Focus Group Discussion (FGD) with 15 participants from various disciplines, including Plastic Surgery, Medicine, Anaesthetics, Physiotherapy, Occupational Therapy, Dietetics, Nursing, Pharmacy, Clinical Psychology, Public Health Nursing and. Laboratory Scientist. Participants were recruited through a convenience sampling technique. The discussion lasting approximately 90 min, were audio recorded, and facilitated by a discussion guide based on existing literature. The audio recordings were transcribed verbatim, and the transcripts were compared with handwritten notes for accuracy. The final transcribed data were coded and analyzed using thematic content analysis to identify recurring themes and patterns. ResultsFindings revealed four primary themes: strengths of current practices (multidisciplinary approach, experienced practitioners), barriers (lack of formal protocols, infrastructure limitations, financial burdens), contextual factors influencing burn care (psychological trauma, inadequate support, socio-cultural beliefs and socioeconomic status), and recommendations for enhancing burns care (improved social welfare, facility upgrades, staff training and mental health support). ConclusionWhile burns care has improved in Ghana, there are clear opportunities for improvement. A move towards more integrated care, the development of locally adapted protocols, better financial support, and enhanced caregiver education are essential next steps in elevating the quality of paediatric burn management in Ghana.

중재연구를 통한 경계선 지능 아동의 학습 변인 연구

The purpose of this study is to analyze the learning variables of borderline intelligent children and suggest educational support plans. From January 2000 to September 2024, research topics, subjects, and learning variables were analyzed for literature related to borderline intelligent learners' learning, intervention, and education. What was attempted as an intervention study can be summarized as understanding language, strengthening computational power, and strengthening learning power. A learning support method and a plan to expand learner participation were presented in consideration of the main characteristics of borderline intelligent children, such as cognitive, social, and emotional characteristics. It was proposed to develop education systems and programs suitable for borderline intelligent learners through research. Future research is expected to include experimental studies that assess the outcomes of the educational support proposed for these learners.

A Study on the Relationship between the Characteristics of Children’s Language Acquisition and the Intrinsic Structural Features of Language: Take the Acquisition of Semantic Types of Double Object Constructions as an Example

The double object constructions in language have different semantic types, which represent meanings such as giving, obtaining, and communication. The semantic types vary among different languages. Some semantic types are common to languages, while others are unique to certain languages. The quantitative distribution pattern of semantic types of double object constructions in languages is an external manifestation of the internal structural features of languages. This paper attempts to explore the relationship between children’s acquisition characteristics of semantic types and the intrinsic structural features of language through corpus research methods. The study found that there is a parallel relationship between them, that is, children usually acquire semantic types that reflect language commonalities earlier, while acquire semantic types that reflect language personality differences later.

Nasal, dermal, oral and indoor dust microbe and their interrelationship in children with allergic rhinitis

BackgroundAllergic rhinitis (AR) subjects might have their microenvironment changed due to pathogenesis and living environment. Whether the nasal microbe in AR children differs from healthy subjects and how it interplays with dermal, oral and indoor dust microbe needs to be elucidated.MethodsIn this case–control study, we analyzed and compared the bacterial characterization and associations in nasal, dermal, oral swab samples and dust samples in 62 children with physician-diagnosed AR(cases) and 51 age- and gender-matched healthy ones with no history of allergic diseases(controls). Full-length 16S rRNA sequencing(swabs) and shotgun metagenomics(dust) were applied. Bacterial diversity, composition, abundance difference characteristics and fast expectation–maximization for microbial source tracking(FEAST) analysis were performed and compared between cases and controls.ResultsThe α-diversity of dust microorganisms in AR was lower than that in control group (P = 0.034), and the β-diversity indices of microorganisms in nasal cavity (P = 0.020), skin (P = 0.001) and dust (P = 0.004) were significantly different from those in control group. At species levels, a total of 10, 15, 12, and 15 bacterial species were differentially enriched in either cases or controls in nasal, dermal, oral, and dust samples, respectively(Linear Discriminant Analysis(LDA) score > 2, P < 0.05). Staphylococcus epidermidis was the single species simultaneously more abundant in nasal, dermal and dust samples in AR children. By FEAST analysis, 8.85% and 10.11% of S. epidermidis in AR dermal and dust samples came from nasal cavity. These proportions were significantly higher than those in controls (2.70% and 3.86%) (P < 0.05). The same significantly higher transfer proportions(P < 0.05) were observed for Staphylococcus aureus enriched in the nasal cavity in AR children. Classification models by random forest regression at species levels showed, bacterial species enriched in indoor dust, nasal and dermal samples had substantial power in distinguishing AR children from healthy ones, with the highest power in the dust samples (AUC = 0.88) followed by nasal(AUC = 0.81) and dermal ones(AUC = 0.80).ConclusionsOur study presented the microbial enrichment characteristics in AR children both in the living environment(dust) and body sites exposed to environment through inhalation(nasal cavity), contact(skin) and ingestion(oral cavity) pathways, respectively. Nasal S.epidermidis and S.aureus had dominant influences on dust and other body sites in AR children.

Phenotype-to-Genotype Description of Prenatal Suspected and Postnatal Discovered Upper Limb Anomalies: A Retrospective Cohort Study.

To evaluate phenotype and genotype characteristics of fetuses and children with upper limb anomalies. Retrospective cohort study of a prenatal and postnatal cohort with upper limb anomalies from January 2007 to December 2021 in a Fetal Medicine Unit. Prenatally on ultrasound suspected upper limb anomalies, such as transverse and longitudinal reduction defects, polydactyly, and syndactyly, and postnatally identified children referred to the Congenital Hand Team were evaluated separately. The prenatal group included 199 pregnancies: 64 transverse and 19 longitudinal reduction defects, 103 polydactylies, and 13 cases with syndactyly. The majority of cases with longitudinal reduction defects (n=10, 52.6%), polydactyly (n=62, 60.2%), and syndactyly (n=10, 76.9%) were non-isolated, as opposed to transverse reduction defects, which were generally isolated (n=41, 64.1%). The postnatal cohort included 362 children with upper limb anomalies with 49 transverse and 22 longitudinal reduction defects, 226 polydactylies, and 65 syndactylies. Chromosomal or monogenic abnormalities were identified in 76/199 (38.2%) cases of the prenatal cohort and in 31/362 (8.6%) cases of the postnatal cohort. Prenatal identification of minor defects of the digits is a challenge, with more postnatal than prenatal cases. The majority of cases with isolated anomalies in both groups had no underlying chromosomal or monogenic cause, nor were they associated with a syndrome, as compared to the non-isolated cases. Conducting structural anomaly scans and genetic counseling are crucial to assess the risk of genetic abnormalities.

Right ventricular volume overload reboots cardiomyocyte proliferation via immune responses

BackgroundRight ventricular volume overload (RVVO) is one of the most important hemodynamic characteristics in children with congenital heart disease (CHD) and heart failure, and cardiomyocyte (CM) proliferation is one of the most vital factors for improving cardiac performance. However, whether and how RVVO reboots CM proliferation remains elusive.Methods and resultsWe first created a neonatal RVVO mouse model via abdominal aorta and inferior vena cava-fistula microsurgery at postnatal day 7 (P7), the edge of CM proliferation window. We subsequently performed bulk RNA-seq, single cell RNA-seq/flow cytometry, and immunofluorescence staining on the right ventricles (RV) of RVVO mice at P14/P21, defined as prepubertal stage, revealing that RVVO temporarily reboots prepubertal CM proliferation via immune responses.ConclusionsIn considering the importance of RVVO and CM proliferation, this study may bring an opportunity to create a novel paradigm to treat pediatric CHDs or heart failure.Graphical

The effect of retrieval-induced forgetting for pain-related memories on child pain-related outcomes: A randomized experimental study.

Children's inability to forget the negative aspects of a painful event is associated with more anticipatory anxiety at an upcoming pain task and lower pain thresholds; however, the impact of forgetting on children's pain outcomes has not been examined. Retrieval-Induced Forgetting (RIF) was experimentally induced to investigate whether children would (1) forget more negative details of a previous painful autobiographic event and; (2) report better pain-related outcomes for an unrelated pain task (i.e., cold pressor task; CPT). Additionally, it was investigated whether the success of RIF was dependent on child characteristics known to influence children's memories for pain (i.e., attention bias to pain, attention switching ability and pain catastrophizing). Healthy school children (N = 128; 9-16 years old) recalled and rehearsed memory details of two painful autobiographical events, while only children in the randomized RIF group rehearsed positive details. All children underwent two CPTs (before and after RIF) and reported pain-related outcomes. Two weeks later, children recalled CPT pain and reported on future pain expectancies. Children in the RIF group remembered less negative details of their past autobiographical pain events, but also reported a greater reduction in pain-related fear from the CPT 2 compared to their ratings for CPT 1, than children in the control group. They furthermore expected less pain-related fear 2 weeks later for a future pain task. Findings suggest that RIF is a promising avenue in pediatric pain management that could be harnessed to foster more positive memories and better future pain experiences. Retrieval-induced forgetting (RIF) makes children forget negative details of a past autobiographical pain experience, decreases experienced pain-related fear for experimental pain and lowers future pain-related fear expectancies. Results show a promising role for RIF- based memory interventions in the context of paediatric pain care.

Cohort profile: the WHO Child Mortality Risk Stratification Multi-Country Pooled Cohort (WHO-CMRS) to identify predictors of mortality through early childhood

PurposeTo provide details of a pooled data set that will be used to estimate absolute and relative mortality risks and other outcomes among children less than 59 months of age...

Injury Patterns and Associated Demographic Characteristics in Children with a Fracture from Equines: A US National Based Study

Background: Fractures often occur due to equestrian activities with injury patterns varying by age. The purpose of this study was to investigate in detail fracture patterns and associated demographics in children due to equine activities. Materials: The US National Electronic Injury Surveillance System was queried for all injuries with the consumer product code 1239 (horseback riding) from 2000 to 2023. Those &lt;16 years old with fractures were extracted. Statistical analyses were performed with SUDAAN 11.0.01™ software to obtain national estimates. Results: There were an estimated 101,677 patients with a fracture. Girls comprised 72.5% and the patient was discharged from the hospital in 81.5% of cases. Fractures involved the upper extremity in 80,973 (80.0%), the pelvis/lower extremity in 11,794 (11.7%), the spine in 3060 (3.0%), the skull/face in 4321 (4.4%), and the rib/sternum in 940 (0.9%). The humerus, elbow, radius/ulna, and wrist accounted for 62.4% of all the fractures. The youngest age group (0- to 5-year-olds) had more boys and was more likely to be admitted to the hospital. The child was injured due to a fall from the horse in 75.7%, bucked/thrown off/kicked off in 17.0%, with the remaining 7.3% from other mechanisms. Conclusions: This extensive description of fractures in children due to equestrian injuries can be used to determine the effectiveness of future prevention strategies, such as protective equipment and educational programs. It also gives pediatric trauma and orthopedic surgeons an overall view of the types of fractures which occur in children due to equestrian activities.

Exploring the relationship between dyscalculia and working memory in Egyptian children

BackgroundDyscalculia, a specific learning disorder per the Diagnostic and Statistical Manual Fifth Edition (DSM-5), involves difficulties in math domains. Research on working memory’s link to dyscalculia is crucial for effective interventions in children with the disorder. This study aims to examine the cognitive characteristics of Egyptian children with developmental dyscalculia by evaluating their performance in verbal and visuospatial working memory. A cross-sectional study was conducted at the Unit of Phoniatrics, Ain Shams University. The study included 60 children, aged 8–11 years, split into two groups: 30 diagnosed with dyscalculia (with or without dyslexia), and 30 with typical development, matched for age and sex, and without any communication, language, speech, or learning disabilities. Both tests—the Test of Mathematical Abilities (TOMA-3) and the working memory test—were administered to both groups.Results and conclusionCases group show notably lower scores on tests measuring dyscalculia and working memory when compared to the control group. The highest percentage of impairment observed is in visual memory. However, there is no clinically significant difference between phonological (auditory) memory and visual memory. The correlation analysis indicated that the visuospatial sketchpad correlates with mathematical symbols and computations, while the phonological (auditory memory) shows a significant positive correlation with word problems.

The Role of Parenting in Cultivating Environmental Attitudes in Early Childhood in Digital Era

In this digital era, parenting plays an important role in shaping environmental awareness and nature-friendly behavior in early childhood. Children at this time are often exposed to technology from an early age, so excessive use can affect children's attitudes and behavior towards the environment. This study aims to identify the role of appropriate parenting on environmental care in the digital era in early childhood. This research uses a qualitative study with a literature review research method by collecting various scientific sources. This research aims to convey information about how the role of parenting can affect children's environmental care attitudes in the digital era. An important finding in this study is that the role of parents in shaping children's character, especially in the digital era, is very important. Parents must understand the characteristics of children in the digital era, apply appropriate parenting patterns and build effective communication with children. The importance of applying democratic and authoritative parenting, in helping children develop positive environmental awareness. Therefore, the importance of early religious and moral values education as an effort to instill environmental awareness in children. Parents' involvement in children's learning, both at home and at school, is a key factor in shaping environmental awareness in early childhood.

Characteristics of Young Children Associated with Diagnostic Utility of the Autism Diagnostic Observation Schedule: A DBPNet Study

Abstract Objective: The aim of this study is to identify characteristics of children for whom a developmental-behavioral pediatrician's (DBP) diagnostic impressions of autism spectrum disorder (ASD) or non-ASD were changed by Autism Diagnostic Observation Schedule (ADOS) results. Method: A prospective study of children 1½ to &lt;6 years consecutively referred to 8 sites for possible ASD. Cognitive/developmental, language, and adaptive testing varied, as each site followed its usual clinical approach. DBPs documented diagnosis as ASD or non-ASD and their degree of diagnostic certainty (1–10) pre- and post-ADOS. Cases where DBP diagnostic impression did not change after ADOS administration (“Stable Group,” n = 314) were compared with those for whom it did change (“Changed Group,” n = 35), followed by matched random sample comparisons. Results: There were no significant differences in child characteristics (age, gender, race, ethnicity, insurance, caregiver education) between the Stable and Changed groups. DBPs' diagnostic certainty was significantly lower, both pre- and post-ADOS, in the Changed versus Stable group. Change was associated with milder symptoms of ASD and less impaired language. In an age- and gender-matched comparison, significant differences remained for diagnostic certainty and severity of social communication impairments. Cognitive scores were significantly higher in the Changed Group. Because of significantly higher caregiver education and a trend toward more privately insured children among the Changed Group, samples (n = 35 each) were then matched on those characteristics, revealing the same differences for diagnostic certainty, severity of ASD symptoms, and language skills. Conclusion: Young children with milder ASD symptoms and less impaired language may benefit most from the administration of the ADOS.

Effects of the COVID-19 Pandemic on Early Childhood Development and Mental Health: A Systematic Review and Meta-Analysis of Comparative Studies

From 2020 to 2023, the coronavirus-19 (COVID-19) pandemic exposed children to a variety of adverse childhood events, including parental loss, abuse, and disruption in services, and it exacerbated societal inequities. Studies evaluating the mental health of older children and adolescents reported increases in depression and anxiety symptoms, but no reviews have addressed the effects of the pandemic on preschool children. This systematic review and meta-analysis is the first to explore these effects. The goal was to analyze and synthesize longitudinal cohort studies to determine impact of the COVID-19 pandemic on the development and mental health of young children. Searches of multiple databases were performed for studies published between 2018 and 2023 with pre- and post-pandemic evaluations of the mental health or development of preschool children (aged 0–6 years) using objective measures and according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Cohen’s d effect sizes were calculated for each study that utilized the Strengths and Difficulties Questionnaire (SDQ), Ages and Stages Questionnaire (ASQ), or the Child Behavior Checklist (CBCL). Random-effects mixed models combined the estimates of effect sizes to calculate the overall mean effect size. The meta-analyses included 22,348 children from 16 countries. The analyses showed small increases in emotional symptoms and conduct problems, as well as increases in emotional reactivity, anxiety/depression, withdrawal symptoms, attention problems, and aggressive behaviors. A decrease in fine motor and personal–social skills was noted. Studies not included in these meta-analyses also showed negative effects on language and executive function. This systematic review characterizes the detrimental effects of the COVID-19 pandemic on the mental health and development of preschool children across the world. Our results suggest the vulnerability of early childhood to pandemic-related disruptions, although the heterogeneity in study design and child characteristics may limit some of these conclusions.