Critical Developmental Period Research Articles

A developmental critical period for ocular dominance plasticity of binocular neurons in mouse superior colliculus

Detecting visual features in the environment is crucial for animals' survival. The superior colliculus (SC) is implicated in motion detection and processing, whereas how the SC integrates visual inputs from the two eyes remains unclear. Using invivo electrophysiology, we show that mouse SC contains many binocular neurons that display robust ocular dominance (OD) plasticity in a critical period during early development, which is similar to, but not dependent on, the primary visual cortex. NR2A- and NR2B-containing N-methyl-D-aspartate (NMDA) receptors play an essential role in the regulation of SC plasticity. Blocking NMDA receptors can largely prevent the impairment of predatory hunting caused by monocular deprivation, indicating that maintaining the binocularity of SC neurons is required for efficient hunting behavior. Together, our studies reveal the existence and function of OD plasticity in SC, which broadens our understanding of the development of subcortical visual circuitry relating to motion detection and predatory hunting.

Adolescents and reproductive health: Promoting healthy habits for reproductive well-being

Adolescence is a critical period of human development in which physical, psychosocial, cognitive, and emotional aspects develop rapidly, especially the reproductive system. Adolescents must be prepared to face reproductive maturation, so they need some information that can solve the changing of their body. Health education about reproductive health is very important to do as an effort to increase knowledge in dealing with puberty. The reproductive health education program for adolescence in facing puberty is one solution that can be done to increase student’s knowledge about reproductive health. This activity aims to increase adolescence knowledge about reproductive health system in adolescence. The community service program was completed by providing health education to 38 students in Banyuurip elementary school, Yogyakarta using games, giving materials, and conducting disscussions.
 Activities were evaluated by using pretest and post-test scores. There was a significant difference in the participants’ knowledge level before and after the reproductive health education. Previously, 52% of participants were in the less category, 42% of them was in sufficient category, and only 5% was in good category. After the reproductive health education was carried out, most of the students had good knowledge at 71%, 29% had sufficient knowledge, and no students had insufficient knowledge. In conclusion, reproductive health education is proven to be able to increase students' knowledge in dealing with puberty and care for reproductive organs.
 Keywords: Early adolescent, health education, reproductive health

Puberty, brain network connectivity and neuropsychiatric outcomes following pediatric traumatic brain injury in females: A research protocol.

Examining the role of sex on recovery from pediatric TBI (pTBI) is a complex task, specifically when referring to injuries occurring during critical developmental and maturation periods. The effect of sex hormones on neurological and neuropsychiatric outcomes has been studied among adult TBI females, but not in children. During development, puberty is considered a key milestone accompanied by changes in physical growth, neuronal maturation, sex hormones, and psychological symptoms. Following pTBI, such changes might have a significant effect on brain re-organization and on long-term neuropsychiatric outcomes. While hormonal dysfunction is a common consequence following pTBI, only few studies have systematically evaluated hormonal changes following pTBI. To describe a multimodal protocol aimed to examine the effect of puberty on brain connectivity and long-term neuropsychiatric outcomes following TBI in female girls and adolescents. A case-control longitudinal prospective design will be used. 120 female participants aged 9 to 16 years (N = 60 per group) will be recruited. In the acute phase (T0-1 month), participants will undergo an MRI protocol for brain connectivity, as well as a clinical evaluation for puberty stage and hormonal levels. In the chronic phase (T1-18-24 months), participants will complete a neuropsychiatric assessment in addition to the MRI and puberty evaluations. Hormonal levels will be monitored at T0 and T1. A moderation-mediation model will be used to examine the moderating effects of puberty on the association between pTBI and neuropsychiatric symptoms in female girls and adolescents, through the mediating effect of brain network connectivity. This study will highlight sex-specific factors related to outcomes among females following pTBI and enhance our understanding of the unique challenges they face. Such information has a substantial potential to guide future directions for research, policy and practice.

PELATIHAN PSIKOEDUKASI UNTUK MENINGKATKAN HARGA DIRI PADA REMAJA

A critical period in an individual's development, adolescence is distinguished by cognitive, physical, and environmental transformations. This study examines the significance of adolescent self-esteem, particularly in rural regions where mental health services and educational opportunities are scarce. In order to foster students' self-esteem awareness, community service was organised in MA Anjasmoro, Jarak Village, Jombang Regency. Eleven MA Anjasmoro students participated in the implementation of psychoeducational training; the results indicated a significant increase in self-esteem following the training. The statistical significance of the difference between the pretest and posttest was confirmed by the Wilcoxon test. In addition to enhancing students' knowledge, the training facilitated the growth of their social and emotional competencies. The findings of the research indicated that the implementation of psychoeducation at MA Anjasmoro effectively enhanced the self-esteem of adolescent students. Students gained new insights regarding character, positive mentality, and positive behaviours as a result of these findings. Psychoeducation has surfaced as a viable substitute for enhancing the self-esteem of adolescents, particularly within the educational landscape of rural regions.

Stunting and Associated Factors among Children Under Five Years in Yemen during the Conflict Period

It remains a significant public health problem in many low and middle-income countries, particularly in Yemen, related to nutritional deficiencies during the most critical periods of growth and development in early childhood. The purpose of this study was to determine the predictors of stunting and the associated factors among Yemeni children under 5 years of age. This study was conducted using a cross-sectional design among 434 mothers and their children aged 6-59 months. Data were collected through face-to-face interview using the structured questionnaire that consists of 28 items. Anthropometric indicator, height-for-age was determined using the current World Health Organization (WHO) growth standards. An analysis of the data was conducted using a multivariable logistic regression model. Statistical significance was determined by the Adjusted Odds Ratio (AOR) and 95% Confidence Interval (CI) from the multivariable analysis. The prevalence of stunting among children under the age of five was 46.1%. According to the multivariable analysis, stunting is statistically associated with children aged 13-24 months (AOR 2.04), 25-36 months (AOR 2.27), 37-48 months (AOR 2.38), secondary education of the father (AOR 0.31), household size of five members (AOR 0.66), and flushed or poured toilets (AOR 1.91). In Yemen, family-specific factors are the primary contributors to stunted development in children. There is a need to emphasize interventions related to food, nutrition, and overall hygiene to reduce malnutrition in the studied region and the country as a whole.

Cortical Structure in Pre-Readers at Cognitive Risk for Dyslexia: Baseline Differences and Response to Intervention.

Early childhood is a critical period for structural brain development as well as an important window for the identification and remediation of reading difficulties. Recent research supports the implementation of interventions in at-risk populations as early as kindergarten or first grade, yet the neurocognitive mechanisms following such interventions remain understudied. To address this, we investigated cortical structure by means of anatomical MRI before and after a 12-week tablet-based intervention in: (1) at-risk children receiving phonics-based training (n = 29; n = 16 complete pre-post datasets), (2) at-risk children engaging with AC training (n = 24; n = 15 complete pre-post datasets) and (3) typically developing children (n = 25; n = 14 complete pre-post datasets) receiving no intervention. At baseline, we found higher surface area of the right supramarginal gyrus in at-risk children compared to typically developing peers, extending previous evidence that early anatomical differences exist in children who may later develop dyslexia. Our longitudinal analysis revealed significant post-intervention thickening of the left supramarginal gyrus, present exclusively in the intervention group but not the active control or typical control groups. Altogether, this study contributes new knowledge to our understanding of the brain morphology associated with cognitive risk for dyslexia and response to early intervention, which in turn raises new questions on how early anatomy and plasticity may shape the trajectories of long-term literacy development.

A Scoping Review on Energy Drink Consumption Among Adolescents and Young Adults

This scoping review aimed to identify empirical studies that have explored the use of energy drink consumption among adolescents and young adults. Method: A scoping review search was conducted in the following five databases: PubMed, Embase, Lilacs, Scopus, and Psycnet. Some inclusion criteria, such as being published in the last 10 years, and exclusion criteria, such as article type, animal-model usage, and age, were used to select the studies, and 11 were analyzed independently. Results: The results showed that adolescents use energy drinks for many factors, such as connection with peers and family, propaganda, and taste. Some studies have been developed in Australia and the United States of America, and some have explored other variables associated with energy drinks and alcohol use. Conclusion: It is essential to understand how energy drink consumption and behaviors are related to health or risky behavior and its associations with other drugs. More research is needed to explore the long-term health impacts of energy drink consumption during the critical developmental periods of childhood and adolescence, as well as its association with alcohol and other substances. The findings underline the importance of stringent regulations, public health policies, and educational initiatives to mitigate the risks associated with energy drink consumption among adolescents. Future research is essential to understand the long-term implications and develop effective preventive strategies to safeguard adolescent health and well-being.

Adolescent morphine exposure changes the endogenous vlPAG opioid response to inflammatory pain in rats.

Adolescence is one of the most critical periods for brain development, and exposure to morphine during this period can have long-life effects on pain-related behaviors. The opioid system in the periaqueductal gray (PAG) is highly vulnerable to drug exposure. However, the impact of adolescent morphine exposure (AME) on the endogenous opioid system in the PAG is currently unknown. This study aims to investigate the long-lasting effects of AME on the endogenous opioid system and its involvement in altering nociceptive behaviors. Adolescent rats were given escalating doses of morphine (2.5-25mg/kg, subcutaneous) or an equal volume of saline twice daily for 10 consecutive days (PND 31-40). After a 30-day washout period, adult rats underwent formalin tests following microinjection of morphine, naloxone, or saline into the ventrolateral PAG (vlPAG) region. The results indicated that morphine microinjection into the vlPAG of the adolescent morphine-treated group significantly reduced the nociceptive score. However, the analgesic response to morphine in this group was significantly lower compared to the saline-treated group during adolescence. Additionally, the nociceptive score significantly increased following naloxone but not saline microinjection into the vlPAG of the saline-treated group during adolescence, rather than the morphine-treated one. These findings indicate that AME has long-lasting effects on the endogenous opioid system in the vlPAG, which can consequently alter behaviors related to inflammatory pain in adulthood.

Adolescent social housing protects against adult emotional and cognitive deficits and alters the PFC and NAc transcriptome in male and female C57BL/6J mice.

Adolescence is a critical period in cognitive and emotional development, characterized by high levels of social interaction and increases in risk-taking behavior including binge drinking. Adolescent exposure to social stress and binge ethanol have individually been associated with the development of social, emotional, and cognitive deficits, as well as increased risk for alcohol use disorder. Disruption of cortical development by early life social stress and/or binge drinking may partly underlie these enduring emotional, cognitive, and behavioral effects. The study goal is to implement a novel neighbor housing environment to identify the effects of adolescent neighbor housing and/or binge ethanol drinking on (1) a battery of emotional and cognitive tasks (2) adult ethanol drinking behavior, and (3) the nucleus accumbens and prefrontal cortex transcriptome. Adolescent male and female C57BL/6J mice were single or neighbor housed with or without access to intermittent ethanol. One cohort underwent behavioral testing during adulthood to determine social preference, expression of anxiety-like behavior, cognitive performance, and patterns of ethanol intake. The second cohort was sacrificed in late adolescence and brain tissue was used for transcriptomics analysis. As adults, single housed mice displayed decreased social interaction, deficits in the novel object recognition task, and increased anxiety-like behavior, relative to neighbor-housed mice. There was no effect of housing condition on adolescent or adult ethanol consumption. Adolescent ethanol exposure did not alter adult ethanol intake. Transcriptomics analysis revealed that adolescent housing condition and ethanol exposure resulted in differential expression of genes related to synaptic plasticity in the nucleus accumbens and genes related to methylation, the extracellular matrix and inflammation in the prefrontal cortex. The behavioral results indicate that social interaction during adolescence via the neighbor housing model may protect against emotional, social, and cognitive deficits. In addition, the transcriptomics results suggest that these behavioral alterations may be mediated in part by dysregulation of transcription in the frontal cortex or the nucleus accumbens.

STUDY OF STRESS RESISTANCE OF OILSEED RADISH VARIETIES TO SUBZERO TEMPERATURES BY CHLOROPHYLL PHEOPHYTINIZATION

The article highlights the results of studying the peculiarities of the formation of stress resistance of 14 oilseed radish varieties of different ecological and geographical origin to subzero temperatures in the context of 5 basic phenological stages (cotyledon phase (BBCH 10), rosette phase (BBCH 14–16), stemming phase (BBCH 34–36), budding phase (BBCH 50–52) and flowering phase (BBCH 65–67)) with a temperature range of -1.0... -12.0 °C with an experimental step of 1.0 °C decrease based on the tested method of chlorophyll phytophytinization after the physiologically appropriate period of freezing of the calves. The peculiarities of stress reactions in terms of the proportion of phytophytinized leaf surface were investigated based on the processing of scanned images of leaf blades taken from living plants at the appropriate stages of their growth and development. The physiological aspects and literature sources on the assessment of temperature tolerance of cruciferous plant species, in particular radish subspecies, were analyzed and generalizations were made about the adaptive potential of oilseed radish as a species for the conditions of the Right-Bank Forest-Steppe of Ukraine. On the basis of a long-term period of research (2015–2022), the optimal physiological interval of the reaction of different genotypes of oil radish to subzero temperatures was estimated and the most stable phenological phases in relation to the frost resistance of plants were determined by the indicator short-term express reaction of leaf tissues based on the results of their freezing under controlled conditions. A dynamic series of oilseed radish varieties was determined in the direction of increasing the genotype stress resistance to subzero temperatures for the averaged values in the interval from the cotyledon phase to the flowering phase: Lybid, Zhuravka, Ramonta, Ivea, Nika, Prygazhunya, Sabina, Fakel, Rainbow, Alpha, Snizhana, Tambovchanka, IRGSGI Line, Olga. The influence of the total stress of oilseed radish plants based on the value of the hydrothermal coefficient (HTC) during the growing season on the determination of stress resistance to low temperatures was assessed and it was concluded that the combinatorial nature of the formation of pre-adaptive reactions of oilseed radish plants to low temperatures. At the same time, the nature of dynamic changes in the curve of phytophytinization of leaf tissue chlorophyll was determined, which can be used to indirectly analyze deviations in resistance to subzero temperatures during critical periods of growth and development of oilseed radish plants. Additionally, the dynamics of the formation of the leaf chlorophyll phytophytinization index in 14 oilseed radish varieties was evaluated with the detailing of this process at different phenostages of growth and development, and the level of lethality of this process at the corresponding value of the applied freezing temperatures was noted. The article formulates the prospects for further research in the field of optimization of diagnostics of oilseed radish plants stress resistance to subzero temperatures based on the new proline biochemical method of identification at the tissue level.

Predictors of COVID-19-related posttraumatic stress and anxiety symptoms in high school students in China

Youth may be particularly vulnerable to negative consequences of the COVID-19 pandemic due to acute and chronic stressors (e.g., social distancing) during a critical period of development. The present study examined factors associated with COVID-19-related posttraumatic stress and anxiety in high school students in China (N = 294) during May 2020. Logistic and zero-inflated negative binomial regression were used to evaluate the effects of self-reported prior mental health concerns, duration of isolation/quarantine measures, impact from the pandemic, behaviors changed during COVID-19, and attitudes surrounding the pandemic on self-reported anxiety and pandemic-related posttraumatic stress. Self-reported history of mental health concerns significantly predicted anxiety and pandemic-related posttraumatic stress. While timing likely contributed to lower rates of clinically significant outcomes than have been reported in other studies, some students exhibited signs of enduring distress. History of mental illness may be a sign of negative psychological outcomes in adolescents and should prompt further screening.

Are the first 1,000 days of life a neglected vital period to prevent the impact on maternal and infant morbimortality of infectious diseases in Latin America? Proceedings of a workshop of experts from the Latin American Pediatric Infectious Diseases Society, SLIPE

While the first 1,000 days of life are a critical period in child's development, limited information on the main determinants affecting this period in the Latin America and the Caribbean (LAC) region is available. Therefore, the Latin American Pediatric Infectious Diseases Society (SLIPE) held an ad hoc workshop in May 2022 with an expert panel designed to analyze the main factors impacting the development of childhood in the region during this period and the main causes of maternal infant morbimortality. The aim was to identify priorities, generate recommendations, and advise practical actions to improve this situation. Considerations were made about the challenges involved in bridging the gap that separates the region from more developed countries regarding an optimal early childhood and maternal care. Extensive discussion was conducted to reach consensus recommendations on general strategies intended to reduce maternal and infant mortality associated with infections and immune-preventable diseases during the first 1,000 days of life in LAC.

Critical Periods in Cognitive and Socioemotional Development: Evidence from Weather Shocks in Indonesia

Abstract Early-life circumstances are important determinants of long-run human capital and well-being outcomes. The first 1,000 days of life are often cited as a ‘critical period’ for child development, but this notion has rarely been directly tested. In a setting where children are potentially subject to shocks in every year of their childhood, I estimate the impact of early-life weather shocks on adult cognitive and socioemotional outcomes for individuals born in rural Indonesia between 1988 and 2000. There is a strong critical period for these shocks at age two for cognitive development, but no evidence for a similar critical period for socioemotional development. The effects appear to be driven by changes in agricultural income and nutritional investment. The impacts are initially latent, only appearing after age 15. I show suggestive evidence for dynamic complementarity in early-life investments.

Sexual Health in Young Adult Patients after Chimeric Antigen Receptor T-Cell Therapy

Background: Chimeric antigen receptor T-cell therapy (CAR T) has shown significant promise for treating relapsed/refractory hematologic malignancies. Although there is growing literature on immune mediated toxicities, studies examining late effects and survivorship concerns are limited. Sexual health is an important survivorship issue with implications for overall health-related quality of life (HRQOL) and is particularly relevant for young adults (YAs) aged 18-39 years. For YAs, cancer co-occurs with a critical period of physical and psychosocial development during which romantic relationships are formed and physical, psychosocial, and sexual milestones are achieved. No studies have evaluated sexual health among YAs treated with CAR T. To address this knowledge gap, we conducted a mixed methods study to examine sexual health and HRQOL after CAR T among YAs and explore communication about sexual health between YA CAR T recipients and their healthcare providers. Methods: This was a cross-sectional, single center study conducted at Moffitt Cancer Center. Participants were adults aged 18-39 years treated with CAR T. Participants were asked to complete a one-time survey and an individual semi-structured interview. The survey included short form measures from the Patient-Reported Outcomes Measurement Information System (PROMIS) assessing sexual health (desire/interest in sexual activity, sexual function, sexual satisfaction) and HRQOL (depression, anxiety, fatigue, sleep disturbance, pain interference, global pain, physical function, social function, cognitive function, emotional impact). PROMIS scores were calculated as T-scores with a normative M=50, SD=10, and a minimally important difference (MID) of 5 points. The survey also included study-specific items assessing patient-provider communication about sexual health. For qualitative data collection, a semi-structured interview guide was used to assess the impact of cancer and CAR T on participants' sexual health and HRQOL, as well as patients' experiences with communicating about sexual health with providers, partners, and their broader support system during and after treatment. Preliminary analysis included descriptive statistics for quantitative data in relation to evidence-based thresholds, and a preliminary thematic analysis of qualitative data. Results: In total, n=13 YA CAR T recipients completed the study survey, and n=10 agreed to participate in individual semi-structured interviews. Participant characteristics are depicted in Table 1. Median age of participants was 35 years (range: 21-39), 61.5% identified as male, and the majority (92.3%) identified as heterosexual. Median time since CAR T infusion was 30 months (range: 1-50). Quantitative data overall and by biological sex are summarized in Table 2. Average interest in sexual activity was low among females (M=35.1, SD=10.0) but not males (M=48.7, SD=10.3). All other average scores were within normal ranges. Several differences in average scores between males and females exceeded the 5-point MID, with female participants reporting less interest in sexual activity, worse fatigue, more impaired social function, and worse emotional impact. Most YAs had not discussed (46.2%) or did not remember discussing (38.5%) sexual health with a healthcare provider before CAR T. Most (76.9%) had not discussed sexual health with a healthcare provider since receiving CAR T. Three major themes emerged from the qualitative data: 1) YAs perceive a lack of awareness of YA sexual health priorities among their healthcare team, 2) There is a lack of communication and information about potential sexual health side effects after CAR T, and 3) Parents as caregivers are a barrier to YAs communicating with their healthcare team about sexual health. Conclusion: This was the first study to explore sexual health outcomes among YA cancer survivors treated with CAR T. Findings highlight a need for improved patient-provider communication regarding sexual health and more publicly available educational resources. Providers may prioritize one-on-one discussions with patients and limit parent involvement when discussing sexual health needs. As the population of CAR T survivors continues to grow, it is imperative to examine patient reported outcomes and late effects to improve survivorship outcomes. Author Note: AB & VIG share first authorship. LO & RF share senior authorship.

Sexual dimorphism in anxiety is programmed in-utero by sex-steroids: Proof of concept using a disease-model and stress responses to COVID pandemic

Sex differences in the psychological impact of the COVID-19 pandemic have been consistently reported, showing disproportionally high rates of anxiety/distress in women relative to men. The mechanisms underlying this sexual dimorphism remain unclear. The present study queries the potential protective role of early hyperandrogenism on brain development. A natural model of sex-steroids abnormality, classic congenital adrenal hyperplasia (CAH), was used to test this question. CAH is characterized by adrenal androgen overproduction in utero (prenatal) through the neonatal critical developmental period. An online survey collected information on subjective responses to the COVID-19 pandemic. Matched on demographic variables, 60 adults carrying a diagnosis of classic CAH and 240 adults from the general population (non-CAH) were compared on levels of anxiety/distress in the first year of the COVID-19 pandemic (May 2020-April 2021). Structural Equation Modeling was used to test the modulation by CAH status of Sex effects on anxiety/distress. Results revealed lower levels of anxiety/distress in the female CAH group compared to the other 3 groups (male CAH, female non-CAH, and male non-CAH). This finding suggests that pre-neonatal hyperandrogenism might impact the development of neural circuits underlying anxiety processes, in a way that enhances resilience to chronic stress.

Experiences of adolescents using sexual health services on Reunion Island: protocol for a qualitative phenomenological study

IntroductionAdolescence and early adulthood are often critical periods of sexual development. The discovery of sexual intercourse can lead to sexual risk-taking which may impact the incidence of sexually transmitted infections...

Parent Perspectives: Part 2-Considerations for the Transition Home Post-NICU Discharge.

This paper is part two of a series of papers written by the mothers of Neonatal Intensive Care Unit (NICU) graduates. The companion paper, "Parent Perspectives: Part 1-Considerations for Changing the NICU Culture", considers all aspects of the NICU experience and provides recommendations for interventions and improvements from a life-course perspective while families are in the NICU. In part two, the focus is the transition home post-NICU stay. The time after NICU discharge is a critical and sensitive developmental period for NICU babies and their families, and an important life course transition. This paper provides a parent's perspective of how to improve the transition home post-NICU stay. Our perspectives draw on the Life Course Health Development approach, which regards health as an active process that is developed over time based on a person's internal biologic and physiologic systems, their external environment and circumstances, and the interactions or relationships between them. This paper describes a collaborative care model where parents and their healthcare teams work together to develop shared care plans. It also describes how we can build trust and family capacity to support long-term care, ensure family well-being, and link families to needed resources and support that can ease the transition from the NICU back to the home and optimize family health trajectories.

The Relationship Between Parenting Style and Adolescents Depression

Adolescence is a critical period of an individuals development. The family factor has a profound and far-reaching influence on adolescents. The present study investigates the relationship between parental practices and adolescent depression during the crucial adolescent transitional period. The four parenting philosophies of authoritarian, permissive, authoritative, and neglectful are identified. Due to a lack of research, the neglectful parenting style is not summarized in this work. A protective factor against adolescent depression occurs in the authoritative style, which is high in control and acceptance. The authoritarian style, which values control over acceptance, on the other hand, has a negative effect on the course of depression. The permissive style produces inconsistent results in different research in different cultural backgrounds. Overall, this study highlights the important role that parenting practices have in teenage mental health and recommends specific interventions to promote well-being. Some limitations of prior research and future research directions are also discussed.

Unveiling early childhood health inequities by age five through the national neighborhood equity index and the early development instrument

There is growing public urgency to close equity gaps in health and development by addressing inequities at multiple levels of children’s developmental ecosystems. Current measurement strategies obscure the dynamic structural and relational patterns of oppression, adversity, and disadvantage that children can experience in their local intimate developmental ecosystem, as well as the leverage points that are necessary to change them. The purpose of this study is to examine the relationship between a universally available measure of neighborhood socio-economic context, the National Neighborhood Equity Index (NNEI), and a population measure of early child development and well-being, the Early Development Instrument (EDI). Data from a convenience sample of 144,957 kindergarteners in neighborhoods across the US demonstrate that children living in neighborhoods with more equity barriers are more likely to be on vulnerable developmental trajectories than those who reside in neighborhoods without any equity barriers. A multi-dimensional measurement approach that incorporates both the EDI and the NNEI can be used to quantify ethnoracialized patterns of structural disadvantage during critical periods of health development. These measures can inform community action to intervene early in the lifecourse to optimize children’s health development trajectories at a population level.

Parent perspectives of engaging with a community paediatric clinic with linked child development supports in a disadvantaged area of Ireland.

Parent experiences of child health services can be used to understand their value and optimise the support provision to families during critical developmental periods. A gap in the literature exists regarding parental perspectives of linked child development supports, particularly in disadvantaged areas. This study examined parent experiences of the impact and value of a community paediatric clinic (Kidscope) with linked, multi-agency supports in a disadvantaged area of Ireland. Using a qualitative analysis design, 10 parents participated in one-to-one interviews. A Community Advisory Group consulted on interview schedules. Data was thematically analysed in line with Braun & Clarke's Framework. Five themes and twenty-two sub-themes emerged. Kidscope's linked, multi-agency approach was valuable for engaging families, addressing developmental delay, supporting readiness for education, and developing parent-child relationships. Relational working and a child and family centred model of care empowered parents to become active agents in children's health. Coronavirus disease 2019, national deficits in healthcare, and staff turnover impeded service delivery. Kidscope and linked supports work in partnership to disrupt the impact exclusion from healthcare has on vulnerable children and families. This study provides evidence of an effective integrated paediatric service delivery model designed around vulnerable children and families and highlights areas for improvement.