Life In Children Research Articles

Nutritional management and autism spectrum disorder: A systematic review

BACKGROUND Autism spectrum disorder (ASD) presents unique challenges related to feeding and nutritional management. Children with ASD often experience feeding difficulties, including food selectivity, refusal, and gastrointestinal issues. Various interventions have been explored to address these challenges, including dietary modifications, vitamin supplementation, feeding therapy, and behavioral interventions. AIM To provide a comprehensive overview of the current evidence on nutritional management in ASD. We examine the effectiveness of dietary interventions, vitamin supplements, feeding therapy, behavioral interventions, and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD. METHODS We systematically searched relevant literature up to June 2024, using databases such as PubMed, PsycINFO, and Scopus. Studies were included if they investigated dietary interventions, nutritional supplements, or behavioral strategies to improve feeding behaviors in children with ASD. We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes. Data extraction focused on intervention types, study designs, participant characteristics, outcomes measured, and intervention effectiveness. RESULTS The review identified 316 studies that met the inclusion criteria. The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies, the effectiveness of these approaches varies. Feeding therapy and behavioral interventions, including gradual exposure and positive reinforcement, promise to improve food acceptance and mealtime behaviors. The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD. CONCLUSION Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications, supplementation, feeding therapy, and behavioral strategies. The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes. Collaborative efforts among healthcare providers, educators, and families are essential to optimize this population's nutritional health and feeding practices. Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.

Taste and smell are associated with dietary intake, eating behavior, nutritional status, and health-related quality of life in children with cancer

Background & aimsSmell and taste changes are frequently reported bothersome treatment symptoms during treatment for childhood cancer and assumed to influence outcomes such as food intake. Since nutritional status of children with cancer is already vulnerable, any detrimental effects on food intake should be prevented. Therefore, understanding the exact relationship between chemosensory changes and dietary intake, eating behavior, and other domains such as health-related quality of life (HRQoL), is important for improving outcomes. MethodsIn this longitudinal study, we followed 87 childhood cancer patients treated for hematological, solid, or brain malignancies. Smell (odor threshold and odor identification) and taste function (total taste score) were objectively investigated using commercial Sniffin’ Sticks and Taste Strips respectively, and by self-report. Dietary intake was measured using a 3-day food dairy. For nutritional status, BMI expressed as standard deviation scores was derived from medical records. Eating behavior and HRQoL were assessed by the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and PedsQL 4.0 Generic Core Scales, respectively. Measurements were taken approximately 6 weeks (T0), 3 months (T1), 6 months after starting chemotherapy (T2), and 3 months after termination of chemotherapy or maintenance phase for children with acute lymphoblastic leukemia (ALL) (T3). Dietary intake, eating behavior, nutritional status, and HRQoL were modelled over time using mixed model analysis. Associations between smell and taste (objective and self-report), as well as patient characteries were studied. ResultsEnergy intake significantly increased during the study period, with a higher age, BMI, and total taste scores associated to this increase. Boys had higher energy intake compared to girls. Eating behavior scores significantly declined, indicating less eating problems. Age, pre-diagnosis eating behavior, self-reported smell changes, and tube feeding were associated to eating behavior. BMI significantly increased, with a higher BMI at diagnosis to be related to a higher BMI during the study period. A lower BMI was found in children receiving tube feeding and self-reported taste changes. HRQoL improved during the study period, with lower HRQoL in children receiving tube feeding and self-reported taste changes. ConclusionBoth objective and subjective measures of taste and smell influence dietary intake, eating behavior, nutritional status, and HRQoL. Individual dietary advice and coping strategies are warranted to prevent detrimental effects of chemosensory changes on food intake and clinical outcomes in children with cancer.

Vaccination in hemophilic children: Challenges, innovations, and future directions

Introduction: Hemophilia, an inherited disorder primarily affecting blood clotting due to deficiencies in clotting factors VIII or IX, presents complex challenges for vaccination. Children with hemophilia require vaccinations to prevent infections that may exacerbate their bleeding disorder. However, traditional intramuscular vaccination poses bleeding risks, necessitating specialized administration methods and careful post-vaccination care. Purpose: This study examines the efficacy and safety of vaccination in pediatric hemophilia patients, emphasizing the importance of individualized protocols to manage bleeding risks effectively. It explores recent advancements, including needle-free technologies, the potential of gene therapy, and mRNA vaccines. Materials and Methods: The study synthesizes current guidelines from global health organizations, hemophilia management protocols, and clinical studies on vaccine safety in hemophilia. It highlights techniques such as subcutaneous administration, clotting factor prophylaxis, and the use of fine-gauge needles to minimize bleeding complications. Results: Findings indicate that with appropriate management, hemophilic children achieve adequate immune responses to vaccines, with reduced bleeding risks. Emerging technologies, such as microneedle patches, jet injectors, and gene therapy, offer promising safer vaccination alternatives. Additionally, mRNA vaccines demonstrate strong immunogenicity without the need for live-virus vectors, reducing complication risks. Conclusions: Vaccination, when adapted to hemophilia-specific needs, remains essential for infection prevention in this vulnerable population. Newer vaccine technologies and individualized care protocols enhance safety and efficacy, contributing to improved quality of life and long-term health outcomes for hemophilic children.

Reliability and validity of the Italian version of the Caregiver Priorities and Child Health Index of Life with Disabilities in children with cerebral palsy.

The Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD™) questionnaire is a reliable indirect indicator of functional, health status and quality of life in children with severe Cerebral Palsy (CP), as well as the caregiving burden. The aim of the study is to validate the Italian translation of Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD™) questionnaire and assess its reliability and validity. A cross-sectional study was conducted. The study involved 60 caregivers of children with CP, classified according to the Gross Motor Function Classification System (GMFCS) levels I-V. There was a self-compilation of the CPCHILD™ by primary caregivers during the clinical visit and a re-administration of the questionnaire 2-3 weeks after the first to a defined sample (N.=30, GMFCS IV-V). The Italian version of CPCHILD™'s psychometric properties were evaluated through internal consistency, test-retest reliability, and validity analyses. The translated CPCHILD™ questionnaire showed excellent test-retest reliability (Intraclass Correlation Coefficient - ICC=0.97) across most sections, with significant construct validity, differentiating well between the various GMFCS levels. The internal consistency was robust (Cronbach's alpha=0.852) except for the health section. The face validity indicated high relevance of the questionnaire items to the caregivers, particularly in emotional well-being and social interaction. The Italian version of CPCHILD™ questionnaire is a reliable and valid tool for assessing the quality of life in children with severe CP, offering insights into the care burden and health status impacts perceived by caregivers.

Leveraging Medico-Legal Interventions as a Last Resort to Save the Lives of High-Risk Mothers and Children: Case Studies From Rural Haryana, India

Leveraging Medico-Legal Interventions as a Last Resort to Save the Lives of High-Risk Mothers and Children: Case Studies From Rural Haryana, India

Religion as Life: Critical Content Analysis of Picturebooks About the Lives of Muslim Children

Religion remains an aspect of culture often missing from picturebooks, based on the misunderstanding that religion has no place in U.S. public schools. This absence is particularly critical for books reflecting the lives of Muslim children, given the rising Islamophobia in the United States. A critical content analysis to examine representations of Muslim children in contemporary picturebooks set in the United States was conducted through a postcolonial lens. Islamic religious practices are integrated into the daily lives of Muslim children in these books for an audience of Muslim and non-Muslim readers. The books represent Muslim children and their families as culturally and religiously diverse, portray religious differences as resources for communities, and reflect the hybrid identities of Muslim children. The books serve as counternarratives, creating a space for Muslim authors and illustrators to voice and validate their life experiences for a broad audience of readers.

Update on Cannabidiol in Drug-Resistant Epilepsy.

Cannabidiol (CBD) has arisen as a promising therapeutic option for children with drug-resistant epilepsy (DRE). CBD has received regulatory nod from different regulatory authorities in the United States, Europe, and India for children with DRE particularly, Dravet syndrome (DS), Lennox Gastaut syndrome (LGS), and Tuberous sclerosis complex (TSC). Recent clinical trials and observational studies highlight the potential of CBD to lower seizure frequency and provide better quality of life in children affected by these disorders. The safety profile is generally favorable with minor common adverse events such as somnolence, diarrhea, and gastrointestinal issues. Furthermore, the expense associated with CBD remains a notable concern, especially in low- and middle-income countries such as India, where access to this promising treatment may be constrained. This draws attention to the cost-effective perspective of CBD. This review aims to explore the pharmacological properties of CBD, its mechanisms of action, and the clinical evidence supporting its use in various pediatric epilepsies, including LGS, DS, and TSC. Additionally, this review sheds light on the current regulatory landscape in India where CBD use is still in its nascent stages, and discusses the challenges and opportunities for integrating CBD into clinical practice.

CACA guidelines for holistic integrative management of retinoblastoma

Retinoblastoma is the most common intraocular malignant tumor that poses a serious threat to the lives of children. Treatment plans for RB vary depending on the stage of the disease, and there is an uneven distribution of medical resources across different regions. To standardize the clinical diagnosis and treatment of RB, experts have conducted extensive discussions and proposed guidelines for RB diagnosis and treatment. These guidelines aim to improve the clinical management of RB and serve as a reference for clinicians in their practice.

ВИКОРИСТАННЯ ІНКЛЮЗИВНОЇ ЛІТЕРАТУРИ В ОСВІТНЬОМУ ПРОЦЕСІ ЗАКЛАДУ ДОШКІЛЬНОЇ ОСВІТИ

The article deals with the problem of inclusive preschool education, as well as the challenges of fostering a tolerant attitude towards children with special needs. The article highlights the ongoing search for effective tools to develop such tolerance. Among these tools, the authors mention inclusive toys, cartoons about children/people with disabilities, and children's literature. For their research, they focused specifically on children's literature, particularly a specific genre – inclusive literature. In the context of the study, inclusive literature that aims to form the concept of «personal diversity», as well as literature about the lives of children with special educational needs, their adventures, experiences, and desire for life, holds particular interest. The aim of the paper is to reveal the role of inclusive literature in the educational process of preschool institutions. To achieve this goal, a survey of preschool educators was conducted, which revealed that inclusive literature is underutilized in the educational process of preschools. This finding was confirmed by observations of the educational process and analysis of educators’ documentation. The research results showed that educators are insufficiently familiar with this genre of literature and require additional information on how to work with inclusive literature as a tool for fostering a tolerant attitude towards children with special educational needs. Methodological work with educators included three workshops: a mini-lecture with training elements titled «Inclusion – The Path to a Society of Equal Opportunities», a seminar-practicum titled «Inclusive Literature: What It Is and Its Role in the Educational Process of Preschools», and a practicum on the use of inclusive literature in the educational process of preschool institutions.

Impact of parenteral nutrition on quality of life, the family and gastrointestinal symptoms in children with intestinal failure.

Intestinal failure (IF) and dependency on parenteral nutrition (PN) are risk factors for lower health-related quality of life (HRQOL) in children. Weaning from PN is a major goal of paediatric IF treatment, however, its impact on HRQOL remains unclear. This study aimed to assess HRQOL, gastrointestinal (GI) symptoms and family impact in children with IF in relation to their need for PN. Data were collected in a cross-sectional study from children with IF and a reference group of healthy children using electronic versions of Paediatric Quality of Life Inventory™ forms. The study included 56 children with IF and 48 healthy children. Parents of children with IF reported significantly lower HRQOL than healthy children (-8.7, p = 0.001). PN dependency did not influence HRQOL scores, but families with children dependent on PN had a lower family impact score than children weaned from PN (49.9 vs. 73.6, p < 0.001). Parents of children in the PN group reported more GI problems than those in the weaned group (-8.1, p = 0.04), and diarrhoea, gas and bloating were common symptoms of IF. GI symptoms varied according to PN dependency and IF aetiology. Multivariate analysis found a significant association between HRQOL and total GI symptom score (parent scores: 0.34, p = 0.02, self-score 0.48, p = 0.02). Children with IF had lower parent-reported HRQOL than healthy children. PN dependency did not affect HRQOL, however, the need for PN had a significant negative impact on family well-being. GI symptoms may negatively impact HRQOL in the IF population.

Anxiety depression levels, anxiety sensitivity, and quality of life in children with chronic spontaneous urticaria: A cross-sectional study

Existing literature offers some insights into the prevalence of anxiety and depression in children with chronic spontaneous urticaria (CSU). However, the literature on anxiety sensitivity (AS) and quality of life (QoL) in these children remains poorly understood. This study aimed to evaluate psychiatric diagnoses, anxiety and depression levels, AS, and QoL in children with CSU compared to healthy controls. The CSU group consisted of 44 children aged 8 to 17 years who were diagnosed with CSU, while the control group consisted of 44 healthy children. A child psychiatrist conducted the psychiatric assessment of the children. The Revised Child Anxiety and Depression Scales (RCADS), the Childhood Anxiety Sensitivity Index (CASI), and the Children’s Dermatology Life Quality Index (CDLQI) were administered. Multiple linear regression analysis was conducted to identify independent predictors of QoL, considering several potential factors, including the urticaria activity score, duration of urticaria, presence of a psychiatric diagnosis, scores on the RCADS major depression disorder, RCADS-total anxiety, and total CASI. A significantly higher prevalence of psychiatric diagnoses and anxiety disorders was observed in the CSU group (P &lt; .05). In the CSU group with a psychiatric diagnosis, CASI-total (0.011), CASI-physical (0.049), CASI-social (0.022), and CDLQI scores (P &lt; .001) were significantly higher than those without a psychiatric diagnosis. In the multiple linear regression analysis, only the presence of a psychiatric diagnosis was found to be a significant predictor of CDLQI scores (OR, 5.918; 95% CI, 2.505–9.330; P: .001). This study indicated that children with CSU exhibited a higher prevalence of psychiatric diagnoses than controls. Additionally, children with psychopathology in the CSU group demonstrated higher AS and greater impairment of QoL than those without psychiatric diagnoses. Furthermore, the most significant predictor of a decline in QoL was the presence of a psychiatric diagnosis.

Health-related quality of life in children and adolescents with paediatric acquired brain injury: Secondary data analysis from a randomised controlled trial.

To explore the characteristic quality of health profiles of children with paediatric acquired brain injury (pABI), and to investigate whether improvement in executive function (EF) following cognitive rehabilitation is associated with improvement in health-related quality of life (HRQOL). A study of secondary endpoints in a blinded, parallel-randomised controlled trial with children (ages 10-17years) with pABI and executive dysfunction. Data was obtained from 73 children-parent dyads. Explorative analyses were conducted comparing baseline with 8-week post-intervention, and 6-month follow-up data. Outcome measures included the EQ-5D-Y-3L health dimensions and the visual analogue scale (VAS). At baseline and 6-month follow-up, mean (SD) VAS were 76.22 (17.98) and 79.49 (19.82) on the parent-report, and 77.19 (16.63) and 79.09 (17.91) on the self-report, respectively. Comparing children who improved EF to those who did not improve/worsened, no significant improvement was found for the VAS (parent-report) over time (BRIEF-BRI: F = 2.19, p = 0.12, BRIEF-MI: F = 2.23, p = 0.12) for either group. A significant main effect by group was found for BRIEF-MI (F = 4.02, p = 0.049), but no time*group interaction (F = 0.414, p = 0.662). The children and their parents reported only minor problems across EQ-5D-Y-3L dimensions and evaluated overall health as relatively good. Participants with a clinically significant change in the metacognitive aspect of EF had higher HRQOL. Cognitive interventions aiming to ameliorate deficits in EF in pABI may be beneficial to improve HRQOL.

The COVID-19 pandemic and social cognitive outcomes in early childhood

The COVID-19 pandemic and ensuing lockdowns led to sweeping changes in the everyday lives of children and families, including school closures, remote work and learning, and social distancing. To date no study has examined whether these profound changes in young children’s day to day social interactions impacted the development of social cognition skills in early childhood. To address this question, we compared the performance of two cohorts of 3.5- to 5.5-year-old children tested before and after the COVID-19 lockdowns on several measures of false-belief understanding, a critical social cognition skill that undergoes important developments in this age range. Controlling for age and language skills, children tested after the pandemic demonstrated significantly worse false-belief understanding than those tested before the pandemic, and this difference was larger for children from lower socioeconomic status (SES) backgrounds. These results suggest that the pandemic negatively impacted the development of social cognition skills in early childhood, especially for lower SES children.

Childhoods under military occupation: everyday experiences and ‘insistence on existence’ as resistance in Kashmir

ABSTRACT This paper examines the experiences of childhoods in the region of India occupied Kashmir. Building on the discourse on India’s occupation and settler colonial project in Kashmir, I discuss the centrality of violence and militarization in the everyday lives of children and young people in Kashmir. In particular, I examine streets and home as sites under occupation and focus on the everyday routines, and emotions of fear and fearlessness as experienced by the children and young people that are critical in understanding their politics of ‘insistence on existence’ as resistance. Their insistence on being seen is their assertion on their everyday and their refusal to be eliminated despite the various strategies of the Indian state to detain, maim, disappear or kill children and young people. Thereby the children and young people continue to participate in Kashmir’s movement for self-determination as political beings.

A Prospective Study on Quality of Life in Children with Asthma and their Care Givers

A Prospective Study on Quality of Life in Children with Asthma and their Care Givers

Health-related quality of life in children with bronchopulmonary dysplasia: examining agreement between child self-report and parent proxy.

In school-aged children with BPD, agreement between parents and children on HRQL scales is poor to moderate. Caregivers are biased towards lower HRQL. When possible, HRQL should be assessed in the patient directly. • Children with chronic respiratory diseases often assess their own health related quality of life different than their caregiver would report for the child. • Recent data suggests that parent reported health related quality of life for children with BPD is similar to the normal population. • There is a consistent bias for parents to report worse health related quality of life on the Patient Reported Outcomes Measurement Information System (PROMIS) standardized assessment than their school-aged children with BPD.

Strategies to Improve Quality of Life in Children with Nephrotic Syndrome

Strategies to Improve Quality of Life in Children with Nephrotic Syndrome

Quality of life and burnout: children and adolescents in cancer treatment.

Pediatric cancer is a complex disease that requires interdisciplinary interventions. This study aims to describe the quality of life and exhaustion levels in children diagnosed with cancer, using validated instruments that reflect the peculiarities of this disease. An observational analytical study was conducted on children and adolescents aged 2 to 18 years with cancer. The PedsQL Cancer Module and FACIT-F instruments were used to assess quality of life and fatigue, respectively, with statistical analysis performed to identify correlations and develop an explanatory model. Notable physical and psychological symptoms such as nausea, fatigue, hyporexia, irritability, and sadness were identified. The PedsQL and FACIT-F indicated a diminished quality of life. There was high concordance between the perceptions of children and their parents, except in the anxiety related to procedures, where children reported higher levels. These symptoms reflect the impact of cancer treatment on children's well-being. The concordance in evaluations suggests that parents have a good understanding of these experiences, highlighting the relevance of psychosocial interventions to improve quality of life through an adequate support network. It is crucial that pediatric cancer treatment addresses not only medical aspects but also the comprehensive support for the emotional and psychosocial well-being of the patients and their families.

Anxious Atmospheres

Focusing on how the inhabitants live and work next to a coal-powered plant in the Senegalese town of Bargny, I explore the atmosphere of anxiety that arises from the cohabitation between the dust-creating infrastructure, the inhabitants, their animals, as well as the natural and spiritual landscape. I demonstrate how this anxiety is directed towards the future as the dust impacts the lives of the residents' children, while also reflecting concerns about the past as the infrastructure gradually destroys an important, sacred heritage site. Nonetheless, I argue that the activism and protests against the polluting infrastructure reawaken animistic beliefs, thereby creating new constellations of human and non-human resistance.

Health-related quality of life and its association with socioeconomic status and mental health in 5- to 7-year-old children: a cross-sectional study.

Assessing socioeconomic status (SES), mental health, and health-related quality of life (HRQoL) in young children is crucial for making informed health care decisions and identifying areas of intervention. The present study aimed to investigate potential associations between SES, mental health, and HRQoL in 5-7-year-old children. The present study included mother-reported health assessments for 621 children aged 5-7years in Grade 1 collected between 2019 and 2023 as part of the Starting Right™ project. Online questionnaires were used to support public health nurses in assessing children's health status. HRQoL (KIDSCREEN-27, 5 subscales) and mental health [Strength and Difficulties Questionnaire (SDQ), 4 subscales] were assessed. Sociodemographic characteristics, sex, maternal education, and income were obtained from Statistics Norway. The data were analyzed using multiple robust regression. Mother-reported mean scores for the KIDSCREEN-27 were within the normal range compared with European norms (8-11years). However, for each KIDSCREEN-27 dimension, there were individuals whose mothers reported scores that were substantially lower than average. Having mental health problems, defined as being in the 80th and 90th percentiles of the SDQ Total problem score, was associated with 2.1-10.7-point lower KIDSCREEN-27 scores (p < 0.001-0.021), which was most noticeable in the KIDSCREEN-27 school environment subscale. Weak but significant positive associations were found between SES and HRQoL. Our results provide important insights into the associations between SES, mental health, and HRQoL in young children. Given the strong association between mental health problems and HRQoL in Grade 1 children, the assessment of both is essential, so that early interventions, an improved caring environment, and nurturing support can be initiated.