Self-reported Parenting Research Articles

The Time and Practice Challenges of Developmental-Behavioral Pediatrics: An Australian National Study

: Developmental/behavioral diagnoses are common in pediatric practice but, until the impact on pediatricians of caring for these children is quantified, training and remuneration barriers are unlikely to be addressed. In a prospective audit of Australian office-based pediatricians, developmental-behavioral and medical consultations were examined regarding (1) consultation characteristics, (2) child and parent health, and (3) referrals and investigations ordered. : In 2008, all 300 eligible members of the nationwide Australian Paediatric Research Network were invited to prospectively record standardized information for every consultation over 2 weeks or 100 consecutive patients, whichever came first. After coding all diagnoses, consultations were classified as developmental/behavioral, medical, or "mixed." These groups were compared using simple 3-group comparisons (Aims 1 and 2) and logistic regression (Aim 3). : One hundred ninety-nine (66%) pediatricians recorded 15,360 diagnoses for 8,335 consultations (34% developmental/behavioral, 48% medical, and 18% mixed). Compared with medical patients, developmental/behavioral patients were older, more likely to be male, and required on average ∼9 minutes more time per consultation; self-reported parent health was worse; and referrals were more common (odds ratio 2.2, 95% confidence interval 1.9 to 2.5; p < .0001), but investigations less common (odds ratio 0.4, 95% confidence interval 0.3 to 0.4; p < .0001). Child health was worst in the "mixed" group. : Developmental/behavioral consultations are common in pediatric office settings. They are time-consuming, often lead to referrals, and the worse health reported by their parents may pose additional challenges. Pediatric training and funding models must address these barriers if adequate and comprehensive care is to be accorded to these complex patients.

The impact of race on participation in part C early intervention services.

To quantify racial differences in receipt of early intervention (EI) services among children ages birth to 3 years. Multivariable analyses of a nationally representative sample of children eligible for EI services using data from the Early Child Longitudinal Study, Birth Cohort was conducted. Birth weight <1000 g, genetic and medical conditions associated with developmental delay, or low scores on a standardized measure of developmental performance defined EI eligibility. Receipt of EI services was ascertained from parent self-report. The effect of race on receipt of EI services was examined in main effect models and models stratified by EI qualifying condition, which was defined as either established medical condition or developmental delay in the absence of an underlying medical diagnosis. At 9 months of age, among the 1000 children eligible for EI services, 9% of children received services; there were no black-white racial differences in receipt of services. At 24 months of age, among the 1000 children eligible for EI services, 12% received services; black children were 5 times less likely to receive services than white children (adjusted odds ratio [aOR] 0.19; 95% confidence interval [CI] 0.09, 0.39). In models stratified by qualifying condition, black children who qualified for services at 24 months based on developmental delay alone were less likely to receive services (aOR 0.09; 95% CI 0.02, 0.39); there were no differences by race among children who qualified based on established medical conditions (aOR 0.56; 95% CI 0.18, 1.72). Racial disparities in EI service receipt, which were not present during infancy, emerged as children became toddlers. These disparities were found most consistently among children who qualified for services based on developmental delay alone.

International Adoption: Assessment of Adaptive and Maladaptive Behavior of Adopted Minors in Spain

Research on adjustment of internationally adopted children indicates that, although they have adequate development, more emotional and behavioral problems are detected compared with nonadopted children. In this research, emotional and behavioral characteristics of a sample of 52 internationally adopted minors were examined with the BASC (Parent Rating Scales and Self-Report of Personality), comparing the outcomes with 44 nonadopted minors, all of them of ages between 6 and 11 years (mean age = 8.01 years). Results indicate differences between adopted and nonadopted children related to somatization, adopted minors are those that obtain lower scores in the scale, and in the adaptability scale, where nonadopted minors obtain higher scores. Significant differences were found in the adaptive abilities scales, suggesting that nonadopted boys show better abilities than adopted ones, and no differences were found among girls. In general, boys present higher scores in externalizing symptomatology and depression than girls. Among adopted children, time spent in an institution is a variable that has negative impact on the onset of externalizing and internalizing problems. Minors coming from Eastern Europe display more attentional problems, poorer adaptive abilities and poorer interpersonal relations than the rest of the minors. According to the age at placement, attentional problems appear in minors adopted after the age of 3 years.

Developing a Genetically Informative Measure of Alcohol Consumption Using Past-12-Month Indices

The goal of this study was to develop a factor score derived from measures of past-12-month alcohol consumption. Data were drawn from two studies-the Adult and Family Development Project (N = 734) and the Missouri Adolescent Female Twin Study (N = 3,787). Data on four indices of alcohol consumption (quantity, frequency, frequency of drinking to intoxication, and frequency of five or more drinks/day) were factor analyzed, and differences in factor loadings across gender, race/ethnicity, and study were tested. Correlations between these factors were computed across three assessments and between parent and offspring self-reports. Finally, using the classical twin design, variance in the past-12-month alcohol consumption factor was decomposed into additive genetic (A), shared environmental (C), and nonshared environmental (E) influences, and the extent to which these factors overlap with those influencing lifetime heaviest drinking were examined. Factor loadings across all groups were high (.69-.95), with some evidence for differing factor loadings across gender, race/ethnicity, and study. The across-wave correlations for the factor ranged from .22 to .62. The within-wave correlation between parental and offspring drinking was .25, suggesting the importance of familial influences, which genetic analyses attributed to both additive genetic (31%) and shared environmental (17%) factors. The overlap between genetic influences on past-12-month and lifetime heaviest drinking was 0.97. A factor score derived from past-12-month drinking measures is heritable and is largely influenced by those genetic factors that influence heaviest drinking, at least in young adults. It also shows moderate across-wave stability. This will allow for large- and small-scale genomic studies to use past-12-month drinking measures in data analysis of similar cohorts.

Prevention of child maltreatment in high-risk rural families: A randomized clinical trial with child welfare outcomes

Few studies have specifically examined prevention of child maltreatment among higher-risk populations in rural communities. The overarching goal of this study was to conduct a randomized clinical trial of SafeCare augmented for rural high-risk population (SC+) compared to standard home-based mental health services (SAU) to examine reductions in future child maltreatment reports, as well as risk factors and factors proximal to child maltreatment. Parents ( N = 105) of young children (5 years or less) who had identifiable risk of depression, intimate partner violence, or substance abuse were randomized to SC+ or SAU. Participants randomized to SC+ were more likely to enroll (83% vs. 35% for SAU) and remain in services (35 h vs. 8 h for SAU). SC+ (for participants who successfully completed services) may have had limited impact on child welfare reports during service provision. Further, SC+ had fewer child welfare reports related to DV than SAU. Parent self-reports of parenting behaviors, risk factors, and protective factors did not demonstrate significant sustained program impact. Limitations include power constraints related to sample size. Promising next steps entail future trials with larger sample sizes examining service compliance and further augmentation of SafeCare to bolster service impact and address risk and protective factors.

Development and Initial Testing of a New Socioeconomic Status Measure Based on Housing Data

Socioeconomic status (SES) has been associated with many health outcomes. Commonly used datasets such as medical records often lack data on SES but do include address information. The authors sought to determine whether an SES measure derived from housing characteristics is associated with other SES measures and outcomes known to be associated with SES. The data come from a telephone survey of parents/guardians of children aged 1-17years who resided in Olmsted County, Minnesota, and Jackson County, Missouri. Seven variables related to housing and six neighborhood characteristics obtained from local government assessor's offices in Olmsted County, Minnesota, were appended to survey responses. An SES index derived from housing characteristics (hereafter, HOUSES) was constructed using principal components factor analysis. For criterion validity, we assessed Pearson's correlation coefficients between HOUSES and other SES measures, including self-reported parents' educational levels, income, Hollingshead Index, and Nakao-Treas Index. For construct validity, we determined the association between HOUSES and outcomes, risks of low birth weight, overweight, and smoking exposure at home. We applied HOUSES to subjects in another community by formulating HOUSES from housing data of subjects in Jackson County, Missouri, using the same statistical algorithm as HOUSES for subjects in Olmsted County, Minnesota. We found that HOUSES had modest to good correlation with other SES measures. Overall, as hypothesized, HOUSES was inversely associated with outcome measures assessed among subjects from both counties. HOUSES may be a useful surrogate measure of individual SES in epidemiologic research, especially when SES measures for individuals are not available.

Beyond thriftiness: Independent and interactive effects of genetic and dietary factors on variations in fat deposition and distribution across populations

The thrifty genotype hypothesis initiated speculation that feast and famine cycling throughout history may have led to group-specific alterations of the human genome, thereby augmenting the capacity for excessive fat mass accrual when immersed in the modern-day obesogenic environment. Contemporary work, however, suggests alternative mechanisms influencing fuel utilization and subsequent tissue partitioning to be more relevant in the etiology of population-based variation in adipose storage. The objective of this study was to evaluate the independent and interactive contribution of ancestral admixture as a proxy for population-based genetic variation and diet on adipose tissue deposition and distribution in peripubertal children and to identify differences in racial/ethnic and sex groups. Two-hundred seventy-eight children (53% male) aged 7-12 years, categorized by parental self-report as African- (n = 91), European- (n = 110), or Hispanic American (n = 77), participated. Ancestral genetic admixture was estimated using 140 ancestry informative markers. Body composition was evaluated by dual-energy X-ray absorptiometry; energy expenditure by indirect calorimetry and accelerometry; and diet by 24-h-recall. Admixture independently contributed to all adiposity parameters; i.e., estimates of European and Amerindian ancestries were positively associated with all adiposity parameters, whereas African genetic admixture was inversely associated with adiposity. In boys, energy intake was associated with adiposity, irrespective of macronutrient profile, whereas in girls, the relationship was mediated by carbohydrate. We also observed moderating effects of energy balance/fuel utilization of the interaction between ancestral genetic admixture and diet. Interactive effects of genetic and non-genetic factors alter metabolic pathways and underlie some of the present population-based differences in fat storage.

Oral medication adherence and disease severity in pediatric inflammatory bowel disease

The purpose of this study was to examine the relationship of oral medication adherence and perceived adherence barriers with disease severity in a sample of adolescents with inflammatory bowel disease (IBD). Participants included 62 adolescents, aged 13-17 years, diagnosed with IBD, and their parents. Data on the measures of parent-rated and patient-rated oral medication adherence and related barriers, behavioral and emotional functioning per parent report and self-report, and disease severity per medical chart reported by a physician were obtained. Fifteen percent of the sample reported clinically elevated depressive symptoms and 24% reported clinically elevated internalizing behavioral problems. Number of reported adherence barriers was 2.6±1.5, and none of the participants reported zero barriers. Parental ratings of medication adherence (t = -2.11, P<0.05) and perceived barriers to adherence (t = 2.05, P<0.05) significantly predicted disease severity after statistically controlling for the contributions of behavioral and disease parameters to disease severity. Results suggest that the oral medication adherence and perceived adherence barriers are significantly related to disease severity in adolescents with IBD. These patients also may be at risk for increased behavioral and emotional problems, which may impact health outcomes as well. Clinicians should make particular efforts to attend to medication adherence issues with their patients. Working with patients and families to develop solutions for eliminating adherence barriers might result in better disease outcomes.

P01-285 - Childhood hyperactivity-inattention symptoms and risk behaviors in young adulthood

IntroductionAttention Deficit Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) are associated with Risk Behaviors (RB) such as substance-related problems, suicidal behaviors and sex risk behaviors. However, some issues remain controversials: is ADHD an independent risk factor for RB? Is CD a confounding factor of the relationship between ADHD and RB?AimTo assess the link between childhood hyperactivity-inattention symptoms and subsequent RB, controlling for other risk factors among which conduct disorder symptoms.MethodsWe have conducted multivariate analyses from a French community-based sample (N = 1107) belonging to the youth GAZEL cohort. The sample was first assessed at ages 4 to 18, and then assessed 8 years later. Child psychopathology and RB patterns were evaluated through parent and adolescent self-reports.ResultsIn males, results show an effect of hyperactivity-inattention symptoms on more severe RB such as regular cannabis use, illicit drug experimentation and suicidal behaviors (adjusted OR = 2 to 5, all Ps significants). In females, they show an effect of hyperactivity-inattention symptoms on regular tobacco use (adjusted OR = 2, P &lt; .05). The risk of RB initiation was increased in youths with high levels of conduct disorder symptoms, particularly in combination with simultaneously high levels of hyperactivity-inattention symptoms (adjusted OR = 2, P &lt; .05).ConclusionsThis work enhances the knowledge of a link between disruptive behaviors in childhood and subsequent risk behaviors. It underscores the importance of a better acknowledgement of these disorders, in order to better identify and treat them to prevent negative long-term outcomes.

Latino Parenting Practices: A Comparison of Parent and Child Reports of Parenting Practices and the Association with Gateway Drug Use

Parent and adolescent self-reports are the most common sources for measuring parenting practices. This study's purpose was to compare how parent and adolescent reports of parenting behaviors differentially predict adolescent gateway drug use. The sample consisted of 252 Latino adolescent-parent dyads. After controlling for potential confounding influences, only adolescents’ reports about their parents’ parenting behaviors were significant and explained 38% of the variance in gateway drug use. Practitioners may recommend to parents seeking parenting advice that they solicit feedback from their adolescent to ensure parenting efforts are received in the manner they were intended.

Spectacle wear in children reduces parental health-related quality of life

To investigate whether spectacle wear in children affects responses on the Intermittent Exotropia Questionnaire (IXTQ) or the Pediatric Quality of Life Inventory (PedsQL). We recruited 49 children, median age 8 years (range, 5-13 years), presenting with visual acuity 20/40 or better and an otherwise-normal eye examination (no strabismus), who either had no refractive error (n=29) or had refractive error corrected with spectacles (n=20). The IXTQ and PedsQL were completed, each comprising a child report (Child IXTQ, Child PedsQL) and a parent proxy report (Proxy IXTQ, Proxy PedsQL). In addition, the IXTQ contains a parent self-report (Parent IXTQ). Each questionnaire is scored from 0 (worst health-related quality of life [HRQOL]) to 100 (best HRQOL). Median scores were compared using Wilcoxon rank-sum tests. Child IXTQ and Proxy IXTQ scores were similar between groups; nevertheless, Parent IXTQ scores were lower for spectacle wearers (90.4 vs 97.1, p=0.01). Parent IXTQ questions that scored lower in the spectacle group were related to parental worry about permanent damage to their child's eyes, long-term eyesight, surgery, self-consciousness, and teasing. The PedsQL composite scores and all subscale scores were similar between spectacle wearers and nonspectacle wearers, both for Child PedsQL and Proxy PedsQL. Parental HRQOL, measured with the use of the Parent IXTQ, was lower for children wearing spectacles than for children who did not wear spectacles. There was no difference between spectacle and no-spectacle groups when either Child IXTQ, Proxy IXTQ, Child PedsQL, or Proxy PedsQL was used.

Rapid effects of neonatal music therapy combined with kangaroo care on prematurely-born infants

The aim of this study was to investigate the influence of music therapy (MT) combined with kangaroo care as dual treatment (DT) on the physiological responses of preterm infants compared with the influence of kangaroo care (KC) only. The infants' heart rate, respiration, transcutaneous O2 saturation and blood pressure were measured before, during, and after every therapy session. Sixty-one preterm infants born at a 24 to 36 week gestational age (GA) participated in the study. During KC, each infant was kept in skin-to-skin contact or held by a parent, and during DT sessions, the infant received music therapy in addition to KC. The DT and KC therapy sessions alternated. The results revealed that repeated DT and KC decreased the pulse, slowed down the respiration and increased the transcutaneous O2 saturation. The DT affected the blood pressure significantly more compared with the KC. Self-reports by the parents post-therapy suggest that DT may relax and calm both infants (51%) and parents (63%). In conclusion we propose that repeated combination of music therapy and kangaroo care may be more beneficial for preterm infants than KC alone in terms of certain physiological outcomes and parent self-reports.

Quality of Life in Pediatric Patients With Implantable Cardioverter Defibrillators

Psychosocial and quality-of-life (QOL) outcomes in adult patients with implantable cardioverter-defibrillators (ICDs) are well studied. Minimal research exists regarding pediatric adjustment, despite a potentially more challenging adjustment process. The purpose of the present study was to examine psychosocial and QOL functioning of pediatric ICD patients from patient and parent self-reports. Children and primary caregiver dyads from several university hospitals were analyzed using the PedsQL, the Device Severity Index, the ICD and Avoidance Survey, and demographic information. Sixty children (25 female, 35 male) were enrolled. The present pediatric sample reported lower psychosocial and physical QOL scores than healthy children's normative scores. In comparison with a sample of chronically ill children, pediatric ICD patients reported lower physical QOL. Parent-observed QOL reports revealed lower psychosocial and physical QOL than parent-observed healthy norms and lower psychosocial and physical QOL than chronically ill norms. There were no QOL differences by ICD shocks or medical severity. Female patients reported lower psychosocial, physical, and cardiac QOL scores. Children reported better QOL than parent observations on psychosocial and physical health. Finally, 84.7% of children reported avoidance behaviors since ICD implantation, with female children avoiding places more than male children. In conclusion, pediatric ICD patients are comparable to children with other chronic illnesses with the exception of lower physical QOL. Similar to adult samples, female children reported poorer QOL and were more likely to engage in avoidance behaviors. Patients indicated better QOL perceptions than their parents' reports. ICD discharges and medical severity did not negatively affect QOL.

Was it something I did wrong? A qualitative analysis of parental perspectives of their child's bipolar disorder

The aims of this study were to examine parental views on the onset of symptoms, impact on functioning and meanings attributed to their child's bipolar disorder. Early onset bipolar disorder impacts on development and functioning across multiple domains. Psychosocial disability fluctuates in parallel with changes in affective symptoms and may significantly affect family members. This study utilized descriptive statistical data and qualitative data from parental self-reports of 85 participants in a trial of psychotherapy for young people (15-34 years) with bipolar disorder. A content analysis was conducted on the written self-reports. Most parents identified the onset of depressive symptoms in their child by early adolescence, but it was not until late adolescence, or later, that parents noted symptoms of mania. The onset of symptoms during a crucial period of development had a considerable impact on social and occupational functioning. Without prompting, the parents took the opportunity to attempt to make sense of the diagnosis by attributing its onset to childhood adversity, parenting or substance misuse. Parents often blame themselves for the development of bipolar disorder in their child. Nursing care for clients with bipolar disorder could include interventions for the family to help them understand and manage the disorder. Such interventions could include: psycho-education, communication enhancement and problem-solving skills training.

Participation and health-related quality of life of Dutch children and adolescents with congenital lower limb deficiencies

To describe participation and health-related quality of life of Dutch children and adolescents with congenital lower limb deficiencies in comparison with typically developing children, and to explore differences between various degrees of limb loss and between parental reports and self-reports on health-related quality of life. Cross-sectional study. Participation was assessed with the Children's Assessment of Participation and Enjoyment questionnaire, and health-related quality of life with the KIDSCREEN-52 questionnaire, both as parental reports and self-reports, for 56 children and adolescents with congenital lower limb deficiencies, aged 8-18 years. Participation and health-related quality of life of children and adolescents with lower limb deficiencies (age range 8-18 years) did not differ from those of the reference group, except that the adolescents with lower limb deficiencies (age range 12-18 years) reported significantly (p < 0.05) less diversity and lower intensity of social and skill-based activities. Degree of limb loss did not affect participation or health-related quality of life. Differences (p < 0.05) between parental reports and self-reports for health-related quality of life were found for the "physical well-being", "moods and emotions" and "self-perception" domains. While parental reports were comparable to the adolescents' self-ratings, parents reported lower health-related quality of life in the "moods and emotions", "self-perception" and "autonomy" domains for their younger children. While the participation and perceived health-related quality of life of Dutch children with lower limb deficiencies do not differ from those among typically developing children, the participation of adolescents with lower limb deficiencies is characterized by less diversity, with less interaction in social and skill-based activities.

Emotional climate, feeding practices, and feeding styles: an observational analysis of the dinner meal in Head Start families

BackgroundA number of studies conducted with ethnically diverse, low-income samples have found that parents with indulgent feeding styles had children with a higher weight status. Indulgent parents are those who are responsive to their child's emotional states but have problems setting appropriate boundaries with their child. Because the processes through which styles impact child weight are poorly understood, the aim of this study was to observe differences in the emotional climate created by parents (including affect, tone of voice, and gestures) and behavioral feeding practices among those reporting different feeding styles on the Caregiver's Feeding Styles Questionnaire. A secondary aim was to examine differences on child weight status across the feeding styles.MethodsParticipants were 177 Head Start families from Houston, Texas (45% African-American; 55% Hispanic). Using an observational approach, the relationship between the observed emotional climate of the meal, behavioral feeding practices, and self-reported parent feeding styles were examined. Mean age of the children was 4.4 years (SD = 0.7) equally distributed across gender. Families were observed on 3 separate dinner occasions. Heights and weight were measured on the parents and children.ResultsParents with self-reported indulgent feeding styles made fewer demands on their children to eat during dinner and showed lower levels of negative affect and intrusiveness. Surprisingly, these parents also showed higher levels of emotional detachment with their children during dinner. Hispanic boys with indulgent parents had significantly higher BMI z scores compared to Hispanic boys in the other three feeding style groups. No other differences were found on child weight status.ConclusionsResults suggest that the emotional climate created by indulgent parents during dinner and their lack of demands on their children to eat may play an important role in how young children become overweight. Numerous observed emotional climate and behavioral differences were found between the other self-reported feeding styles as well. Results suggest that parents' self-reported feeding styles may be a proxy for the emotional climate of the dinner meal, which may in turn influence the child's eating behaviors and weight status.

Maternal depressive symptoms and participation in early intervention services for young children.

Many young children with developmental delay who are eligible for early intervention (EI) services fail to receive them. We assessed the relationship between depressive symptoms in mothers, a potentially modifiable risk, and receipt of EI services by their eligible children. We conducted multivariable analyses of a nationally representative sample of children eligible for EI services at 24 months using data from the Early Childhood Longitudinal Study-Birth Cohort. Maternal depressive symptoms were assessed at 9 and 24 months. Birthweight <1,000 g, genetic and medical conditions associated with developmental delay, or low scores on measures of developmental performance defined EI eligibility. Service receipt was ascertained from parental self-report. Models were adjusted for sociodemographic and child risk. Among the 650 children who were eligible to receive EI services as infants, 33.2% of children whose mothers were depressed received services compared to 27.0% whose mothers were not depressed (aOR 1.8; 95% CI 0.8, 4.0). Among the 650 children who became eligible to receive services as toddlers, 13.0% of children whose mothers were depressed received services compared to 2.6% whose mothers were not depressed (aOR 4.6, 95% CI 1.5, 14.6). Among children receiving EI services, prevalence of depressive symptoms was 23.0% for mothers whose children became eligible as infants and 57.5% for mothers whose children became eligible as toddlers. Depressive symptoms in mothers of children eligible to receive EI services did not appear to limit participation. EI programs may be an appropriate setting in which to address maternal depressive symptoms.

Chinese parents' perceptions of their children's weights and their relationship to parenting behaviours

The purpose of this study is to examine Chinese parents' perceptions of their children's weights and explore the parenting behaviours associated with these perceptions. A total of 2143 adolescents and 1869 parents were recruited from secondary schools in Ganzhou and Shantou in China. The adolescents' actual weights and heights were measured by trained testers. The self-reported parents' weights and heights, parental perception of the adolescents' weights, adolescents' perception of their own weights, parenting behaviours and demographic information were collected through the questionnaires distributed to the respondents. The results based on Kappa statistics show only a slight agreement between parental perception of their children's weights and the adolescents' actual weights (Kappa = 0.221). The results from the logistic regression show that the parents' gender [odds ratio (OR) = 0.80, 95% confidence interval (CI): 0.64-1.00], adolescents' gender (OR = 1.61, 95% CI: 1.29-2.01) and perception of their own weights (OR = 0.30, 95% CI: 0.24-0.38) are associated with the parents' perception of their children's weights. Statistically significant difference in several parenting behaviours was found between the parents with correct and incorrect perceptions of their children's weight. Misconceptions about their children's weights are prevalent among Chinese parents. The association between parents' perception of their children's weight and parenting behaviours suggests that the accurate classification of children's weights could help prevent childhood obesity.

Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study

This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36-Item Short Form Health Survey (SF-36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self-report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self-report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow-up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood.

Patterns of body size and adiposity among UK children of South Asian, black African–Caribbean and white European origin: Child Heart And health Study in England (CHASE Study)

Background The objective of this study was to examine adiposity patterns in UK South Asian, black African–Caribbean and white European children using a range of adiposity markers. A cross-sectional survey in London, Birmingham and Leicester primary schools was conducted. Weight, height, waist circumference, skinfold thickness values (biceps, triceps, subscapular and suprailiac) were measured. Fat mass was derived from bioimpedance; optimally height-standardized indices were derived for all adiposity markers. Ethnic origin was based on parental self-report. Multilevel models were used to obtain adjusted means and ethnic differences adjusted for gender, age, month, observer and school (fitted as a random effect). A total of 5887 children aged 9–10 years participated (response rate 68%), including 1345 white Europeans, 1523 South Asians and 1570 black African–Caribbeans.Results Compared with white Europeans, South Asians had a higher sum of all skinfolds and fat mass percentage, and their body mass index (BMI) was lower. South Asians were slightly shorter but use of optimally height-standardized indices did not materially affect these comparisons. At any given fat mass, BMI was lower in South Asians than white Europeans. In similar comparisons, black African–Caribbeans had a lower sum of all skinfolds but a higher fat mass percentage, and their BMI was higher. Black African–Caribbeans were markedly taller. Use of optimally height-standardized indices yielded markedly different findings; sum of skinfolds index was markedly lower, whereas fat mass index and weight-for-height index were similar. At any given fat mass, BMI was similar in black African–Caribbeans and white Europeans.Conclusions UK South Asian children have higher adiposity levels and black African–Caribbeans have similar or lower adiposity levels when compared with white Europeans. However, these differences are not well represented by comparisons based on BMI, which systematically underestimates adiposity in South Asians, and in black African–Caribbeans it overestimates adiposity because of its association with height.