Risk For Development Research Articles

Developmental Patterns and Risk Factors of Scoliosis After Hemipelvectomy for the Pelvic Bone Tumor

Background: Postoperative scoliosis is often seen after hemipelvectomy for malignancies involving the pelvic area, but the details remain unclear. The objectives were to investigate the development patterns and risk factors of scoliosis after hemipelvectomy. Methods: We retrospectively reviewed 30 patients who underwent hemipelvectomy at our hospital between 1998 and 2020. The risk factors of scoliosis with a Cobb angle of ≥10° were investigated. Results: The postoperative Cobb angle significantly increased in all patients compared with the preoperative one (p < 0.001), and the change ratio of the Cobb angle was significantly higher during the first postoperative year than thereafter. The external hemipelvectomy (EH) group demonstrated a larger Cobb angle and a higher change ratio than the internal hemipelvectomy group. Nine patients developed scoliosis with a final Cobb angle of ≥10°, and the risk factors were EH (p = 0.017), P1+2+3+4 resection according to the Enneking classification (p = 0.005), iliac crest resection (p = 0.004), L5/S resection (p = 0.020), and no pelvic ring reconstruction after hemipelvectomy (p = 0.004). Conclusions: Approximately 30% of patients who underwent hemipelvectomy developed scoliosis with a Cobb angle of ≥10°, and this angle increased rapidly during the first postoperative year. Hence, careful follow-up of scoliosis is required after hemipelvectomy.

Behavioral, Social, and Emotional Development of Five-Year-Old Children Conceived by Assistive Reproductive Technologies (In-Vitro Fertilization)

Preschool children conceived through In-Vitro Fertilization (IVF) tend to demonstrate particular behavioral, social, and emotional patterns that correlate with their physical development. The authors used a number of techniques to assess the behavior and social and emotional development of five-year-old IVF children. Such questionnaires as Your Child’s Behavior and Child’s Relationship with Friends and Family cast light on the behavioral, social, and emotional status. To define the physical development, the authors used such questionnaires as Child Feeding Issues, Three-Month History of Infectious Diseases, History of Injuries and Accidents, and Chronic Disease History. The sample consisted of 81 IVF children and 153 naturally-conceived children (aged 5); it included subgroups of children with perinatal developmental risks. Most parents of the IVF children reported neither behavioral nor social issues. However, the IVF children demonstrated more severe emotional issues. The IVF children with perinatal developmental risks had more pronounced emotional and anxiety issues, which was not typical of naturally-conceived children with perinatal risks. Both groups included children with difficulties in social and emotional development. The study revealed four significant factors that defined the difficulties of the socio-emotional development in the IVF children: behavioral disorders, aggression, social issues, and emotional issues. The significant correlations of behavioral, social, and emotional development in the IVF group indicated some specificity against the control. The correlating indicators of mental and physical development proved that physical development might affect behavioral, social, and emotional development in IVF children.

Antiepileptic drugs, folate one-carbon metabolism, genetics, and epigenetics: Congenital, developmental, and neuropsychological risks and antiepileptic action.

Antiepileptic drugs, folate one-carbon metabolism, genetics, and epigenetics: Congenital, developmental, and neuropsychological risks and antiepileptic action.

Biological and contextual determinants of early development in marginalized Roma communities: A research protocol of the RomaREACH study

BackgroundThe period of early childhood bears significant importance from the lifespan perspective. Children from marginalized Roma communities face several risk factors that endanger their early development. Based on the gaps in available evidence, the aim of the RomaREACH research project (Research on Early Childhood in marginalized Roma communities) is, therefore, to explore the complex mechanisms influencing psychomotor development in the first 3 years of a child’s life in marginalized Roma communities, and to translate and adapt instruments for measuring development and parenting in marginalized Roma communities and assess their psychometric qualities and suitabilityMethodsThe project comprises two parts. The first part is a validation study of the translated Caregiver-Reported Early Development Instrument (CREDI) and the Comprehensive Early Childhood Parenting Questionnaire (CECPAQ), tools for the assessment of early development and of parenting strategies and practices. The second part is a longitudinal cohort study, in which the relationships of risk and protective factors with development are explored.DiscussionThe RomaREACH project is a multicomponent study of social determinants of health and development in early childhood that can provide new evidence on the relationship of risk and protective factors with early development. Such young children from difficult-to-reach marginalized Roma communities are rarely included in research, and information about the scope and the extent of inequities in health and development in the period of early childhood is scarce. The expected results of the RomaREACH project have the potential to influence policy and practice by providing validated tools and evidence-based insights that can help mitigate the developmental risks faced by children in marginalized Roma communities and contribute to improving developmental outcomes and equity.

Subjective well-being of college students: Developmental trajectories, predictors, and risk for depression

The study aimed to identify different developmental trajectories of subjective well-being for 2 473 college students from freshman to senior year (female = 47.15%; mean age = 19.6 years, SD = 0.894 years). We further explored the associations between categories of well-being development and depression levels across different groups of subjective well-being. Students completed a longitudinal survey over four academic years, self-reporting their subjective well-being, mental state, demographic characteristics, family background, and academic performance. Growth mixture model analysis revealed three distinct developmental trajectories of college students’ subjective well-being: high stable (HS), low increasing (LI), and high decreasing (HD). Factors such as sex, physical health, self-esteem, parental education level, and peer relationships were significantly associated with the subjective well-being classification trajectories. In addition, a stable and high level of subjective well-being was associated with lower risk for depression. The results indicate the importance of subjective well-being practices for students’ long-term schooling-related quality of life.

Transitions in Suicide Risk from Early Adolescence to Early Adulthood

Objective Understanding patterns of suicide risk over the course of development can aid our ability to prevent suicide. Our community-based study examined changes in suicide risk status and predictors of changes in risk status in a sample of 521 adolescents over six assessments between the start of middle school and young adulthood (ages 12–22). Methods Suicidal thoughts and behaviors (STB) were measured with the Diagnostic Interview Schedule for Children and the Moods and Feelings Questionnaire. Latent transition analysis (LTA) was utilized to evaluate transitions in suicide risk status over the course of development. Nine risk factors’ initial values and change over time were modeled as predictors in the LTA. Results Latent class analysis identified a four-class model of developmental suicide risk patterns: Class 1: Infrequent STB (73–87% of participants), Class 2: Diminishing STB (1–17% of participants), Class 3: Escalating STB (6–16% of participants), and Class 4: Consistently High STB (1–5% of participants). LTA demonstrated that infrequent STB members and escalating STB members were likely to maintain their risk class across time points. Conclusions Classification of STB trajectories demonstrated self-worth and family involvement were salient variables affecting transitions in risk over time and suggest prevention targets early in adolescence that could have impact on suicide risk in adulthood.

Risk of Developmental Delay in Infants Born to Perinatal COVID-19-Positive Mothers at a Tertiary Care Hospital: A Cross-Sectional Study

Purpose: Prenatal and perinatal experiences of the mother are known to influence infant development. Maternal exposure to coronavirus disease 2019 (COVID-19) during pregnancy has been associated with increased morbidity and mother-baby separation. However, the developmental outcomes of infants born to COVID-19-positive mothers remain unclear. This study represents an initial exploratory effort to assess the developmental risks faced by infants born to mothers who tested positive for COVID-19. Methods: This cross-sectional study involved telephonic interviews and developmental screenings of 45 infants, aged 9 to 15 months, who were born to perinatal COVID-19-positive mothers between July 2020 and May 2021. The Ages & Stages Questionnaire was used for the developmental assessment. The impacts of maternal, infant and separation-related factors on development were analyzed. Results: Within the study population, 28.8% (13 of 45 infants) presented with a risk of developmental delay. The gross motor and problem-solving domains were the most frequently impacted. Among the factors studied, prolonged separation period (exceeding 7 days), advanced maternal age, and gestational age (preterm birth) were associated with higher proportions of infants at risk of developmental delay; however, these associations were not statistically significant.Conclusion: This study suggests that infants born to mothers who tested positive for COVID-19 during the perinatal period face a risk of developmental delay. Factors such as maternal age, gestational age at birth, metabolic disease during pregnancy, and infant-mother separation could exacerbate this risk. Future research should prioritize objective assessments of development and long-term follow-up to monitor developmental outcomes in this population.

The Homeostasis-Enrichment-Plasticity (HEP®) Approach for Premature Infants with Developmental Risks: A Pre-Post Feasibility Study.

Background: The environmental enrichment (EE) framework has inspired several early intervention (EI) approaches. This study evaluated the feasibility, safety, caregiver acceptance, and satisfaction of implementing the HEP Approach intervention, a novel EI model based on the EE paradigm. Outcome measures for motor development, individual functional goals, sensory functions, caregiver-provided environmental affordances, and motivation for movement were examined. Methods: A pre-post-study design examined 18 premature infants (<33 weeks six days gestation) with a corrected age of 4-10 months. A 21-item Likert scale survey assessed the feasibility, safety, acceptability, and satisfaction of implementing the HEP Approach intervention. The Peabody Developmental Motor Scales-2, Test of Sensory Functions in Infants, Affordances in the Home Environment for Motor Development, and Infant Movement Motivation Questionnaire were used for outcomes. The goal attainment scale measured progress toward parent goals. The HEP Approach consisted of 12 one-hour sessions implemented over three months. Results: Most participating parents found the HEP Approach intervention feasible, safe, acceptable, and satisfactory. GAS scores demonstrated significant gains with a mean t-score of 67.75 (SD = 2.00). Results found significant improvement (p ≤ 0.05) in all outcome measures. Conclusions: Results suggest that the HEP Approach intervention is safe, feasible, and acceptable to implement. Outcome measures were meaningful and sensitive in identifying improved motor development, individualized parental goals, sensory functions, caregivers' use of environmental opportunities, and movement motivation in premature at-risk infants. Results suggest further studies on the HEP Approach are feasible, and highlight the potential of this intervention to inspire and guide future research in this field.

Early life child protection contacts and developmental risk at age five: a whole-of-population cohort study of 479,413 children in two Australian states.

IntroductionChildren who experience maltreatment have worse health and development outcomes than other children. Early prevention relies on opportunities to respond to system contacts that reliably indicate the population burden of children’s future developmental risk. Objectives and ApproachWe quantified the population burden of developmental vulnerability at age five by the type, timing, and frequency of child protection contacts before school, among children in two Australian states. We used linked whole-population births, child protection and Australian Early Development Census (AEDC) data (2009-2018 cycles) in New South Wales (NSW) and South Australia (SA). Results56,650/398,702 (14%) NSW and 12,617/80,731 (16%) SA children had ≥1 child protection contacts before school. The risk of developmental vulnerability on ≥1 domains was lowest in the no child protection group (NSW, 17-18%; SA, 19%), with higher risks in the child protection report (NSW, 28-29%; SA, 32-35%) through to the OOHC (NSW, 35-38%; SA, 39-50%) groups, with a similar pattern for the risk of medically diagnosed conditions. Children with only one child protection report before school had a higher developmental risk than the no child protection group (NSW, 34% versus 21%; SA, 42% versus 24%). Conclusions/ImplicationsEven a single child protection report in the first 2000 days of children’s lives was a robust indicator of developmental risk at age five, with higher developmental risks among children with more serious child protection contacts before school. Child protection reports represent an under-utilised asset to inform early universal and targeted support from health, human and early education services.

Prenatal exposure to ambient air pollution and persistent postpartum depression

BackgroundAmbient air pollution during pregnancy has been linked with postpartum depression up to 12 months, but few studies have investigated its impact on persistent depression beyond 12 months postpartum. This study aimed to evaluate prenatal ambient air pollution exposure and the risk of persistent depression over 3 years after childbirth and to identify windows of susceptibility. MethodsThis study included 361 predominantly low-income Hispanic/Latina participants with full-term pregnancies in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort. We estimated daily residential PM2.5, PM10, NO2, and O3 concentrations throughout 37 gestational weeks using inverse-distance squared spatial interpolation from monitoring data and calculated weekly averaged levels. Depression was assessed by the 20-item Center for Epidemiologic Studies-Depression (CES-D) scale at 12, 24, and 36 months postpartum, with persistent postpartum depression defined as a CES-D score ≥16 at any of these timepoints. We performed robust Poisson log-linear distributed lag models (DLM) via generalized estimating equations (GEE) to estimate the adjusted risk ratio (RR). ResultsDepression was observed in 17.8 %, 17.5 %, and 13.4 % of participants at 12, 24, and 36 months, respectively. We found one IQR increase (3.9 ppb) in prenatal exposure to NO2 during the identified sensitive window of gestational weeks 13–29 was associated with a cumulative risk ratio of 3.86 (95 % CI: 3.24, 4.59) for persistent depression 1–3 years postpartum. We also found one IQR increase (7.4 μg/m3) in prenatal exposure to PM10 during gestation weeks 12–28 was associated a cumulative risk ratio of 3.88 (95 % CI: 3.04, 4.96) for persistent depression. No clear sensitive windows were identified for PM2.5 or O3. ConclusionsMid-pregnancy PM10 and NO2 exposures were associated with nearly 4-fold increased risks of persistent depression after pregnancy, which has critical implications for prevention of perinatal mental health outcomes.

Early childcare and developmental delay risk at 3.5 years: Insights from the French ELFE cohort.

We tested the association between early childcare attendance in the first three years of life and child development at age 3.5years in the French context, where early childcare is subsidized. In the ELFE (Étude Longitudinale Français depuis l'Enfance) birth cohort study set in metropolitan France, children's development was reported by parents at age 3.5years (n = 11,033) via the Child Development Inventory (CDI) questionnaire. CDI scores were transformed into a development quotient (DQ), with a DQ < 90 corresponding to possible and a DQ < 85 corresponding to a probable developmental delay. Inverse probability weighted multivariable regression models were used to analyse whether early childcare in the first three years of life (centre-based, childminder, informal or parental care) was associated to development delay. Compared to children in exclusive parental care, those in centre-based childcare (CBC) or with a childminder prior to school entry were significantly less likely to experience possible (OR = 0.56, [95% CI = 0.51-0.61] for CBC and OR = 0.77, [95% CI = 0.72-0.83] for childminder attendance) and probable developmental delay (OR = 0.62, [0.58-0.67] for CBC and OR = 0.80 [0.76-0.83] for childminder). Informal childcare attendance was not significantly associated with children's possible nor probable developmental delay ((OR = 0.97, [0.84-1.12]) and (OR = 0.97, [0.82-1.15]), respectively). Conclusions: Overall, our findings add to the existing scientific literature, showing that in the French context, where childcare can start as early as 3months of age, early childcare attendance can contribute to child's development. What's Known on This Subject: • Studies on early childcare attendance and child development have shown mixed results, associations with better psychomotor development mainly being observed in Nordic countries, while some studies in other countries such as the USA showed no or negative associations. What This Study Adds: • In a country with broad and subsidized access to childcare such as France, access to early childhood education can positively contribute to children's psychomotor development. However, we found that access to childcare does not appear to reduce social inequalities in children's psychomotor development.

Why Should Developmental Scientists Engage in Research on Adolescent Suicide? The Case for Developmentally Informed Suicidology

Adolescent suicide is a critical and prevalent issue yet is rarely studied by developmental psychologists. We assert that developmentalists’ lack of engagement has stymied progress on adolescent suicide research and practice, and we demonstrate how developmental perspectives can contribute to the next decade of research and practice in suicidology. Specifically, we (a) review theories in suicidology (that are largely a-developmental); (b) discuss how developmental phenomena may explain findings regarding the epidemiology of adolescent suicide; (c) review the evidence on the etiology of adolescent suicide, where efforts to identify risk factors have not led to strong predictions, highlighting underutilized approaches from the developmental risk and resilience literature; and (d) review strategies and developmental gaps across the suicide prevention continuum from primary prevention to postvention, recommending an adolescent developmental perspective on the development and study of school- and community-based suicide prevention and postvention. In doing so, we propose a new subfield of Developmentally Informed Suicidology.

Trajectory of Infant Problematic Feeding Symptoms: Study Protocol.

Infants with developmental risk factors are more likely to have feeding problems and develop chronic feeding disorders. Early detection and understanding of the progression of problematic feeding and its relationship with a child's biological functioning and the family feeding environment will enhance effective symptom management and development of interventions to prevent pediatric feeding disorders. The New Through Two (NewThru2) feeding study protocol is described. Study aims are to (a) characterize symptoms of problematic feeding and trajectories of symptoms from pre-discharge from neonatal intensive care through age 24 months; (b) determine the relationship of child biological function at discharge with symptom characteristics and trajectories; (c) describe the child's feeding environment and its relationship to symptoms from discharge through 24 months; and (d) determine the relationship between problematic feeding symptoms and growth and developmental outcomes. NewThru2 is a prospective, longitudinal, mixed method study following over 200 infants who received care in a neonatal intensive care unit and were identified as at risk for compromised development. The study follows enrolled infants through 24 months of age. Symptoms of problematic feeding are measured pre-discharge by clinical observation and medical record review and post-discharge by parent report. Biological function is measured by medical history and cardiorespiratory and autonomic nervous system function during feeding prior to discharge. Child feeding environment is measured by strategies parents use to manage feeding, the effect of feeding on the parent and family, and the use of feeding services. A subset of parents is interviewed to achieve a contextual understanding of the family feeding environment. Child outcome measures include parent-reported feeding skills and clinician-reported growth and neurodevelopment. The results of this study will improve understanding of pediatric feeding disorders during a time of development sensitive to adequate nutrition and with infants at risk for developmental delays or impairments.

Smartphone GPS-Based Exposure to Greenspace and Walkability and Accelerometer-Assessed Physical Activity During Pregnancy and Early Postpartum-Evidence from the MADRES Cohort.

A growing number of studies have associated walkability and greenspace exposure with greater physical activity (PA) in women during pregnancy. However, most studies have focused on examining women's residential environments and neglected exposure in locations outside the home neighborhood. Using 350 person-days (N = 55 participants) of smartphone global positioning system (GPS) location and accelerometer data collected during the first and third trimesters and 4-6months postpartum from 55 Hispanic pregnant women from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study, we examined the day-level effect of women's exposure to walkability and greenspace on their PA outcomes during pregnancy and in the early postpartum period. Moderate-to-vigorous physical activity [MVPA] minutes per day was assessed using accelerometers. Walkability and greenspace were measured using geographic information systems (GIS) within women's daily activity spaces (i.e., places visited and routes taken) recorded using a smartphone GPS and weighted by time spent. We used a generalized linear mixed-effects model to estimate the effects of daily GPS-derived environmental exposures on day-level MVPA minutes. Results showed that women engaged in 23% more MVPA minutes on days when they had some versus no exposure to parks and open spaces in activity spaces (b = 1.23; 95%CI: 1.02-1.48). In addition, protective effects of daily greenspace and walkability exposure on MVPA were stronger in the first and third trimesters, among first-time mothers, and among women who had high pre-pregnancy body mass index (BMI) and lived in least-safe neighborhoods. Our results suggest that daily greenspace and walkability exposure are important for women's PA and associated health outcomes during pregnancy and early postpartum.

Cardiovascular Management of Aortopathy in Children: A Scientific Statement From the American Heart Association.

Aortopathy encompasses a spectrum of conditions predisposing to dilation, aneurysm, dissection, or rupture of the aorta and other blood vessels. Aortopathy is diagnosed commonly in children, from infancy through adolescence, primarily affecting the thoracic aorta, with variable involvement of the peripheral vasculature. Pathogeneses include connective tissue disorders, smooth muscle contraction disorders, and congenital heart disease, including bicuspid aortic valve, among others. The American Heart Association has published guidelines for diagnosis and management of thoracic aortic disease. However, these guidelines are predominantly focused on adults and cannot be applied adeptly to growing children with emerging features, growth and developmental changes, including puberty, and different risk profiles compared with adults. Management to reduce risk of progressive aortic dilation and dissection or rupture in children is complex and involves genetic testing, cardiovascular imaging, medical therapy, lifestyle modifications, and surgical guidance that differ in many ways from adult management. Pediatric practice varies widely, likely because aortopathy is pathogenically heterogeneous, including genetic and nongenetic conditions, and there is limited published evidence to guide care in children. To optimize care and reduce variation in management, experts in pediatric aortopathy convened to generate this scientific statement regarding the cardiovascular care of children with aortopathy. Available evidence and expert consensus were combined to create this scientific statement. The most common causes of pediatric aortopathy are reviewed. This document provides a general framework for cardiovascular management of aortopathy in children, while allowing for modification based on the personal and familial characteristics of each child and family.

Early childhood risk factors for later onset of pediatric chronic pain: a multi-method longitudinal study

BackgroundPediatric chronic pain (i.e., pain lasting ≥ 3 months) is prevalent, disabling, and costly. It spikes in adolescence, interrupts psychosocial development and functioning, and often co-occurs with mental health problems. Chronic pain often begins spontaneously without prior injuries and/or other disorders. Prospective longitudinal cohort studies following children from early childhood, prior to chronic pain onset, are needed to examine contributing factors, such as early pain experiences and mental health. Using data from a longitudinal community pregnancy cohort (All Our Families; AOF), the present study examined the associations between early developmental risk factors, including early childhood pain experiences and mental health symptoms, and the onset of pediatric chronic pain at ages 8 and 11 years.MethodsAvailable longitudinal AOF data from child age 4 months, as well as 1, 2, 3, 5, 8, and 11 years, were used. Mothers reported their child’s pain experiences (e.g., hospitalizations, vaccinations, gut problems) at each timepoint from 4 months to 8 years, child chronic pain at age 8, and child mental health symptoms at ages 5 and 8 years. Children reported their chronic pain frequency and interference at age 11. Adaptive least absolute shrinkage and selection operator (LASSO) regressions were used to select predictor variables. Complete case analyses were complemented by multiple imputation using chained equation (MICE) models.ResultsGut problems, emergency room visits, frequent pain complaints, and headaches at age 5 or earlier, as well as female sex, were associated with increased risk of maternal reported child chronic pain at age 8. Maternal reported chronic pain at age 8 was associated with higher levels of child-reported pain frequency and pain interferences at age 11. Boys self-reported lower levels of pain interference at age 11.ConclusionsSome, but not all, painful experiences (e.g., gut problems, ER visits, pain complaints) in early life contribute to pediatric chronic pain onset and should be considered for screening and early intervention.

Transgenerational transmission of psychopathology: when are adaptive emotion regulation strategies protective in children?

BackgroundChildren of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children’s psychopathology with a focus on the role of parental and child ER.MethodsParticipants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4–16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires.ResultsBoth COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low.Conclusions The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms.

The Internet as the New Backyard: Developmental Consequences of the Smartphone Lifestyle

This article discusses the threats related to the excessive use of smartphones, which have replaced backyard games for children in the past, as well as its consequences for the development of the young generation. Robert Kegan’s concept of development is used as an analytical tool to diagnose such threats. The text indicates the following developmental risks: a reduced sense of inner control, underdeveloped reflexivity, and reduced physical activity.

Risk of behavioural and developmental difficulties in early childhood in the Australian Capital Territory.

We aimed to estimate the prevalence of risk for developmental and behavioural problems for children in their first year of full-time primary education in the Australian Capital Territory (ACT). We conducted an analysis of the 2014-2017 Kindergarten Health Check (KHC), an annual series of complete enumeration surveys of all children in their first year of full-time primary education in the ACT. Risk for developmental and behavioural problems was determined using the Parents' Evaluation of Developmental Status (PEDS) questionnaire. 19 414 children (mean age 5.56 years; 51.4% boys; 2.3% Aboriginal and Torres Strait Islander; 18.4% quintile of greatest relative disadvantage) who participated in the 2014-2017 KHC were included in the study (87%). More than half of ACT children in their first year of primary education had low/no developmental risk identified through the PEDS questionnaire, with 1 in 10 at high risk. Those more likely to have a high risk PEDS score were boys, those from the areas experiencing relative disadvantage, and Aboriginal and Torres Strait Islander children. While we can identify children at risk through screening, the greater challenge remains to identify and address the underlying causes of healthy inequalities, even within highly socioeconomically advantaged communities.

Infants’ early recovery from sleep disturbance is associated with a lower risk of developmental delay in the Japan Environment and Children’s Study

To examine whether patterns, such as the timings of onset or recovery from sleep disturbance, are associated with later developmental problems, including autism spectrum disorder (ASD). Mothers participating in the Japan Environment and Children’s Study with a child aged 3 years were included in the analyses. Children were assessed for short sleep and frequent awakenings at 1 month, 6 months, and 1 year of age. Developmental problems were evaluated at 3 years of age based on ASD diagnosis and developmental delay, using the Japanese translation of the Ages and Stages Questionnaire (ASQ) 3rd edition. Sleep disturbance patterns were classified by onset age, and developmental problem risks were examined based on onset/recovery ages. Among 63,418 mother-infant dyads, 0.4% of infants were later diagnosed with ASD, and 14.4% had abnormal scores on any ASQ domains. The later the onset of short sleep, the lower the risk of abnormal ASQ scores (RR of short sleep onset at 1 year: 1.41; 6 months: 1.52; 1 month: 1.57). The earlier the infants recovered from short sleep persistence, the lower the risk of developmental delay (RR of remittance of sleep problems identified at 1 month by 6 months: 1.07; 1 year: 1.31; not before 1 year: 1.57). Although not all patterns were significant, later short sleep onset and earlier recovery were associated with lower ASD risk. These findings may have significant implications for future interventions in infant development.