Social-emotional Domains Research Articles

Effect of Early Intervention on Developmental Domains and Parent-Child Interaction Among Children With Developmental Delay: A Randomized Controlled Study.

The scope of early intervention (EI) programs, which mostly focus on motor skills, needs to be expanded. To examine the effects of an EI on developmental domains and parent-child interactions. Randomized controlled study. Children ages 24-36 mo with developmental delay (DD; intervention group, n = 30; control group, n = 40). Pediatric occupational therapy unit of Hacettepe University. The intervention group received an intervention that used the Goal Activity and Motor Enrichment (GAME) approach and a home program, whereas the control group received a home program only. Both groups received the same intervention dosage. Developmental domains were assessed using the Bayley Scales of Infant and Toddler Development Third Edition (Bayley III) and the Ages and Stages Questionnaires (ASQ). Sensory processing was assessed with the Infant/Toddler Sensory Profile 2 (ITSP-2), social-emotional development with the ASQ:Social-Emotional (ASQ:SE), and parent-child interaction with the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO™). A compliance checklist was used to determine compliance with the home program. A significant between-groups difference was found on all Bayley III and PICCOLO subscales and on the Gross Motor, Fine Motor, Problem-Solving, and Social-Emotional domains of the ASQ and ASQ:SE in favor of the intervention group (p < .05). The intervention group showed more typification (normal sensory processing) in sensory quadrants and general processing. Both groups were 100% compliant with the home program. The GAME-based intervention for children with DD, including sensory and cognitive activities, is effective in improving developmental domains and parent-child interactions. Plain-Language Summary: The scope of early intervention programs mostly focuses on motor skills and needs to be expanded to include the essential roles of children's sensory and cognitive abilities. This study provides important insights into early interventions by occupational therapists and the impact on children with developmental delay and parent-child interactions. We found that the Goal Activity and Motor Enrichment (GAME) intervention for children with developmental delay, which includes sensory and cognitive activities, is effective in improving developmental domains and parent-child interactions.

Behavioral observation and assessment protocol for language and social-emotional development study in children aged 0–6: the Chinese baby connectome project

BackgroundThe global rise in developmental delays underscores the critical need for a thorough understanding and timely interventions during early childhood. Addressing this issue, the Chinese Baby Connectome Project (CBCP)’s behavior branch is dedicated to examining language acquisition, social-emotional development, and environmental factors affecting Chinese children. The research framework is built around three primary objectives: developing a 0–6 Child Development Assessment Toolkit, implementing an Intelligent Coding System, and investigating environmental influence.MethodsUtilizing an accelerated longitudinal design, the CBCP aims to enlist a minimum of 1000 typically developing Chinese children aged 0–6. The data collected in this branch constitutes parental questionnaires, behavioral assessments, and observational experiments to capture their developmental milestones and environmental influences holistically. The parental questionnaires will gauge children’s developmental levels in language and social-emotional domains, alongside parental mental well-being, life events, parenting stress, parenting styles, and family relationships. Behavioral assessments will involve neurofunctional developmental evaluations using tools such as the Griffiths Development Scales and Wechsler Preschool and Primary Scale of Intelligence. Additionally, the assessments will encompass measuring children’s executive functions (e.g., Head-Toe-Knee-Shoulder), social cognitive abilities (e.g., theory of mind), and language development (e.g., Early Chinese Vocabulary Test). A series of behavior observation. experiments will be conducted targeting children of different age groups, focusing primarily on aspects such as behavioral inhibition, compliance, self-control, and social-emotional regulation. To achieve the objectives, established international questionnaires will be adapted to suit local contexts and devise customized metrics for evaluating children’s language and social-emotional development; deep learning algorithms will be developed in the observational experiments to enable automated behavioral analysis; and statistical models will be built to factor in various environmental variables to comprehensively outline developmental trajectories and relationships.DiscussionThis study’s integration of diverse assessments and AI technology will offer a detailed analysis of early childhood development in China, particularly in the realms of language acquisition and social-emotional skills. The development of a comprehensive assessment toolkit and coding system will enhance our ability to understand and support the development of Chinese children, contributing significantly to the field of early childhood development research.Trial registrationThis study was registered with clinicaltrials.gov NCT05040542 on September 10, 2021.

Cognitive and Social-Emotional Development in Girls With Fragile X Syndrome.

To evaluate the developmental trajectory of key cognitive, social, and emotional features in girls with fragile X syndrome (FXS). This longitudinal, parallel cohort study collected data between January 2018 and December 2022. Participants were evaluated 3 times with ∼12-18 months between visits. Participants included 65 girls with FXS, 6 to 16 years, and 52 age- and developmentally-matched girls without FXS. Participants' scores from direct assessment and caregiver report evaluated 3 cognitive domains (verbal abilities, nonverbal abilities, executive function) and 4 social-emotional domains (depression, general anxiety, social behavior, and social anxiety). Participants included 117 girls (mean [M] [SD] age at study entry: FXS M = 10.59 [3.00]; comparison M = 10.45 [2.40])). Omnibus tests showed 4 domains with significant group differences: Verbal (P < .0001, eg, Differential Abilities Scale-II(DAS-II), Picture Vocabulary (-6.25 [1.87])), nonverbal (P < .0001, eg, Kaufman Test of Educational Achievement, Third Edition, Brief Form, Math (-8.56 [2.90])), executive function (P < .0001, eg, NIH Toolbox List Sorting (-6.26 [1.48])), and social anxiety (P < .03, eg, Anxiety, Depression, and Mood Scale (ADAMS) Social Avoidance (1.50 [0.65])). Three domains had significant group by age interaction: Verbal (P < .04, eg, DAS-II, Word Definitions (-1.33 [0.55])), social behavior (P < .01, eg, Social Responsiveness Scale-2 Social Communication (1.57 [0.51])), and social anxiety (P < .01, eg, ADAMS Social Avoidance (0.46 [0.19])). These findings support the development of early, disorder specific interventions for girls with FXS targeting verbal and nonverbal skills, executive function, social behavior, and social anxiety.

The Jewels in English Language Teaching: Attributes of Quality English Language Teachers in Second Language Setting

The growing demand for high-quality English language teachers who can effectively facilitate language learning has prompted the need for research in this area. By utilising a phenomenological approach and in-depth interviews, this study explores the lived experiences of ten experienced English language teachers from the Eastern part of Malaysia and five stakeholders in the English language teaching (ELT) field. The aim is to gain insights into their perceptions of what constitutes a quality English language teacher. The findings highlight that passion for teaching, cognitive abilities, social-emotional competencies, personality traits and a concept of ‘going beyond teaching’ are crucial for quality teachers. This research contributes to a deeper understanding of essential attributes that define a quality English language teacher, enabling teacher training institutions to refocus their curriculum and incorporate courses that prepare teachers holistically and enhance second language teaching and learning, particularly in the social-emotional domain. Several recommendations for including specific components in teacher training programs are also discussed.

Gender similarities and differences in early childhood development in low- and middle-income countries

Gender differences in early childhood development are under-researched in low- and middle-income countries (LMICs) where almost 90% of the world’s young children live. This study examines the direction, magnitude, and variation of gender similarities and differences in 3- and 4-year-olds’ early childhood development in 71 low- and middle-income countries (LMICs). Moreover, we explore whether country-level gender inequality correlates with gender differences in early development. We analyzed Early Childhood Development Index (ECDI) data from UNICEF’s Multiple Indicators Cluster Surveys and the Demographic and Health Surveys between 2010 and 2019 (n = 226,980). Using logistic regression, we estimated children’s odds of being developmentally on track in literacy-numeracy, approaches to learning, social-emotional, and physical domains. We also used meta-analytic regression to examine associations between early childhood development and country-level indicators of gender inequality. In approximately one-half of LMICs, odds of being developmentally on track did not significantly differ for girls and boys; in countries with significant differences, girls were more likely to be on track than boys (odds ratio [OR] = 1.21, 95% confidence interval [CI] = [1.18–1.24], p < .001). Differences favoring girls were largest in the social-emotional domain (OR = 1.27, 95% CI = [1.24–1.30], p < .001). Country-level gender development index explained a substantial amount of variation in gender differences across countries. Overall, findings suggest that when gender differences exist, girls are more likely than boys to be developmentally on track, particularly in the social-emotional domain and in countries with greater gender equality.

How developmental coordination disorder affects daily life: The adolescent perspective

BackgroundFew studies have focused on the implications of developmental coordination disorder (DCD) in the teen years. Understanding the unique needs of adolescents with DCD and the challenges they face are imperative to inform clinical care. AimTo understand how DCD affects daily life from adolescents living with the disorder. MethodsParticipants were recruited from a database of adolescents who were formally diagnosed with DCD in childhood. Nineteen semi-structured interviews of adolescents with DCD (13–18 years) were conducted and analyzed using an interpretive description approach. ResultsData analysis revealed four overarching themes: (1) Through the years; (2) Standing out, left out, opting out; (3) Rising into Resilience; and (4) Help me to be me. Adolescents with DCD face challenges in physical, cognitive, social, emotional, and mental health domains, but their success can be optimized through provision of support, fostering social connections, the use of strategies, and increasing public understanding. Few services currently exist for adolescents with DCD, as treatment is not standard of care. Conclusions and implicationsInsights gained from this study provide client-centred evidence to advocate for intervention for adolescents with DCD, and guide recommendations for clinical care and community support to meet the needs of this under-served population. What this paper adds?This paper qualitatively explores the lived experience of adolescents with DCD, adding to the limited research within this population. Expanding beyond the typical focus of motor challenges, this paper highlights the widespread influence of DCD on daily life, including in cognitive, mental health, and social-emotional domains. Common environmental contexts that exacerbate challenges during adolescent years are explored, including high school PE class and electives, learning to drive, beginning employment, and preparing for post-secondary education. Through an interpretive description methodology, this paper delves into clinical and practical solutions to support adolescents with DCD, from an individualized and client-centered perspective.

Toward the total semiotic fact

Abstract This paper explores the quest for an account of the total linguistic or semiotic fact. Speech act theory, sociolinguistics, linguistic anthropology, and social semiotics have all attempted, in various ways and at various times, to find a way to describe as much as possible what is going on around any speech event. While this search for the total linguistic fact will always be a chimerical goal, this paper draws on the inspirational work of Jan Blommaert to suggest a framework for moving in this direction. The acronym SEMIOSIS points to the complexity of what is at play, comprising social relations, emotional and affective domains, multilingual practices, iterative activity, objects and assemblages, spatial repertoires, interactivity, and sensory relations. Looking at data from a small Bangladeshi-run store in Tokyo, the paper shows how bringing in this wider set of concerns allows a more comprehensive account of semiotic moments.

The gradients of the relationship between child discipline practices at home and early childhood development of young children

BackgroundAlthough the literature suggests a negative association between early childhood development (ECD) and violent disciplinary measures, little is known about the gradient of this relationship. ObjectiveThis study examined the gradient of the relationship between the number and types of child discipline practices at home and the ECD of children aged from 36-to-59 months. Participants and settingThe study used nationally representative data from the Multiple Indicator Cluster Survey Bangladesh 2019. MethodsWe analysed secondary data using multivariable logistic regression to examine the relationship between child discipline practices and ECD. The gradients were measured using three sets of summative indexes of disciplinary practices and psychometric approach to the physical, literacy-numeracy, learning and social-emotional domains of ECD. ResultsAbout 94 % of children had at least one of the eight violent disciplinary measures during the month preceding the survey. Approximately three-quarters of the children were on track in their ECD. The probability that children were on track in ECD significantly increased with non-violent disciplinary practices and decreased with violent disciplinary practices used. For one unit increase in the overall violent disciplinary index, the odds of children being on track in their ECD was reduced by 12 %, and the reduction was significant (adjusted odds ratio = 0.88; 95%CI: 0.86–0.91). ConclusionsChildren who had experienced several forms of violent disciplinary measures were more likely than those who did not to be delayed in their ECD. Banning violent punishments in all settings and positive parenting programs are recommended.

Reading, singing, and storytelling: the impact of caregiver-child interaction and child access to books and preschool on early childhood development in Ghana

Optimal early childhood development (ECD) is crucial in shaping future academic and economic accomplishments. Recognising its profound influence, the United Nations has included a specific target and indicator related to ECD in the Sustainable Development Goals to ensure universal access to high-quality ECD for all preschoolers by 2030. This study investigated whether caregiver-child engagements, early stimulation, and learning opportunities are associated with ECD among children aged 36–59 months. Data on 6752 children were pooled from the 2011 and 2017 Ghana Multiple Indicator Cluster Surveys. The ECD outcomes of interest were literacy-numeracy, social-emotional, learning-cognitive, and physical development, measured with UNICEF's Early Childhood Development Index (ECDI). Binary logistic regression assessed the effects of various caregiver-child engagements and early learning opportunities on the ECD outcomes. We found that most children were developmentally on track in the physical (95.0%) and learning-cognitive (86.4%) domains, but fewer were on track in the literacy-numeracy (36.7%) and social-emotional (68.6%) domains. Reading to or with a child (aOR 1.72; 95% CI 1.35–2.19), telling them stories (aOR 1.61; 95% CI 1.26–2.04), counting or drawing with them (aOR 1.63; 95% CI 1.30–2.04) and a child’s attendance at preschool (aOR 4.62; 95% CI 3.34–6.38) were associated with a higher odds for on track literacy-numeracy development. Playing with a child was associated with higher odds of on-track social-emotional development (aOR 1.29; 95% CI 1.04–1.59), physical development (aOR 1.61; 95% CI 1.01–2.55), and learning-cognitive development (aOR 1.51; 95% CI 1.14–2.00). However, singing songs to or with a child (aOR 0.78; 95% CI 0.62–0.89) and taking a child outside the home (aOR 0.78; 95% CI 0.64–0.95) were associated with lower odds for on track social-emotional development. Access to children's books at home was associated with higher odds for on track literacy-numeracy and social-emotional development. In subgroup analysis, some observed associations varied depending on a child's residence (urban or rural). Our findings confirmed that caregiver-child interaction and early learning opportunities could increase a child’s likelihood of achieving early developmental milestones.

Effect of a Mediterranean Diet or Mindfulness-Based Stress Reduction During Pregnancy on Child Neurodevelopment

Maternal suboptimal nutrition and high stress levels are associated with adverse fetal and childhood neurodevelopment. To test the hypothesis that structured interventions based on a Mediterranean diet or mindfulness-based stress reduction (MBSR) during pregnancy improve child neurodevelopment at age 2 years. This was a prespecified analysis of the parallel-group Improving Mothers for a Better Prenatal Care Trial Barcelona (IMPACT BCN) randomized clinical trial, which was conducted at a university hospital in Barcelona, Spain, from February 2017 to March 2020. A total of 1221 singleton pregnancies (19 to 23 weeks' gestation) with high risk of delivering newborns who were small for gestational age were randomly allocated into 3 groups: a Mediterranean diet intervention, an MBSR program, or usual care. A postnatal evaluation with the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III), was performed. Data were analyzed from July to November 2022. Participants in the Mediterranean diet group received monthly individual and group educational sessions and free provision of extra virgin olive oil and walnuts. Those in the stress reduction group underwent an 8-week MBSR program adapted for pregnancy. Individuals in the usual care group received pregnancy care per institutional protocols. Neurodevelopment in children was assessed by Bayley-III at 24 months of corrected postnatal age. A total of 626 children (293 [46.8%] female and 333 [53.2%] male) participated at a mean (SD) age of 24.8 (2.9) months. No differences were observed in the baseline characteristics between intervention groups. Compared with children from the usual care group, children in the Mediterranean diet group had higher scores in the cognitive domain (β, 5.02; 95% CI, 1.52-8.53; P = .005) and social-emotional domain (β, 5.15; 95% CI, 1.18-9.12; P = .01), whereas children from the stress reduction group had higher scores in the social-emotional domain (β, 4.75; 95% CI, 0.54-8.85; P = .02). In this prespecified analysis of a randomized clinical trial, maternal structured lifestyle interventions during pregnancy based on a Mediterranean diet or MBSR significantly improved child neurodevelopmental outcomes at age 2 years. ClinicalTrials.gov Identifier: NCT03166332.

Borderline intelligence, academic and social emotional development: The role of ICTs

The purpose of this study is to examine the cognitive deficits that children with borderline intelligence exhibit and where they are at a disadvantage in the social-emotional domain compared to their "typically developing" peers. Finally, an attempt is made to emphasize the need for special learning and social support, so that in the future children and adults with borderline intelligence can claim the same rights and opportunities. A total of 12 studies were recorded from the international literature that studied the particular cognitive and socio-emotional profile of children with borderline intelligence

Impact of Screen Time on Children’s Development: Cognitive, Language, Physical, and Social and Emotional Domains

Technology has become integral to children’s lives, impacting many aspects, from academic to socialization. Children of today’s generation are growing up with digital devices, such as mobile phones, iPads, computers, video games, and smart gadgets; therefore, screen time has become ubiquitous in children’s daily routines. This paper provides a review of screen time usage and its impact in children across multiple developmental domains: cognitive, language, physical, and socio-emotional domain of children under eight years of age. The cognitive domain considers factors such as attention span and memory; language domain examines vocabulary, speech, and language development; physical domain focuses on motor development, exercise, sleep, and diet; and social-emotional domain considers relationships, self-identity, and emotional behaviors/regulation. Our findings are mixed, as there are both benefits and drawbacks in technology use, but screen time in children requires controlled observation and monitoring for sustainable improved progress across developmental domains. Specific recommendations advise that children’s screen time per day should be limited to zero minutes (min) (0–2 years), &lt;60 min (3–5-years), and 60 min (6–8 years).

Global Citizenship Education in Pre-Service Teacher Education: Status and Implementation

The National Education Policy 2020 champions the cause of Global Citizenship Education at all stages of education. This will naturally entail a big shift in the curriculum so as to include the development of cognitive, behavioural and social-emotional domains of future global citizens .This education shall include the development of attitudes, values and skill sets that prevail upon in developing societies that are peaceful, tolerant and inclusive. In order to evolve as global citizens, students at the tertiary stage of education firstly need to be empowered in understanding the need and relevance of multicultural education which teaches them to respect diversity and inclusion. Secondly the learners need to be equipped as ambassadors of protection of human rights who uphold the values of social justice, equality and equity in all walks of life. This in turn shall go a long way in ensuring their civic participation. Thirdly it is important that as responsible and responsive citizens they contribute to economic development too .This would mean mastering the twenty first century skills including developing an entrepreneurial mindset. For societies to be tolerant and peaceful it is a pre-requisite to manage resources judiciously .GCED therefore shall also include a discourse on environmental conservation and sustainable development in order to sensitise students towards the need for environmental protection. In order to reflect on the modalities of implementation of the mandate of integrating GCED in the higher education curriculum this paper examines the different subjects and pedagogical strategies that may be adopted at the under graduate and post graduate level of pre service teacher education programmes in India. The focus of implementation this paper examined is keeping in mind the development of future teachers, teacher educators, curriculum developers, policy planners and administrators in the field of education who are well equipped as global citizens.

Early childhood developmental status and its associated factors in Bangladesh: a comparison of two consecutive nationally representative surveys

BackgroundInadequate cognitive and socio-emotional development in children leads to physical and mental illness. We aimed to investigate the status of early childhood development (ECD) and its associated factors. Additionally, aimed to compare the changes of significantly associated factors using two multiple indicator cluster surveys (MICS) in Bangladesh.MethodsWe used data from the Multiple Indicator Cluster Surveys (MICS) 2012 and 2019 nationally representative surveys. A total of 17,494 children aged 36–59 months were included in the analysis. The outcome variable was ECD status: either developmentally on-track or not. We used bivariable analysis and crude and adjusted multivariable logistic models to assess the ECD status and its associated factors.ResultsComparing both MICS surveys, the overall and individual domains of ECD status improved from 2012 (65.46%) to 2019 (74.86%), and the indicators of child literacy-numeracy domain improved from 21.2 to 28.8%, physical domain improved from 92.2 to 98.4%, and social-emotional domain improved from 68.4 to 72.7%. The learning approach domain was 87.5% in 2012 and increased to 91.4% in 2019. According to the adjusted logistic model in both surveys (2012 and 2019), the age of 4 years had an adjusted odds ratio (AOR) of 1.61 and 1.78 times higher developmentally on track than the age of 3. Female children were 1.42 (in 2012) and 1.44 (in 2019) times more developmentally on track than males. Compared to mothers with only primary education, children raised by mothers with secondary or higher education were 1.77 and 1.50 times more on track in their development. Moreover, Children from affluent families had 1.32- and 1.26 times higher odds- on track than those from the poorest families. Families with books had 1.50 and 1.53 times higher developmentally on track than their counterparts.Conclusion and recommendationIn summary, our study shows that the overall ECD status improved between MICS 2012 and MICS 2019. Important factors influence ECD status, including early childhood education programs, families’ possession of children’s books, mothers’ educational level, and wealth index. The findings of our study will help making necessary public health-related initiatives in Bangladesh to improve ECD program.

Design, Implementation, and Evaluation of a Preventive Intervention Program to Foster Social-Emotional Development and Attachment Security of Toddlers in Early Childhood Education and Care: The Papilio-U3 Program

Due to an increasing number of children under the age of three attending early childhood education and care (ECEC), there is an increasing need for high-quality care settings. In addition to primary caregivers, ECEC teachers are important socializers of children’s emotional development and may become children’s attachment figures. Early preventive interventions bear the potential to reduce the risk for later maladaptive development in the social-emotional domain. The first objective of the present article is to introduce the Papilio-U3 program, a universal preventive intervention program to foster positive and sensitive teacher-child interactions, to foster children’s early social-emotional competence and secure child-teacher attachment relationships in ECEC, and to prevent children’s emotional and behavioral problems. Furthermore, we report the design and first results of the formative evaluation derived from the pilot evaluation study. The program was developed according to the Intervention Mapping Approach, and the present article describes the planning process comprising a needs assessment and description of the intervention context, the derivation of the logic model of change, a detailed account of the program design, production, implementation, and an overview of the program evaluation study (multi-centric, randomized-controlled trial). The total sample of the evaluation study comprised 125 teachers (age M= 34.0, SD = 10.1, 98.4 % female) from 55 ECEC centers. For the formative evaluation, teachers of the intervention group (n = 61) reported on training content, methods, material, organizational conditions, and potential challenges in the course of program implementation. Finally,we provide directions to revise the program and to guide future implementation of preventive intervention programs in the ECEC context.

Characterizing Relationships Among the Cognitive, Physical, Social-emotional, and Health-related Traits of Military Personnel.

Personnel engaged in high-stakes occupations, such as military personnel, law enforcement, and emergency first responders, must sustain performance through a range of environmental stressors. To maximize the effectiveness of military personnel, an a priori understanding of traits can help predict their physical and cognitive performance under stress and adversity. This work developed and assessed a suite of measures that have the potential to predict performance during operational scenarios. These measures were designed to characterize four specific trait-based domains: cognitive, health, physical, and social-emotional. One hundred and ninety-one active duty U.S. Army soldiers completed interleaved questionnaire-based, seated task-based, and physical task-based measures over a period of 3-5 days. Redundancy analysis, dimensionality reduction, and network analyses revealed several patterns of interest. First, unique variable analysis revealed a minimally redundant battery of instruments. Second, principal component analysis showed that metrics tended to cluster together in three to five components within each domain. Finally, analyses of cross-domain associations using network analysis illustrated that cognitive, health, physical, and social-emotional domains showed strong construct solidarity. The present battery of metrics presents a fieldable toolkit that may be used to predict operational performance that can be clustered into separate components or used independently. It will aid predictive algorithm development aimed to identify critical predictors of individual military personnel and small-unit performance outcomes.

Longitudinal investigation of cognition, social competence, and anxiety in children and adolescents with Turner syndrome

Turner syndrome (TS), a common neurogenetic disorder caused by complete or partial absence of an X chromosome in females, is characterized by distinct physical, cognitive, and social-emotional features. Girls with TS typically display average overall intellectual functioning with relative strength in verbal abilities and weaknesses in visuospatial processing, executive function (EF), and social cognition. This study was designed to better understand longitudinal trajectories of cognitive and social-emotional domains commonly affected in TS. Participants included 57 girls with monosomic 45,X TS and 55 age- and verbal-IQ matched girls who completed behavioral, child-report, and parent-report measures across four timepoints. Group differences in visuospatial processing, EF, social cognition, and anxiety were assessed longitudinally. Potential effects of estrogen replacement therapy (ERT) were assessed cross-sectionally on an exploratory basis. The TS group showed poorer performance on measures of visuospatial processing, EF, and social cognition, but not anxiety, compared to controls throughout childhood and adolescence. There were no significant group differences in the trajectory of skill development over time. Exploratory analyses within the TS group revealed that girls who were receiving ERT showed better performance on measures of overall IQ, expressive vocabulary, and visuospatial processing compared to those not receiving ERT. Consistent with existing literature, weaknesses in visuospatial processing, EF, and social competence among girls with TS persisted throughout childhood and adolescence. Exploratory analyses suggest that ERT may help improve some aspects of cognitive function in TS, although other pre-existing, nonhormonal differences between the two TS subgroups may alternatively explain these findings, given our study design. Future studies are needed to examine potential impacts of ERT on cognitive and social-emotional development in TS.

72 Prevalence of Neurodevelopmental Disorder among Indigenous Children: A Systematic Review

Abstract Background Neurodevelopment involves sensory-motor, cognitive, and social-emotional domains, which can be influenced by biological and psychosocial factors. Poor neurodevelopment can result in missing developmental milestones and neurodevelopmental disorders (NDs) that translate into negative consequences for long-term health and well-being. Indigenous children in countries with similar colonial histories face a disproportionate burden of infant mortality, chronic diseases, injuries, and disability compared to non-Indigenous children. However, there is no consensus on the prevalence of NDs among Indigenous children around the world. Objectives This systematic review (PROSPERO 2021 CRD42021238669) synthesized current evidence on the prevalence of NDs among Indigenous children in Australia, Canada, New Zealand, and the USA. Design/Methods Comprehensive searches of five databases from 2005 to Feb 15, 2021 were conducted to identify cohort and cross-sectional studies that assessed the objective. Two independent reviewers conducted study selection, data extraction/analysis, and risk of bias assessment. Risk of bias was assessed using the Newcastle-Ottawa scale for cohort and ecological studies (adapted), and the Quality Assessment Tool for Prevalence Studies by Hoy et al. for cross-sectional studies. Prevalence odds ratios (pOR) with 95% confidence intervals (CI) were calculated in random-effects meta-analyses for each ND outcome if there were two or more studies of the same study design. Results Of the 864 studies identified, 25 studies met the inclusion criteria. Twelve studies were conducted in Australia, one in Canada, four in New Zealand, and eight in the USA. Four studies evaluated attention-deficit/hyperactivity disorder (ADHD) prevalence, 13 for autism spectrum disorder (ASD), 10 for intellectual disability (ID), and five for motor disorders (MD). Most cohort studies (10/17) had high risk of bias. All cross-sectional studies (n=8) had low risk of bias. The prevalence of ADHD, ASD, ID, and MD for Indigenous children ranged from 2.7-3.9%, 0.07-3.0%, 1.1-3.9%, and 0.18-0.47%, respectively. Prevalence in non-Indigenous children ranged from 1.6-5.6%, 0.31-3.3%, 0.87-2.3%, and 0.22-0.37%. In cross-sectional studies, Indigenous children had decreased odds of ASD (three studies; pOR=0.80; 95% CI: 0.71-0.89) compared to non-Indigenous children. In cohort studies, higher odds of MD (two studies; pOR=1.57; 95%CI: 1.35-1.84) and lower odds of ASD (four studies; pOR=0.46; 95% CI: 0.28-0.76) were found in Indigenous children compared to non-Indigenous children. Conclusion Prevalence rates are greater in Indigenous children for MD and lower for ASD compared to their non-Indigenous counterparts. Differences in NDs prevalence between Indigenous and non-Indigenous children may be due to differences in access to health care services/assessment.

Using a Facebook Virtual Examination Room to Enhance ROP Training in Armenia

PurposeRetinopathy of prematurity (ROP) is a leading cause of worldwide childhood blindness with increasing incidence in low and middle income countries (LMICs) due to advances in neonatal care. There are insufficient numbers of healthcare professionals specialized in ROP management and few local training opportunities in LMICs. Social media platforms provide a promising solution to enable interactive medical education across geographic and logistic barriers. As an adjunct to an ROP training program for ophthalmologists in Armenia, we implemented a Facebook Virtual Examination Room (VER) for case discussion with a global community of collaborators and preceptors. To evaluate training through VER, we operationalized engagement as a multilayer meta-construct that includes cognitive, behavioral, and social-emotional domains.MethodsA concurrent mixed methods approach was taken to collect and analyze data from comments and activities within VER. Quantitative data was analyzed for descriptive statistics on group utilization, participant activity, and clinical metrics. Qualitative data was analyzed by conducting thematic analysis involving initial and pattern coding.ResultsTen participants (7 trainees and 3 preceptors) interacted in the Facebook group across 153 unique cases, with 218 threads, 414 comments, and 216 likes. Of the 120 unique cases eligible for consensus evaluation, treatment was mentioned most frequently (87), followed by location (68), staging (65), and plus disease (31), with agreement ranging from 67% to 97%. Based on the qualitative analysis, the most common themes of discussion were clinical management, dilemma resolution, knowledge growth, and gratitude.ConclusionA closed Facebook group for case-based discussions can be a useful adjunct to an existing ROP training program by engaging learners across social-emotional, behavioral, and cognitive domains. For international training partnerships, the financial and logistical advantages can be significant, though focus should remain on the primary curriculum and training modality.

Identification of novel pathogenic variants in the GCDH gene and assessment of neurodevelopmental outcomes in 24 children with glutaric aciduria type 1.

To evaluate the pathogenic variants in GCDH gene and to assess the neurodevelopmental outcomes in children with Glutaric aciduria type 1 (GA-1). Cross-sectional observational study between January 2019 and June 2020 in consecutive North Indian children with a clinical and biochemical suspicion of GA-1. Variants in the coding regions of GCDH gene were identified through Sanger sequencing. Neurodevelopmental and quality of life assessment was done using standardized scales. 24 children with GA-1 were identified. The median age at diagnosis was 12 months and the median delay in diagnosis was 3 months. Genetic analysis was done in 14 cases. It revealed 12 variants (11 missense and one nonsense) from 13 patients. Most of the pathogenic variants were in exon 9 and exon 5. Three novel variants were identified in three patients: two missense variants c.169G>A (p.Glu57Lys), c.1048T > C (p.Cys350Arg) and one nonsense variant c.331C > T (p.Lys111Ter). On neurodevelopmental assessment, majority of children with GA-1 were non ambulatory (62.5%), had limited hand skills (58.3%) and impaired communication (58.3%). Overall, poor global development was noted in 43.7%. A pre-existing developmental delay was significantly associated with impaired communication skills (p=0.03), and the number of episodes of encephalopathy were significantly associated with impaired gross motor skill (p=0.02). Presence of encephalopathy was significantly associated with poor performance in social emotional (p=0.01) and cognitive (p=0.03) domains of Developmental Profile-III scale and development of severe dystonia (p=0.01). Our findings highlight the clinical, biochemical, radiological and genetic spectrum of GA-1 in children in North India and report the presence of novel pathogenic variations.