Young Toddlers Research Articles

Parent-Child Interaction Therapy for Toddlers: A Pilot Study

Parent-Child Interaction Therapy (PCIT) is an evidence-based program used to treat behavioral disorders in early childhood (2–7 years; Eyberg, 1988). This article describes a modified version of PCIT for young toddlers (PCIT-T) adapted to meet the developmental needs of children aged 12–24 months. A pilot study was conducted to evaluate the effectiveness of PCIT-T with 29 parent-toddler dyads (children aged <2 years) presenting with significant behavior problems, assessed pretreatment and posttreatment. Outcomes for two groups of older children who participated in PCIT (Group 1: 2–3 years, n = 29; Group 2: 3–4 years, n = 29) were also assessed. Results showed PCIT-T to be associated with a range of positive child and parental outcomes including decreased intensity of disruptive child behaviors, increased parental utilization of PCIT parenting skills, decreased parental depressive symptoms, and high levels of consumer satisfaction with the program. This study provides early evidence that a modified version of PCIT can be successfully used to treat behavior disorders in children aged less than 2 years.

Pain and nurses' emotion work in a paediatric clinic: treatment procedures and nurse-child alignments.

In the treatment of cancer in children, treatment procedures have been reported to be one of the most feared elements, as more painful than the illness as such. This study draws on a video ethnography of routine needle procedure events, as part of fieldwork at a paediatric oncology clinic documenting everyday treatment negotiations between nurses and young children. On the basis of detailed transcriptions of verbal and nonverbal staff-child interaction, the analyses focus on ways in which pain and anxiety can be seen as phenomena that are partly contingent on nurses' emotion work. The school-age children did not display fear. In the preschool group, though, pain and fear seemed to be phenomena that were greatly reduced through nurses' emotion work. This study focuses on three preschoolers facing potentially painful treatment, showing how the nurses engaged in massive emotion work with the children, through online commentaries, interactive formats (delegation of tasks, consent sequences, collaborative 'we'-formats), as well as solidarity-oriented moves (such as praise and endearment terms). Even a young toddler would handle the distress of needle procedures, when interacting with an inventive nurse who mobilized child participation through skilful emotion work.

Checkers and Dot at the Beach by J. Torres

Torres, J. Checkers and Dot at the Beach. Illus. J. Lum. Toronto: Tundra Books, 2013. Print.The team of Ontario-based author and illustrator (and comics veterans) J. Torres and J. Lum brings young babies the duo of Checkers and Dot. Torres is best known for his Alison Dare graphic novels and other comics while this is graphic designer Lum’s first opportunity at illustrating for a children’s audience.Checkers, a young boy in a checkered shirt and his friend Dot, a little girl in a polka-dotted jumper are introduced as part of a larger series of Checkers and Dot titles, all with a high-contrasted and heavily-designed black and white motif. This high contrast design is said to appeal to young babies and toddlers as well as provide visual stimulation that may lead to increased brain development. The small size and sturdy binding is a plus.In Checkers and Dot on the Farm, the youngest of children are introduced to animal sounds in rhyming prose that will be fun for any parent or caregiver to read aloud. The images are highly stylized and will be mesmerizing to young children and the characters, a little reminiscent of anime, are quite cute. In Checkers and Dot at the Beach the concept of basic counting to 5 is introduced via ocean animals. Both volumes have a slight plot which makes it more palatable to adults.Though toddlers will enjoy re-reading these books to practice their farm animal sounds and basic counting, they may bore of the black and white in favour of more colourful &amp; engaging board books aimed at preschoolers. The series is aimed at ages 0-4, however I feel it better suits the 0-2 age range. Suitable for public and home libraries.Recommended: 3 stars out of 4Reviewer: Debbie FeisstDebbie is a Public Services Librarian at the H.T. Coutts Education Library at the University of Alberta. When not renovating, she enjoys travel, fitness and young adult fiction.

Infantile spasms in a boy with an abnormal karyotype (46, XY, der(9)t(7;9)(p15;p22)pat)

Infantile spasm (IS) is an epilepsy syndrome affecting infants and young toddlers and many causes have been reported, including occasional chromosomal abnormalities. We describe a 6-month-oldboy who experienced his first seizure at 5 months of age. The seizures were characterized by brief head nods and forceful flexion of the trunk and limbs. The patient has been developmentally delayed since birth and had deteriorated remarkably in the last month. Interictal electroencephalography showed modified hypsarrhythmia. Magnetic resonance imaging showed delayed myelination and widened brain extracellular space. Chromosomal analysis revealed the karyotype 46, XY, der(9) t(7;9)(p15;p22) pat. His father has the asymptomatic reciprocal translocation t(7;9)(p15;p22). This chromosomal abnormality is probably the etiology for the ISs and severe developmental anomalies in this patient. Chromosomal analysis may be done in patients with IS with no obvious cause.

An Unusual Case of Drowning

Drowning remains a significant cause of accidental death in young children. The site of drowning varies among the communities and is influenced by cultural and geographic factors, including the availability of particular water sources. An open shallow drain with a small collection of water let off from the bathroom turned fatal to a young toddler. Only partial submersion of face was present and had led to death characterised by the absence of pathognomonic drowning signs. This paper demonstrates specific issues that may arise in such cases. As this is a new hazard in home environment, precautions should be recommended by the forensic pathologists and awareness should be created among the public that even partial submersion in a shallow collection of water can result in fatal drowning. Language: en

Taking Early Aim at Autism

By spotting signs of this developmental disorder in young toddlers, parents and therapists may be able to target a child's deficits before they become debilitating

Obstructive sleep apnea syndrome in children younger than 2 years of age

Obstructive sleep apnea syndrome (OSAS) occurs in 1–3% of the pediatric population and may result in severe complications if left untreated. The prevalence of OSAS peaks at 3–7 years of age, when adenotonsillar hypertrophy (AH) is maximum. In infants and young toddlers, OSAS results frequently from craniofacial malformations and neurologic abnormalities; AH may be also related, isolated or in association to the previous conditions. In these cases, OSAS may be more severe and with a high recurrence or incomplete recovery rate after surgery. The authors characterize their clinical experience in OSAS in children younger than 2 years of age. Retrospective analysis of clinical and polysomnographic (PSG) data of children younger than 2 years of age followed in a pediatric sleep laboratory between January/2007 and June/2013. The analysis of PSG data was based on the AASM guidelines. Twenty-eight children younger than 2 years were studied, 67.9% were male and the median age of the onset of snoring was 7.5 months (0 – 23 months). Five patients (17.8%) had medical syndromes associated with increased risk of OSAS – Crouzon, Down, Goldenhar, polymalformative, chromosomopathy – and 17 (60.7%) had adenotonsillar hypertrophy grade 3 or 4. PSG showed moderate or severe OSAS in 78.5% patients. Median respiratory disturbance index was 16.7 (1.7 – 280.8) and nadir SpO2 varied between 38% and 95% (median 81%). Twenty-two patients underwent adenotonsillectomy, 1 is waiting surgery, 3 are under medical treatment and 2 in non-invasive ventilation (syndromatic patients). In all patients, clinical symptoms resolved or improved after treatment. PSG was performed in ten patients 3 – 6 months after ENT surgery: 3 syndromatic and 7 with severe OSAS. Nine out of the 10 PSG were abnormal: upper airways resistance syndrome (7) and moderate OSAS (2). Median respiratory disturbance index after surgery was 4.5 (0.6 – 5.4) ) and nadir SpO2 after surgery varied between 89% and 97% (median 91%). The present series, although small, alerts medical attention to the possibility of precocious onset of OSAS and that in this age severe adenotonsillar hypertrophy may be associated. In spite of the clinical improvement, almost all PSG performed after surgery showed alterations, pointing to the need of post- treatment control of sleep parameters and follow-up in this age group.

Strategies and Suggestions for a Healthy Toddler Diet

Nutritional challenges for toddlers are common because their eating behaviors are inconsistent; they may eat more or less than requirements meal to meal and day to day. To help reduce parental stress, it's essential to discuss with parents/caregivers their expectations on how and what they think their toddler should be eating. It is important to remember that toddlers are not little adults; portion sizes are often distorted (too large), and portions should reflect the individual child's age and development. Parents/caregivers can help with new food acceptance by modeling good mealtime behaviors such as limiting high-energy, low-nutritional food and drinks, eating healthy foods along with their children together at the table with the television shut off, and eating appropriate portion sizes. Pediatricians should inform concerned parents/caregivers that toddlers commonly do not accept new foods; foods may need to be introduced repeatedly, up to 10 to 15 times before a child will eat them. To adhere to National Heart, Lung, and Blood Institute (NHLBI) guidelines, parents and caregivers should focus on providing balanced meals that offer a variety of foods, with at least three to four food groups for meals and one to two food groups for snacks, always including familiar foods along with new foods. It is important to reassure families that adherence to NHLBI guidelines for toddlers may be difficult at first, but with the proper education, planning ahead for meal/snack times, and education of all providers caring for the toddler (including nannies, daycares, and family members), it can be done successfully. Improving the nutrition and health of their young toddler will help prevent risk factors for the development of cardiovascular disease.

Prevention of Meningococcal Infections in the First 2 Years of Life

The spectrum of disease caused by Neisseria meningitidis includes bacteremia, fulminant sepsis (meningococcemia), meningitis, and pneumonia. The incidence of meningococcal infection has long been higher in infancy than adolescents or adults older than 65 years (a third group with an increased risk based on age). Five meningococcal serogroups (A, B, C, Y, and W135) cause the great majority of human disease. Serogroup B strains cause about two-thirds of disease in children younger than 6 years. For this reason, new meningococcal vaccine formulations have been developed and evaluated in children younger than 2 years. Of four meningococcal vaccines currently licensed in the United States, two conjugate products, (MenACWY-D [Menactra], Sanofi Pasteur; HibMenCY-TT [MenHibrix], GlaxoSmithKline), are recommended for infants and toddlers younger than 2 years who have an increased risk for invasive meningococcal disease. High-risk conditions are complement deficiencies, community outbreaks, functional or anatomic asplenia, and travel to high-risk areas in which serogroup A infection is prevalent. Recommendations vary by age, dosing, and indication between these two products. Both licensed products are immunogenic and have side-effect profiles that are considered safe for use. In most cases, concomitant use with other recommended childhood vaccines does not interfere with responses to these vaccines. As of yet, there has not been universal adoption of this immunization in the infant population by parents or providers. Factors that weigh against the implementation of a national routine infant program include the prevention of only 40 to 50 meningococcal cases, two to four deaths per year, and a relatively low case fatality among infants. Some argue that costs should not be considered a barrier because infant deaths and morbidity would be prevented. The availability of a serogroup B vaccine would improve impact and cost-effectiveness of a routine infant meningococcal vaccine program. Debate over the implementation of routine infant meningococcal vaccination in the United States is ongoing. This review focuses on vaccines for the prevention of N. meningitidis infection in infants and young toddlers in the first 2 years of life.

Using infrared eye-tracking to explore ordinal numerical processing in toddlers with Fragile X Syndrome.

BackgroundFragile X syndrome (FXS) is the most common cause of inherited intellectual disability and non-idiopathic autism. Individuals with FXS present with a behavioral phenotype of specific and selective deficits in an array of cognitive skills. Disruption of number processing and arithmetic abilities in higher-functioning adults and female adolescents with FXS has been well established. Still, both numerical skills and developmentally antecedent cognitive processes have just begun to be investigated in toddlers with FXS. The goal of the current study was to assess how very young children with FXS respond to ordinal relationships among numerical magnitudes.MethodsInfrared eye-tracking was used to explore infants’ novelty recognition during passive viewing of ordinal numerical sequences; t-tests were used to analyze group differences in looking time.ResultsOrdinal recognition of numerical magnitudes is significantly impaired in young toddlers with FXS.ConclusionsThis study is the first to experimentally evaluate early number sense and ordinal recognition in toddlers with FXS, and our findings reveal that ordinal recognition of numerical magnitudes is significantly impaired in young toddlers with FXS, suggesting that later arithmetic impairments associated with FXS may have their origins in a developmental impairment of this more basic aspect of numerical cognition.

Prognostic role of oral atropine in the subacute phase of organophosphate poisoning

Organophosphates (OPs) are widely used as insecticides. Accidental OP poisoning is reported world over. These compounds inhibit the enzyme acetylcholinesterase within the peripheral and central nervous system by phosphorylation of its esteratic site. The resultant accumulation of acetylcholine at the cholinergic receptor sites, leads to signs of cholinergic toxicity. Accidental OP ingestion has rarely been reported in young toddlers. We report a case of acute OP poisoning (dichlorvos) in an 18-month-old boy with special reference to use of oral atropine treatment in subacute phase.

Do young toddlers act on their social preferences?

From preschool age to adulthood, most humans prefer to help someone who has treated others well over helping someone who has treated others badly. Researchers have recently made opposing predictions about whether such observation-based preferential helping is present when children begin to help in the second year of life. In the present study, 84 toddlers (16-27 months) observed 1 experimenter (antisocial) take a ball from, and 1 experimenter (prosocial) return a ball to, a neutral experimenter. In subsequent tests, children could help either the antisocial or the prosocial experimenter. Only the oldest children showed a significant preference for helping the prosocial agent first. Most children in all age groups were willing to help both experimenters when given multiple opportunities to help. Across age groups, children who looked longer at the continuation of the antisocial interaction were more likely to help the prosocial agent. These findings suggest that social evaluations do affect toddlers' helping behavior but that interactions between human agents may be difficult to evaluate for very young children.

Injuries of the Upper Cervical Spinal Column are Markers of Severe Forces in the First Two Years of Life

Cervical spinal column injuries occur uncommonly in infants and young toddlers, and rarely in the upper cervical spine. Any injury, when discovered at forensic autopsy, must be interpreted within the context of a complete case investigation, and available science. When severe upper cervical spinal column injury is detected, such as atlanto-occipital dislocation (AOD), atlanto-axial dislocation (AAD) or spinal cord transection, forensic pathologists commonly regard such trauma as a marker of significant forces. This retrospective study evaluated 60 cases of accidental and homicidal deaths occurring in the first 24 months of life and investigated by a large metropolitan medical examiner jurisdiction. All cases with AOD, AAD or spinal cord transection occurred under documented accidental circumstances, and all of those cases involved severe forces, including being struck by or run over by a car. While such high cervical spinal column pathology is not unusual when an infant or young toddler is struck by or run over by a motor vehicle, or other accidental circumstance involving severe forces, this discovery in a case of apparent natural death or death following alleged short fall or other commonplace activity of daily living should be considered highly suspect.

Chapter 11: The infant and toddler with wheezing

Recurrent wheezing is common in young infants and toddlers with 27% of all children having at least one wheezing episode by the age of 9 years. The initial wheezing episodes in young children often are linked to respiratory infections due to viral pathogens such as respiratory syncytial virus, rhinovirus, human metapneumovirus, and influenza virus. Bacterial colonization of the neonatal airway also may be significant in the late development of recurrent wheeze and asthma. Some 60% of children who wheeze in the first 3 years of life will have resolution of wheezing by age 6 years ("transient early wheezers"). Children who are "transient early wheezers" have reduced lung function, which remains low at age 6 years, although wheezing has ceased when compared with children who have never wheezed. In contrast, "nonatopic wheezers" represent 20% of wheezing toddlers <3 years of age. These children have more frequent symptoms during the 1st year of life and may continue to wheeze through childhood, but, typically, episodes become less frequent by early adolescence. Lung function in "nonatopic wheezers" is slightly lower than in control subjects from birth to 11 years of age, but they do not have bronchial hyperreactivity on methacholine challenge. The third phenotype refers to "atopic wheezing" or wheezing associated with IgE sensitization. This phenotype accounts for the last 20% of wheezing children <3 years of age. These "atopic wheezers" have normal lung function in infancy; however, lung function is reduced by age 6 years and bronchial hyperreactivity typically is observed.

Autism and epistemology III: Child development, behavioral stability, and reliability of measurement

Early diagnosis and treatment of autism increases the likelihood that symptoms associated with the disorder can be alleviated. However, the behaviors of both typically and atypically developing young infants and toddlers are quite variable and often change as these children age. Studies have shown that this is the case for same-aged children who are diagnosed with autistic disorder (AD) or other Pervasive Developmental Disabilities (PDDs). Therefore, an early accurate assessment of AD or PDD may be problematic. Moreover, instruments used to make the diagnosis may not be as reliable as desired. Statistics employed to evaluate diagnostic accuracy and behavioral stability of instruments' or clinicians' assessments suggest that their diagnoses have been only moderately successful. In addition, the statistics themselves have limitations that would suggest that the measures of diagnostic accuracy and behavioral stability implemented may not be as effective as they would seem. A resolution to these problems is proposed.

How Three Young Toddlers Transition From an Infant to a Toddler Child Care Classroom: Exploring the Influence of Peer Relationships, Teacher Expectations, and Changing Social Contexts

Research Findings: Three infants were followed over the course of 9 months from their last semester in their infant classroom through their transition to a toddler classroom at a university-based child care center. Using participant observation, video observation, and teacher interview, we qualitatively constructed and analyzed profiles of each child's experiences to reveal both overall trends and individual differences in the children's transitions. Findings from this study indicate that transitioning from an infant to a toddler classroom presented a unique situation for individual children that influenced their relationships with peers and their ways of behaving in the new environment. Peers’ interactions, teachers’ expectations and interactions, and the impact of the changes in social context were experienced very differently by each child. Practice or Policy: This study reflects the ways in which a university laboratory school environment can support and nurture collaborative research between faculty mentors and students that has implications for policy and practice. Our findings add depth to the scarce knowledge on this topic offered by previous literature.

Complications of delayed cranial repair after decompressive craniectomy in children less than 1 year old

Decompressive craniectomy is an effective treatment option in case of refractory intracranial hypertension after severe head injury. The incidence of complications following cranial repair after decompressive craniectomy for traumatic brain injury is not negligible, particularly in infants and young toddlers. However, only a few dedicated papers can be found in the literature. We describe the complications observed in two boys and one girl under 1 year of age that were treated in the last decade by hemicranial decompressive craniotomy and enlarging hemispheric duraplasty, and subsequent cranial repair by means of autologous bone-flap replacement. Despite good clinical and neurological outcome, the postoperative clinical course was complicated in all cases by early or late evidence of subdural fluid collections associated to the occurrence of hydrocephalus and causing recurrent dislocation and progressive resorption of the autologous bone flap. Infants less than 1 year old, undergoing decompressive craniectomy after traumatic brain injury, experience a high rate of complications following subsequent cranial repair. Subdural collections and resorption of the autologous bone flap are to be considered as extremely common complications.

Children's Development of Self-Regulation in Speech Production

Species-specific vocalizations fall into two broad categories: those that emerge during maturation, independent of experience, and those that depend on early life interactions with conspecifics. Human language and the communication systems of a small number of other species, including songbirds, fall into this latter class of vocal learning. Self-monitoring has been assumed to play an important role in the vocal learning of speech and studies demonstrate that perception of your own voice is crucial for both the development and lifelong maintenance of vocalizations in humans and songbirds. Experimental modifications of auditory feedback can also change vocalizations in both humans and songbirds. However, with the exception of large manipulations of timing, no study to date has ever directly examined the use of auditory feedback in speech production under the age of 4. Here we use a real-time formant perturbation task to compare the response of toddlers, children, and adults to altered feedback. Children and adults reacted to this manipulation by changing their vowels in a direction opposite to the perturbation. Surprisingly, toddlers' speech didn't change in response to altered feedback, suggesting that long-held assumptions regarding the role of self-perception in articulatory development need to be reconsidered.

How infants and toddlers react to antisocial others

Although adults generally prefer helpful behaviors and those who perform them, there are situations (in particular, when the target of an action is disliked) in which overt antisocial acts are seen as appropriate, and those who perform them are viewed positively. The current studies explore the developmental origins of this capacity for selective social evaluation. We find that although 5-mo-old infants uniformly prefer individuals who act positively toward others regardless of the status of the target, 8-mo-old infants selectively prefer characters who act positively toward prosocial individuals and characters who act negatively toward antisocial individuals. Additionally, young toddlers direct positive behaviors toward prosocial others and negative behaviors toward antisocial others. These findings constitute evidence that the nuanced social judgments and actions readily observable in human adults have their foundations in early developing cognitive mechanisms.

“Cohabitation” between NICU and PICU

Neonatal and paediatric intensive care are usually provided in distinct units, characterized by highly specialized staffs dedicated either to critically ill newborns (NICUs) or to critically ill children (PICUs). However, such a model may be not suitable or even applicable to all medical organisations or to different local needs. Actually, in Europe there are several PICUs which routinely provide care also to neonatal patients, including extremely preterm infants. Conversely, there are many NICUs which occasionally, or systematically, admit also young infants and toddlers. Whilst many aspects of modern neonatal care do resemble those routinely used in the paediatric intensive care setting, several clinical issues are unique to each respective sector and cannot be easily translated to the other one. In order to guarantee the best quality of care, NICU doctors and nurses should acquire adequate competence and skills, by means of focused multidisciplinary training programmes, as well as extensive exposure to a wide paediatric case mix.