Young Children Ages Research Articles

Reflections of parents of children with 22q11.2 Deletion Syndrome on the experience of receiving psychiatric genetic counseling: ‘Awareness to Act’

Individuals with 22q11.2 deletion syndrome (22qDS) have a 25%-41% risk for a psychotic disorder. Although early intervention for psychiatric conditions leads to the best long-term outcomes, healthcare providers often provide inadequate information about these issues and psychiatric services are underused by this population. We conducted semi-structured interviews with parents of children with 22qDS a month after they received psychiatric genetic counseling (pGC), to evaluate outcomes and perceived value of pGC with respect to parents' needs. Using grounded theory, we generated a theoretical framework of the process of building parental awareness of psychiatric risks associated with 22qDS and protective and management strategies for mental health (MH). Parents described how after their child's diagnosis with 22qDS, a variety of barriers stalled their building awareness of psychiatric risk and protective/management strategies: dealing with the immediate symptoms of 22qDS; child's young age; parental fear and stigma; and missing MH guidance. These barriers led them to carry the burden of worrying over missing emerging psychiatric symptoms and the stress over advocating for their child's MH. Parents indicated pGC was beneficial in that led them to achieve an 'awareness to act,' feeling confident in being alert and equipped to protect and/or manage their child's MH.

Family adjustment to COVID-19 lockdown in Italy: Parental stress, coparenting, and child externalizing behavior.

Evidence of psychological distress in families during COVID‐19 outbreak are arising. However, the perceived changes in psychological adjustment during home confinement with respect to the period before the pandemic have not been addressed yet. Moreover, little is known about the role of coparenting and specific COVID‐19 contextual variables on parental stress and children's behavioral difficulties in the Italian context. Using a cross‐sectional survey, we collected data on 841 Italian parents of children aged 3–11 years with typical development during the home confinement (20th April–18th May). We analyzed levels of parental stress, coparenting, and child externalizing behaviors before and during the home confinement. Additionally, hierarchical regressions were performed to investigate predictors of parental stress and child externalizing behaviors during the lockdown. Results showed that parental stress (especially in mothers) and child externalizing behaviors increased during the lockdown period. Coparenting was a strong predictor of parental stress, together with being a mother, younger child age, less time dedicated to the child, and scarce feasibility of remote working. Besides, child externalizing behaviors were predicted by male gender, less parental time dedicated to the child, higher parental stress, and child distance learning workload. Our findings indicate a negative impact of COVID‐19 lockdown in both parents and children, suggesting that positive coparenting and time dedicated to children may help to reduce the detrimental effect of pandemic restrictions on family adjustment.

Pediatric respiratory assessment measure in evaluation of the severity of bronchial asthma exacerbation in children

Objective The aim was to study the role of pediatric respiratory assessment measure (PRAM) score in evaluation of acute asthma exacerbation in children. Background Acute severe asthma is one of the most common medical emergency situations in childhood, where accurate assessment and management is of extreme importance and may be lifesaving. PRAM score has been used to classify asthma severity and treatment. Patients and methods A prospective cohort study was adopted by applying the PRAM score on 108 asthmatic children presented to the Emergency Department of Elraml Pediatric Hospital in Alexandria by acute asthma exacerbation in the period of the study. Results The study included 66 (61.1%) boys and 42 (38.9%) girls, aged from 2 to 12 years, with mean age of 5.07 ± 2.68 years. The most common triggering factor according to our study was viral infection or common cold (90.7%). Increasing severity of acute asthma exacerbation was associated with increasing initial PRAM score. There was significantly increased severity of grade of PRAM score after initial bronchodilator therapy in relation to young aged children ( Conclusion PRAM score in this study is useful for predicting fate of patients in emergency room, and after initial bronchodilator therapy, it is an excellent sensitive and specific tool to predict the admitted patients from the discharged patients.

Vaccine prevention in children of young age based on current clinical recommendations and personal experience

Vaccine prevention in children of young age based on current clinical recommendations and personal experience

Clinical, serological and epidemiological features of hepatitis A in León, Nicaragua.

Background and ObjectivesTo monitor and document the endemicity and disease burden of acute hepatitis A in the area of an ongoing vaccine effectiveness study in León, Nicaragua.MethodsAt community health centres in León, all children, adolescents and young adults presenting with jaundice and/or other clinical signs of hepatitis were offered free serologic screening (hepatitis A, B and C) and blood tests for liver enzymes and bilirubin. Clinical and socioeconomic data were collected with a structured questionnaire. Diagnosis of acute hepatitis A was confirmed by anti-HAV IgM testing. Using logistic regression we compared the characteristics and living conditions of acute hepatitis A cases with those of non-cases.ResultsOf 557 eligible subjects enrolled between May 2006 and March 2010, 315 (56.6%) were diagnosed with hepatitis A, 80.6% of them ≤10 years and five >18 years of age. No severe cases were encountered. Apart from jaundice (95.6%) and other signs of hepatitis A (fever, pale stool, dark urine, nausea, vomiting, anorexia), two thirds of patients had moderately raised liver enzymes. Cases occurred throughout the year, with highest incidences from August to March. Poor sanitary conditions and crowding were the main risk factors.ConclusionsIn the study area, hepatitis A is still highly endemic in young and school age children living in low socioeconomic conditions. There are, however, first indications that the endemicity level is shifting from high to high-intermediate.

Caregiver burden in pediatric dialysis: application of the Paediatric Renal Caregiver Burden Scale.

Caring for a child with kidney failure on dialysis profoundly impacts caregivers' lives, yet the depth of this burden is not well understood. The Paediatric Renal Caregiver Burden Scale (PR-CBS) is a recently validated instrument used to measure caregiver burden in this population. We performed a cross-sectional study of caregiver burden for caregivers of children with kidney failure receiving dialysis at three pediatric centers. Caregivers completed the PR-CBS instrument as part of a larger qualitative study of caregiver experience. We performed descriptive statistics. T-tests were used to examine differences between dialysis modality and within key demographics. Multivariate linear regression was utilized to assess associations between significant factors and total score. Ten caregivers of children receiving peritoneal dialysis (PD) and 21 receiving hemodialysis (HD) participated. Total burden score and mean score for every domain was higher for caregivers of children on HD compared to PD. PR-CBS score was significantly associated with younger child age and married status in caregivers. In adjusted multivariate analysis, dialysis modality and married marital status were significantly associated with PR-CBS score. This study found that dialysis caregivers experience significant caregiver burden and demonstrates the utility of the PR-CBS in an American population. We found higher burdens among HD caregivers, younger children, and married caregivers. While these findings must be replicated on a larger scale, they suggest possible areas for targeted interventions to improve the quality of life of children with kidney failure and their families. A higher resolution version of the Graphical abstract is available as Supplementary information.

Survival characteristics of localized pediatric adrenocortical carcinoma managed with adenectomy: A national cancer center database analysis

Pediatric adrenocortical carcinoma (ACC) is a rare malignancy, encompassing less than 0.2% of all childhood malignancies. Due to the scarcity of this diagnosis, it is often managed according to guidelines established for adults, as there is a lack of reliable evidence regarding optimal adjuvant treatment options for pediatric patients. It is our aim to identify recent treatment trends as well as clinical and tumor characteristics and their impact on overall survival. Using the National Cancer Data Base (NCDB), this study identified 49 patients under 18 years old with localized ACC (M0) undergoing adrenalectomy from 2004 to 2017. Kaplan-Meier analysis was performed to determine overall survival (OS) from patient characteristics and treatments received. Comparison of survival was performed using the log rank test. The median age of our cohort was 3 years old with a slight female predominance of 61%. The median tumor size was 9.4cm, and patients older than 4 years were significantly (p=0.03) more likely to present with larger tumors (11.33cm vs 8.76cm). Adjuvant treatment in the form of systemic therapy was administered in 20 of 49 (41%) patients and radiation therapy in 2 of 49 (4%) patients. Three-year OS for patients 4 years old and younger was 92.6% vs 61.8% for those older than 4 years (p=0.002). Patients presenting with tumor size ≥9cm had worse three-year OS compared to those with tumors <9cm (95.24% vs 67.1% respectively, p=0.02, Fig. 1). In patients with tumors≥9cm, younger children age 0-4 years had significantly (p=0.04) higher OS rates than older children age 5-17 years. ACC is a rare pediatric malignancy with a female predominance. Those older than 4 years and those with presenting tumor size ≥9cm have decreased overall survival rates after adrenalectomy for localized disease. Additionally, children older than 4 have poorer prognosis, even after controlling for larger tumor size. This is the largest contemporary series of localized pediatric ACC to date. However, multi-institutional prospective cohort or randomized-controlled trials are necessary to better evaluate relevant prognostic factors and the role of adjuvant therapies following adrenalectomy.

586-P: Characteristics Associated with A1C at 18-Months after Diagnosis in Young Children with Type 1 Diabetes

Introduction: The incidence of T1D in young children is increasing, yet the majority of children do not achieve glycemic targets, and little is known about predictors of A1c in young children. This study examines demographic predictors of A1c among young children through 18 months post-diagnosis. Methods: Participants were 37 young children (age 1-6 years, Mage=4.53(1.64), MA1c at diagnosis= 10.47(1.93)) with T1D whose parents were randomized to the usual care condition of a multi-site behavioral intervention trial within 8 weeks of diagnosis. At baseline, parents self-reported on sociodemographic information, CGM use and depression symptoms; DKA status at diagnosis and A1c values at 18 months were obtained from medical records. Child A1c at 18-months post-diagnosis (MA1c= 8.05 (0.93)) was dichotomized into “below target” (≤7.5%; n=15; 40.5%) or “above target” (&amp;gt;7.5%; n=22; 59.5%). Results: Family income (two-tailed Fisher’s exact test, p=.019), parent race/ethnicity (χ2(1, N=37)=8.97 p=.003), and child sex (χ2(1, N=37)=3.96, p=.047) were all significantly associated with 18-month A1c. Post hoc analyses using Bonferroni corrections indicated families with higher income, parents who identified as non-Hispanic white, and male children were more likely to be in the “below target” group compared to families with lower income, parents who identify as a racial/ethnic minority and female children, respectively. The 18-month A1c was not associated with baseline CGM use or parent depressive symptoms, nor DKA at diagnosis (p&amp;gt;.05). Conclusions: There are limited prospective studies of early predictors of A1c in young children. Our results are consistent with findings regarding demographic correlates of A1c found in older children and highlight the importance of social determinants of health. Future research using larger samples should explore the role of additional potential correlates of later glycemic control. Disclosure J. S. Eng: None. K. Rooney: None. C. Henderson: None. B. E. Marks: None. C. Tully: None. M. Monaghan: None. M. E. Hilliard: None. R. Streisand: None. C. H. Wang: None. Funding National Institute of Diabetes and Digestive and Kidney Disease (R01DK102561)

Sex Differences in the Temporalis Tendon-Aponeurotic Complex: An in vivo MRI Macroscopic Analysis in Children and Adolescents

The tendon-aponeurosis complex (TAC) of the temporalis dissipates forces produced during function. Abnormally reduced temporalis TACs have been found in individuals with chronic muscular temporomandibular disorders – a painful musculoskeletal condition that is more frequent in women than men. Whether there are sex differences in the temporalis TAC in healthy individuals is currently unknown. Here, we characterized and measured the temporalis TAC in healthy male and female young individuals between 5 and 15 years old to determine whether the volume of the temporalis TAC and the TAC-to-muscle ratio are different between males and females. We collected MRI studies from 90 healthy individuals, including equal numbers (15 M and 15 F) of young children (ages 5–7), children (9–11), and adolescents (13–15) and segmented the right temporalis and its TAC using software. Using general linear models, we tested the effect of sex, age, and their interaction on the volumes of the temporalis and its TAC, and the TAC-to-muscle ratio. The volumes of the temporalis and its TAC increased with age (both p < 0.001) and were not affected by sex (p = 0.252 and p = 0.179) or by the interaction sex-by-age (p = 0.079 and p = 0.095, respectively). The TAC-to-muscle ratio did not change significantly with age (p = 0.655) and was not affected by sex (0.438) or by the interaction sex-by-age (0.524). We provide, for the first time, volumetric data of the temporalis TAC in children and adolescents. The volumes of the temporalis TAC and the TAC-to-muscle ratio are not different between male and female individuals until the age of 15.

Use of Text Messaging and Facebook Groups to Support the Healthy Children, Strong Families 2 Healthy Lifestyle Intervention for American Indian Families

ABSTRACTBackgroundFew obesity interventions have been developed for American Indian (AI) families despite the disproportionate risk of obesity experienced within AI communities. The emergence of mobile technologies to enhance intervention delivery could particularly benefit AI communities, many of which are hard to reach and underserved.ObjectivesThis study aimed to assess the use and perceptions of text messaging and Facebook to support delivery of the Healthy Children, Strong Families 2 (HCSF2) mailed healthy lifestyle/obesity prevention intervention and discuss lessons learned regarding intervention support via these platforms among AI participants.MethodsFrom among AI families with young children (ages 2–5 y), 450 adult-child dyads were recruited from 5 rural and urban communities for a year-long intervention. Intervention content was delivered by mail and supported by text messaging and optional Facebook groups. Participants provided feedback on text message and Facebook components post-intervention, and Facebook analytic data were tracked.ResultsSelf-report feedback indicated high satisfaction with both text messaging and Facebook, with tangible content (e.g., recipes, physical activity ideas) cited as most useful. Overall, participants reported higher satisfaction with and perceived efficacy of Facebook content compared with text messaging. Analytic data indicate the optional HCSF2 Facebook groups were joined by 67.8% of adult participants. Among those who joined, 78.4% viewed, 50.8% “liked,” and 22.6% commented on ≥1 post. Engagement levels differed by urban-rural status, with more urban participants “liking” (P = 0.01) and commenting on posts (P = 0.01). Of note, nearly one-third of participants reported changing phone numbers during the intervention.ConclusionsThis study demonstrates high satisfaction regarding mobile delivery of HCSF2 intervention support components. Best practices and challenges in utilizing different mobile technologies to promote wellness among AI families are discussed, with particular focus on urban-rural differences. Future mobile-based interventions should consider the context of unstable technology maintenance, especially in low-resource communities.This work is part of the HCSF2 trial, which is registered at clinicaltrials.gov (NCT01776255).

The prevalence and associated factors of undernutrition among under-five children in South Sudan using the standardized monitoring and assessment of relief and transitions (SMART) methodology

BackgroundConflict regions bear the heaviest brunt of food insecurity and undernutrition. South Sudan is one of the fragile countries following years of conflict that led to large displacements. Moderate to severe undernutrition among under-five children has been associated with elevated morbidity and mortality. This study, therefore, was conducted to assess the magnitude and factors influencing undernutrition (wasting, underweight and stunting) among children aged 6 to 59 months in Yambio County, South Sudan.MethodsA cross-sectional study was conducted from 26 October to 6 November 2018 in Yambio County, South Sudan among 630 children aged 6–59 months from the 348 households surveyed in 39 clusters using two-stage cluster sampling design. Data were collected using questionnaires and nutritional anthropometric measurements. The Standardized Monitoring and Assessment of Relief and Transitions (SMART) Methodology was followed to obtain the prevalence of wasting, underweight and stunting based on respective z scores and according to the 2006 world health organization child growth standards. Data were exported to Stata version 16 for further analysis. Bivariate analysis of independent variables and undernutrition was done using binary logistic regression. Mixed effects logistic regression analysis was conducted to control for possible confounders and account for random effects at household and cluster levels. Unadjusted and adjusted odds ratios (cOR and aOR) with 95% confidence intervals (CI) and p-values were computed. P-values of ≤0.05 were considered statistically significant.ResultsThe prevalence of undernutrition explained by wasting (weight-for-height Z-score (WHZ) < − 2), underweight (weight-for-age z-scores (WAZ) < − 2) and stunting (height-for-age z-scores (WHZ) < − 2) were 2.3% (1.3–4.1, 95% CI), 4.8% (3.1–7.5, 95% CI) and 23.8% (19.1–29.2, 95% CI). Male sex (aOR [95% CI], p-value: 5.6 [1.10–30.04], p = 0.038), older child’s age (aOR [95% CI], p-value: 30.4 [2.65–347.60], p = 0.006) and non-residents (cOR [95% CI], p-value: 4.2 [1.4–12.2] p = 0.009) were associated with increased risk of wasting. Household size (cOR [95% CI], p-value: 1.09 [1.01–1.18] p = 0.029) and younger child age (cOR [95% CI], p-value: 4.2 [1.34–13.23] p = 0.014) were significantly associated with underweight. Younger child age (aOR [95% CI], p-value: 5.4 [1.82–16.44] p = 0.003) and agricultural livelihood (aOR [95% CI], p-value: 3.4 [1.61–7.02] p = 0.001) were associated with stunting.ConclusionBased on a cut off of less than − 2 standard deviations for 2006 World Health Organization (WHO) child growth standards, the wasting prevalence was very low, underweight prevalence was low while stunting prevalence was high. The county lies in the only livelihood region in South Sudan with bimodal reliable rainfall pattern and it seems that the impact of the 2016 conflicts that lead to large displacements may not have greatly affected under-five undernutrition. Interventions targeted at improving food diversity, increasing nutrition knowledge and enhancing resilience in male children might reduce undernutrition. In the short-term, investment in continued surveillance of nutritional status should be a main focus.

Is there any incremental benefit to conducting neuroimaging and neurocognitive assessments in the diagnosis of ADHD in young children? A machine learning investigation

Given the negative trajectories of early behavior problems associated with ADHD, early diagnosis is considered critical to enable intervention and treatment. To this end, the current investigation employed machine learning to evaluate the relative predictive value of parent/teacher ratings, behavioral and neural measures of executive function (EF) in predicting ADHD in a sample consisting of 162 young children (ages 4–7, mean age 5.55, 82.6 % Hispanic/Latino). Among the target measures, teacher ratings of EF were the most predictive of ADHD. While a more extensive evaluation of neural measures, such as diffusion-weighted imaging, may provide more information as they relate to the underlying cognitive deficits associated with ADHD, the current study indicates that measures of cortical anatomy obtained in research studies, as well cognitive measures of EF often obtained in routine assessments, have little incremental value in differentiating typically developing children from those diagnosed with ADHD. It is important to note that the overlap between some of the EF questions in the BRIEF, and the ADHD symptoms could be enhancing this effect. Thus, future research evaluating the importance of such measures in predicting children’s functional impairment in academic and social areas would provide additional insight into their contributing role in ADHD.

Parental Nonstandard Work Schedules and Child Development: Evidence from Dual-Earner Families in Hong Kong.

With the emergence of 24/7 economies, the practice of working nonstandard schedules has become increasingly common. This trend raises a concern about how parental nonstandard work schedules affect child development outcomes. Using data from dual-earner families with young children (age 5–6) in Hong Kong, this study examined the association between parental work schedules and child development. It also examined under what conditions parental nonstandard work schedules affect child development, with a focus on the moderating role of family income. Results showed that paternal nonstandard work schedules were negatively associated with overall child development. This association was particularly salient among low-income families. By contrast, maternal nonstandard work schedules were not associated with child development outcomes. These findings suggest that it is important to equip parents, in particular low-income fathers, to address challenges resulting from their nonstandard work schedules.

Proximity to SNAP-authorized retailers and child maltreatment reports

The Supplemental Nutrition Assistance Program (SNAP) has been shown to have positive benefits for children. Families may face fewer barriers to accessing food they can purchase with their benefits if more stores in their neighborhoods accept SNAP benefits. We examine whether proximity to stores accepting SNAP benefits is related to child maltreatment (abuse and neglect) reports, particularly those potentially related to food insecurity. We combine geographically identified child maltreatment report data from the state of Connecticut from 2011 through 2015 with state SNAP-authorized retailer data. Using within-Census block group changes in the presence of a SNAP-authorized store, we find that in large, rural areas, one additional SNAP store is associated with a 4.4 percent decrease in the child maltreatment report rate (p < 0.05), and an 11.3 percent decrease in substantiated cases of maltreatment (p < 0.10), even net of changing zip code level factors and time-invariant neighborhood characteristics. The relationship between a neighborhood SNAP store and child maltreatment reports in these rural areas is largely driven by neglect, concentrated among young and school-aged children (ages 0–9), and primarily due to fewer reports by medical personnel. We find no effects of a neighborhood SNAP store on child maltreatment reports in smaller, more densely populated neighborhoods. Sensitivity checks affirm these results. Results indicate the benefits of access to SNAP retailers on the child welfare system and child well-being more broadly, especially in rural areas.

Family Social Capital: Links to Weight-Related and Parenting Behaviors of Mothers with Young Children.

Family social capital includes the social relationships, values, and norms shared by a family and is positively linked with children’s mental and physical health status. This cross-sectional study addresses a gap in the literature related to family social capital vis-à-vis weight-related behaviors and home environments of 557 mothers and their young children (ages 2 to 9 years). Mothers completed an online survey comprised of valid, reliable questionnaires assessing family relationships and weight-related behavioral and home environment measures. The measures that determined family social capital (i.e., supportive, engaged parenting behaviors; family cohesion; family conflict; and family meal frequency) yielded distinct tertile groups that differed significantly (p < 0.001) on every family social capital measure with large effect sizes. Analysis of variance with Tukey post-hoc test revealed greater family social capital was linked to significantly better maternal health, dietary intake, physical activity, and sleep behavior. Additionally, maternal modeling of healthy eating and physical activity, child feeding practices, and home environments was higher in groups with greater family social capital. Child mental and physical health, physical activity, and sleep quality were better in families with greater family social capital. Findings suggest greater family social capital is linked to healthier weight-related behaviors and home environments. Future intervention studies should incorporate strategies to build family social capital and compare longitudinal outcomes to traditional interventions to determine the relative value of family social capital on health behaviors.

Whose Story Is It? Thinking Through Early Childhood with Young Children’s Photographs

Child-centered practices and pedagogies of listening to children are part and parcel of progressive early childhood education. As critical early childhood teachers and researchers, we demonstrate that we value the voices and narratives of children by placing them at the center of our classroom and research agendas. Simultaneously, however, young children’s social position can put them at the mercy of adults’ (teachers’ and researchers’) whims, and their stories may easily be consumed in the name of provocative classroom displays or academic articles. This work explores the potential for visual participatory research, guided by critical childhood studies, to grasp the stories that young children themselves want to tell. Through interviews and group meetings wherein young children (ages 2 to 5) show, gesture, and talk about the photographs they take, the children and their peers make determinations as to how their stories take shape. The narrative I share in this work illustrates one young child’s identity work during the Collaborative Seeing process. Jaylen’s participation in the study speaks to how we can come to see and know children on their terms.

Impact of atopic dermatitis on the quality of life of children and their families.

Background Atopic dermatitis (AD) is the most common chronic inflammatory skin disease, with a significant effect on the quality of life (QoL). This study aims to evaluate the impact of AD on the QoL of children and their parents and to identify predictors affecting their QoL. Methods The cross-sectional study was conducted in Montenegro. It included 200 children with AD aged 5-16 years and their parents. The severity of disease was measured by the Three Item Severity (TIS) score, while QoL was assessed with the Children's Dermatology Life Quality Index (CDLQI) and the Dermatitis Family Impact (DFI) questionnaire. Results The mean CDLQI score of the children affected by AD was 17.11 and the mean DFI score of their parents 19.86. There was a significant correlation between AD severity score assessed by a doctor (TIS) and both CDLQI and DFI scores (r=0.53 and r=0.27, respectively). A moderate positive correlation was observed between the QoL of children with AD and QoL of their parents (r=0.53). According to multiple linear regression, more impaired QoL of affected children was associated with more severe AD, younger parent's age and their lower educational level. Poorer QoL of parents was associated with female sex, younger age of children, more severe AD, lower educational level of parents and absence of a family history of atopic disease. Conclusions The present study confirmed that AD has a large negative impact on QoL of both patients with AD and their families. More impaired QoL was associated with more severe AD.

Multilab Direct Replication of Flavell, Beach, and Chinsky (1966): Spontaneous Verbal Rehearsal in a Memory Task as a Function of Age

Work by Flavell, Beach, and Chinsky indicated a change in the spontaneous production of overt verbalization behaviors when comparing young children (age 5) with older children (age 10). Despite the critical role that this evidence of a change in verbalization behaviors plays in modern theories of cognitive development and working memory, there has been only one other published near replication of this work. In this Registered Replication Report, we relied on researchers from 17 labs who contributed their results to a larger and more comprehensive sample of children. We assessed memory performance and the presence or absence of verbalization behaviors of young children at different ages and determined that the original pattern of findings was largely upheld: Older children were more likely to verbalize, and their memory spans improved. We confirmed that 5- and 6-year-old children who verbalized recalled more than children who did not verbalize. However, unlike Flavell et al., substantial proportions of our 5- and 6-year-old samples overtly verbalized at least sometimes during the picture memory task. In addition, continuous increase in overt verbalization from 7 to 10 years old was not consistently evident in our samples. These robust findings should be weighed when considering theories of cognitive development, particularly theories concerning when verbal rehearsal emerges and relations between speech and memory.

Self-regulation task in young school age children born preterm: Correlation with early academic achievement

BackgroundChildren born preterm are at risk for difficulties in executive function (EF), however there are limited tools to assess EF in young children and it is not fully understood how these early deficits are related to emerging academic skills. AimsTo examine (a) early EF differences in young children born preterm, (b) how a measure of behavioral self-regulation correlates with other measures of EF in children born preterm, and (c) how this measure relates to academic outcomes in children born preterm. Study designLongitudinal cohort study. SubjectsThirty-three healthy children born preterm (25–32 weeks gestation) and 14 children born full term were assessed before starting kindergarten at age 5 and again at ages 6 and 7 years. Outcome measuresEach assessment included a measure of behavioral self-regulation, the Head Toes Knees Shoulders task (HTKS), performance-based measures of EF, parent rating scales of EF and behavior problems, a measure of motor ability, and academic measures. ResultsChildren born preterm performed worse on all measures of self-regulation, EF, parent-report, academic outcomes, and motor ability across time. The HTKS had weak to moderate correlations with parent-report and performance-based measures of EF, moderate to strong correlations with academic performance, and was not correlated with motor ability. ConclusionThis study shows the predictive value of early EF measures on functional academic outcomes and their potential as targets of effective interventions in this high-risk population.

Undernutrition and associated factors among children under 2 years of age in Jimma Zone, Southwest Ethiopia

Undernutrition among children is a primary concern in sub-Saharan African countries such as Ethiopia. The objective of this paper is to measure the magnitude of undernutrition and associated factors among children under 2 years of age in the Jimma Zone of Southwest Ethiopia. A community-based cross-sectional study with stratified multistage sampling was conducted. Data were collected using a semi-structured questionnaire and anthropometric measurements. Bivariate and multivariable logistic regression models were fitted using SPSS 20.0 for Windows. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to measure the strength of the association between dependent and associated variables at a p value <0.05. Among the study participants, 142 (25.4%) were stunted, 73 (13.1%) were underweight, and 54 (9.7%) were wasted. Older child age [AOR = 1.1, 95% CI (1.1, 1.2)], male sex [AOR = 2.601, 95% CI (1.681, 4.025)], and residing in an urban area [AOR = 0.526, 95% CI (0.323, 0.857)] were significantly associated with stunting. Independent predictors of wasting were younger child age [AOR = 0.894, 95% CI (0.833, 0.96)], living in a lowland area [AOR = 3.3, 95% CI (1.4, 8.1)], and living a in poor household [AOR = 6.2, 95% CI (2.2, 17.7)]. Underweight was significantly associated with male sex [AOR = 2.09, 95% CI (1.179, 3.703)], delayed initiation of breastfeeding [AOR = 2.1, 95% CI (1.0, 4.2)], and living in a poor household [AOR = 2.2, 95% CI (1.0, 4.6)]. Child malnutrition was found to be a moderate public health problem in the study area. Urban dwellers had higher levels of undernutrition than rural dwellers. Children living in lowlands had higher undernutrition than those living in highland areas.