The Future of Preschool Prevention, Assessment, and Intervention

Association between maternal exercise during pregnancy and attention-deficit/hyperactivity disorder among preschool children in Southwest China

Objective

Maternal moderate-intensity exercise during pregnancy has important health benefits for the offspring, however, less is known about its association with offspring attention-deficit/hyperactivity disorder (ADHD). This study aimed to explore the association between maternal exercise during pregnancy and ADHD among preschool children in Southwest China.

Methods

A web-based cross-sectional study was performed in 2021, and the revised Conners Parental Symptom Questionnaire and maternal exercise during pregnancy were obtained through a self-reported structured questionnaire. A binary logistic regression model was used to assess the association between maternal exercise during pregnancy and the likelihood of childhood ADHD after adjustment for covariates.

Results

A total of 4,184 preschool children aged 3-6 years were included in our final analysis. Children whose mothers exercised for <20 min per day were more likely to be at risk of ADHD (6.3%), compared to those whose mothers exercised for more than 40 min (3.1%) or 20-40 min (2.8%) per day. Daily exercise of <20 min during pregnancy was associated with higher odds of childhood ADHD (adjusted OR = 2.11; 95% CI: 1.41, 3.16) after multivariable adjustment. The association of maternal exercise during pregnancy with childhood ADHD was similar in subgroups stratified by child's sex, and by maternal smoking, sleep duration and gestational anemia during pregnancy.

Conclusion

Our findings highlight the importance of maternal moderate-intensity exercise during pregnancy for the prevention of childhood ADHD. Prospective studies are needed to confirm our findings in the future.

Yoga and Mindfulness Interventions for Preschool-Aged Children in Educational Settings: A Systematic Review

Early childhood and the pre-school stage of development constitute a dynamic period for acquisition of social-emotional competencies. Yoga and mindfulness practices (YMP) have become increasingly used in schools for social emotional learning, but less is known about their utility in early childhood settings. A systematic review using PRISMA guidelines was undertaken to explore the effect of YMP on social emotional function among preschool-aged children (3-5 years). The review resulted in identification of 1115 records, of which 80 full text articles were screened, with final inclusion of 16 studies. Included studies evaluated the effect of YMP on social-emotional functioning, and identified the potential for YMP to improve regulatory skills such as behavioral self-regulation and executive function. Among studies reviewed, 13 reported improvements in these domains, but quality appraisal indicated significant variability in risk of bias across studies, and heterogeneity of outcome measurements hindered comparison. Programs appeared to produce better results when implemented for at least 6 weeks and among children who had lower baseline social-emotional functioning. YMP constitute a promising strategy for social emotional development in early childhood settings, but additional rigorously designed studies are needed to expand understanding of how and why these programs are effective.

Effects of group singing versus group music listening on hospitalized children and adolescents with mental disorders: A pilot study

Background

There is an emerging view that music-related interventions (MuRI) may play an important role for youth with mental disorders. Here, we assessed the potential neuroendocrine (cortisol), immune (IgA) and psychological (mood state, health-related quality of life (HRQOL), well-being) efficacy of a brief program of MuRI (group singing versus group music listening) in children and adolescents with mental disorders in a clinical setting.

Methods

We performed this observational pilot study with 17 patients (aged 11-18; 11 female) admitted to the Department for Child and Adolescent Psychiatry/PMU Salzburg, Austria between March 2015 and April 2016. Patients participated in either a singing program or a music listening program, delivered through five daily, consecutive 45-minute sessions in one week.

Outcomes

Saliva samples for cortisol and IgA, and subjective measures of mood were taken daily, pre- and post-MuRI. HRQOL and well-being were measured pre- and post-5-day-program of MuRI. The program in singing led to a significantly larger mean drop in cortisol than in music listening (mean difference: -0·32; 95% CI -0·57 to -0·07), while listening led to a significantly higher mean positive change in the dimension calmness (mean difference: -2·66, 95%CI -4·99 to -0·33) than singing. Moreover, singing was associated with an improvement in HRQOL, and listening with an improvement in well-being.

Interpretation

Our preliminary findings suggest that MuRI may provide benefits for children and adolescents with mental disorders. The differences in psychobiological responses to singing and music listening invite further investigations. A larger, suitably powered study is now needed to provide a precise estimate of the effects of MuRI for mental health promotion, both on psychological and biological experiences. Funding: Salzburg Festival, Austria, and Focus Area 'Science and Art', Salzburg, Austria.

Protocol for digital intervention for effective health promotion of small children-A cluster randomized trial

AIM

This article introduces the protocol of a study aiming to evaluate the effectiveness of digital WellWe intervention in supporting the participation of families with small children in the promotion of their health.

BACKGROUND

Early childhood is a meaningful period for building a strong base for good health. Parents play a key role in affecting the health behaviour and psychosocial development of their children. A family-centred approach makes it possible to support families' individual health literacy needs and empower them to take actions towards promoting healthier behaviour. However, there are a lack of family-centred digital health interventions intended for parents and their small children.

DESIGN

The study is designed as a two-arm cluster, randomized, controlled trial with a 4-month follow-up.

METHODS

The data are being collected from 200 families with a 4-year-old child. Cluster randomization is being performed at the municipality level. Municipalities (N = 4) located in Southwest Finland, comprising child health clinics (N = 15) with their family clients, were randomly allocated to either an intervention (WellWe intervention) or a control group (usual care). The outcome measures include parental self-efficacy for healthy behaviours, mindfulness in parenting and the family-centred approach of the extensive health examination. Data collection is being performed at baseline, after the intervention and at a 4-month follow-up.

DISCUSSION

The results from this study will make it possible to determine whether this new method can be recommended for implementation in child health clinic settings to support the participation of families with small children in promoting their health.