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Markkula A, Pyhälä-Neuvonen R, Stolt S. Interventions and their efficacy in supporting language development among preterm children aged 0-3 years - A systematic review. Early Hum Dev 2024; 195:106057. [PMID: 38901388 DOI: 10.1016/j.earlhumdev.2024.106057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/26/2024] [Accepted: 06/03/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Preterm children have a higher risk for linguistic delays than full-term infants but are rarely provided with language intervention at an early age. Knowledge on early language interventions targeted to preterm children is scarce, and efficacy of the interventions is rarely reported. AIM This systematic review aims to identify interventions for preterm children aged 0-3 years with at least one language outcome. Efficacy of the interventions and quality of the study reports were evaluated. STUDY DESIGN The article search was carried out in six databases: EBSCOhost, Scopus, ERIC, LLBA, Ovid, and Web of Science. Effect sizes (Hedges' g) were calculated for language outcomes. Quality of the study reports was assessed using the levels of evidence system by the American Speech-Language-Hearing Association. RESULTS The 28 studies identified were divided into three groups: interventions at Neonatal Intensive Care Unit, interventions during the first year, and interventions during the second and/or third years. Most of the interventions focused on supporting child-care and general development. Of the interventions, 61 % were efficacious in supporting language development of preterm children. The most promising results regarding efficacy were interventions conducted during the second and/or third years (80 %). Quality of the reports varied from high/good (89 %) to low (11 %). CONCLUSION The 28 existing studies provide limited evidence of the efficacy of very early interventions promoting language development of preterm children. However, especially the results for interventions conducted during the second and/or third years show promise. More studies, particularly language-focused interventions with longer follow-ups, are needed.
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Affiliation(s)
- Anna Markkula
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Riikka Pyhälä-Neuvonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Suvi Stolt
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Duncan AF, Gerner GJ, Neel ML, Burton VJ, Byrne R, Warschausky S. Interventions to improve executive functions in children aged 3 years and under: A systematic review. Child Care Health Dev 2024; 50:e13298. [PMID: 38958229 DOI: 10.1111/cch.13298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/27/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Early executive functioning (EF) skills are foundational capabilities that predict school readiness, academic development and psychiatric risk. Early interventions enhancing these capabilities could have critical import in improving outcomes. However, to develop interventions, it is necessary to identify specific EF skills that will vary with child age. Thus, we aimed to examine the characteristics and efficacy of interventions targeting EF in infancy and early childhood up to age 3. METHODS A comprehensive search of PubMed, Embase, CINAHL and APA PsycINFO databases was performed for studies published before December 2022. Randomized and non-randomized studies of interventions designed to improve at least one EF skill in children ≤3 years were included. EF skills included attentional control, inhibition/self-regulation, activity initiation, working memory, cognitive flexibility, planning ability, problem-solving and performance monitoring. We independently extracted data, used the revised Cochrane Risk-of-Bias tool to assess the quality of the evidence and conducted Synthesis Without Meta-analysis (SWiM). The overall quality of the evidence and the strength of recommendations was determined using elements of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS Thirty-five studies met inclusion criteria (original n = 7467). Studies were highly variable in the EF skill targeted, target subject (i.e., child, parent and teacher), nature and dosage of the intervention, and timing of outcome assessment. Most interventions focused on improving impulse control and self-regulation. The overall quality of evidence was low to moderate with a high risk of bias, though six studies had low risk of bias but yielded mixed findings of efficacy. CONCLUSIONS The relatively small number of early EF intervention studies uses such variable methods that there is currently no converging evidence of efficacy to recommend a specific intervention. Thus, findings support the need for a more systematic, targeted approach to the design and implementation of early EF interventions for target populations.
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Affiliation(s)
- Andrea F Duncan
- Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Gwyn J Gerner
- Division of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mary Lauren Neel
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Vera J Burton
- Division of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Neurology and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rachel Byrne
- Cerebral Palsy Foundation, New York, New York, USA
| | - Seth Warschausky
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
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Orton J, Doyle LW, Tripathi T, Boyd R, Anderson PJ, Spittle A. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database Syst Rev 2024; 2:CD005495. [PMID: 38348930 PMCID: PMC10862558 DOI: 10.1002/14651858.cd005495.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
BACKGROUND Infants born preterm are at increased risk of cognitive and motor impairments compared with infants born at term. Early developmental interventions for preterm infants are targeted at the infant or the parent-infant relationship, or both, and may focus on different aspects of early development. They aim to improve developmental outcomes for these infants, but the long-term benefits remain unclear. This is an update of a Cochrane review first published in 2007 and updated in 2012 and 2015. OBJECTIVES Primary objective To assess the effect of early developmental interventions compared with standard care in prevention of motor or cognitive impairment for preterm infants in infancy (zero to < three years), preschool age (three to < five years), and school age (five to < 18 years). Secondary objective To assess the effect of early developmental interventions compared with standard care on motor or cognitive impairment for subgroups of preterm infants, including groups based on gestational age, birthweight, brain injury, timing or focus of intervention and study quality. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and trial registries in July 2023. We cross-referenced relevant literature, including identified trials and existing review articles. SELECTION CRITERIA Studies included randomised, quasi-randomised controlled trials (RCTs) or cluster-randomised trials of early developmental intervention programmes that began within the first 12 months of life for infants born before 37 weeks' gestational age (GA). Interventions could commence as an inpatient but had to include a post discharge component for inclusion in this review. Outcome measures were not prespecified, other than that they had to assess cognitive outcomes, motor outcomes or both. The control groups in the studies could receive standard care that would normally be provided. DATA COLLECTION AND ANALYSIS Data were extracted from the included studies regarding study and participant characteristics, timing and focus of interventions and cognitive and motor outcomes. Meta-analysis using RevMan was carried out to determine the effects of early developmental interventions at each age range: infancy (zero to < three years), preschool age (three to < five years) and school age (five to < 18 years) on cognitive and motor outcomes. Subgroup analyses focused on GA, birthweight, brain injury, time of commencement of the intervention, focus of the intervention and study quality. We used standard methodological procedures expected by Cochrane to collect data and evaluate bias. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS Forty-four studies met the inclusion criteria (5051 randomly assigned participants). There were 19 new studies identified in this update (600 participants) and a further 17 studies awaiting outcomes. Three previously included studies had new data. There was variability in the focus and intensity of the interventions, participant characteristics, and length of follow-up. All included studies were either single or multicentre trials and the number of participants varied from fewer than 20 to up to 915 in one study. The trials included in this review were mainly undertaken in middle- or high-income countries. The majority of studies commenced in the hospital, with fewer commencing once the infant was home. The focus of the intervention programmes for new included studies was increasingly targeted at both the infant and the parent-infant relationship. The intensity and dosages of interventions varied between studies, which is important when considering the applicability of any programme in a clinical setting. Meta-analysis demonstrated that early developmental intervention may improve cognitive outcomes in infancy (developmental quotient (DQ): standardised mean difference (SMD) 0.27 standard deviations (SDs), 95% confidence interval (CI) 0.15 to 0.40; P < 0.001; 25 studies; 3132 participants, low-certainty evidence), and improves cognitive outcomes at preschool age (intelligence quotient (IQ); SMD 0.39 SD, 95% CI 0.29 to 0.50; P < 0.001; 9 studies; 1524 participants, high-certainty evidence). However, early developmental intervention may not improve cognitive outcomes at school age (IQ: SMD 0.16 SD, 95% CI -0.06 to 0.38; P = 0.15; 6 studies; 1453 participants, low-certainty evidence). Heterogeneity between studies for cognitive outcomes in infancy and preschool age was moderate and at school age was substantial. Regarding motor function, meta-analysis of 23 studies showed that early developmental interventions may improve motor outcomes in infancy (motor scale DQ: SMD 0.12 SD, 95% CI 0.04 to 0.19; P = 0.003; 23 studies; 2737 participants, low-certainty evidence). At preschool age, the intervention probably did not improve motor outcomes (motor scale: SMD 0.08 SD, 95% CI -0.16 to 0.32; P = 0.53; 3 studies; 264 participants, moderate-certainty evidence). The evidence at school age for both continuous (motor scale: SMD -0.06 SD, 95% CI -0.31 to 0.18; P = 0.61; three studies; 265 participants, low-certainty evidence) and dichotomous outcome measures (low score on Movement Assessment Battery for Children (ABC) : RR 1.04, 95% CI 0.82 to 1.32; P = 0.74; 3 studies; 413 participants, low-certainty evidence) suggests that intervention may not improve motor outcome. The main source of bias was performance bias, where there was a lack of blinding of participants and personnel, which was unavoidable in this type of intervention study. Other biases in some studies included attrition bias where the outcome data were incomplete, and inadequate allocation concealment or selection bias. The GRADE assessment identified a lower certainty of evidence in the cognitive and motor outcomes at school age. Cognitive outcomes at preschool age demonstrated a high certainty due to more consistency and a larger treatment effect. AUTHORS' CONCLUSIONS Early developmental intervention programmes for preterm infants probably improve cognitive and motor outcomes during infancy (low-certainty evidence) while, at preschool age, intervention is shown to improve cognitive outcomes (high-certainty evidence). Considerable heterogeneity exists between studies due to variations in aspects of the intervention programmes, the population and outcome measures utilised. Further research is needed to determine which types of early developmental interventions are most effective in improving cognitive and motor outcomes, and in particular to discern whether there is a longer-term benefit from these programmes.
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Affiliation(s)
- Jane Orton
- Royal Women's Hospital, Parkville, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Tanya Tripathi
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
| | - Roslyn Boyd
- The University of Queensland, Brisbane, Australia
| | - Peter J Anderson
- Department of Clinical Sciences, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Alicia Spittle
- Department of Physiotherapy, University of Melbourne, Parkville, Australia
- Murdoch Childrens Research Institute and the University of Melbourne, Parkville, Australia
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Khajehei M. Endorphins, Sexuality, and Reproduction. ADVANCES IN NEUROBIOLOGY 2024; 35:397-433. [PMID: 38874734 DOI: 10.1007/978-3-031-45493-6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Beta-endorphin is secreted from the hypothalamus and pituitary in both mother and newborn. The placenta produces numerous pituitary hormones from the third month of pregnancy, one of which is βE. It has been suggested that βE has a role in the appetitive and precopulatory phase of sexual behavior in animals. An increase in endorphin levels during sexual activity in humans may contribute to attachment and bonding between partners, but contradictory reports in the literature question the association between sexuality and βE levels. The level of βE also increases during pregnancy, rises in early labor, peaks in late labor, and drops in the postpartum period. This fluctuation provides natural analgesia, raises the pain threshold, decreases the sensation of pain, or suppresses pain, and decreases fear levels during labor and birth. Beta-endorphin also protects the fetus from hypoxia during labor and birth and potential neural damage by aiding blood flow to the brain under hypoxic conditions. It has been suggested that a variety of pharmacologic and nonpharmacologic complementary therapies, when used in pregnancy, labor, and birth, activate the opioid receptors in the CNS and alter the sensation of pain during labor and birth, affect the mother-child attachment and affect sexual function. These studies report contradictory results that will be discussed in this chapter.
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Duncan AF. Interventions for Executive Function in High-Risk Infants and Toddlers. Clin Perinatol 2023; 50:103-119. [PMID: 36868701 DOI: 10.1016/j.clp.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
This review summarizes the current state of evidence regarding interventions for executive function in high-risk infants and toddlers. Currently, there is a paucity of data in this area, with the interventions that have been studied highly variable in their content, dosage, target, and results. Self-regulation is the executive function construct targeted the most, with mixed results. The few studies that report later child outcomes in prekindergarten/school-aged children are encouraging, overall indicating improved cognition and behavior in the children of parents who received a parenting style intervention.
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Affiliation(s)
- Andrea F Duncan
- Division of Neonatology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, 2nd Floor Main, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Erickson SJ, Kubinec N, Vaccaro S, Moss N, Avila-Rieger R, Rowland A, Lowe JR. The role of maternal interactive behavior and gestational age in predicting infant affect during the Still-Face Paradigm. Early Hum Dev 2021; 163:105485. [PMID: 34649191 DOI: 10.1016/j.earlhumdev.2021.105485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/13/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Emotion regulation develops through bidirectional affective communication. AIM To investigate the role of maternal interactive behavior in predicting infant affect among preterm versus full-term infants. STUDY DESIGN The association between maternal interactive behavior (contingent, attention seeking, watching) and infant affect during a modified Still Face (SF) paradigm in a sample of 22 preterm and 28 full term infants (3 ½ - 4 ½ months old) was investigated. METHODS Maternal behavior and infant affect were coded in one second intervals. RESULTS Maternal contingent interaction was positively correlated with positive infant affect (p < 0.001 for Play; p < 0.001 for Reunion#1; p < 0.01 for Reunion#2, respectively), with a stronger association during the second reunion for preterm infants (p < 0.001). In the preterm sample but not in the full-term sample, attention seeking maternal interaction at Play (baseline), Reunion#1, and Reunion#2 were all positively correlated with negative infant affect at Still Face#2. Maternal watching was negatively associated with positive infant affect for the full sample for both Reunion episodes (p < 0.05). Full term infants' negative affect increased from baseline to the first SF episode and then plateaued, whereas preterm infants demonstrated greater negative affect and less recovery throughout. Mothers of full-term infants showed increased contingent responding after the first SF stressor, while mothers of preterm infants did not (p < 0.05). CONCLUSIONS Preterm infants may be more susceptible to both positive and negative maternal behaviors and mothers of full-term infants may be more responsive to infants' increased distress. Relationship-focused interventions addressing maternal behaviors may enhance positive emotionality and improve self-regulation in medically at-risk infants.
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Affiliation(s)
- Sarah J Erickson
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States.
| | - Nicole Kubinec
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States
| | - Suzanne Vaccaro
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States
| | - Natalia Moss
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States
| | - Rebecca Avila-Rieger
- Department of Psychology, University of New Mexico, Logan Hall, MSC03 2220, Albuquerque, NM 87131, United States
| | - Andrew Rowland
- UNM College of Population Health, University of New Mexico, Albuquerque, NM 87131, United States
| | - Jean R Lowe
- Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, United States
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Finlay-Jones A, Ang JE, Bennett E, Downs J, Kendall S, Kottampally K, Krogh-Jespersen S, Lim YH, MacNeill LA, Mancini V, Marriott R, Milroy H, Robinson M, Smith JD, Wakschlag LS, Ohan JL. Caregiver-mediated interventions to support self-regulation among infants and young children (0-5 years): a protocol for a realist review. BMJ Open 2021; 11:e046078. [PMID: 34112642 PMCID: PMC8194327 DOI: 10.1136/bmjopen-2020-046078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/17/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Self-regulation is a modifiable protective factor for lifespan mental and physical health outcomes. Early caregiver-mediated interventions to promote infant and child regulatory outcomes prevent long-term developmental, emotional and behavioural difficulties and improve outcomes such as school readiness, educational achievement and economic success. To harness the population health promise of these programmes, there is a need for more nuanced understanding of the impact of these interventions. The aim of this realist review is to understand how, why, under which circumstances and for whom, early caregiver-mediated interventions improve infant and child self-regulation. The research questions guiding this review were based on consultation with families and community organisations that provide early childhood and family services. METHODS AND ANALYSIS Realist reviews take a theory-driven and iterative approach to evidence synthesis, structured around continuous refinement of a programme theory. Programme theories specify context-mechanism-outcome configurations to explain what works, for whom, under which circumstances and how. Our initial programme theory is based on prior work in this field and will be refined through the review process. A working group, comprising service users, community organisation representatives, representatives from specific populations, clinicians and review team members will guide the evidence synthesis and interpretation, as well as the development and dissemination of recommendations based on the findings of the review. The review will involve searching: (i) electronic databases, (ii) connected papers, articles and citations and (iii) grey literature. Decisions to include evidence will be guided by judgements about their contribution to the programme theory and will be made by the research team, with input from the working group. Evidence synthesis will be reported using the Realist and MEta-narrative Evidence Synthesis: Evolving Standards guidelines. ETHICS AND DISSEMINATION Ethical approval is not required as this is a review. Findings will be disseminated to our working group and through peer-reviewed publications and conference presentations. REVIEW REGISTRATION NUMBER The protocol is registered with Open Science Framework https://osf.io/5ce2z/registrations.
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Affiliation(s)
- Amy Finlay-Jones
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Jetro Emanel Ang
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Elaine Bennett
- School of Nursing & Midwifery, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Murdoch, Western Australia, Australia
| | - Jenny Downs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
- Child Disability, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Sally Kendall
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Keerthi Kottampally
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Psychological Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA
| | - Yi Huey Lim
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Leigha A MacNeill
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA
| | - Vincent Mancini
- Early Neurodevelopment and Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Rhonda Marriott
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Murdoch, Western Australia, Australia
| | - Helen Milroy
- Youth Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Department of Psychiatry, School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Monique Robinson
- Youth Mental Health, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Justin D Smith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- School of Medicine, The University of Utah, Salt Lake City, Utah, USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA
| | - Jeneva L Ohan
- School of Psychological Sciences, The University of Western Australia, Crawley, Western Australia, Australia
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Rajabi A, Maleki A, Dadashi M, Karami Tanha F. The Effect of Problem-Solving-Approach-Based Counselling on Maternal Role Adaptation in Women with Late Preterm Infant: A Randomized Controlled Trial. J Caring Sci 2021; 10:62-69. [PMID: 34222114 PMCID: PMC8242297 DOI: 10.34172/jcs.2021.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 11/08/2019] [Indexed: 11/09/2022] Open
Abstract
Introduction: Mothers with preterm infants experience numerous stressful problems which can have negative effects on maternal role adaptation. This study aimed to investigate the effectiveness of consultation using a problem-solving approach on adaptation to the maternal role in women with late preterm infants. Methods: This randomized controlled trial (RCT) was carried out on 80 women with spontaneous late preterm infants recruited at Ayatollah Mousavi Hospital of Zanjan. Using convenience sampling method, the participants were assigned into two groups of intervention and control according to block design. Taking a problem-solving approach, counselling was carried out individually in four sessions. The control group received only routine care. The data were collected using adaptation to maternal role questionnaire including 33 items based on a five-point Likert scale ranging in seven areas, in two steps (before counselling and one month after the last counselling session). Data analysis was performed using the SPSS ver. 16.0 software (SPSS, Inc., Chicago, IL). Results: The total score of adaptations to maternal role and its areas was significantly higher in the intervention group after the follow-up period. Conclusion: A comprehensive counselling including various dimensions of maternity adaptation had a positive effect on improving the adaptation to maternal role in mothers with late preterm infants.
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Affiliation(s)
- Atefeh Rajabi
- Department of Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azam Maleki
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohsen Dadashi
- Department of Clinical Psychology, Social Determinants of Health Research Center, Zanjan University of Medical Science, Zanjan, Iran
| | - Farzaneh Karami Tanha
- Department of Community Medicine, Zanjan University of Medical Science, Zanjan, Iran
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Pathways to social-emotional functioning in the preschool period: The role of child temperament and maternal anxiety in boys and girls. Dev Psychopathol 2020; 32:961-974. [PMID: 31345275 DOI: 10.1017/s0954579419000853] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Individual differences in social-emotional functioning emerge early and have long-term implications for developmental adaptation and competency. Research is needed that specifies multiple early risk factors and outcomes simultaneously to demonstrate specificity. Using multigroup longitudinal path analysis in a sample of typically developing children (N = 541), we examined child temperament dimensions (surgency, negative affectivity, and regulation/effortful control) and maternal anxiety in infancy and age 2 as predictors of child externalizing, internalizing, dysregulation, and competence behaviors at age 3. Four primary patterns emerged. First, there was stability in temperament dimensions and maternal anxiety from infancy to age 3. Second, negative affectivity was implicated in internalizing problems and surgency in externalizing problems. Third, effortful control at age 2 was a potent mediator of maternal anxiety in infancy on age 3 outcomes. Fourth, there was suggestive evidence for transactional effects between maternal anxiety and child effortful control. Most pathways operated similarly for boys and girls, with some differences, particularly for surgency. These findings expand our understanding of the roles of specific temperamental domains and postnatal maternal anxiety in a range of social-emotional outcomes in the preschool period, and have implications for efforts to enhance the development of young children's social-emotional functioning and reduce risk for later psychopathology.
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Klebanoff MA, Fried P, Yeates KO, Rausch J, Wilkins DG, Blei H, Sullivan JA, Phillips W, Wiese A, Jude A, Boone KM, Murnan A, Keim SA. Lifestyle and Early Achievement in Families (LEAF) study: Design of an ambidirectional cohort study of prenatal marijuana exposure and child development and behaviour. Paediatr Perinat Epidemiol 2020; 34:744-756. [PMID: 32744733 PMCID: PMC9514219 DOI: 10.1111/ppe.12693] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/17/2020] [Accepted: 05/10/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Marijuana is the most-used illicit substance during pregnancy in the USA, but only two cohort studies, begun over 30 years ago, were specifically established to assess the association of pregnancy use with childhood outcomes. They found use to be associated with specific deficits in executive function at 8+ years, but did not focus on these outcomes earlier in life when intervention may be more successful. Two general purpose cohorts found increased aggression in exposed female toddlers and increased behavioural problems and tic disorders in exposed school-age children. OBJECTIVES The Lifestyle and Early Achievement in Families (LEAF) study assesses the association of in utero marijuana exposure, documented prospectively by biomarker, self-report, and medical records, with executive function and aggression at age 3½-7 years. METHODS This ambidirectional cohort (historical cohort with continued follow-up) includes women enrolled in the Perinatal Research Repository during prenatal care at Ohio State University Wexner Medical Center and their children, recontacted 3½-7 years post-birth. Children complete 1-2 study visits including cognitive testing, behavioural observation, and maternal and teacher report of behaviour. Family and social environmental factors are assessed. RESULTS Child follow-up began in September 2016; visits continue through August 2020. There are 362 eligible children; 32% had mothers who used marijuana during pregnancy, 10% of mothers completed college, and 23% did not complete high school. Mean maternal age at study registration in pregnancy was 26.4 years, and 63% of mothers were African American. To date, 268 children have completed at least 1 study visit. CONCLUSIONS The LEAF Study will document the association of prenatal marijuana exposure with development and behaviour in the current era when marijuana is more potent than when previous cohorts were studied. The results may inform policy and interventions to counsel reproductive-aged women about the risks of use during pregnancy and guide prevention and treatment of adverse effects among children.
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Affiliation(s)
- Mark A Klebanoff
- Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Peter Fried
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Keith O Yeates
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Joseph Rausch
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Diana G Wilkins
- Center for Human Toxicology, University of Utah, Salt Lake City, UT, USA
| | - Holly Blei
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Jacqueline A Sullivan
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Whitney Phillips
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Anna Wiese
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Abigail Jude
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Kelly M Boone
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Aaron Murnan
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Sarah A Keim
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH, USA
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
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11
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Bulut O, Cam S, Ovali F. Impact of sleep behaviors on social and emotional problems in three-year-old children born prematurely. Sleep Med 2020; 74:173-178. [DOI: 10.1016/j.sleep.2020.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 12/01/2022]
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12
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Belanger R, Leroux D, Lefebvre P. Supporting caregivers of children born prematurely in the development of language: A scoping review. Paediatr Child Health 2019; 26:e17-e24. [PMID: 33542775 DOI: 10.1093/pch/pxz124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/08/2019] [Indexed: 11/13/2022] Open
Abstract
Background Infants born prematurely can display impairments that negatively impact the early years of their development. Compared to their peers born at term, preterm children have higher risks of cerebral palsy, sensory deficits, learning disabilities, cognitive and language deficits, as well as difficulties related to attention and behaviour. Following discharge, parents of preterm children are often supported through neonatal follow-up programs or by community health care practitioners. Through assessment and consultation, professionals foster parental resilience by teaching them about their child's development. Research shows a large volume of literature on improving outcomes for preterm infants, but less attention has been given to the impact and potential importance of education of parents regarding the care they provide from the home. Objective A scoping review was completed to determine the best practices for early intervention in premature children regarding the development of language skills during the preschool years. Methods The review followed the guidelines for the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Results Four general themes emerged from the review and included the importance of providing (1) parental training in the care of an infant born prematurely during neonatal intensive care unit stay; (2) education on the development of language and the importance of parental responsiveness; (3) provision of activities to support child language learning; and (4) overall and ongoing monitoring and support by qualified health professionals. Conclusions The conclusions drawn will provide guidance to health care professionals regarding the education of parents on best practices for stimulating language development in their child.
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Affiliation(s)
- Roxanne Belanger
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
| | - Dominique Leroux
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
| | - Pascal Lefebvre
- School of Speech-Language Pathology, Laurentian University, Sudbury, Ontario
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13
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Morawska A, Dittman CK, Rusby JC. Promoting Self-Regulation in Young Children: The Role of Parenting Interventions. Clin Child Fam Psychol Rev 2019; 22:43-51. [PMID: 30715651 DOI: 10.1007/s10567-019-00281-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Self-regulation is a foundational skill in childhood and underpins various positive and negative outcomes throughout childhood, adolescence and into adulthood. Parents and the way they parent their children play a key role in the development of young children's self-regulatory capacity. However, there is limited evidence for the effectiveness of parenting interventions on child self-regulatory outcomes. This paper provides an overview of the role of parenting in the development of child self-regulation and a summary of the evidence base for parenting interventions to promote self-regulation in children under age eight, focusing on infancy, the toddler/preschooler period, and early school-age. We conclude by examining the gaps in this field of research and providing directions for future research.
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Affiliation(s)
- Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Upland Rd St Lucia, Brisbane, 4072, Australia.
| | - Cassandra K Dittman
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Upland Rd St Lucia, Brisbane, 4072, Australia
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14
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Stack DM, Matte-Gagné C, Dickson DJ. Persistence of Effects of VLBW/PT Birth Status and Maternal Emotional Availability (EA) on Child EA Trajectories. Front Psychol 2019; 9:2715. [PMID: 30761058 PMCID: PMC6361804 DOI: 10.3389/fpsyg.2018.02715] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/17/2018] [Indexed: 11/21/2022] Open
Abstract
Few studies have examined the longitudinal impact of birth status on the infant-mother relationship and on children's socio-emotional development. In the present study we investigated developmental patterns of such relationships [using the Emotional Availability (EA) Scales] in fullterm and VLBW/PT infants from infancy to emerging school age. Our objectives were to: (a) model the developmental trajectories of EA dimensions (maternal sensitivity, structuring, non-hostility; child responsiveness, involvement) in a VLBW/PT and fullterm sample, (b) identify potential effects of VLBW/PT status on these trajectories, and (c) determine whether the effects of VLBW/PT status on children's socio-emotional development (child EA) remained after accounting for the effect of maternal EA. Child-mother dyads (n = 109) were observed in home-based interactions (face-to-face and free play) when children were 6, 12, 18, and 57-months-old in fullterm (37-41 weeks, >2500 g; n = 48) and healthy VLBW/PT (26-32 weeks gestation, birth weight 800-1500 g, corrected for gestational age; n = 61) children. Developmental trajectories of maternal and child EA were assessed using multilevel growth modeling in Mplus. Results indicated that, even after controlling for maternal EA, there was a persistent negative effect of VLBW/PT birth status on child EA trajectories. Both initially and over time, VLBW/PT infants lagged behind their fullterm counterparts on levels of responsiveness and involvement with mothers. There was also a persistent positive effect of maternal EA (sensitivity and structuring) on child EA trajectories. Higher average levels of maternal sensitivity and structuring across time were also associated with higher and persistent levels of child responsiveness and involvement of their mothers. Importantly, results held after modeling both effects together, and after controlling for maternal education and child gender. Our results have implications for VLBW/PT children's development, the parent-child relationship, and integrating family level factors and relationship dimensions in early prevention and intervention programs.
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Affiliation(s)
- Dale M. Stack
- Centre for Research in Human Development, Department of Psychology, Concordia University, Montréal, QC, Canada
| | | | - Daniel J. Dickson
- Centre for Research in Human Development, Department of Psychology, Concordia University, Montréal, QC, Canada
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15
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Yang X, Yin Z, Cheng Y, Yang W, Zhu Z, Zhang M, Li D, Liu D, Yan H, Zeng L. Features and Associated Factors of the Behavioral Development of 24-month-old Children in Rural China: Follow-up Evaluation of a Randomized Controlled Trial. Sci Rep 2018; 8:13977. [PMID: 30228354 PMCID: PMC6143539 DOI: 10.1038/s41598-018-32171-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 08/29/2018] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to assess the risk factors associated with the behavioral development among 24-month-old children in rural northwestern China. A total of 657 children whose mothers had participated in a double-blinded, randomized, controlled trial of antenatal micronutrient supplementation in western China were followed until 24 months of age. Their mental, psychomotor, and behavioral development were assessed by the Bayley Scales of Infant Development. Multivariate logistic regression models were used to examine the factors associated with infant behavioral development. Six behavioral factors of infants were presented: activity, social adaptability, reactivity, endurance, concentration, and motor coordination. Further analysis demonstrated that maternal malnutrition, exposure to risk factors during pregnancy, and adverse birth outcomes negatively affected the behavioral development of children at 24 months, which is a common co-occurrence with cognitive and emotional problems. These results suggest that strategies to improve infant behavioral development should consider the maternal pregnancy status.
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Affiliation(s)
- Xue Yang
- Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China.,Department of Health, Northwest Women's and Children's Hospital, Xi'an, Shaanxi Province, 710061, China
| | - Zhaoyang Yin
- Department of Pediatrics, the Shangluo Central Hospital, Shang Luo, Shaanxi Province, 726000, China
| | - Yue Cheng
- Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China
| | - Wenfang Yang
- Department of Prevention and Health Care, the First Affiliated Hospital of Medical College in Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China
| | - Zhonghai Zhu
- Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China
| | - Min Zhang
- Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China
| | - Danyang Li
- Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China
| | - Danli Liu
- Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China
| | - Hong Yan
- Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China.,Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Xi'an, Shaanxi Province, 710061, China
| | - Lingxia Zeng
- Department of Epidemiology & Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, 710061, China.
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16
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Yu YT, Hsieh WS, Hsu CH, Lin YJ, Lin CH, Hsieh S, Lu L, Cherng RJ, Chang YJ, Fan PC, Yao NJ, Chen WJ, Jeng SF. Family-centered Care Improved Neonatal Medical and Neurobehavioral Outcomes in Preterm Infants: Randomized Controlled Trial. Phys Ther 2017; 97:1158-1168. [PMID: 29186633 DOI: 10.1093/ptj/pzx089] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 08/30/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Family-centered care for preterm infants in Western societies has yielded short- to medium-term benefits. However, the intervention effects have rarely been validated in Eastern societies. OBJECTIVE The aim of this study was to examine whether a family-centered intervention program (FCIP) could improve the short-term medical and neurobehavioral outcomes in preterm infants with very low birth weight (VLBW; a birth weight of <1,500 g) in Taiwan over the outcomes seen with a usual care program (UCP). DESIGN This was a multicenter, single-blind, randomized controlled trial study. SETTING Three medical centers in northern and southern Taiwan were the locations for the study. PARTICIPANTS The participants were 251 VLBW preterm infants without severe perinatal complications. INTERVENTION The infants were randomly assigned to receive the FCIP or the UCP during hospitalization. MEASUREMENTS Infant morbidities, feeding, growth, and neurobehavioral performance were evaluated during the neonatal period. Parental adherence to interventions was measured in the FCIP group. RESULTS The FCIP promoted earlier full enteral feeding (β = -1.1 weeks; 95% CI = -1.9 to -0.2 weeks) and hospital discharge (β = -0.6 week; 95% CI = -1.1 to -0.1 weeks), greater weight gain (β = 3.3 g/d; 95% CI = 0.1 to 6.6 g/d), and better neurobehavioral performance than the UCP (β = 1.2 points; 95% CI = 0.2 to 2.3 points). Furthermore, a higher degree of parental motivation in interventions, goal attainment, and comprehensiveness of home activities was significantly associated with greater effects in infants' neurobehavioral performance and weight gain (r = .20-.31; all Ps < .05). LIMITATIONS The findings may not be generalized to preterm infants with severe perinatal diseases and parents with a low level of interest in interventions. CONCLUSIONS Family-centered care facilitated short-term medical and neurobehavioral outcomes in VLBW preterm infants in Taiwan; the effects were likely achieved through parental adherence to interventions. The designated strategies may be considered in a future launch of family-centered care in Taiwan.
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Affiliation(s)
- Yen-Ting Yu
- Y.-T. Yu, PhD, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wu-Shiun Hsieh
- W.-S. Hsieh, MD, EMBA, Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chyong-Hsin Hsu
- C.-H. Hsu, MD, Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yuh-Jyh Lin
- Y.-J. Lin, MD, Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chyi-Her Lin
- C.-H. Lin, MD, Department of Pediatrics, National Cheng Kung University Hospital
| | - Shulan Hsieh
- S. Hsieh, PhD, Department of Psychology; Institute of Allied Health Sciences, College of Medicine; and Department and Institute of Public Health, National Cheng Kung University, Tainan, Taiwan
| | - Lu Lu
- L. Lu, MD, PhD, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital
| | - Rong-Ju Cherng
- R.-J. Cherng, PT, PhD, Department of Physical Therapy, National Cheng Kung University
| | - Ying-Ju Chang
- Y.-J. Chang, PhD, Department of Nursing, Medical College, National Cheng Kung University
| | - Pi-Chuan Fan
- P.-C. Fan, MD, PhD, Department of Pediatrics, National Taiwan University Hospital
| | - Nai-Jia Yao
- N.-J. Yao, PT, MS, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University
| | - Wei J Chen
- W.J. Chen, MD, ScD, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University
| | - Suh-Fang Jeng
- S.-F. Jeng, PT, ScD, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Floor 3, No. 17, Xu-Zhou Road, 100 Taipei, Taiwan
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17
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FitzGerald T. Does a comprehensive family-centred early intervention service affect stress reactivity and emotion regulation in very low birthweight preterm infants at toddler age? Acta Paediatr 2017; 106:1887. [PMID: 28675466 DOI: 10.1111/apa.13941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Tara FitzGerald
- School of Physiotherapy; The University of Melbourne and Murdoch Childrens Research Institute; Melbourne VIC Australia
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18
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Multimodal Executive Function Measurement in Preschool Children Born Very Low Birth Weight and Full Term: Relationships Between Formal Lab-Based Measure Performance, Parent Report, and Naturalistic Observational Coding. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2017. [DOI: 10.1007/s40817-017-0047-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Caravale B, Sette S, Cannoni E, Marano A, Riolo E, Devescovi A, De Curtis M, Bruni O. Sleep Characteristics and Temperament in Preterm Children at Two Years of Age. J Clin Sleep Med 2017; 13:1081-1088. [PMID: 28760193 DOI: 10.5664/jcsm.6728] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 07/06/2017] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES We aimed to compare 2-year-old children born preterm with children born full term regarding: (1) sleep characteristics, (2) temperament, and (3) relations between sleep pattern and habits and temperament. METHODS The study included 51 preterm children with normal cognitive, language, and motor development (mean = 20.94 months, standard deviation [SD] = 4.08) and 57 full-term children (mean = 21.19, SD = 4.32). To assess sleep-related difficulties and habits and child temperament, mothers completed the following questionnaires: the (1) Sleep Disturbance Scale for Children-adapted (SDSC); (2) Brief Infant Sleep Questionnaire (BISQ); and (3) Italian Temperament Questionnaires-version 12-36 months (QUIT). RESULTS Preterm children needed less support to fall asleep and fell asleep more often alone in their own bed compared to those born at full term; however, preterm children showed more frequent sleep difficulties, such as restlessness and breathing problems during the night. In addition, preterm children had lower scores in the temperamental dimension of attention and higher scores in negative emotionality than full-term children. Finally, sleep problems were correlated with higher motor activity, lower social orientation and attention, and increased negative emotionality; a shorter nocturnal sleep duration was related to higher motor activity and lower inhibition to novelty whereas an earlier rise time was associated with lower attention and social orientation. CONCLUSIONS Preterm children showed sleep pattern problems and disturbance, predominance of attention problems, and negative emotionality related to sleep disruption.
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Affiliation(s)
- Barbara Caravale
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Stefania Sette
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Eleonora Cannoni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Assunta Marano
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Erika Riolo
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonella Devescovi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Mario De Curtis
- Department of Paediatrics, Sapienza University of Rome, Rome, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
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