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Viegas da Silva E, Hartwig FP, Santos TM, Yousafzai A, Santos IS, Barros AJD, Bertoldi AD, Freitas da Silveira M, Matijasevich A, Domingues MR, Murray J. Predictors of early child development for screening pregnant women most in need of support in Brazil. J Glob Health 2024; 14:04143. [PMID: 39173149 PMCID: PMC11341113 DOI: 10.7189/jogh.14.04143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Background Home visiting programmes can support child development and reduce inequalities, but failure to identify the most vulnerable families can undermine such efforts. We examined whether there are strong predictors of poor child development that could be used to screen pregnant women in primary health care settings to target early interventions in a Brazilian population. Considering selected predictors, we assessed coverage and focus of a large-scale home visiting programme named Primeira Infância Melhor (PIM). Methods We undertook a prospective cohort study on 3603 children whom we followed from gestation to age four years. We then used 27 potential socioeconomic, psychosocial, and clinical risk factors measurable during pregnancy to predict child development, which was assessed by the Battelle Developmental Inventory (BDI) at the age of four years. We compared the results from a Bonferroni-adjusted conditional inference tree with exploratory linear regression and principal component analysis (PCA), and we conducted external validation using data from a second cohort from the same population. Lastly, we assessed PIM coverage and focus by linking 2015 cohort data with PIM databases. Results The decision tree analyses identified maternal schooling as the most important variable for predicting BDI, followed by paternal schooling. Based on these variables, a group of 214 children who had the lowest mean BDI (BDI = -0.48; 95% confidence interval (CI) = -0.63, -0.33) was defined by mothers with ≤5 years and fathers with ≤4 years of schooling. Maternal and paternal schooling were also the strongest predictors in the exploratory analysis using regression and PCA, showing linear associations with the outcome. However, their capacity to explain outcome variance was low, with an adjusted R2 of 5.3% and an area under the receiver operating characteristic curve of 0.62 (95% CI = 0.60, 0.64). External validation showed consistent results. We also provided an online screening tool using parental schooling data to support programme's targeting. PIM coverage during pregnancy was low, but the focus was adequate, especially among families with longer enrolment, indicating families most in need received higher dosage. Conclusions Information on maternal and paternal schooling can improve the focus of home visiting programmes if used for initial population-level screening of pregnant women in Brazil. However, enrolment decisions require complementary information on parental resources and direct interactions with families to jointly decide on inclusion.
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Affiliation(s)
- Eduardo Viegas da Silva
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Fernando Pires Hartwig
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Thiago Melo Santos
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Aisha Yousafzai
- Global Health and Population Department, Harvard School of Public Health, Boston, USA
| | - Iná S Santos
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Aluísio J D Barros
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Andréa Dâmaso Bertoldi
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Alicia Matijasevich
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Marlos Rodrigues Domingues
- Postgraduate Programme in Physical Education, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Joseph Murray
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Chang R, Li C, Wei M, Jiang Y, Zhang J. Roles of caregiver-child interaction on the association of socioeconomic status with early childhood development: a population-based study in rural China. BMC Public Health 2024; 24:1604. [PMID: 38880881 PMCID: PMC11181537 DOI: 10.1186/s12889-024-18803-4] [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] [Received: 12/06/2023] [Accepted: 05/08/2024] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVE Socioeconomic status (SES) has been previously associated with children's early development, health, and nutrition; however, evidence about the potential role of caregiver-child interaction in such associations was limited. This study aimed to explore the effect of caregiver-child interaction on the associations of SES with child developmental outcomes, including early neurodevelopment and social-emotional behavior. METHODS A cross-sectional survey was conducted among 2078 children aged 0-6 in a rural county that just lifted out of poverty in 2020 in Central China. The Ages & Stages Questionnaires-Chinese version (ASQ-C) and the Social-Emotional (ASQ: SE) questionnaire were used to assess children's early neurodevelopment and social-emotional behavior, respectively. Caregiver-child interaction was evaluated with the Brigance Parent-Child Interactions Scale. Regression-based statistical mediation and moderation effect were conducted with the PROCESS macro of SPSS. RESULTS Children with low SES had an increased risk of suspected neurodevelopmental delay [OR = 1.92, 95% CI: 1.50, 2.44] and social-emotional developmental delay [OR = 1.31, 95% CI: 1.04, 1.66]. The caregiver-child interaction partially mediated the associations of SES with child developmental outcomes; the proportion of the indirect effect was 14.9% for ASQ-C total score and 32.1% for ASQ: SE score. Moreover, the caregiver-child interaction had a significant moderation effect on the association of SES with ASQ-C total score (P < 0.05). A weaker association was observed in children with high-level caregiver-child interaction than in medium and low ones. Similar moderating effects were found among boys but not girls. CONCLUSION Caregiver-child interaction plays a vital role in the relationship between SES and child development. Children with low SES households will benefit more in terms of their early development from intervention programs strengthening caregiver-child interaction.
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Affiliation(s)
- Rui Chang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunan Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengna Wei
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanfen Jiang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Tovo-Rodrigues L, Camerini L, Martins-Silva T, Carpena MX, Bonilla C, Oliveira IO, de Paula CS, Murray J, Barros AJD, Santos IS, Rohde LA, Hutz MH, Genro JP, Matijasevich A. Gene - maltreatment interplay in adult ADHD symptoms: main role of a gene-environment correlation effect in a Brazilian population longitudinal study. Mol Psychiatry 2024:10.1038/s41380-024-02589-3. [PMID: 38744991 DOI: 10.1038/s41380-024-02589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024]
Abstract
Childhood maltreatment correlates with attention-deficit/hyperactivity disorder (ADHD) in previous research. The interaction between ADHD genetic predisposition and maltreatment's impact on ADHD symptom risk remains unclear. We aimed to elucidate this relationship by examining the interplay between a polygenic score for ADHD (ADHD-PGS) and childhood maltreatment in predicting ADHD symptoms during young adulthood. Using data from the 2004 Pelotas (Brazil) birth cohort comprising 4231 participants, we analyzed gene-environment interaction (GxE) and correlation (rGE). We further explored rGE mechanisms through mediation models. ADHD symptoms were assessed at age 18 via self-report (Adult Self Report Scale - ASRS) and mother-reports (Strength and Difficulties Questionnaire - SDQ). The ADHD-PGS was derived from published ADHD GWAS meta-analysis. Physical and psychological child maltreatment was gauged using the Parent-Child Conflict Tactics Scale (CTSPC) at ages 6 and 11, with a mean score utilized as a variable. The ADHD-PGS exhibited associations with ADHD symptoms on both ASRS (β = 0.53; 95% CI: 0.03; 1.03, p = 0.036), and SDQ (β = 0.20; 95% CI: 0.08; 0.32, p = 0.001) scales. The total mean maltreatment score was associated with ADHD symptoms using both scales [(βASRS = 0.51; 95% CI: 0.26;0.77) and (βSDQ = 0.24; 95% CI: 0.18;0.29)]. The ADHD-PGS was associated with total mean maltreatment scores (β = 0.09; 95% CI: 0.01; 0.17; p = 0.030). Approximately 47% of the total effect of ADHD-PGS on maltreatment was mediated by ADHD symptoms at age 6. No evidence supported gene-environment interaction in predicting ADHD symptoms. Our findings underscore the significant roles of genetics and childhood maltreatment as predictors for ADHD symptoms in adulthood, while also indicating a potential evocative mechanism through gene-environment correlation.
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Affiliation(s)
- Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
| | - Laísa Camerini
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Thais Martins-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Carolina Bonilla
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | - Isabel Oliveira Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Institute of Biology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Luis Augusto Rohde
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents & National Center for Research and Innovation in Child Mental Health, Sao Paulo, Brazil
- Medical School Council, UniEduK, São Paulo, Brazil
| | - Mara Helena Hutz
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Genetics and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Julia Pasqualini Genro
- ADHD Outpatient Program & Development Psychiatry Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Bioscience, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
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Sánchez-Luquez KY, Carpena MX, Karam SM, Martins-Silva T, Barros FC, de Oliveira IO, Santos IS, Barros AJD, Matijasevich A, Tovo-Rodrigues L. Evaluation of genomic factors and early childhood stimulation on intelligence in children from a Brazilian birth cohort: The primary role of independent factors. Prog Neuropsychopharmacol Biol Psychiatry 2024; 131:110932. [PMID: 38169242 DOI: 10.1016/j.pnpbp.2023.110932] [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: 07/20/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Childhood cognitive abilities are a predictor of health outcomes and adult income potential. Identifying factors associated with childhood intelligence and their interactions is essential in behavioral research. We assessed the impact of genetic variants and early child stimulation (ECS) on child intelligence and examined their possible interaction as potential modifiers of IQ in a population-based longitudinal study. METHODS Participants of the 2004 Pelotas Birth Cohort study (N = 4231) underwent intelligent quotient (IQ) by WISC-III assessment at 6 years of age. At 24 and 48-months, mothers answered five ECS marker questions, whose sum was used to create a score. The polygenic score for intelligence (IQ-PGS) was constructed from the GWAS-weighted estimate of cognition. Association was assessed using multiple linear regression models adjusted for maternal, family, and child confounding variables. To explore the possible influence of skin color and ethnoracial classification, the regression models were stratified according to the skin color variable, as a sensitivity analysis. RESULTS In the adjusted analysis, IQ-PGS (β = 0.79, 95% confidence interval [95% CI] 0.26;1.31) as well as ECS (β = 2.34; 95% CI: 1.76;2.92) were associated with IQ in this sample. The association between IQ-PGS and IQ was significant only in the white Brazilian group in the sensitivity analysis. However, there was no interaction between IQ-PGS and ECS on IQ (p(IQ-PGS x ECS) = 0.46). CONCLUSIONS ECS did not modify the impact of genetic potential on intellectual development during childhood, suggesting that genetic factors and ECS exert independent effects on the IQ levels of children.
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Affiliation(s)
| | - Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Postgraduate Program in Epidemiology, Pelotas, Brazil
| | - Simone M Karam
- Department of Pediatrics, Medicine Faculty, Federal University of Rio Grande, Rio Grande, Brazil
| | - Thais Martins-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Postgraduate Program in Epidemiology, Pelotas, Brazil
| | - Fernando C Barros
- Post Graduate Program in Health in the Vital Cycle, Catholic University of Pelotas, Pelotas, Brazil
| | - Isabel O de Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brasil
| | - Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Postgraduate Program in Epidemiology, Pelotas, Brazil.
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Wei R, Sullivan EF, Begum F, Rahman N, Tofail F, Haque R, Nelson CA. Parental communicative input as a protective factor in Bangladeshi families living in poverty: A multi-dimensional perspective. Dev Sci 2024:e13494. [PMID: 38504647 DOI: 10.1111/desc.13494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 02/03/2024] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Abstract
Studies from high-income populations have shown that stimulating, supportive communicative input from parents promote children's cognitive and language development. However, fewer studies have identified specific features of input supporting the healthy development of children growing up in low- or middle-income countries. The current study proposes and tests a multi-dimensional framework for understanding whether and how caregiver communicative input mediates the associations between socio-economic conditions and early development. We also examine how caregiver conceptual scaffolding and autonomy support uniquely and synergistically explain variation in child outcomes. Participants were 71 Bangladeshi families with five-year-olds who were exposed to a range of biological and psychosocial hazards from birth. Caregiver-child interactions during snack sharing and semi-structured play were coded for caregiver conceptual scaffolding, autonomy support, and child engagement. Findings indicate that the two dimensions of input were correlated, suggesting that caregivers who provided richer conceptual scaffolds were simultaneously more supportive of children's autonomy. Notably, conceptual scaffolding and autonomy support each mediated associations between maternal education and child verbal intelligence quotient (IQ) scores. Further, caregivers who supported greater autonomy in their children had children who participated in conversations more actively, and these children in turn had higher performance IQ scores. When considered simultaneously, conceptual scaffolding was associated with verbal IQ over and above autonomy support, whereas autonomy support related to child engagement, controlling for conceptual scaffolding. These findings shed new light on how environmental factors may support early development, contributing to the design of family-centered, culturally authentic interventions. A video abstract of this article can be viewed at https://youtu.be/9v_8sIv7ako RESEARCH HIGHLIGHTS: Studies from high-income countries have identified factors mitigating the impacts of socio-economic risks on development. Such research is scarce in low- and middle-income countries. The present study conceptualized and evaluated caregiver communicative input in Bangladeshi families along two interrelated yet distinct dimensions: conceptual scaffolding and autonomy support. Conceptual scaffolding and autonomy support individually mediated associations between maternal education and child verbal IQ, shedding light on protective factors in families living in poverty. Parents providing richer conceptual scaffolds were simultaneously more supportive of children's autonomy. However, the two dimensions each related to cognition and language through unique pathways.
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Affiliation(s)
- Ran Wei
- Graduate School of Education, Peking University, Beijing, China
| | - Eileen F Sullivan
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Brookline, Massachusetts, USA
- Harvard Graduate School of Education, Cambridge, Massachusetts, USA
| | - Fatema Begum
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Brookline, Massachusetts, USA
| | - Navin Rahman
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Brookline, Massachusetts, USA
| | - Fahmida Tofail
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Charles A Nelson
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Brookline, Massachusetts, USA
- Harvard Graduate School of Education, Cambridge, Massachusetts, USA
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Martins-Silva T, Bauer A, Matijasevich A, Munhoz TN, Barros AJD, Santos IS, Tovo-Rodrigues L, Murray J. Early risk factors for conduct problem trajectories from childhood to adolescence: the 2004 Pelotas (BRAZIL) Birth Cohort. Eur Child Adolesc Psychiatry 2024; 33:881-895. [PMID: 37097345 PMCID: PMC10126565 DOI: 10.1007/s00787-023-02178-9] [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: 06/14/2022] [Accepted: 02/23/2023] [Indexed: 04/26/2023]
Abstract
Conduct problems are associated with an increased risk of a wide range of physical, mental, and social problems. However, there is still uncertainty about how early risk factors differentiate different developmental patterns of conduct problems and whether findings replicate across diverse social contexts. We aimed to identify developmental trajectories of conduct problems, and test early risk factors, in the 2004 Pelotas Birth Cohort in Brazil. Conduct problems were measured at ages 4, 6, 11, and 15 years from caregiver reports on the Child Behaviour Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ). Conduct problem trajectories were estimated using group-based semi-parametric modeling (n = 3938). Multinomial logistic regression was used to examine associations between early risk factors and conduct problem trajectories. We identified four trajectories: three with elevated conduct problems, including early-onset persistent (n = 150; 3.8%), adolescence-onset (n = 286; 17.3%), and childhood-limited (n = 697; 17.7%), and one with low conduct problems (n = 2805; 71.2%). The three elevated conduct problem trajectories were associated with a wide range of sociodemographic risk factors, prenatal smoking, maternal mental health, harsh parenting, childhood trauma, and child neurodevelopmental risk factors. Early-onset persistent conduct problems were particularly associated with trauma, living without a father figure, and attention difficulties. The four trajectories of conduct problems from ages 4 to 15 years in this Brazilian cohort have similar longitudinal patterns to those identified in high-income countries. The results confirm previous longitudinal research and developmental taxonomic theories on the etiology of conduct problems in a Brazilian sample.
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Affiliation(s)
- Thais Martins-Silva
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Andreas Bauer
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Tiago N Munhoz
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Luciana Tovo-Rodrigues
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
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de Andrade Leão OA, Bertoldi AD, Domingues MR, Murray J, Santos IS, Barros AJD, Matijasevich A, Mielke GI. Cross-sectional and prospective associations between screen time and childhood neurodevelopment in two Brazilian cohorts born 11 years apart. Child Care Health Dev 2024; 50:e13165. [PMID: 37609715 DOI: 10.1111/cch.13165] [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: 10/13/2022] [Revised: 07/12/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND The aim of this study was to investigate the associations between screen time from ages 2 to 4 years and child neurodevelopment at age 4. METHODS The participants were from the 2004 (N = 3787) and 2015 (N = 3604) Pelotas (Brazil) birth cohort studies. Childhood neurodevelopment was assessed at age 4 using the Battelle Development Inventory. The time children spent on screen devices was reported by their guardians at ages 2 and 4 years. Linear regression models were used to investigate the association of: (i) time spent on television at ages 2 and 4 years; (ii) time spent on other screens at age 4; and (iii) total screen time at age 4 (television + other screens) with childhood neurodevelopment at age 4. RESULTS Average daily screen time among children born in 2004 and those born in 2005 aged 4 years were 3.4 (SD: 2.4) and 4.4 h (SD: 2.9), respectively. Overall, few associations of very small magnitude between screen time and child neurodevelopment were observed. Television time at 2 years of age was statistically associated with lower neurodevelopment at 4 years of age in the 2015 cohort (β = -0.30, 95%CI = -0.55; -0.05). Conversely, television time (β = 0.17, 95%CI = 0.07, 0.26) and total screen time (β = 0.22, 95%CI = 0.13, 0.31) at age 4 were associated with higher neurodevelopment at age 4 in the 2004 cohort. CONCLUSIONS The findings of this study suggest that the amount of time spent on screen devices might not be associated with neurodevelopment of children under 5 years of age. The small magnitude and inconsistencies in the direction of associations did not find evidence to support the current guidelines for screen time at this age. Therefore, more studies, especially those with longitudinal data, are important to comprehend the true effect of screen time on neurodevelopment and other health outcomes.
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Affiliation(s)
| | | | | | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná Silva Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluisio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Gregore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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Girshovitz I, Amit G, Goldshtein I, Zimmerman DR, Baruch R, Akiva P, Avgil Tsadok M, Sadaka Y. Increased rates of unattained developmental milestones among Israeli children between 2016 and 2020: a national report. Isr J Health Policy Res 2023; 12:38. [PMID: 38129917 PMCID: PMC10740256 DOI: 10.1186/s13584-023-00586-5] [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] [Received: 02/07/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The early years of children's lives are critical for their healthy development. Although children's growth and development rates may vary, a significant delay during early childhood could indicate a medical or a developmental disorder. Developmental surveillance is used worldwide by healthcare providers in routine encounters, as well as by educators and parents, to elicit concerns about child development. In this work, we used a national dataset of developmental assessments to describe temporal trends of milestone attainment rates and associations between milestone attainment and various sociodemographic factors. METHODS The study included 1,002,700 children ages birth until 6 years with 4,441,689 developmental visits between the years 2016 and 2020. We used the Israeli developmental scale to assess the annual rates of failure to attain language, social and motoric milestones by the entire population, as well as by subgroups stratified by sociodemographic factors. In addition, we evaluated the rates of parental concern for child development and of the nurse's report of development inadequate for age. We used multivariable logistic regression to analyze the impact of different sociodemographic factors on the odds of failure to attain milestones, while controlling for confounding. RESULTS Milestone failure rates progressively increased over the examined years in all developmental domains, and most prominently in the language domain. Conversely, the rates of parental concern for developmental delay remained constant. In multivariable analysis, higher risk of milestone attainment failure was observed in children whose mothers were divorced, unemployed, immigrant, had lower education, of Bedouin origin or were over 40 years old when giving birth. CONCLUSIONS This report describes national trends of child development in the gross motor, fine motor, language, and social domains. A periodic report of these trends should be published to objectively evaluate subgroups in need for intervention, and to assess the effectiveness of intervention programs in attempt to maximize the developmental potential of children in Israel.
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Affiliation(s)
| | - Guy Amit
- KI Research Institute, Kfar Malal, Israel
| | | | - Deena R Zimmerman
- Department of Maternal and Child Health, Public Health Division, Ministry of Health, Jerusalem, Israel
| | - Ravit Baruch
- Department of Maternal and Child Health, Public Health Division, Ministry of Health, Jerusalem, Israel
| | | | - Meytal Avgil Tsadok
- TIMNA Initiative, Big Data Platform, Israel Ministry of Health, Jerusalem, Israel
| | - Yair Sadaka
- KI Research Institute, Kfar Malal, Israel.
- Neuro-Developmental Research Center, Mental Health Institute, Be'er-Sheva, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.
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9
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Maruyama JM, Bauer A, Hammerton G, Halligan SL, Santos IS, Munhoz TN, Barros AJD, Barros FC, Fairchild G, Matijasevich A. Pathways from maternal depression to child resilience: Socioeconomic, family, and individual factors in the 2004 Pelotas (Brazil) birth cohort. JCPP ADVANCES 2023; 3:e12188. [PMID: 38054047 PMCID: PMC10694539 DOI: 10.1002/jcv2.12188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/16/2023] [Indexed: 12/07/2023] Open
Abstract
Background The negative impacts of maternal depression on child mental health outcomes are well-documented. However, some children show adaptive functioning following exposure to maternal depression, demonstrating resilience. In a large birth cohort from Brazil, a middle-income country, we examined direct and indirect pathways, considering socioeconomic, family, and individual factors, contributing to the development of resilience. Methods Using data from the 2004 Pelotas Birth Cohort (N = 4231), we restricted the sample to those exposed to maternal depression up to age 6 years (depression present at ≥2 out of 5 assessment waves; n = 1132; 50% boys). Resilience was defined as scoring below or equal to the mean of the unexposed group on all four problem subscales of the parent-report Strengths and Difficulties Questionnaire at age 11 years. We examined pathways from socioeconomic status (SES; measured at birth) to resilience via cognitive stimulation (CS) (at 24 and 48 months) and Intelligence quotient (IQ) (at 6 years), and from CS to resilience via IQ, using counterfactual mediation. Results A minority of children exposed to maternal depression showed resilience (12.4%). There was evidence of indirect pathways from SES to resilience via CS (odds ratio (OR) = 1.76, 95% confidence interval (CI) 1.02-3.38) and IQ (OR = 1.19, 95% CI 1.01-1.42), such that higher SES was associated with resilience via both higher levels of CS and higher IQ, which, in turn, were each positively associated with resilience. Furthermore, there was evidence of a direct (OR = 1.86, 95% CI 1.01-3.76) and total effect (OR = 1.94, 95% CI 1.05-3.89) of CS on resilience, even after controlling for SES. However, these effects varied depending on how persistent and severe depression was defined. Conclusions These findings suggest that CS in early childhood may represent a modifiable protective factor for children exposed to maternal depression and a promising intervention target to promote child resilience in the context of maternal depression exposure.
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Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina PreventivaFaculdade de Medicina FMUSPUniversidade de São PauloSão PauloBrazil
| | - Andreas Bauer
- Department of PsychologyUniversity of BathBathUK
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Gemma Hammerton
- Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
| | - Sarah L. Halligan
- Department of PsychologyUniversity of BathBathUK
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Ina S. Santos
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Postgraduate Program in Paediatrics and Child HealthPontifical Catholic University of Rio Grande do SulPorto AlegreBrazil
| | - Tiago N. Munhoz
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Faculty of PsychologyFederal University of PelotasPelotasBrazil
| | | | - Fernando C. Barros
- Postgraduate Program in Health and BehaviourCatholic University of PelotasPelotasBrazil
| | | | - Alicia Matijasevich
- Departamento de Medicina PreventivaFaculdade de Medicina FMUSPUniversidade de São PauloSão PauloBrazil
- Postgraduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
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10
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Alam M, Hickie IB, Poulsen A, Ekambareshwar M, Loblay V, Crouse J, Hindmarsh G, Song YJC, Yoon A, Cha G, Wilson C, Sweeney-Nash M, Troy J, LaMonica HM. Parenting app to support socio-emotional and cognitive development in early childhood: iterative codesign learnings from nine low-income and middle-income countries. BMJ Open 2023; 13:e071232. [PMID: 37192801 DOI: 10.1136/bmjopen-2022-071232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE Many children in low-income and middle-income countries are disadvantaged in achieving early developmental potential in childhood as they lack the necessary support from their surroundings, including from parents and caregivers. Digital technologies, such as smartphone apps, coupled with iterative codesign to engage end-users in the technology-delivered content development stages, can help overcome gaps in early child development (ECD). We describe the iterative codesign and quality improvement process that informs the development of content for the Thrive by Five International Program, localised for nine countries in Asia and Africa. DESIGN Between 2021 and 2022, an average of six codesign workshops in each country were conducted in Afghanistan, Indonesia, Kyrgyzstan, Uzbekistan, Cameroon, the Democratic Republic of the Congo, Ethiopia, Kenya and Namibia.ParticipantsA total of 174 parents and caregivers and 58 in-country subject matter experts participated and provided feedback to refine and inform the cultural appropriateness of the Thrive by Five app and its content. Detailed notes from the workshops and written feedback were coded and analysed using established thematic techniques. RESULTS Four themes emerged from the codesign workshops: local realities, barriers to positive parenting, child development and lessons learnt about the cultural context. These themes, as well as various subthemes, informed content development and refinement. For example, childrearing activities were requested and developed to promote inclusion of families from diverse backgrounds, encourage best parenting practices, increase engagement of fathers in ECD, address parents' mental well-being, educate children about cultural values and help bereaved children with grief and loss. Also, content that did not align with the laws or culture of any country were removed. CONCLUSIONS The iterative codesign process informed the development of a culturally relevant app for parents and caregivers of children in the early years. Further evaluation is required to assess user experience and impact in real world settings.
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Affiliation(s)
- Mafruha Alam
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Adam Poulsen
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Victoria Loblay
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Jacob Crouse
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Gabrielle Hindmarsh
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Yun J C Song
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Adam Yoon
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Grace Cha
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Chloe Wilson
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Jakelin Troy
- Faculty of Arts and Social Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Haley M LaMonica
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
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Degli Esposti M, Matijasevich A, Collishaw S, Martins-Silva T, Santos IS, Baptista Menezes AM, Domingues MR, Wehrmeister FC, Barros F, Murray J. Secular trends and social inequalities in child behavioural problems across three Brazilian cohort studies (1993, 2004 and 2015). Epidemiol Psychiatr Sci 2023; 32:e23. [PMID: 37066785 PMCID: PMC10130841 DOI: 10.1017/s2045796023000185] [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: 06/28/2022] [Revised: 01/31/2023] [Accepted: 03/24/2023] [Indexed: 04/18/2023] Open
Abstract
AIMS Previous epidemiological evidence identified a concerning increase in behavioural problems among young children from 1997 to 2008 in Brazil. However, it is unclear whether behavioural problems have continued to increase, if secular changes vary between sociodemographic groups and what might explain changes over time. We aimed to monitor changes in child behavioural problems over a 22-year period from 1997 to 2019, examine changing social inequalities and explore potential explanations for recent changes in behavioural problems between 2008 and 2019. METHODS The Child Behaviour Checklist was used to compare parent-reported behavioural problems in 4-year-old children across three Brazilian birth cohorts assessed in 1997 (1993 cohort, n = 633), 2008 (2004 cohort, n = 3750) and 2019 (2015 cohort, n = 577). Response rates across all three population-based cohorts were over 90%. Moderation analyses tested if cross-cohort changes differed by social inequalities (demographic and socioeconomic position), while explanatory models explored whether changes in hypothesized risk and protective factors in prenatal development (e.g., smoking during pregnancy) and family life (e.g., maternal depression and harsh parenting) accounted for changes in child behavioural problems from 2008 to 2019. RESULTS Initial increases in child behavioural problems from 1997 to 2008 were followed by declines in conduct problems (mean change = -2.75; 95% confidence interval [CI]: -3.56, -1.94; P < 0.001), aggression (mean change = -1.84; 95% CI: -2.51, -1.17; P < 0.001) and rule-breaking behaviour (mean change = -0.91; 95% CI: -1.13, -0.69 P < 0.001) from 2008 to 2019. Sex differences in rule-breaking behaviour diminished during this 22-year period, whereas socioeconomic inequalities in behavioural problems emerged in 2008 and then remained relatively stable. Consequently, children from poorer and less educated families had higher behavioural problems, compared to more socially advantaged children, in the two more recent cohorts. Changes in measured risk and protective factors partly explained the reduction in behavioural problems from 2008 to 2019. CONCLUSIONS Following a rise in child behavioural problems, there was a subsequent reduction in behavioural problems from 2008 to 2019. However, social inequalities increased and remained high. Continued monitoring of behavioural problems by subgroups is critical for closing the gap between socially advantaged and disadvantaged children and achieving health equity for the next generation.
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Affiliation(s)
- Michelle Degli Esposti
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Stephan Collishaw
- Wolfson Centre for Young People’s Mental Health and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales
| | - Thaís Martins-Silva
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Iná S. Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | - Fernando Barros
- Post Graduate Course in Health in the Life Cycle, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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12
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Martins‐Silva T, Bauer A, Matijasevich A, Santos I, Barros A, Ekelund U, Tovo‐Rodrigues L, Murray J. Educational performance and conduct problem trajectories from childhood to adolescence: Observational and genetic associations in a Brazilian birth cohort. JCPP ADVANCES 2022; 2:e12105. [PMID: 37431415 PMCID: PMC10242956 DOI: 10.1002/jcv2.12105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/24/2022] [Indexed: 11/14/2023] Open
Abstract
Background Educational difficulties are an important potential influence on both the onset and course of children's conduct problems. This study evaluated the association between school failure and children's conduct problems in Brazil, a context with high rates of both conditions, using both observational and genetic approaches. Methods Prospective, population-based, birth cohort study in Pelotas city, Brazil. Parents reported on conduct problems four times between ages 4-15 years, and group-based trajectory analysis was used to classify 3469 children into trajectories of childhood-limited, early-onset persistent, adolescence-onset, or low conduct problems. School failure was measured as having repeated a school grade up to age 11, and a polygenic risk score (PRS) predicting educational attainment was calculated. Multinomial adjusted regression models were used to estimate the association between school failure (observational measure and the PRS) and conduct problem trajectories. To consider possible variation in effects of school failure by social context, interactions were tested with family income and school environment (using both observational and PRS methods). Results Children repeating a school grade had increased odds of being on to childhood-limited (OR: 1.57; 95% CI 1.21; 2.03), adolescence-onset (OR: 1.96; 95% CI 1.39; 2.75), or early-onset persistent trajectory (OR: 2.99; 95% CI 1.85; 4.83), compared to the low conduct problem trajectory. School failure also predicted increased risk for early-onset persistent problems versus the childhood-limited problems (OR: 1.91; 95% CI 1.17; 3.09). Using a genetic PRS approach, similar findings were observed. Associations varied according to the school environment: school failure had larger effects on children in better school environments. Conclusion School performance, whether measured in terms of repeating school grades or genetic susceptibility, was consistently associated with trajectories of child conduct problems into mid-adolescence. We also found a larger association for children in better school environments.
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Affiliation(s)
- Thais Martins‐Silva
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Andreas Bauer
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Alicia Matijasevich
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Departamento de Medicina PreventivaFaculdade de Medicina FMUSPUniversidade de São PauloSão PauloBrazil
| | - Iná Santos
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- Postgraduate Program in Pediatrics and Child HealthSchool of MedicinePontifical Catholic University of Rio Grande do SulPorto AlegreBrazil
| | - Aluísio Barros
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
- International Center for Equity in HealthFederal University of PelotasPelotasBrazil
| | - Ulf Ekelund
- Department of Sport MedicineNorwegian School of Sport SciencesOsloNorway
- Department of Chronic Diseases and AgeingNorwegian Institute of Public HealthOsloNorway
| | - Luciana Tovo‐Rodrigues
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
| | - Joseph Murray
- Human Development and Violence Research Centre (DOVE)Federal University of PelotasPelotasBrazil
- Post‐Graduate Program in EpidemiologyFederal University of PelotasPelotasBrazil
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13
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Godoy PBG, Shephard E, Argeu A, Silveira LR, Salomone E, Aldred C, Green J, Polanczyk GV, Matijasevich A. Social communication therapy for children at risk for neurodevelopmental difficulties: Protocol for a clinical trial. Ann N Y Acad Sci 2022; 1514:104-115. [PMID: 35506888 DOI: 10.1111/nyas.14784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Exposure to adverse environments are risk factors for neurodevelopmental problems in childhood. Children exposed to such environments may benefit from interventions that target social communication abilities, since these are protective factors for healthy neurodevelopment. This randomized controlled trial will test the efficacy of Paediatric Autism Communication Therapy (PACT) in improving social communication development in young children at risk for neurodevelopmental difficulties living in poverty in Brazil. Participants will be 160 children aged 2-4 years with lower-than-average social communication abilities and their primary caregivers. Child-caregiver dyads will be recruited from public childhood education centers in impoverished urban regions of the city of São Paulo, Brazil. Lower-than-average social communication abilities will be defined by standard scores (≤84) on the socialization and/or communication domains of the Vineland Adaptive Behavior Scales. Child-caregiver dyads will be randomized to receive 12 sessions of the PACT intervention (n = 80) or 5 months of community support as usual plus psychoeducation (n = 80). The primary outcome (parent-child interaction) and secondary outcomes (parent-reported social communication abilities and neurophysiological activity during a live social interaction) will be measured pre- and postintervention. This study may lead to new interventions for vulnerable young children in Brazil and better understanding of the neural mechanisms of PACT.
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Affiliation(s)
- Priscilla B G Godoy
- Department of Psychiatry, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Elizabeth Shephard
- Department of Psychiatry, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Adriana Argeu
- Department of Psychiatry, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Leticia R Silveira
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Erica Salomone
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Catherine Aldred
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Guilherme V Polanczyk
- Department of Psychiatry, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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14
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Effects of Regular Exercise During Pregnancy on Early Childhood Neurodevelopment: The Physical Activity for Mothers Enrolled in Longitudinal Analysis Randomized Controlled Trial. J Phys Act Health 2022; 19:203-210. [PMID: 35168196 DOI: 10.1123/jpah.2021-0477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/10/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effect of exercise during pregnancy on early childhood neurodevelopment (cognitive, motor, and language domains). METHODS A randomized controlled trial nested into the 2015 Pelotas (Brazil) Birth Cohort was conducted. Healthy pregnant women were enrolled between 16 and 20 weeks of gestation; 424 women and their children (intervention [n = 141]; control [n = 283]) were analyzed. An exercise-based intervention 3 times per week was delivered over 16 weeks. Child neurodevelopment and its domains were assessed at 1, 2, and 4 years. Standardized mean differences and 95% confidence intervals are presented. RESULTS No effects of exercise during pregnancy on child neurodevelopment and its domains at age 1 year were observed. Compared with the control group, children from women in the exercise group had higher language score at age 2 years (standardized mean differences = 0.23; 95% confidence intervals, 0.02 to 0.44) and higher cognitive score (standardized mean differences = 0.22; 95% confidence intervals, 0.03 to 0.41) at age 4 years. No effects of exercise during pregnancy were observed in the motor domain at 1, 2, and 4 years. CONCLUSIONS No detrimental effects of exercise during pregnancy on child neurodevelopment were observed. In addition, these findings suggest that exercise during pregnancy can result in small benefits for language and cognitive development.
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15
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Araujo WRM, Malta MB, Faggiani LD, Cardoso MA, Matijasevich A. Suspected neuropsychomotor developmental delay in the first 2 years of life in a birth cohort in the Brazilian Amazon: Incidence, persistence and risk factors. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Maíra Barreto Malta
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Lucas Damasio Faggiani
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health Universidade de São Paulo São Paulo Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP Universidade de São Paulo São Paulo Brazil
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16
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Longitudinal Associations Between Device-Measured Physical Activity and Early Childhood Neurodevelopment. J Phys Act Health 2022; 19:80-88. [PMID: 34983024 DOI: 10.1123/jpah.2021-0587] [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: 09/02/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to investigate longitudinal associations between physical activity and early childhood neurodevelopment. METHODS Data from 1673 children from the 2015 Pelotas (Brazil) birth cohort study were analyzed. Physical activity was measured using accelerometers on the wrist at ages 1, 2, and 4 years. Neurodevelopment was measured using the Battelle Development Inventory at age 4 years. Linear regression models were used to test trajectories and cumulative associations of physical activity with child neurodevelopment. RESULTS Of the 3 physical activity trajectories observed, children in the medium (β = 1.17; 95% confidence interval, 0.25 to 2.10) and high (β = 2.22; 95% confidence interval, 0.61 to 3.82) trajectories showed higher neurodevelopment scores than children in the lower activity trajectory. Cumulative analyses showed that children in the highest tertile of physical activity in all follow-ups presented a mean neurodevelopment score 4.57 (95% confidence interval, 2.63 to 6.51) higher than children in the lowest tertile in all follow-ups. All analyses showed a dose-response characteristic of association, with higher physical activity indicating higher neurodevelopment scores. CONCLUSIONS Physical activity may be an important predictor of neurodevelopment through early childhood.
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Viegas da Silva E, Hartwig FP, Barros F, Murray J. Effectiveness of a large-scale home visiting programme (PIM) on early child development in Brazil: quasi-experimental study nested in a birth cohort. BMJ Glob Health 2022; 7:e007116. [PMID: 35074788 PMCID: PMC8788193 DOI: 10.1136/bmjgh-2021-007116] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A large-scale parenting programme with weekly home visits (Primeira Infância Melhor (PIM)) has been implemented in the south of Brazil for nearly two decades, but lacks evaluation of its effects on early childhood development (ECD). This quasi-experimental study aimed to assess the effects of PIM in real-life settings within a population-based birth cohort study. METHODS Data from the 2015 Pelotas Birth Cohort Study and the state programme information system were linked to identify study children who received PIM. Propensity score matching was used to create a comparable control group (using one-to-one matching) to estimate the effect of PIM on ECD measured at age 4 years. First, the impact of any enrolment in PIM was evaluated; then the intervention group was stratified according to whether enrolment occurred during pregnancy or after birth. Double adjustment was applied in linear regression to analyse child development scores, and Poisson regression for delayed development (below the 10th percentile of whole cohort). Effect modification due to family income was explored. RESULTS There was no evidence that any enrolment in PIM (601 pairs) by age 4 years was associated with child development. However, PIM starting during pregnancy (estimated for 121 pairs) predicted higher development scores (0.27 SD; 95% CI 0.02 to 0.52), and 71% lower prevalence of delayed development (prevalence ratio=0.29; 95% CI 0.13 to 0.69), compared with the control group. There was strong statistical evidence (p=0.003, test of interaction) that the effect of PIM starting in pregnancy was larger than when starting after birth (480 pairs). The effect of PIM starting during pregnancy was found to be restricted to poorer families. CONCLUSIONS In a real-life setting, PIM was effective only when starting during pregnancy and only for poorer families. A higher-quality programme might be more effective with a broader population.
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Affiliation(s)
- Eduardo Viegas da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, RS, Brazil
- State Health Surveillance Centre of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Pires Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernando Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, RS, Brazil
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Quality of the home, daycare and neighborhood environment and the cognitive development of economically disadvantaged children in early childhood: A mediation analysis. Infant Behav Dev 2021; 64:101619. [PMID: 34385051 DOI: 10.1016/j.infbeh.2021.101619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/20/2021] [Accepted: 07/24/2021] [Indexed: 11/20/2022]
Abstract
The objective of this study was to investigate how socioeconomic factors and the quality of ecological environments affect motor and cognitive development of economically disadvantaged children. This is a cross-sectional, predictive and correlational study using structural equation modeling to analyze data on 147 economic disadvantage children of 24-36 months attending public daycare. The Bayley-III Scales, the Home Observation for Measurement of the Environment Inventory, the Infant/Toddler Environment Rating Scale-Revised Edition, a socioeconomic index and a specifically designed questionnaire on neighborhood quality were applied. The ecological environments did not affect motor development, but 25 % of variations in cognitive development were explained by socioeconomic differences and differences in the quality of the neighborhood, home and daycare. However, only the quality of the home and daycare had a direct impact, with the other factors affecting the outcome indirectly and to a lesser extent. In conclusion, this study investigated the association between the ecological contexts of economically disadvantaged children and their cognitive and motor development. The findings showed that the environmental context had effect on cognitive development. The home was the environment that exerted the most significant direct effect, followed by daycare and, indirectly and to a lesser extent, the neighborhood. Therefore, the coordination of public policies between health, education and social assistance sectors, aiming at the three ecological environments is important in order to promote the cognitive development of economically disadvantaged children.
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Giugliani ERJ, Gomes E, Santos IS, Matijasevich A, Camargo-Figuera FA, Barros AJD. All day-long pacifier use and intelligence quotient in childhood: A birth cohort study. Paediatr Perinat Epidemiol 2021; 35:511-518. [PMID: 33570810 DOI: 10.1111/ppe.12752] [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: 05/11/2020] [Revised: 11/23/2020] [Accepted: 12/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Literature on pacifier use remains controversial, but mostly suggests an inverse association with childhood intelligence. OBJECTIVES The objective of this study was to assess the association between pacifier use and intelligence quotient (IQ) in six-year-old children from a birth cohort. METHODS Data from 3532 children from the 2004 Pelotas (Brazil) Birth Cohort were analysed. Children were recruited and assessed at birth and followed up at 3 months, and 1, 2, 4, and 6 years. Data on pacifier use duration and intensity were obtained via interviews with mothers in all six follow-up visits. IQ was estimated at 6 years using the Wechsler Intelligence Scale for Children and standardised for the analyses. Crude and adjusted coefficients were calculated (linear regression) for all the data collected in follow-up assessments for pacifier use. RESULTS IQ was inversely associated with all pacifier use indicators. Children who used a pacifier all day long (ADL) at any follow-up showed an IQ 0.18 (95% confidence interval [CI] 0.11, 0.24) standard deviations below those who never used it ADL, after adjusting for confounders. The strength of association increased with number of assessments reporting ADL pacifier use, from a reduction in IQ of 0.13 (95% CI 0.06, 0.21) to 0.34 (95% CI 0.15, 0.52) standard deviations for ADL use in one and in all four follow-up visits, respectively. CONCLUSIONS We found a strong association between intense pacifier use up to 4 years of age and lower IQ at 6 years. A dose-response gradient was observed, with greater IQ deficits in children who used a ADL pacifier for longer durations. The mechanisms underlying this association need to be clarified. One hypothesis is that children using a pacifier, especially those who use it more intensely, are less stimulated.
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Affiliation(s)
- Elsa R J Giugliani
- Faculdade de Medicina, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Erissandra Gomes
- Faculdade de Odontologia, Departamento de Cirurgia e Ortopedia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Iná S Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Programa de Pós-Graduação em Pediatria e Saúde da Criança, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alicia Matijasevich
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Faculdade de Medicina, Departamento de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brazil
| | - Fabio A Camargo-Figuera
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil.,Escuela de Enfermería, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Aluísio J D Barros
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
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20
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Leão OADA, Mielke GI, da Silveira MF, Domingues MR, Murray J, Neumann NA, Dalabona CC, Bertoldi AD. Influence of center-based child care on development of two-year-olds in a Brazilian cohort. Rev Saude Publica 2021; 55:32. [PMID: 34190898 PMCID: PMC8225318 DOI: 10.11606/s1518-8787.2021055002958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/23/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the association between child care attendance since birth and development in two-years-old Brazilian children. METHODS The study used longitudinal data from the 2015 Pelotas Birth Cohort. The childhood development (cognitive, fine and gross motor skills, and language) at two-years-old children was assessed using INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). The child care attendance was measured at ages one and two years and categorized as: a) never attended child care; b) attended some child care (one or two years); and c) always attended child care (one and two years). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analyses of child care attendance and development were carried out using linear regression. RESULTS Out of the 3,870 infants included in the analyses, around 1/3 attended center-based child care. In crude analyses, attending center-based child care was associated with positive developmental outcomes, except in motor domains. In adjusted analyses, compared to those children that have never attended child care, children who did attend presented higher scores for cognitive development (always in child care: β: 2.44, 95%CI: 0.83-4.05; some child care: β: 1.35, 95%CI: 0.17-2.53). CONCLUSIONS This study suggests that center-based child care may help improve child cognitive development in the Brazilian context. Furthermore, the association was higher for early and continued attendance. Considering the low prevalence of children in external care, it is recommended to improve child care opportunities in early childhood.
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Affiliation(s)
- Otávio Amaral de Andrade Leão
- Univerisdade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniverisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Gregore Iven Mielke
- The University of QueenslandSchool of Human Movement and Nutrition SciencesBrisbaneQueenslandAustraliaThe University of Queensland. School of Human Movement and Nutrition Sciences. Brisbane, Queensland, Australia
| | - Mariângela Freitas da Silveira
- Univerisdade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniverisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Marlos Rodrigues Domingues
- Universidade Federal de PelotasEscola Superior de Educação FísicaPrograma de Pós-Graduação em Educação FísicaPelotasRSBrasilUniversidade Federal de Pelotas. Escola Superior de Educação Física. Programa de Pós-Graduação em Educação Física. Pelotas, RS, Brasil
| | - Joseph Murray
- Univerisdade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniverisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
- Human Development and Violence Research CentrePelotasRSBrasilHuman Development and Violence Research Centre (DOVE). Pelotas, RS, Brasil
| | - Nelson Arns Neumann
- Coordenação Nacional da Pastoral da CriançaCuritibaPRBrasilCoordenação Nacional da Pastoral da Criança. Curitiba, PR, Brasil
| | - Caroline Caus Dalabona
- Coordenação Nacional da Pastoral da CriançaCuritibaPRBrasilCoordenação Nacional da Pastoral da Criança. Curitiba, PR, Brasil
| | - Andréa Dâmaso Bertoldi
- Univerisdade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasilUniverisdade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
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21
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Sirajee R, Conroy AL, Namasopo S, Opoka RO, Lavoie S, Forgie S, Salami BO, Hawkes MT. Growth Faltering and Developmental Delay in HIV-Exposed Uninfected Ugandan Infants: A Prospective Cohort Study. J Acquir Immune Defic Syndr 2021; 87:730-740. [PMID: 33819206 DOI: 10.1097/qai.0000000000002626] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/30/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND HIV-exposed but uninfected (HEU) infants are at increased risk of impaired early linear growth and cognitive development. We examined associations between prenatal and postnatal growth and subsequent neurodevelopment in Ugandan HEU infants, hypothesizing that early insults may explain alterations in both somatic growth and brain development. METHODS We prospectively followed a cohort of HEU infants from birth to 18 months of age, and measured length/height, weight, head, and arm circumference longitudinally. The Malawi Development Assessment Tool (MDAT, 12 and 18 months) and the Color Object Association Test (18 months) were used for developmental assessments. RESULTS Among 170 HEU infants, the prevalence of low-birth weight and failure to thrive was 7.6% and 37%, respectively. HEU infants had MDAT scores that were similar to the reference population. The mean (SD) score on the Color Object Association Test was 5.5 (3.1) compared with 6.9 (5.3) in developmentally normal children. Developmental ability at age 18 months showed strong cross-sectional correlation with weight-for-age (ρ = 0.36, P < 0.0001), length/height-for-age (ρ = 0.41, P < 0.0001), head circumference-for-age (ρ = 0.26, P = 0.0011), and mid-upper arm circumference-for-age (ρ = 0.34, P = 0.0014). There was a statistically significant correlation between birth weight and MDAT z-score at 18 months (ρ = 0.20, P = 0.010). Failure to thrive was associated with lower MDAT z-score [median -0.13 (IQR -0.75 to +0.14) versus +0.14 (IQR -0.44 to +0.63), P = 0.042]. CONCLUSION Growth faltering in HEU infants was associated with lower attainment of developmental milestones at age 18 months. Our findings point to a simple screening method for identifying HEU infants at risk for developmental intervention.
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Affiliation(s)
- Reshma Sirajee
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Andrea L Conroy
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, IN
| | - Sophie Namasopo
- Department of Paediatrics, Jinja Regional Referral Hospital, Jinja, Uganda
| | - Robert O Opoka
- Department of Paediatrics and Child Health, Mulago Hospital and Makerere University, Kampala, Uganda
| | - Stephanie Lavoie
- National Laboratory for HIV Reference Services (NLHRS), National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Sarah Forgie
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Bukola O Salami
- Women and Children's Health Research Institute; and
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Michael T Hawkes
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
- Women and Children's Health Research Institute; and
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
- Department of Global Health, School of Public Health, University of Alberta, Edmonton, AB, Canada
- Distinguished Researcher, Stollery Science Lab
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22
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Perumal N, Roth DE, Cole DC, Zlotkin SH, Perdrizet J, Barros AJD, Santos IS, Matijasevich A, Bassani DG. Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes. Am J Epidemiol 2021; 190:477-486. [PMID: 32809017 PMCID: PMC7936033 DOI: 10.1093/aje/kwaa169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 08/03/2020] [Accepted: 08/11/2020] [Indexed: 12/27/2022] Open
Abstract
Child growth standards are commonly used to derive age- and sex-standardized anthropometric indices but are often inappropriately applied to preterm-born children (<37 weeks of gestational age (GA)) in epidemiology studies. Using the 2004 Pelotas Birth Cohort, we examined the impact of correcting for GA in the application of child growth standards on the magnitude and direction of associations in 2 a priori–selected exposure-outcome scenarios: infant length-for-age z score (LAZ) and mid-childhood body mass index (scenario A), and infant LAZ and mid-childhood intelligence quotient (scenario B). GA was a confounder that had a strong (scenario A) or weak (scenario B) association with the outcome. Compared with uncorrected postnatal age, using GA-corrected postnatal age attenuated the magnitude of associations, particularly in early infancy, and changed inferences for associations at birth. Although differences in the magnitude of associations were small when GA was weakly associated with the outcome, model fit was meaningfully improved using corrected postnatal age. When estimating population-averaged associations with early childhood growth in studies where preterm- and term-born children are included, incorporating heterogeneity in GA at birth in the age scale used to standardize anthropometric indices postnatally provides a useful strategy to reduce standardization errors.
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Affiliation(s)
- Nandita Perumal
- Correspondence to Dr. Nandita Perumal, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 90 Smith Street, 3rd Floor, Boston MA 02215 (e-mail: )
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23
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Schneider A, Rodrigues M, Falenchuk O, Munhoz TN, Barros AJD, Murray J, Domingues MR, Jenkins JM. Cross-Cultural Adaptation and Validation of the Brazilian Portuguese Version of an Observational Measure for Parent-Child Responsive Caregiving. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1246. [PMID: 33573217 PMCID: PMC7908563 DOI: 10.3390/ijerph18031246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 01/16/2023]
Abstract
Responsive caregiving is the dimension of parenting most consistently related to later child functioning in both developing and developed countries. There is a growing need for efficient, psychometrically sound and culturally appropriate measurement of this construct. This study describes the cross-cultural validation in Brazil of the Responsive Interactions for Learning (RIFL-P) measure, requiring only eight minutes for assessment and coding. The cross-cultural adaptation used a recognized seven-step procedure. The adapted version was applied to a stratified sample of 153 Brazilian mother-child (18 months) dyads. Videos of mother-child interaction were coded using the RIFL-P and a longer gold standard parenting assessment. Mothers completed a survey on child stimulation (18 months) and child outcomes were measured at 24 months. Internal consistency (α = 0.94), inter-rater reliability (r = 0.83), and intra-rater reliability (r = 0.94) were all satisfactory to high. RIFL-P scores were significantly correlated with another measurement of parenting (r's ranged from 0.32 to 0.47, p < 0.001), stimulation markers (r = 0.34, p < 0.01), and children's cognition (r = 0.29, p < 0.001), language (r = 0.28, p < 0.001), and positive behavior (r = 0.17, p < 0.05). The Brazilian Portuguese version is a valid and reliable instrument for a brief assessment of responsive caregiving.
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Affiliation(s)
- Alessandra Schneider
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S, Canada; (A.S.); (M.R.)
| | - Michelle Rodrigues
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S, Canada; (A.S.); (M.R.)
| | - Olesya Falenchuk
- Ontario Institute for Studies in Education, University of Toronto, Toronto, ON M5S, Canada;
| | - Tiago N. Munhoz
- Faculty of Psychology, Federal University of Pelotas, Pelotas 96010900, Brazil;
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas 96010900, Brazil; (A.J.D.B.); (J.M.)
| | - Aluisio J. D. Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas 96010900, Brazil; (A.J.D.B.); (J.M.)
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas 96010900, Brazil; (A.J.D.B.); (J.M.)
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas 96010900, Brazil
| | - Marlos R. Domingues
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas 96010900, Brazil;
| | - Jennifer M. Jenkins
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, ON M5S, Canada; (A.S.); (M.R.)
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24
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Matijasevich A, Pearson RM, Loret de Mola C, Maruyama JM, La Maison C, Munhoz TN, Barros FC, Santos IS, D Barros AJ. Early child stimulation and attention-related executive functions at 11 years: 2004 Pelotas birth cohort study. Eur Child Adolesc Psychiatry 2020; 29:1265-1276. [PMID: 31748986 DOI: 10.1007/s00787-019-01440-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
Abstract
The study aimed to explore associations between socioeconomic position (SEP) indicators, early child stimulation (ECS) and attention-related executive functions (EF) at age 11. Children born in Pelotas, Brazil, in 2004, were recruited to a birth cohort (n = 4231, non-response rate at recruitment < 1%) and followed from birth to age 11. SEP variables were family income and maternal schooling. At the 24 and 48-month follow-ups, five markers of cognitive stimulation and social interaction were recorded and positive answers were summed to a score ranging from 0 to 5. At age 11, attentional-switching and control, and selective-attention were assessed using the adapted Test-of-Everyday-Attention-for-Children (TEA-Ch). We used multivariable logistic regression models and mediation analysis to investigate potential mediator role of ECS in the association between SEP and EF. 3106 children were included in the analyses. Less than 7% of the more stimulated individuals showed low performance in attention-related EFs at age 11 compared with almost 20% in the bottom groups of stimulation. Higher child stimulation scores were associated with fewer impairments in attentional-control (OR adj 0.84; CI 95% 0.72-0.98) and attentional-switching (OR adj 0.85; CI 95% 0.73-0.99). Mediation analysis suggested that for attentional-switching, ECS mediated almost 20% of the total protective effect of maternal schooling for impaired EF. Assuming causal relationships, if maximum stimulation was provided to all children, the advantageous effect of maternal schooling on EF would be reduced by 47%. ECS may represent a protective factor for cognitive impairments in childhood and can be easily implemented at relatively low cost.
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Affiliation(s)
- Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2º andar sala 2166, São Paulo, SP, CEP 01246-903, Brazil.,Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Rebecca M Pearson
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.,Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2º andar sala 2166, São Paulo, SP, CEP 01246-903, Brazil.
| | - Carolina La Maison
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2º andar sala 2166, São Paulo, SP, CEP 01246-903, Brazil
| | - Tiago N Munhoz
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Health and Behaviour, Catholic University of Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Aluísio J D Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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25
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Tovo-Rodrigues L, Carpena MX, Martins-Silva T, Santos IS, Anselmi L, Barros AJD, Barros FC, Bertoldi AD, Matijasevich A. Low neurodevelopmental performance and behavioural/emotional problems at 24 and 48 months in Brazilian children exposed to acetaminophen during foetal development. Paediatr Perinat Epidemiol 2020; 34:278-286. [PMID: 32196712 DOI: 10.1111/ppe.12649] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 11/26/2019] [Accepted: 12/22/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Several studies have reported that there is an association between developmental and emotional/behavioural problems in children exposed to acetaminophen during foetal development. However, few studies have focused on development and behavioural outcomes in early life. OBJECTIVES To test the association between prenatal exposure to acetaminophen and low neurodevelopmental performance at 24 months and behavioural/emotional problems at 48 months of life. METHODS We used data from the 2004 Pelotas Birth Cohort, a population-based longitudinal prospective study. Neurodevelopment was evaluated at 24 months using Battelle's Developmental Inventory (BDI) (n = 3737). We assessed global function as well as each domain (personal-social, adaptative, motor, cognitive, and communication). Behavioural/emotional problems were assessed at 48 months using the Child Behaviour Checklist (CBCL) (n = 3624). We used the CBCL total, externalising, and internalising symptomatology and individual subscales (withdrawn, somatic complaints, anxious/depressed, social problems, cognitive problems, attention problems, aggressive behaviour, and rule-breaking behaviour). Acetaminophen use during pregnancy was retrospectively assessed at the perinatal follow-up. Poisson regression and multiple linear regression analyses were used to test the association, adjusting for several family and maternal sociodemographic and health factors, medication use during pregnancy, and the sex of the child. RESULTS Acetaminophen exposure during prenatal development was not associated with low neurodevelopmental performance at 24 months assessed using the BDI or to emotional and behavioural problems assessed at 48 months using the CBCL in the adjusted models. CONCLUSIONS We cannot confirm the existence of an association between acetaminophen used during pregnancy and low neurodevelopmental performance at 24 months and emotional/behavioural problems at 48 months of life based on the present results.
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Affiliation(s)
| | - Marina Xavier Carpena
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Thais Martins-Silva
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil.,Postgraduate Program Pediatrics Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana Anselmi
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Andréa D Bertoldi
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, SP, Brazil
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Neves PAR, Gatica-Domínguez G, Santos IS, Bertoldi AD, Domingues M, Murray J, Silveira MF. Poor maternal nutritional status before and during pregnancy is associated with suspected child developmental delay in 2-year old Brazilian children. Sci Rep 2020; 10:1851. [PMID: 32024929 PMCID: PMC7002477 DOI: 10.1038/s41598-020-59034-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/23/2020] [Indexed: 01/17/2023] Open
Abstract
Inadequate pre-pregnancy BMI and gestational weight gain (GWG) have been associated with sub-optimal child development. We used data from the 2015 Pelotas (Brazil) Birth Cohort Study. Maternal anthropometry was extracted from antenatal/hospital records. BMI (kg/m2) and GWG (kg) adequacy were classified according to WHO and IOM, respectively. Development was evaluated using the INTER-NDA assessment tool for 3,776 children aged 24 months. Suspected developmental delay (SDD) was defined as <10th percentile. Associations between maternal exposures and child development were tested using linear and logistic regressions. Mediation for the association between BMI and child development through GWG was tested using G-formula. Sex differences were observed for all child development domains, except motor. Maternal pre-pregnancy underweight increased the odds of SDD in language (OR: 2.75; 95%CI: 1.30-5.80), motor (OR: 2.28; 95%CI: 1.20-4.33), and global (OR: 2.14; 95% CI: 1.05-4.33) domains for girls; among boys, excessive GWG was associated with SDD in language (OR: 1.59; 95%CI: 1.13-2.24) and cognition (OR: 1.59; 95%CI: 1.15-2.22). Total GWG suppressed the association of pre-pregnancy BMI with percentiles of global development in the entire sample. Maternal underweight and excessive GWG were negatively associated with development of girls and boys, respectively. The association of pre-pregnancy BMI with global child development was not mediated by GWG, irrespective of child's sex.
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Affiliation(s)
- Paulo A R Neves
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil.
| | - Giovanna Gatica-Domínguez
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
| | - Andréa D Bertoldi
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
| | - Marlos Domingues
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
- Postgraduate Program in Physical Education, School of Physical Education, Universidade Federal de Pelotas. Rua Luís de Camões, 625, Três Vendas, 96055-630, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
| | - Mariângela F Silveira
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
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Sania A, Sudfeld CR, Danaei G, Fink G, McCoy DC, Zhu Z, Fawzi MCS, Akman M, Arifeen SE, Barros AJD, Bellinger D, Black MM, Bogale A, Braun JM, van den Broek N, Carrara V, Duazo P, Duggan C, Fernald LCH, Gladstone M, Hamadani J, Handal AJ, Harlow S, Hidrobo M, Kuzawa C, Kvestad I, Locks L, Manji K, Masanja H, Matijasevich A, McDonald C, McGready R, Rizvi A, Santos D, Santos L, Save D, Shapiro R, Stoecker B, Strand TA, Taneja S, Tellez-Rojo MM, Tofail F, Yousafzai AK, Ezzati M, Fawzi W. Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries. BMJ Open 2019; 9:e026449. [PMID: 31585969 PMCID: PMC6797384 DOI: 10.1136/bmjopen-2018-026449] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs). DESIGN Meta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data. DATA SOURCES We searched Medline, bibliographies of key articles and reviews, and grey literature to identify studies from LMICs that collected data on early life exposures and child development. The most recent search was done on 4 November 2014. We then invited the first authors of the publications and investigators of unpublished studies to participate in the study. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies that assessed at least one domain of child development in at least 100 children under 7 years of age and collected at least one early life factor of interest were included in the study. ANALYSES Linear regression models were used to assess SMDs in child development by parental and child factors within each study. We then produced pooled estimates across studies using random effects meta-analyses. RESULTS We retrieved data from 21 studies including 20 882 children across 13 LMICs, to assess the associations of exposure to 14 major risk factors with child development. Children of mothers with secondary schooling had 0.14 SD (95% CI 0.05 to 0.25) higher cognitive scores compared with children whose mothers had primary education. Preterm birth was associated with 0.14 SD (-0.24 to -0.05) and 0.23 SD (-0.42 to -0.03) reductions in cognitive and motor scores, respectively. Maternal short stature, anaemia in infancy and lack of access to clean water and sanitation had significant negative associations with cognitive and motor development with effects ranging from -0.18 to -0.10 SDs. CONCLUSIONS Differential parental, environmental and nutritional factors contribute to disparities in child development across LMICs. Targeting these factors from prepregnancy through childhood may improve health and development of children.
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Affiliation(s)
- Ayesha Sania
- ICAP and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York city, New York, USA
| | - Christopher R Sudfeld
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Goodarz Danaei
- Deaprtment of Global Health and Population, and Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Günther Fink
- Household Economics and Health System Research Unit, Schweizerisches Tropen- und Public Health-Institut, Basel, Switzerland
| | - Dana C McCoy
- Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts, USA
| | - Zhaozhong Zhu
- Departments of Epidemiology and Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Mary C Smith Fawzi
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Mehmet Akman
- Department of Family Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Shams E Arifeen
- Maternal and Child Health Division, ICDDR,B, Dhaka, Bangladesh
| | - Aluisio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - David Bellinger
- Department of Neurology, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Alemtsehay Bogale
- Nutrition and Scientific Affairs, The Nature's Bounty Co, Ronkonkoma, New York, USA
| | - Joseph M Braun
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Nynke van den Broek
- Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Verena Carrara
- Department of Maternal and Child Health, Shoklo Malaria Research Unit, Mae Sot, Thailand
| | - Paulita Duazo
- Office of Population Studies Foundation, Inc, University of San Carlos, Cebu City, Philippines
| | - Christopher Duggan
- Center for Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Lia C H Fernald
- Community Health Sciences, School of Public Health, University of California, Berkeley, California, USA
| | - Melissa Gladstone
- Women and Children's Health, University of Liverpool, Institute of Translational Medicine, Liverpool, UK
| | - Jena Hamadani
- Maternal and Child Health Division, ICDDR,B, Dhaka, Bangladesh
| | - Alexis J Handal
- College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA
| | - Siobán Harlow
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Melissa Hidrobo
- Poverty Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA
| | - Chris Kuzawa
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Center, Bergen, Norway
| | - Lindsey Locks
- Department of Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Karim Manji
- Department of Pediatrics and Child Health, Muhibili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brasil
| | - Christine McDonald
- Children's Hospital Oakland Research Institute, UCSF Benioff Children's Hospital, Oakland, California, USA
| | - Rose McGready
- Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Arjumand Rizvi
- Pediatrics and Child Health, Aga Khan Medical University, Karachi, Pakistan
| | - Darci Santos
- Department of Collective Health, Universidade Federal da Bahia, Salvador, Brazil
| | - Leticia Santos
- Department of Collective Health, Universidade Federal da Bahia, Salvador, Brazil
| | - Dilsad Save
- Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey
| | - Roger Shapiro
- Department of Immunology and Infectious Disease, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Barbara Stoecker
- Department of Nutritional Sciences, Oklahoma State University College of Human Environmental Sciences, Stillwater, Oklahoma, USA
| | - Tor A Strand
- Department of Laboratory Medicine, Sykehuset Innlandet Helseforetaket, Brumunddal, Norway
| | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | | | - Fahmida Tofail
- Nutrition and Clinical Services Division, ICDDR,B, Dhaka, Bangladesh
| | - Aisha K Yousafzai
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Majid Ezzati
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Wafaie Fawzi
- Deaprtment of Global Health and Population, Epidemiology, and Nutrition, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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dos Santos Costa F, Agostini BA, Schuch HS, Britto Correa M, Goettems ML, Demarco FF. Parent-child interaction and stimulation in early life can be related to caries in primary dentition? Hypotheses from a life-course approach. Med Hypotheses 2019; 130:109291. [DOI: 10.1016/j.mehy.2019.109291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/25/2019] [Indexed: 11/28/2022]
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He GH, Liu L, Strodl E, Ruan ZL, Jiang H, Jing J, Jin Y, Chen WQ. Parental Type D Personality and Children's Hyperactive Behaviors: The Mediating Role of Parent⁻Child Interactive Activities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071116. [PMID: 30925765 PMCID: PMC6480101 DOI: 10.3390/ijerph16071116] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 01/27/2023]
Abstract
This study explored the associations between parental Type D personality (TDP), parent–child interactive activities, and children’s hyperactive behaviors. Moreover, the study examined whether parent–child interactive activities mediated the associations between parental TDP and children’s hyperactive behaviors. A cross-sectional survey was conducted among children from all kindergartens in a district of a southern city in China. Data on parental TDP, the frequency of parent–child interactive activities, children’s hyperactive behaviors, and socio-demographic characteristics were provided by 47,648 parent–child dyads. Multiple regression analysis was employed to assess the associations between parental TDP, parent–child interactive activities, and children’s hyperactive behaviors. Mediation analysis was applied to explore the mediating role of parent–child interactive activities on the associations between parental TDP and children’s hyperactive behaviors. Parental TDP was negatively associated with the frequency of parent–child interactive activities and positively associated with children’s hyperactive behaviors. The frequencies of parent–child interactive activities were negatively associated with children’s hyperactive behaviors. The frequency of parent–child interactive activities partially mediated the associations between parental TDP and children’s hyperactive behaviors. Future research may consider parental TDP and parent–child interactive activities as potential important predictors of hyperactive behaviors in children. Such research will help identify further targets for intervention to reduce hyperactive behaviors in children.
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Affiliation(s)
- Guan-Hao He
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Li Liu
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane 4059, Queensland, Australia.
| | - Zeng-Liang Ruan
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hui Jiang
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Jin Jing
- Department of Women and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Yu Jin
- Department of Women and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Wei-Qing Chen
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
- Department of Information Management, Xinhua College of Sun Yat-Sen University, Guangzhou 510080, China.
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Barros AJD, Ewerling F. Early childhood development: a new challenge for the SDG era. LANCET GLOBAL HEALTH 2018; 4:e873-e874. [PMID: 27855856 DOI: 10.1016/s2214-109x(16)30298-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
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Larson LM, Martorell R, Bauer PJ. A Path Analysis of Nutrition, Stimulation, and Child Development Among Young Children in Bihar, India. Child Dev 2018. [PMID: 29529358 PMCID: PMC6174960 DOI: 10.1111/cdev.13057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Nutrition plays an important role in the development of a child, particularly in low‐ and middle‐income countries where malnutrition is often widespread. The relation between diet, hemoglobin, nutritional status, motor development, stimulation and mental development was examined in a cross‐sectional sample of 1,079 children 12–18 months of age living in rural Bihar, India. Path analysis revealed associations between (a) length‐for‐age z‐scores and motor development, standardized β (β) = .285, p < .001, and (b) motor and all mental development outcomes (language: β = .422; personal‐social: β = .490; memory: β = .139; and executive function: β = .072, all p < .001). Additionally, stimulation was significantly associated with language scores and hemoglobin concentration with memory. These findings inform interventions aimed at improving child development in Northern India.
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Black MM, Merseth KA. First 1000 Days and Beyond: Strategies to Achieve the Sustainable Development Goals. DEVELOPMENTAL SCIENCE AND SUSTAINABLE DEVELOPMENT GOALS FOR CHILDREN AND YOUTH 2018. [DOI: 10.1007/978-3-319-96592-5_5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Zhang C, Zhao C, Liu X, Wei Q, Luo S, Guo S, Zhang J, Wang X, Scherpbier RW. Inequality in early childhood neurodevelopment in six poor rural counties of China: a decomposition analysis. Int J Equity Health 2017; 16:212. [PMID: 29221451 PMCID: PMC5723085 DOI: 10.1186/s12939-017-0691-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 11/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies about inequality in children's health focused more on physical health than the neurodevelopment. In this study, we aimed to evaluate the inequality in early childhood neurodevelopment in poor rural China and explore the contributions of socioeconomic factors to the inequality. METHOD Information of 2120 children aged 0 to 35 months and their households in six poor rural counties of China was collected during July - September, 2013. Age and Stages Questionnaire-Chinese version, concentration index and decomposition analysis were used to assess the neurodevelopment of early childhood, measure its inequality and evaluate the contributions of socioeconomic factors to the inequality, respectively. RESULT The prevalence of suspected developmental delay in children under 35 months of age in six poor rural counties of China was nearly 40%, with the concentration index of -0.0877. Household economic status, caregivers' depressive symptoms, learning material and family support for learning were significantly associated with children's suspected developmental delay, and explained 34.1, 14.1, 8.9 and 7.0% of the inequality in early childhood neurodevelopment, respectively. CONCLUSION The early childhood neurodevelopment in the surveyed area is poor and unfair. Factors including household economic status, caregivers' depressive symptoms, learning material and family support for learning are significantly associated with children's suspected developmental delay and early developmental inequality. The results highlight the urgent need of monitoring child neurodevelopment in poor rural areas. Interventions targeting the caregivers' depressive symptoms, providing learning material and developmental appropriate stimulating activities may help improve early childhood neurodevelopment and reduce its inequality.
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Affiliation(s)
- Cuihong Zhang
- Department of Child, Adolescent and Women’s Health, School of Public Health, Peking University, Beijing, China
| | | | - Xiangyu Liu
- Department of Biostatistics, School of Public Health, The University of Texas Health Science Center at Houston, Houston, USA
| | - Qianwei Wei
- Department of Child, Adolescent and Women’s Health, School of Public Health, Peking University, Beijing, China
| | - Shusheng Luo
- Department of Child, Adolescent and Women’s Health, School of Public Health, Peking University, Beijing, China
| | | | - Jingxu Zhang
- Department of Child, Adolescent and Women’s Health, School of Public Health, Peking University, Beijing, China
| | - Xiaoli Wang
- Department of Child, Adolescent and Women’s Health, School of Public Health, Peking University, Beijing, China
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Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, McCoy DC, Fink G, Shawar YR, Shiffman J, Devercelli AE, Wodon QT, Vargas-Barón E, Grantham-McGregor S. Early childhood development coming of age: science through the life course. Lancet 2017; 389:77-90. [PMID: 27717614 PMCID: PMC5884058 DOI: 10.1016/s0140-6736(16)31389-7] [Citation(s) in RCA: 1177] [Impact Index Per Article: 168.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 07/07/2016] [Accepted: 08/05/2016] [Indexed: 12/19/2022]
Abstract
Early childhood development programmes vary in coordination and quality, with inadequate and inequitable access, especially for children younger than 3 years. New estimates, based on proxy measures of stunting and poverty, indicate that 250 million children (43%) younger than 5 years in low-income and middle-income countries are at risk of not reaching their developmental potential. There is therefore an urgent need to increase multisectoral coverage of quality programming that incorporates health, nutrition, security and safety, responsive caregiving, and early learning. Equitable early childhood policies and programmes are crucial for meeting Sustainable Development Goals, and for children to develop the intellectual skills, creativity, and wellbeing required to become healthy and productive adults. In this paper, the first in a three part Series on early childhood development, we examine recent scientific progress and global commitments to early childhood development. Research, programmes, and policies have advanced substantially since 2000, with new neuroscientific evidence linking early adversity and nurturing care with brain development and function throughout the life course.
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Affiliation(s)
- Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA; RTI International, Research Park, NC, USA.
| | - Susan P Walker
- Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Lia C H Fernald
- Division of Community Health Sciences, School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | | | | | - Chunling Lu
- Division of Global Health Equity, Brigham and Women's Hospital, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Dana C McCoy
- Harvard Graduate School of Education, Boston, MA, USA
| | - Günther Fink
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Yusra R Shawar
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
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Corsi C, Santos MMD, Marques LDAP, Rocha NACF. Impact of extrinsic factors on fine motor performance of children attending day care. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2016; 34:439-446. [PMID: 27094472 PMCID: PMC5176064 DOI: 10.1016/j.rpped.2016.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 01/18/2016] [Accepted: 01/22/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the impact of extrinsic factors on fine motor performance of children aged two years old. METHODS 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R), fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development - III (BSITD-III), socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. RESULTS The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item "language and understanding". CONCLUSIONS Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care.
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Affiliation(s)
- Carolina Corsi
- Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brasil.
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Marphatia AA, Devakumar D, Wells JCK, Saville N, Reid A, Costello A, Manandhar DS, Osrin D. Maternal phenotype, independent of family economic capital, predicts educational attainment in lowland nepalese children. Am J Hum Biol 2016; 28:687-98. [PMID: 27135632 PMCID: PMC5026068 DOI: 10.1002/ajhb.22852] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 01/05/2016] [Accepted: 02/25/2016] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Factors acting before children are born or reach school-going age may explain why some do not complete primary education. Many relevant factors relate to maternal phenotype, but few studies have tested for independent associations of maternal factors relative to those characterizing the family in general. METHODS Using data from a longitudinal study of 838 children in Dhanusha, Nepal, we used logistic regression models to test whether indices of maternal somatic and educational capital, or family economic capital, were independently associated with children having had ≤2 versus 3+ years of schooling at a mean age of 8.5 years. We also tested whether maternal age, children's early growth, and urban/rural location mediated such associations. RESULTS Children had a higher risk of completing less schooling if their mothers were short, thin, anemic, and uneducated. Independently, lower family material assets and land acreage also increased children's odds of less schooling. There was an indication of gender differences, with the risk of poor educational attainment in girls associated with low maternal somatic and educational capital, whereas in boys the relevant factors were low maternal education and family land ownership. CONCLUSIONS Our analysis demonstrates that, independent of broader indices of family capital such as land or material assets, children's educational attainment is associated with factors embodied in maternal phenotype. Both somatic and educational maternal capital appeared important. A composite index of maternal capital could provide a new measurable proxy, prior to school entry, for identifying children at risk of completing fewer years of schooling. Am. J. Hum. Biol. 28:687-698, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Delan Devakumar
- Institute for Global Health, University College London, London, United Kingdom
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, University College London Institute of Child Health, London, United Kingdom
| | - Naomi Saville
- Institute for Global Health, University College London, London, United Kingdom
| | - Alice Reid
- Department of Geography, University of Cambridge, United Kingdom
| | - Anthony Costello
- Institute for Global Health, University College London, London, United Kingdom
| | | | - David Osrin
- Institute for Global Health, University College London, London, United Kingdom
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Karam SM, Barros AJD, Matijasevich A, Dos Santos IS, Anselmi L, Barros F, Leistner-Segal S, Félix TM, Riegel M, Maluf SW, Giugliani R, Black MM. Intellectual Disability in a Birth Cohort: Prevalence, Etiology, and Determinants at the Age of 4 Years. Public Health Genomics 2016; 19:290-7. [PMID: 27595410 PMCID: PMC5079101 DOI: 10.1159/000448912] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 08/06/2016] [Indexed: 01/21/2023] Open
Abstract
Background Intellectual disability (ID), characterized by impairments in intellectual function and adaptive behavior, affects 1-3% of the population. Many studies investigated its etiology, but few are cohort studies in middle-income countries. Aims To estimate prevalence, etiology, and factors related to ID among children prospectively followed since birth in a Southern Brazilian city (Pelotas). Methods In 2004, maternity hospitals were visited daily and births were identified. Live-born infants (n = 4,231) whose family lived in the urban area have been followed for several years. At the age of 2 and 4 years, performances in development and intelligence tests were evaluated using the Battelle Developmental Inventory and Wechsler Intelligence Scale, respectively. Children considered as having developmental delay were invited to attend a genetic evaluation. Results At 4 years of age, the prevalence of ID was 4.5%, and the etiology was classified into 5 groups: environmental (44.4%), genetic (20.5%), idiopathic (12.6%), neonatal sequelae (13.2%), other diseases (9.3%). Most children presented impairment in two or more areas of adaptive behavior. There was no difference in prenatal care attendance or maternal schooling among the groups. Conclusion For about 40% of children, ID was attributed to nonbiological factors, suggesting that the rate may be reduced with appropriate interventions early in life.
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Affiliation(s)
- Simone M Karam
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, UFRGS, Porto Alegre, Brazil
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Black MM, Fernandez-Rao S, Hurley KM, Tilton N, Balakrishna N, Harding KB, Reinhart G, Radhakrishna KV, Nair KM. Growth and development among infants and preschoolers in rural India. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2016. [DOI: 10.1177/0165025416644690] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Economic inequities are common in low and middle-income countries (LMIC), and are associated with poor growth and development among young children. The objectives are to examine whether maternal education and home environment quality: 1) protect children by attenuating the association between economic inequities and children’s growth and development, or 2) promote children’s growth and development, regardless of economic inequities. The sample includes 512 infants and 321 preschoolers in 26 villages in rural India (Project Grow Smart). Data for children: physical growth (weight and length/height measured) and development (Mullen Scales of Early Learning); for mothers/households: economic inequities measured by household assets, education, depressive symptoms, and home environment (HOME Inventory). Data are analyzed with linear mixed models (LMM) for infants and preschoolers separately, adjusted for village/preschool clustering, including asset-by-education/home interactions. Among infants, but not preschoolers, the education/home factor attenuates relations between assets and growth, eliminating differential relations in infant growth between high/low-asset families, suggesting protection. Among infants and preschoolers, the education/home factor is significantly or marginally associated with most child development scales, regardless of economic inequities, suggesting promotion. Strategies to enhance maternal education and home environment quality may protect infants in low-asset families from poor growth, promote development among infants and preschoolers, and prevent early disparities.
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Affiliation(s)
- Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sylvia Fernandez-Rao
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, Telangana, India
| | - Kristen M. Hurley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicholas Tilton
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nagalla Balakrishna
- National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, Telangana, India
| | | | - Greg Reinhart
- The Mathile Institute for the Advancement of Human Nutrition, Dayton, OH, USA
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Herman KC, Cohen D, Owens S, Latimore T, Reinke WM, Burrell L, McFarlane E, Duggan A. Language Delays and Child Depressive Symptoms: the Role of Early Stimulation in the Home. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:533-43. [DOI: 10.1007/s11121-016-0647-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Elgibaly O, Aziz MM. Assessment of the needs of mothers and primary healthcare providers to support early childhood development in Egypt: a qualitative study. Child Care Health Dev 2016; 42:394-401. [PMID: 27004968 DOI: 10.1111/cch.12337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 02/10/2016] [Accepted: 02/15/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND The early childhood period is considered the most important developmental phase in an individual's lifespan. However, it is not addressed in the Egyptian health system. We aimed to explore mothers' and healthcare providers' perceptions about early childhood development (ECD) and identify their needs to support ECD in Egypt. METHODS Focus group discussions with 79 mothers of children younger than 2 years old from different socio-economic backgrounds and residing in urban and rural areas and 26 primary healthcare providers were used to collect data. Emerging themes and subthemes were identified from the data analysis. RESULTS Urban and rural mothers in Egypt of all educational levels are not well prepared to support their children's early development, especially the cognitive and emotional aspects. Limited sources of information about ECD, the large families of rural women and an absence of developmental health services and family support were the most important factors that led to a neglect of mother-child communication and stimulation. CONCLUSION Raising community awareness and training primary healthcare providers to counsel mothers about ECD are important prerequisites for supporting ECD in Egypt. Rural and first-time mothers would be the most valuable starting point.
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Affiliation(s)
- O Elgibaly
- Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt
| | - M M Aziz
- Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt
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Corsi C, Santos MMD, Marques LDAP, Rocha NACF. Impact of extrinsic factors on fine motor performance of children attending day care. ACTA ACUST UNITED AC 2016. [PMID: 27094472 PMCID: PMC5176064 DOI: 10.1016/j.rppede.2016.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess the impact of extrinsic factors on fine motor performance of children aged two years old. METHODS 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R), fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development - III (BSITD-III), socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. RESULTS The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item "language and understanding". CONCLUSIONS Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care.
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Affiliation(s)
- Carolina Corsi
- Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brasil.
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Larson LM, Yousafzai AK. A meta-analysis of nutrition interventions on mental development of children under-two in low- and middle-income countries. MATERNAL AND CHILD NUTRITION 2015; 13. [PMID: 26607403 DOI: 10.1111/mcn.12229] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 09/07/2015] [Accepted: 09/07/2015] [Indexed: 12/26/2022]
Abstract
Interventions to improve nutritional status of young children in low- and middle-income countries (LMIC) may have the added benefit of improving their mental and motor development. This meta-analysis updates and goes beyond previous ones by answering two important questions: (1) do prenatal and postnatal nutritional inputs improve mental development, and (2) are effects on mental development associated with two theoretically interesting mediators namely physical growth and motor development? The meta-analysis of articles on Medline, PsycINFO, Global Health and Embase was limited to randomized trials in LMICs, with mental development of children from birth to age two years as an outcome. The initial yield of 2689 studies was reduced to 33; 12 received a global quality rating of strong. Of the 10 prenatal and 23 postnatal nutrition interventions, the majority used zinc, iron/folic acid, vitamin A or multiple micronutrients, with a few evaluating macronutrients. The weighted mean effect size, Cohen's d (95% CI) for prenatal and postnatal nutrition interventions on mental development was 0.042 (-0.0084, 0.092) and 0.076 (0.019, 0.13), respectively. Postnatal supplements consisting of macronutrients yielded an effect size d (95% CI) of 0.14 (0.0067, 0.27), multiple micronutrients 0.082 (-0.012, 0.18) and single micronutrients 0.058 (-0.0015, 0.12). Motor development, but not growth status, effect sizes were significantly associated with mental development in postnatal interventions. In summary, nutrition interventions had small effects on mental development. Future studies might have greater effect if they addressed macronutrient deficiencies combined with child stimulation and hygiene and sanitation interventions.
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Affiliation(s)
- Leila Margaret Larson
- Emory University, Nutrition and Health Sciences Program, Laney Graduate School, Atlanta, Georgia, USA
| | - Aisha K Yousafzai
- Aga Khan University, Department of Paediatrics and Child Health, Division of Women and Child Health, Karachi, Sindh, Pakistan
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Karam SM, Riegel M, Segal SL, Félix TM, Barros AJD, Santos IS, Matijasevich A, Giugliani R, Black M. Genetic causes of intellectual disability in a birth cohort: a population-based study. Am J Med Genet A 2015; 167:1204-14. [PMID: 25728503 PMCID: PMC4863139 DOI: 10.1002/ajmg.a.37011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 01/22/2015] [Indexed: 11/25/2022]
Abstract
Intellectual disability affects approximately 1–3% of the population and can be caused by genetic and environmental factors. Although many studies have investigated the etiology of intellectual disability in different populations, few studies have been performed in middle‐income countries. The present study estimated the prevalence of genetic causes related to intellectual disability in a cohort of children from a city in south Brazil who were followed from birth. Children who showed poor performance in development and intelligence tests at the ages of 2 and 4 were included. Out of 4,231 liveborns enrolled in the cohort, 214 children fulfilled the inclusion criteria. A diagnosis was established in approximately 90% of the children evaluated. Genetic causes were determined in 31 of the children and 19 cases remained unexplained even after extensive investigation. The overall prevalence of intellectual disability in this cohort due to genetic causes was 0.82%. Because this study was nested in a cohort, there were a large number of variables related to early childhood and the likelihood of information bias was minimized by collecting information with a short recall time. This study was not influenced by selection bias, allowing identification of intellectual disability and estimation of the prevalence of genetic causes in this population, thereby increasing the possibility of providing appropriate management and/or genetic counseling. © 2015 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Simone M Karam
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, UFRGS, Porto Alegre, Brazil.,Faculdade de Medicina, Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil
| | - Mariluce Riegel
- Serviço de Genética Médica, HCPA, Porto Alegre, Brazil.,Programa de Pós-Graduação em Genética e Biologia Molecular, UFRGS, Porto Alegre, Brazil
| | | | - Têmis M Félix
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, UFRGS, Porto Alegre, Brazil.,Serviço de Genética Médica, HCPA, Porto Alegre, Brazil
| | | | - Iná S Santos
- Programa de Pós-Graduação em Epidemiologia, UFPel, Pelotas, Brazil
| | - Alicia Matijasevich
- Programa de Pós-Graduação em Epidemiologia, UFPel, Pelotas, Brazil.,Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Roberto Giugliani
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, UFRGS, Porto Alegre, Brazil.,Serviço de Genética Médica, HCPA, Porto Alegre, Brazil.,Departamento de Genética, UFRGS, Porto Alegre, Brazil
| | - Maureen Black
- John A Scholl MD and Mary Louise Scholl MD Endowed Professor, Department of Pediatrics and Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland
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Camargo-Figuera FA, Barros AJD, Santos IS, Matijasevich A, Barros FC. Early life determinants of low IQ at age 6 in children from the 2004 Pelotas Birth Cohort: a predictive approach. BMC Pediatr 2014; 14:308. [PMID: 25510879 PMCID: PMC4272809 DOI: 10.1186/s12887-014-0308-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 12/07/2014] [Indexed: 11/22/2022] Open
Abstract
Background Childhood intelligence is an important determinant of health outcomes in adulthood. The first years of life are critical to child development. This study aimed to identify early life (perinatal and during the first year of life) predictors of low cognitive performance at age 6. Methods A birth cohort study started in the city of Pelotas, southern Brazil, in 2004 and children were followed from birth to age six. Information on a broad set of biological and social predictors was collected. Cognitive ability—the study outcome—was assessed using the Wechsler Intelligence Scale for Children (WISC). IQ scores were standardized into z-scores and low IQ defined as z < −1. We applied bootstrapping methods for internal validation with a multivariate logistic regression model and carried out external validation using a second study from the 1993 Pelotas Birth Cohort. Results The proportion of children with IQ z-score < −1 was 16.9% (95% CI 15.6–18.1). The final model included the following early life variables: child’s gender; parents’ skin color; number of siblings; father’s and mother’s employment status; household income; maternal education; number of persons per room; duration of breastfeeding; height-for-age deficit; head circumference-for-age deficit; parental smoking during pregnancy; and maternal perception of the child’s health status. The area under the ROC curve for our final model was 0.8, with sensitivity of 72% and specificity of 74%. Similar results were found when testing external validation by using data from the 1993 Pelotas Birth Cohort. Conclusions The study results suggest that a child’s and her/his family’s social conditions are strong predictors of cognitive ability in childhood. Interventions for promoting a healthy early childhood development are needed targeting children at risk of low IQ so that they can reach their full cognitive potential. Electronic supplementary material The online version of this article (doi:10.1186/s12887-014-0308-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fabio Alberto Camargo-Figuera
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. .,Universidad Industrial de Santander (UIS), Bucaramanga, Colombia.
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. .,Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Fernando C Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. .,Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.
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Physical activity during pregnancy and offspring neurodevelopment and IQ in the first 4 years of life. PLoS One 2014; 9:e110050. [PMID: 25350666 PMCID: PMC4211660 DOI: 10.1371/journal.pone.0110050] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 09/15/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Maternal physical activity during pregnancy could alter offspring's IQ and neurodevelopment in childhood. METHODS Children belonging to a birth cohort were followed at 3, 12, 24 and 48 months of age. Physical activity during pregnancy was assessed retrospectively at birth. Neurodevelopment was evaluated by Battelle's Development Inventory (12, 24 and 48 months) and IQ by the Weschler's Intelligence Scale (48 months). Neurodevelopment was based on Battelles' (90th percentile) and also analyzed as a continuous outcome. IQ was analyzed as a continuous outcome. Potential confounders were: family income, mother's age, schooling, skin color, number of previous births and smoking; and newborns': preterm birth, sex and low birth weight. RESULTS From birth to 48 months, sample size decreased from 4231 to 3792. Crude analysis showed that IQ at 48 months was slightly higher (5 points) among children from active women. The Battelle's score at 12 and 24 months was higher among offspring from active mothers. After controlling for confounders, physical activity during pregnancy was positively associated to the Battelle's Inventory at 12 months IQ, however, at 48 months no association was observed. CONCLUSION Physical activity during pregnancy does not seem to impair children's neurodevelopment and children from active mothers presented better performance at 12 months.
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Hamadani JD, Tofail F, Huda SN, Alam DS, Ridout DA, Attanasio O, Grantham-McGregor SM. Cognitive deficit and poverty in the first 5 years of childhood in Bangladesh. Pediatrics 2014; 134:e1001-8. [PMID: 25266433 DOI: 10.1542/peds.2014-0694] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We aimed to determine the timing and size of the cognitive deficit associated with poverty in the first 5 years of life and to examine the role of parental characteristics, pre- and postnatal growth, and stimulation in the home in Bangladeshi children. We hypothesized that the effect of poverty on cognition begins in infancy and is mainly mediated by these factors. METHODS We enrolled 2853 singletons, a subsample from a pregnancy supplementation trial in a poor rural area. We assessed mental development at 7, 18, and 64 months; anthropometry at birth, 12, 24, and 64 months; home stimulation at 18 and 64 months; and family's socioeconomic background. In multiple regression analyses, we examined the effect of poverty at birth on IQ at 64 months and the extent that other factors mediated the effect. RESULTS A mean cognitive deficit of 0.2 (95% confidence interval -0.4 to -0.02) z scores between the first and fifth wealth quintiles was apparent at 7 months and increased to 1.2 (95% confidence interval -1.3 to -1.0) z scores of IQ by 64 months. Parental education, pre- and postnatal growth in length, and home stimulation mediated 86% of the effects of poverty on IQ and had independent effects. Growth in the first 2 years had larger effects than later growth. Home stimulation had effects throughout the period. CONCLUSIONS Effects of poverty on children's cognition are mostly mediated through parental education, birth size, growth in the first 24 months, and home stimulation in the first 5 years.
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Affiliation(s)
- Jena D Hamadani
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh;
| | - Fahmida Tofail
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Syed N Huda
- Institute of Nutrition and Food Science, Dhaka University, Dhaka, Bangladesh; and
| | - Dewan S Alam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Orazio Attanasio
- Department of Economics, University College London, London, United Kingdom
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Abstract
Health and nutritional risks co-occur in the lives of children under the age of 2 years who live in developing countries. We review evidence showing how these risks, in addition to inadequate psychosocial stimulation, prevent children from developing expected cognitive and language abilities. A systematic review and meta-analysis of 21 interventions aimed at enhancing stimulation and 18 interventions that provided better nutrition--all conducted since 2000--revealed that stimulation had a medium effect size of 0.42 and 0.47 on cognitive and language development, respectively, whereas nutrition by itself had a small effect size of 0.09. The implementation processes of these interventions are described and compared. A number of unresolved issues are outlined and discussed, including ways to maximize parental health behavior change, assess mediators that account for intervention effects, and expand the assessment of young children's brain functions that underlie language and cognition and are affected by nutrition and stimulation.
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Affiliation(s)
- Frances E Aboud
- Department of Psychology, McGill University, Montreal, H3A 1B1 Canada;
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Bielemann RM, Xavier MO, Gigante DP. Preferência por comportamentos favoráveis à prática de atividade física e nível de atividade física de crianças de uma cidade do sul do Brasil. CIENCIA & SAUDE COLETIVA 2014; 19:2287-96. [PMID: 25014307 DOI: 10.1590/1413-81232014197.11202013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/08/2013] [Indexed: 11/21/2022] Open
Abstract
O artigo objetiva descrever preferências por comportamentos favoráveis à prática de atividade física (AF) e avaliar sua influência sobre o nível de AF de crianças da cidade de Pelotas, RS. Estudo transversal de base populacional com crianças de 4 a 11 anos. Comportamentos favoráveis à prática de AF foram avaliados pelo Netherlands Physical Activity Questionnaire (NPAQ). O tempo de AF moderada ou vigorosa (AFMV) foi medido por acelerometria. Análise de variância e regressão linear foram usadas para avaliar associações entre as perguntas do NPAQ e variáveis independentes e entre cada comportamento e o tempo de AFMV, respectivamente. Crianças de maior nível econômico gostaram mais de desenhar e preferiram menos brincadeiras agitadas e brincar na rua do que crianças de menor nível econômico. Crianças de maior idade foram menos extrovertidas e gostaram menos de desenhar do que crianças mais novas. Gostar de esportes, ter falta de interesse por desenhar e preferir brincar na rua foram positivamente associados ao tempo diário de AFMV. Algumas das características estudadas mostraram-se associadas a comportamentos favoráveis à prática de AF, sendo a maior influência observada para o nível econômico. Preferências como gostar de esportes influenciaram positivamente o tempo gasto em AFMV.
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49
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Breastfeeding, parenting, and early cognitive development. J Pediatr 2014; 164:487-93. [PMID: 24268637 DOI: 10.1016/j.jpeds.2013.10.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/26/2013] [Accepted: 10/04/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To explain why breastfeeding is associated with children's cognitive development. STUDY DESIGN By using a nationally representative longitudinal survey of early childhood (N = 7500), we examined how breastfeeding practices, the early introduction of solid foods, and putting an infant to bed with a bottle were associated with cognitive development across early childhood. We also explored whether this link can be explained by parenting behaviors and maternal education. RESULTS There is a positive relationship between predominant breastfeeding for 3 months or more and child reading skills, but this link is the result of cognitively supportive parenting behaviors and greater levels of education among women who predominantly breastfed. We found little-to-no relationship between infant feeding practices and the cognitive development of children with less-educated mothers. Instead, reading to a child every day and being sensitive to a child's development were significant predictors of math and reading readiness outcomes. CONCLUSIONS Although breastfeeding has important benefits in other settings, the encouragement of breastfeeding to promote school readiness does not appear to be a key intervention point. Promoting parenting behaviors that improve child cognitive development may be a more effective and direct strategy for practitioners to adopt, especially for disadvantaged children.
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50
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Santos MM, Corsi C, Marques LAP, Rocha NACF. Comparison of motor and cognitive performance of children attending public and private day care centers. Braz J Phys Ther 2013; 17:579-87. [PMID: 24346293 PMCID: PMC4207148 DOI: 10.1590/s1413-35552012005000126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 07/31/2013] [Indexed: 11/27/2022] Open
Abstract
Background Given that environmental factors, such as the school environment, can
influence child development, more attention should be paid to the
development of children attending day care centers. Objective Todetermine whether there are differences in the gross motor, fine motor, or
cognitive performances of children between 1 and3 years-old of similar
socioeconomic status attending public and private day care centers full
time. Method Participants were divided into 2 groups, 1 of children attending public day
care centers (69 children) and another of children attending private day
care centers (47 children). All children were healthy and regularly attended
day care full time for over 4 months. To assess cognitive, gross and fine
motor performance, the Bayley Scales of Infant and Toddler Development III
was used. The Mann-Whitney test was used for comparative analyses between
groups of children between 13 and 24 months, 25 and 41 months, and 13 and 41
months. Results Children in public day care centers exhibited lower scores on the cognitive
development scale beginning at 13 months old. The fine and gross motor
performance scores were lower in children over the age of 25 months
attending public centers. Maternal education was not related to the
performance of children in either group. Conclusion The scores of cognitive performance as well as fine and gross motor
performance of children of similar socioeconomic status who attend public
day care centers are lower than children attending private daycare
centers.
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Affiliation(s)
- Mariana M Santos
- Universidade Federal de São Carlos, Physical Therapy Department, São CarlosSP, Brazil
| | - Carolina Corsi
- Universidade Federal de São Carlos, Physical Therapy Department, São CarlosSP, Brazil
| | - Luisa A P Marques
- Universidade Federal de São Carlos, Physical Therapy Department, São CarlosSP, Brazil
| | - Nelci A C F Rocha
- Universidade Federal de São Carlos, Physical Therapy Department, São CarlosSP, Brazil
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