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Dreyer BP. Let Us Be Vigilant: COVID-19 Is Poised to Obliterate Gains in Healthy Child Development Globally. Pediatrics 2020; 146:peds.2020-012591. [PMID: 32817438 DOI: 10.1542/peds.2020-012591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Benard P Dreyer
- Department of Pediatrics, NYU Grossman School of Medicine, New York University, New York, New York
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2
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Williams PG, Lerner MA, Sells J, Alderman SL, Hashikawa A, Mendelsohn A, McFadden T, Navsaria D, Peacock G, Scholer S, Takagishi J, Vanderbilt D, De Pinto CL, Attisha E, Beers N, Gibson E, Gorski P, Kjolhede C, O’Leary SC, Schumacher HK, Weiss-Harrison A. School Readiness. Pediatrics 2019; 144:peds.2019-1766. [PMID: 31331984 DOI: 10.1542/peds.2019-1766] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
School readiness includes the readiness of the individual child, the school's readiness for children, and the ability of the family and community to support optimal early child development. It is the responsibility of schools to meet the needs of all children at all levels of readiness. Children's readiness for kindergarten should become an outcome measure for a coordinated system of community-based programs and supports for the healthy development of young children. Our rapidly expanding insights into early brain and child development have revealed that modifiable factors in a child's early experience can greatly affect that child's health and learning trajectories. Many children in the United States enter kindergarten with limitations in their social, emotional, cognitive, and physical development that might have been significantly diminished or eliminated through early identification and attention to child and family needs. A strong correlation between social-emotional development and school and life success, combined with alarming rates of preschool expulsion, point toward the urgency of leveraging opportunities to support social-emotional development and address behavioral concerns early. Pediatric primary care providers have access to the youngest children and their families. Pediatricians can promote and use community supports, such as home visiting programs, quality early care and education programs, family support programs and resources, early intervention services, children's museums, and libraries, which are important for addressing school readiness and are too often underused by populations who can benefit most from them. When these are not available, pediatricians can support the development of such resources. The American Academy of Pediatrics affords pediatricians many opportunities to improve the physical, social-emotional, and educational health of young children, in conjunction with other advocacy groups. This technical report provides an updated version of the previous iteration from the American Academy of Pediatrics published in 2008.
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Affiliation(s)
- P. Gail Williams
- Department of Pediatrics, Weisskopf Child Evaluation Center, University of Louisville, Louisville, Kentucky; and
| | - Marc Alan Lerner
- Center for Autism and Neurodevelopmental Disorders, University of California, Irvine, Irvine, California
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3
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Lee H, Park H, Ha E, Hong YC, Ha M, Park H, Kim BN, Lee SJ, Lee KY, Kim JH, Jeong KS, Kim Y. Stability of cognitive development during the first five years of life in relation to heavy metal concentrations in umbilical cord blood: Mothers' and Children's Environmental Health (MOCEH) birth cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 609:153-159. [PMID: 28738198 DOI: 10.1016/j.scitotenv.2017.07.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/08/2017] [Accepted: 07/09/2017] [Indexed: 06/07/2023]
Abstract
The objective of this study was to investigate stability of cognitive development during the first five years of life in relation to heavy metal concentrations in umbilical cord blood in Korean children. This research is part of the Mothers' and Children's Environmental Health (MOCEH) study, a multi-center prospective birth cohort study of pregnant women in Korea who were recruited from 2006 to 2010. We analyzed the complete follow-up data of children who were 5years-old in 2016. We measured lead, mercury, and cadmium levels in the umbilical cord blood of 251 children, and analyzed them, for whom neurodevelopmental data were available. We determined stability of cognitive development scores using three methods. First, we used partial correlation analyses to examine the stability of cognitive development at each measurement time. Second, we used Cramer's V to investigate the magnitude and direction of changes in cognitive development scores at each follow-up period among three groups (high, medium, and low scores). The results showed that cognitive development scores measured at the closest times had the strongest correlations, and the stability of cognitive development scores increased with age, from 6 to 60months. Groups at the extreme ends of cognitive development (high or low scores) had more stable scores, and this tendency was also stronger in infants >24months-old. The stability of cognitive development was unrelated to the umbilical cord level of heavy metals, based on analysis with Fisher's transformation. In conclusion, the present study showed that the cognitive development scores in a cohort of infants (6 to 60months-old) were stable.
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Affiliation(s)
- Hyungmin Lee
- Department of Child and Family Welfare, Hankyong National University, Anseong, South Korea
| | - Hyewon Park
- Department of Child and Family Welfare, University of Ulsan, Ulsan, South Korea
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, South Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Bung-Nyun Kim
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Kyung Yeon Lee
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Ja Hyeong Kim
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, College of Medicine, Dongguk University, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
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Chung EK, Siegel BS, Garg A, Conroy K, Gross RS, Long DA, Lewis G, Osman CJ, Jo Messito M, Wade R, Shonna Yin H, Cox J, Fierman AH. Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians. Curr Probl Pediatr Adolesc Health Care 2016; 46:135-53. [PMID: 27101890 PMCID: PMC6039226 DOI: 10.1016/j.cppeds.2016.02.004] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Approximately 20% of all children in the United States live in poverty, which exists in rural, urban, and suburban areas. Thus, all child health clinicians need to be familiar with the effects of poverty on health and to understand associated, preventable, and modifiable social factors that impact health. Social determinants of health are identifiable root causes of medical problems. For children living in poverty, social determinants of health for which clinicians may play a role include the following: child maltreatment, child care and education, family financial support, physical environment, family social support, intimate partner violence, maternal depression and family mental illness, household substance abuse, firearm exposure, and parental health literacy. Children, particularly those living in poverty, exposed to adverse childhood experiences are susceptible to toxic stress and a variety of child and adult health problems, including developmental delay, asthma and heart disease. Despite the detrimental effects of social determinants on health, few child health clinicians routinely address the unmet social and psychosocial factors impacting children and their families during routine primary care visits. Clinicians need tools to screen for social determinants of health and to be familiar with available local and national resources to address these issues. These guidelines provide an overview of social determinants of health impacting children living in poverty and provide clinicians with practical screening tools and resources.
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Affiliation(s)
- Esther K Chung
- The Department of Pediatrics, The Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA; Nemours, Wilmington, DE.
| | - Benjamin S Siegel
- The Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, MA
| | - Arvin Garg
- The Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, MA
| | - Kathleen Conroy
- The Division of General Pediatrics, Boston Children׳s Hospital, Boston, MA
| | - Rachel S Gross
- The Department of Pediatrics, Albert Einstein College of Medicine, The Children׳s Hospital at Montefiore, Bronx, NY
| | - Dayna A Long
- The Department of Pediatrics, UCSF Benioff Children׳s Hospital Oakland, Oakland, CA
| | - Gena Lewis
- The Department of Pediatrics, UCSF Benioff Children׳s Hospital Oakland, Oakland, CA
| | - Cynthia J Osman
- The Department of Pediatrics, New York University, New York, NY
| | - Mary Jo Messito
- The Department of Pediatrics, New York University, New York, NY
| | - Roy Wade
- The Department of Pediatrics, The Children׳s Hospital of Philadelphia, Philadelphia, PA
| | - H Shonna Yin
- The Department of Pediatrics, New York University, New York, NY
| | - Joanne Cox
- The Division of General Pediatrics, Boston Children׳s Hospital, Boston, MA
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Tette EMA, Sifah EK, Nartey ET. Factors affecting malnutrition in children and the uptake of interventions to prevent the condition. BMC Pediatr 2015; 15:189. [PMID: 26586172 PMCID: PMC4653928 DOI: 10.1186/s12887-015-0496-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 10/23/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Malnutrition is a major cause of child morbidity and mortality. There are several interventions to prevent the condition but it is unclear how well they are taken up by both malnourished and well nourished children and their mothers and the extent to which this is influenced by socio-economic factors. We examined socio-economic factors, health outcomes and the uptake of interventions to prevent malnutrition by mothers of malnourished and well-nourished in under-fives attending Princess Marie Louise Children's Hospital (PML). METHODS An unmatched case control study of malnourished and well-nourished children and their mothers was conducted at PML, the largest facility for managing malnutrition in Ghanaian children. Malnourished children with moderate and severe acute malnutrition were recruited and compared with a group of well-nourished children attending the hospital. Weight-for-height was used to classify nutritional status. Record forms and a semi-structured questionnaire were used for data collection, which was analysed with Stata 11.0 software. RESULTS In all, 182 malnourished and 189 well-nourished children and their mothers/carers participated in the study. Children aged 6-12 months old formed more than half of the malnourished children. The socio-demographic factors associated with malnutrition in the multivariate analysis were age ≤24 months and a monthly family income of ≤200 GH Cedis. Whereas among the health outcomes, low birth weight, an episode of diarrhoea and the presence of developmental delay were associated with malnutrition. Among the interventions, inadequate antenatal visits, faltering growth and not de-worming one's child were associated with malnutrition in the multivariate analysis. Immunisation and Vitamin A supplementation were not associated with malnutrition. Missed opportunities for intervention were encountered. CONCLUSION Poverty remains an important underlying cause of malnutrition in children attending Princess Marie Louise Children's Hospital. Specific and targeted interventions are needed to address this and must include efforts to prevent low birthweight and diarrhoea, and reduce health inequalities. Regular antenatal clinic attendance, de-worming of children and growth monitoring should also be encouraged. However, further studies are needed on the timing and use of information on growth faltering to prevent severe forms of malnutrition.
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Affiliation(s)
- Edem M A Tette
- Department of Community Health, School of Public Health, University of Ghana, P.O. Box 4236, Accra, Ghana.
- Princess Marie Louis Children's Hospital (PML), P.O. Box GP 122, Accra, Ghana.
| | - Eric K Sifah
- Princess Marie Louis Children's Hospital (PML), P.O. Box GP 122, Accra, Ghana.
| | - Edmund T Nartey
- World Health Organisation Collaborating Centre for Advocacy and Training in Pharmacovigilance, Centre for Tropical Clinical Pharmacology & Therapeutics, School of Medicine and Dentistry, University of Ghana, P. O. Box GP 4236, Accra, Ghana.
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6
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Jeong KS, Park H, Ha E, Hong YC, Ha M, Park H, Kim BN, Lee BE, Lee SJ, Lee KY, Kim JH, Kim Y. Performance IQ in children is associated with blood cadmium concentration in early pregnancy. J Trace Elem Med Biol 2015; 30:107-11. [PMID: 25511909 DOI: 10.1016/j.jtemb.2014.11.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 10/31/2014] [Accepted: 11/19/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate whether performance IQ in children is associated with maternal blood cadmium concentration in early pregnancy. METHOD The present study is a component of the Mothers' and Children's Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 119 children whose mothers underwent testing of blood cadmium during early pregnancy. All children were evaluated using the Korean version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R), at 60 months of age. Multivariate linear regression analysis was performed to analyze the correlation between IQ in children and maternal blood cadmium concentration in early pregnancy, after adjustment for covariates. RESULTS Maternal blood cadmium concentration during early pregnancy was inversely associated with performance IQ, after adjustment for covariates such as sex, educational levels of both parents, family income, and maternal BMI. Maternal blood cadmium concentration, however, was not associated with cognitive IQ. CONCLUSION Performance IQ in children is associated with maternal blood cadmium concentration in early pregnancy.
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Affiliation(s)
- Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Hyewon Park
- Dept of Child and Family Welfare, University of Ulsan, Ulsan, Republic of Korea
| | - Eunhee Ha
- Department of Preventive Medicine, Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Bo-Eun Lee
- Environmental Health Research Division, National Institute of Environmental Research, Incheon, Republic of Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Kyung Yeon Lee
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Ja Hyeong Kim
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
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van der Linde J, Swanepoel DW, Glascoe FP, Louw EM, Vinck B. Developmental screening in South Africa: comparing the national developmental checklist to a standardized tool. Afr Health Sci 2015; 15:188-96. [PMID: 25834548 PMCID: PMC4370141 DOI: 10.4314/ahs.v15i1.25] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Worldwide, more than 200 million children in low- and middle-income countries have developmental delays and/or disabilities. In South Africa the only nationally implemented developmental 'screening' tool is integrated as part of 'The Road to Health Booklet (RTHB). METHOD The study employed a comparative cross-sectional within-subject design to evaluate the accuracy of the RTHB developmental checklist against a standardized international tool i.e. the PEDS tools, consisting of the PEDS and PEDS:DM. A total of 201 participants were included through convenience sampling at primary health care facilities in Tshwane, South Africa. RESULTS Sensitivity of the RTHB developmental checklist is low, but specificity is high. The RTHB developmental checklist failed to identify more than half the infants at risk of delays or disorders. The nationally implemented developmental checklist is ineffective to identify at-risk infants. It should be adapted and validated or replaced in order to improve identification of at-risk infants.
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Affiliation(s)
- Jeannie van der Linde
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Nedlands
- Australia Ear Science Institute Australia, Subiaco, Australia
| | | | - EM Louw
- Department of Statistics, University of Pretoria, South Africa
| | - Bart Vinck
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Department of Speech-Language Pathology and Audiology, Ghent University, Belgium
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Adams RC, Tapia C. Early intervention, IDEA Part C services, and the medical home: collaboration for best practice and best outcomes. Pediatrics 2013; 132:e1073-88. [PMID: 24082001 DOI: 10.1542/peds.2013-2305] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The medical home and the Individuals With Disabilities Education Act Part C Early Intervention Program share many common purposes for infants and children ages 0 to 3 years, not the least of which is a family-centered focus. Professionals in pediatric medical home practices see substantial numbers of infants and toddlers with developmental delays and/or complex chronic conditions. Economic, health, and family-focused data each underscore the critical role of timely referral for relationship-based, individualized, accessible early intervention services and the need for collaborative partnerships in care. The medical home process and Individuals With Disabilities Education Act Part C policy both support nurturing relationships and family-centered care; both offer clear value in terms of economic and health outcomes. Best practice models for early intervention services incorporate learning in the natural environment and coaching models. Proactive medical homes provide strategies for effective developmental surveillance, family-centered resources, and tools to support high-risk groups, and comanagement of infants with special health care needs, including the monitoring of services provided and outcomes achieved.
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SCHERZER ALFREDL, CHHAGAN MEERA, KAUCHALI SHUAIB, SUSSER EZRA. Global perspective on early diagnosis and intervention for children with developmental delays and disabilities. Dev Med Child Neurol 2012; 54:1079-84. [PMID: 22803576 PMCID: PMC3840420 DOI: 10.1111/j.1469-8749.2012.04348.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Low- and middle-income countries are experiencing a significant reduction in mortality of children under 5 years of age. This reduction is bringing in its wake large numbers of surviving children with developmental delays and disabilities. Very little attention has been paid to these children, most of whom receive minimal or no support. Thus, there is an urgent need to recognize that improving the quality of life of the survivors must complement mortality reduction in healthcare practice and programs. The incorporation of early evaluation and intervention programs into routine pediatric care is likely to have the most impact on the quality of life of these children. We therefore call for leadership from practitioners, governments, and international organizations to prioritize regular childhood developmental surveillance for possible delays and disabilities, and to pursue early referral for intervention.
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Affiliation(s)
- ALFRED L SCHERZER
- Department of Pediatrics, Stony Brook University School of Medicine, New York, NY, USA
| | - MEERA CHHAGAN
- Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa
| | - SHUAIB KAUCHALI
- Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa
| | - EZRA SUSSER
- Mailman School of Public Health and New York State Psychiatric Institute, Columbia University, New York, NY, USA
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