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The objective of this study was to examine the effects of variations in presentation of play materials on social behaviour of 18- to 30-month-old children. The study group included 102 children attending infant and toddler classes in 14 public childcare centres in Israel. Play materials were presented to the children either in a suggestive manner (as part of a scenario suggesting a context for play) or a random manner (without any planned organisation). Social behaviour of the two age groups was differentially affected by the manner in which play materials were presented. Toddlers showed a decline in aggressive behaviour following the suggestive presentation, whereas infants showed an increase in aggressive behaviour. Clinical implications of the current study include the possibility of using physical environmental variables as means for affecting children's experiences in childcare. [ABSTRACT FROM AUTHOR]

The increased prevalence of autism spectrum disorder (ASD) and its detection during the first 3 years of life have substantial relevance for early intervention. The purpose of this article is to summarize current scientific and policy information on early identification and early intervention for infants and toddlers with ASD and their families. Following a brief overview that provides basic information about ASD, the authors discuss early warning signs of the disorder and available screening and diagnostic tools. Finally, they highlight focused intervention practices and comprehensive treatment models appropriate for infants and toddlers with ASD, as well as issues affecting the delivery of effective early intervention services to children and families. [ABSTRACT FROM AUTHOR]

The article discusses the implementation, strengths and weaknesses and challenges encountered during the use of the apprenticeship model, a system designed to provide early intervention practitioner development. A comprehensive system of personnel development (CSPD) is required from states providing services to infants and toddlers with disabilities and their families under Part C of the Individuals with Disabilities Education Act (IDEA, 1997). Key elements for implementing a CSPD program include classification of early intervention personnel, standards of practice guidelines and evaluation of practitioner's knowledge.

BACKGROUND: Oral health of children is associated with oral health knowledge of their mothers, as oral health related habits (related to oral hygiene and diet) are established during infancy and maintained throughout early childhood. AIM: To assess the mother's knowledge, attitude & practice about feeding habits and oral health care in infants and toddlers in Panchkula, India. METHODS AND MATERIAL: A cross-sectional descriptive survey was undertaken using a comprehensive, self-administered questionnaire covering socio-demographic characteristics, dietary & oral hygiene knowledge, attitude & practice which were distributed to 200 mothers of children aged 0-3 years. A pilot study was performed and all the modifications and changes necessary were taken into consideration. 'Student t-test' was used & study data was analyzed with descriptive analysis using IBM Statistical Product & Service Solutions (SPSS) STATISTICS VERSION 20. RESULTS: Breastfeeding was the preferred method (100%). Majority of mothers were against bottle-feeding with sweetened milk (67.7%) & honey dipped pacifiers (76.8%). Maximum number of mothers (65.7%) weaned off their children after 6 months and they knew about cleaning gumpads (61.1%) & teeth (88.9%) & also knew about the maintenance of teeth & gums (63.1%) after giving sweet medicated syrups to their children. CONCLUSION: Mothers knowledge, attitude and practice about the importance of dental health needs to be improved. Coordinated efforts by paediatricians, paediatric dentists and other health professionals are required to impart dental health education about oral hygiene, feeding practices, importance of primary dentition & to promote preventive dental programmes. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: With more children receiving cochlear implants during infancy, there is a need for validated assessments of pre-verbal and early verbal auditory skills. The LittlEARS® Auditory Questionnaire is presented here as the first module of the LittlEARS® test battery. The LittlEARS® Auditory Questionnaire was developed and piloted to assess the auditory behaviour of normal hearing children and hearing impaired children who receive a cochlear implant or hearing aid prior to 24 months of age. This paper presents results from two studies: one validating the LittlEARS® Auditory Questionnaire on children with normal hearing who are German speaking and a second validating the norm curves found after adaptation and administration of the questionnaire to children with normal hearing in 15 different languages. Methods: Scores from a group of 218 German and Austrian children with normal hearing between 5 days and 24 months of age were used to create a norm curve. The questionnaire was adapted from the German original into English and then 15 other languages to date. Regression curves were found based on parental responses from 3309 normal hearing infants and toddlers. Curves for each language were compared to the original German validation curve. Results: The results of the first study were a norm curve which reflects the age-dependence of auditory behaviour, reliability and homogeneity as a measure of auditory behaviour, and calculations of expected and critical values as a function of age. Results of the second study show that the regression curves found for all the adapted languages are essentially equal to the German norm curve, as no statistically significant differences were found. Conclusions: The LittlEARS® Auditory Questionnaire is a valid, language-independent tool for assessing the early auditory behaviour of infants and toddlers with normal hearing. The results of this study suggest that the LittlEARS® Auditory Questionnaire could also be very useful for documenting children''s progress with their current amplification, providing evidence of the need for implantation, or highlighting the need for follow-up in other developmental areas. [Copyright &y& Elsevier]

Summary: Narcolepsy is a chronic disease commonly diagnosed in middle adulthood. However, the first symptoms often appear in childhood and/or adolescence. Pediatric cases of narcolepsy are among the most often underrecognised and underdiagnosed diseases. This fact raises questions about the reasons for such diagnostic delay from the clinical point of view, and what kind of help can be expected from auxiliary diagnostic examinations. The aim of the review is to stress some specific features of the clinical picture in children, to discuss the role of auxiliary examinations at the onset of the disease including sleep studies, tests for human leukocyte antigens (HLAs), and cerebrospinal fluid hypocretin (Hcrt) measurement, and to draw attention to the most common cases of pediatric misdiagnosis. Frequent cataplectic attacks at an early age should lead to detailed clinical, neuroimaging and genetic examinations to rule out a secondary etiology. Beside the typical symptoms (excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic/hypnopompic hallucinations), some additional features including obesity and nocturnal bulimia can appear. Also poor school performance and emotional disorder are common complaints. Treatment should start as early as possible to avoid the development of problems with progress at school, and close cooperation between school and family should be maintained. [Copyright &y& Elsevier]

Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party insurance, and children's developmental skill areas influence the level and the intensity of early intervention services provided. In addition, findings show that county demographic factors also influence service provision, specifically the interaction between rural and poverty status. Implications for social policy are discussed. [ABSTRACT FROM AUTHOR]

Objective This study assessed the stability of ratings on the McMaster Mealtime Interaction Coding System (MICS), an observational measure of family functioning, across three typical evening meals. Methods Participants included families of infants and toddlers with cystic fibrosis (n = 33) and with no chronic illness (n = 33). Three meals were videotaped across a 3-week period (M = 17.4 days) and involved a secondary data analysis from a larger study. Results Across both groups, test-retest reliability (paired correlation coefficients) was generally moderate, but significant, for all scales at each time point comparison. Analyses revealed no significant within-or between-group differences across time periods on healthy versus unhealthy ratings. Conclusions This study highlights the limitations of coding a single mealtime observation or interpreting multiple observations using the MICS. Findings highlight that family, meal, illness, and assessment factors may impact variability in ratings over time. [ABSTRACT FROM AUTHOR]

The authors examined the effects of welfare programs that increased maternal employment and family income on the development of very young children using data from 5 random-assignment experiments. The children were 6 months to 3 years old when their mothers entered the programs; cognitive and behavioral outcomes were measured 2-5 years later. While there were no overall program impacts, positive or negative, on the development of children in this age group, there was a pair of domain- and age-specific effects: The programs decreased positive social behavior among 1-year-olds and increased school achievement among 2-year-olds. After exploring several explanations for these results, the authors suggest that the contextual changes engendered by the programs, including children's exposure to center-based child care, interacted differentially with specific developmental transitions. [ABSTRACT FROM AUTHOR]

Results from a study investigating the factors associated with variations in the reported use of service coordinator practices are presented. The study participants were parents and other primary caregivers of infants and toddlers with identified disabilities or developmental delays in Individuals with Disabilities Education Act Part C early intervention programs. Finding showed that different service coordination structural and process variables, but not child, parent, or family background variables, accounted for differences in the reported use of service coordinator practices. Among 3 sets of service coordination measures, the use of family-centered helpgiving practices accounted for the largest percentage of variance in the dependent measures. [ABSTRACT FROM AUTHOR]

Drawmg on the take-home messages from recent neuroscience and developmental research, this article focuses on the challenge of using that knowledge in the service of a more appropriate policy framework to support the healthy development of infants and toddlers and to better support their families and other caregivers. Using data from a recent 50 state study of current health, child care and family support policies, the article maps the current policy status against the research knowl- edge base, and finds the current framework wanting, particularly for the lack of policy attention to promoting health relationships right from the start. It then highlights 5 core policy challenges: en- acting a national family leave, expanding access to child and family programs like Early Head Start, providing policy incentives and resources for high-quality infant and toddler child care, strength- ening the early identification and treatment for infants and toddlers at risk of poor development, and building a policy framework to support, in every state, an infant and early childhood mental health infrastructure. The article concludes with a set of research-informed principles that could guide a next generation of targeted infant-toddler policies that address these critical challenges. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to compare the prelinguistic communicative abilities of toddlers with hearing loss and without hearing loss during the 2nd year of life and shortly before the emergence of productive single-word lexicons. Method: The participants were 28 toddlers with hearing loss who participated in an early intervention program and 92 toddlers with normal hearing at similar language levels and close chronological ages. The assessment consisted of the Hebrew Parent Questionnaire--Communication and Early Language (HPQ-CEL; E. Dromi, H. Ben-Shahar-Treitel, E. Guralnik, & D. Ringwald-Frimerman, 1992) that guided parents' observations of their toddlers in 6 contexts at home. Parents reported on a range of prelinguistic communicative abilities. Results: Profile analysis indicated that the 2 groups used a remarkably similar overall profile of prelinguistic behaviors. Interrelationships among behaviors were noticeably similar, too. Two communication properties unique to toddlers with hearing loss were relatively lower spontaneous use of words and reduced involvement in triadic book reading interactions. In addition, the associations between use of words and gestures in toddlers with hearing loss were slightly different from the toddlers with normal hearing, and the range of innovative gestures that they produced was greater. Conclusion: The remarkable similarity between the 2 groups support the feasibility of adopting goals and principles known to hold true in typical development for fostering communication in toddlers with hearing loss. [ABSTRACT FROM AUTHOR]

Objective.-To evaluate the effectiveness of an oral health educational intervention designed to increase proficiency of pediatric residents in oral health. Methods.-Pediatric residents at the University of North Carolina at Chapel Hill (UNC) participated in oral health education that included didactic sessions, hands-on instruction by pediatric dentists and residents, preventive dentistry prompts, and change strategies to introduce oral health into practice. Pediatric residents at East Carolina University (ECU), who had a short practicum in oral health, and Wake Forest University (WFU), who had no specific oral health instruction, served as comparison groups. All residents completed questionnaires before and 12 months after instruction began at UNC. Effects were tested for each school separately by repeated-measure analysis of variance. Results.-The mean percentage of UNC residents who answered 18 knowledge questions correctly and reported frequently performing 10 preventive dental practices increased by 17.7% and 65.1%, respectively, from baseline levels. Residents' confidence in performing 10 counseling and oral health screening activities improved by 17.9%. Opinions about including oral health in their clinical care improved only slightly. Changes at ECU and WFU were small, but low response rates in those schools preclude substantive conclusions from between schools comparisons. Conclusions.-Multifaceted instruction in oral health was effective in improving pediatric residents' knowledge about oral health, their confidence in providing oral health services, and the delivery of these services in their ambulatory care practices. Residents also adopted the use of fluoride varnish, an innovation in pediatrics. More studies are needed to define the most efficient and effective residency-based instruction. [ABSTRACT FROM AUTHOR]

Abstract: Objective:: Children involved in motor vehicle crash (MVC) events might experience angular accelerations similar to those experienced by children with inflicted traumatic brain injury (iTBI). This is a pilot study to determine whether the progression of signs and symptoms and radiographic findings of MVC brain injury (mvcTBI) in children of the age at greatest risk of iTBI could be evaluated with retrospective data. The ultimate goal was to examine the association of subdural hematoma (SDH) with initial loss of consciousness (LOC) and outcome. Methods:: Retrospective review of records was conducted of 51 patients involved in a MVC, between birth and 36 months, admitted to Harborview Medical Center between January 1996 and December 2001. Radiographs were reviewed. Simple descriptive statistics and Fisher''s exact test were used. Results:: Ambulance reports were available for 57% of the patients, while Glasgow Coma Scale (GCS) scores (from any source) were only available for 76% of patients. Thirty-nine percent of patients sustained skull fractures, 8% long bone fractures, 20% thoracic injuries, and 8% intra-abdominal injuries. Twenty-four percent of the patients had SDHs; half of these experienced LOC. SDH patients without initial LOC had computed tomography findings and clinical courses indicative of focal impact injury, not angular acceleration. Conclusions:: Initial LOC and subsequent evolution of GCS scores are inconsistently documented in retrospective records. Seven of the 12 patients with SDHs had simple contact injuries, while 5 exhibited diffuse brain injury. Initial LOC was associated with diffuse brain injury and poor outcome. Due to the high rate of simple contact injury, mvcTBI may be a difficult model for iTBI. [Copyright &y& Elsevier]

In 2001, the authors assessed the quality of care provided to children in 51 care groups from 39 child-care centers in The Netherlands using the Infant/Toddler Environment Rating Scale (T. Harms, D. Cryer, & R. M. Clifford, 1990) and compared the results with the quality of child care assessed in 1995 (M. H. van IJzendoorn, L. W. C. Tavecchio, G. J. Stams, M. J. E. Verhoeven, & E. J. Reiling, 1998). The overall quality and scale scores for language and learning activities were significantly lower in 2001 than in 1995. Child-care centers founded within the past 6 years (all nonsubsidized centers) scored considerably lower than did older, mostly subsidized, centers. The results are discussed from the perspective of changes in the socioeconomic and political context of child care. [ABSTRACT FROM AUTHOR]

Early childhood caries is a significant public health problem in low-income children, with important negative consequences for the child and the family. The purpose of this paper is to describe the development, implementation, and preliminary outcomes of preventive dentistry programs in North Carolina that target low-income children from birth to thirty-five months of age. The focus is on Into the Mouths of Babes, a statewide program in which pediatricians, family physicians, and providers in community health clinics are reimbursed by Medicaid to provide preventive dental services for children (risk assessment, screening, referral, fluoride varnish application) and caregivers (counseling). The provider intervention includes continuing medical education lectures and interactive sessions, practice guidelines for the patient interventions, case-based problems, practical strategies for implementation, a toolkit with resource materials, and follow-up training. In the first two years of the statewide program, 1,595 medical providers have been trained. The number of providers billing for these services has steadily increased, and by the last quarter of 2002, the number of visits in which preventive dental services were provided in medical offices reached 10,875. A total of 38,056 preventive dental visits occurred in medical offices in 2002. By the end of 2002, only sixteen of the state's one hundred counties had no pediatrician, family physician, or local health department participating. The preliminary results from this program demonstrate that nondental professionals can integrate preventive dental services into their practices. The program has increased access to preventive dental services for young Medicaid children whose access to dentists is restricted. Assessments of effectiveness and cost-effectiveness of both the provider and patient interventions are under way. [ABSTRACT FROM AUTHOR]

The literacy understandings, values and skills that children bring to early childhood settings are based upon their home and community experiences. If what they bring is recognised, valued and built upon in early literacy programmes, then children are constructed as capable, confident learners. Where they are not (see, for example, Hill, Comber, Louden, Rivalland & Reid, 1998; Makin, Hayden, Holland, Arthur, Beecher, Jones Diaz & McNaught, 1999; Hanlen, 2002), children's life narratives may unfold in very different ways, since literacy and life opportunities are closely linked (Morrow, 2002). Children whose home and community experiences are similar to those valued in early childhood settings have easier access to literacy in these settings. The reverse also occurs. In this paper, findings from three early literacy research projects carried out in Australia between 1998 and 2001 are reported with the aim of identifying guiding principles to assist early childhood educators to reflect upon their current early literacy practices and to construct more inclusive literacy narratives for children prior to school entry. [ABSTRACT FROM PUBLISHER]

Background: The transition from a predominantly milk-based diet to a diverse family diet is a window of opportunity for optimal child growth and development., Objectives: The study aims to examine the nutritional status and food-consumption patterns of children under 4 y of age in the United Arab Emirates (UAE) and their adherence to nutrient and dietary recommendations., Methods: A population-based cross-sectional survey of 525 children aged 0-47.9 mo was conducted in 3 major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometric measurements were obtained, and dietary assessment was conducted using the 24-h dietary recall approach. Usual intakes of energy, macronutrient, and micronutrients, including from supplements, were assessed using PC-SIDE software. Adherence to food-group recommendations was evaluated based on the American Heart Association/American Academy of Pediatrics dietary guidelines., Results: Among 0-4-y-old children, 10% were stunted, 6% were wasted, 17% were at risk of overweight, 5% were overweight, and 3% were obese. The contribution of sweets and sugar sweetened beverages to energy intake increased from 5% in 6-11.9-mo-old children to 17% in 36-47.9-mo-old children. Compared with dietary guidelines, the lowest adherence was for fruit (13-18%) and vegetables (7-12%), while protein was within the recommendations, and 92% and 89% of children (aged 24 to 35.9 mo and 36 to 47.9 mo, respectively) had high intakes of saturated fat. Almost all toddlers failed to meet the Adequate Intake for fiber. The proportions of children exceeding the free-sugar upper limit increased from 10.6% in infants (0-5.9 mo) to 56.7% in toddlers (12- 23.9 mo). Micronutrient inadequacies were observed, particularly for calcium, zinc, folate, and vitamins A and D., Conclusions: This study suggests a triple burden of malnutrition among infants and young children in the UAE. Results call for national nutrition intervention strategies aimed at improving dietary quality in the pediatric population., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)

High consumption of ultra-processed foods (UPF) increases the risks of non-communicable diseases and all-cause mortality in adulthood, and the risk of early childhood caries. Limited evidence about factors influencing children's consumption of UPF exists. This study was conducted to assess the prevalence of UPF consumption among children less than three years of age, and identify its associations with caregivers' emotional and instrumental feeding, and children's emotional eating. A cross-sectional study was conducted in Shijiazhuang, Hebei Province, China. Caregivers caring for children aged 6-36 months ( n = 408) were recruited. Caregivers' emotional and instrumental feeding practices and children's emotional eating were assessed by the Parents' Feeding Practices Scale for Infant and Young Child and Children's Eating Behaviour Questionnaire, respectively. Children's UPF consumption was assessed by a validated Food Frequency Questionnaire. Of the children, 86.8% consumed UPF. The highest percentage of UPF consumed was pastries (63.5%), followed by solid or semi-solid dairy products (58.8%), and reconstituted meat products (56.4%). Caregivers' emotional and instrumental feeding was positively associated with children's consumption of UPF (OR = 1.59, 95%CI: 1.01, 2.49), a higher frequency of UPF consumption weekly (OR = 1.80, 95%CI: 1.35, 2.39), and a larger amount of UPF consumption weekly (OR = 1.85, 95% CI: 1.38, 2.49). Children's higher frequency of emotional undereating was associated with their UPF consumption (OR = 1.61, 95%CI: 1.07, 2.42) and a higher frequency of UPF consumption weekly (OR = 1.33, 95%CI: 1.03, 1.73). Children's emotional undereating significantly mediated the associations between caregivers' emotional and instrumental feeding and children's consumption of reconstituted meat products. Caregivers should be educated to avoid emotional and instrumental feeding practices, and cultivate children's good eating habits to improve children's diet quality.

Traditional models of service delivery prevent speech-language therapists and audiologists from identifying and implementing early communication intervention(ECI) in South Africa. This study utilized the framework of the transdisciplinary team approach to develop a collaborative partnership between community nurses and speech-language therapists and audiologists. An interdisciplinary in-service training programme was implemented with 24 community nurses employed at family health clinics in KwaZulu-Natal; with the aim of enhancing their knowledge and attitudes toward the early identification and referral of at-risk children to speech-language therapists and audiologists. Three questionnaires were used to evaluate the nurses' knowledge and attitudes. Results indicated that the training programme significantly improved the nurses' knowledge regarding ECI but not their attitudes. Implications of these findings are discussed in terms of service delivery for ECI, and the education and training of early interventionists in the South African context.

Descriptions of the implementation of community-based participatory mixed-methods research (CBPMMR) in all phases of the engagement approach are limited. This manuscript describes the explicit integration of mixed-methods in four stages of CBPR: (1) connecting and diagnosing, (2) prescribing-implementing, (3) evaluating, and (4) disseminating and refining an intervention that aimed to motivate Latino parents (predominantly Central American in the US) of infants and toddlers to replace sugary drinks with filtered tap water. CBPMMR allowed for co-learning that led to the identification of preliminary behavioral outcomes, insights into potential mechanisms of behavior change, and revisions to the intervention design, implementation and evaluation. [ABSTRACT FROM AUTHOR]

This study examined the patterns and characteristics of non-parental child care arrangements for Chinese very young children before they enter preschool and the extent to which families' utilization of non-parental child care influenced parenting stress. A total of 3,842 Chinese parents of infants and toddlers were selected from 10 provinces to participate in this study. The results indicated that (1) Chinese families relied heavily on grandparents to care for their children; (2) a set of family demographics predicted the utilization of non-parental child care arrangements, including parents' educational level, household income, labor force participation, and maternal age; (3) there existed a clear parental preference for publicly funded, affordable, and high-quality child care services; and (4) families' use of non-parental child care was generally not linked to parenting stress. These findings shed light on the development of the infant-toddler non-parental child care system in the Chinese sociocultural context., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hong, Zhu and Luo.)

Recent research has provided evidence on genome-wide alterations in DNA methylation patterns due to trisomy 21, which have been detected in various tissues of individuals with Down syndrome (DS) across different developmental stages. Here, we report new data on the systematic genome-wide DNA methylation perturbations in blood cells of individuals with DS from a previously understudied age group—young children. We show that the study findings are highly consistent with those from the prior literature. In addition, utilizing relevant published data from two other developmental stages, neonatal and adult, we track a quasi-longitudinal trend in the DS-associated DNA methylation patterns as a systematic epigenomic destabilization with age. [ABSTRACT FROM AUTHOR]

Surveyed a nonclinical sample of 413 parents of infants and toddlers about child-rearing difficulties, child behavior problems, and their own needs for support. Despite their high educational and income level, the parents surveyed reported raising young children to be a difficult task. Most concerns centered on children's irritating but developmentally typical behavior such as whining, noncompliance with adult requests, and interruption of adult activities. Parental reports of difficulties were highest for parents with more than one child and when children were past their second birthday. [ABSTRACT FROM AUTHOR]

The period of infancy and early childhood is a critical time for interventions to prevent future mental health problems. The first signs of mental health difficulties can be manifest in infancy, emphasizing the importance of understanding and identifying both protective and risk factors in pregnancy and the early postnatal period. Parents are at a higher risk of developing mental health problems during the perinatal period. An understanding of the evidence around prevention and intervention for parental anxiety and depression is vital to the process of prevention of early mental health disorders in infants and young children. Here we review the existing prevention and treatment interventions in the early years focusing on the period from conception to 3 years - the majority targeting parents in order to improve their mental health, and that of their infants. Elements of successful programs for parents include psychoeducation and practical skills training, as well as work on the co-parenting relationship, developing secure attachment, and enhancing parental reflective functioning. While both targeted and universal programs have produced strong effect sizes, universal programs have the added benefit of reaching people who may otherwise not have sought treatment. In synthesizing this information, our goal is to inform the development of integrated models for prevention and novel early intervention programs as early in life as possible., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Izett, Rooney, Prescott, De Palma and McDevitt.)

Objective: To explore the trend and associated factors of neuropsychological development of infants and toddlers in China., Methods: A longitudinal study was conducted among 619 infants and toddlers (2914 person-times) aged 0 to 36 months from different provinces or cities in China from January 2013 to December 2019., Results: The development age of each area increased with the extension of follow-up time, but this upward trend slowed down with physiological age at first measurement increasing. Among a low age group and each area, most of the development qualification rates in different follow-up periods were higher than that in the baseline ( p < 0.05); however, many of them were not higher than that in the baseline among the medium or high age group ( p > 0.05). For the areas of gross motor and self-care, the growth of qualification rate with the extension of follow-up was not obvious in the medium and high age group (both p trend > 0.05). Some impact factors of development in all areas were identified., Conclusions: The neuropsychological development delay of various areas of infants and toddlers, especially that of gross motor and self-care, should be paid early (within 1 years old) and constant attention. The impact of gender and maternal age on the development of young children has been further confirmed in the present study.

Research suggests that parents play a critical role in introducing technology to their young children and that parent-child joint engagement with technology can improve learning and social outcomes. The present mixed-methods study extends the current literature by directly observing the interactions of 30 parents with their infant or toddler child (ages 12-24 months) while introducing and engaging with familiar and novel mobile technologies. Qualitative analysis of observations yielded five overarching themes that described key content of parent-child interactions. Subthemes further clarified the types of verbal interactions of the child and of the parent, as well as issues of control over the device, activities and selection choices, skill needs/supports, and interest in the interactions. Developmental milestones and parental surveys contributed to the understanding of developmental change and family media use. Familiarity with the device influenced frequencies of identified themes with greater likelihood for fewer interactions, scaffolds and more passive screen activities with familiar technology. More varied verbal scaffolding was related to higher developmental scores. Physical scaffolding was provided infrequently, despite limited skill in the children. Counter to parental expectations, initiating and sustaining interest even for a short period of time was challenging in some cases. Outcomes suggest that parents engage in a wide array of relevant scaffolds with variability across individuals and child age. Overall, the study provides a rich and complex description of interactions and behaviors when parents introduce mobile devices to their infants and toddlers. [ABSTRACT FROM AUTHOR]

• FCC teachers are struggling with the managerial demands of their programs. • FCC and center teachers are equally underpaid and economically stressed. • Teachers in both settings are not rewarded for advanced training and education. • FCC and center teachers share beliefs about child development and pedagogies. • Both workshops and coaching are highly valued by FCC and center teachers. As the provision of publicly funded pre-kindergarten has expanded in recent years, public programs for infants and toddlers have received relatively little policy attention. However, federal, state, and local governments are now trying to promote quality in family child care and center-based programs that serve infants and toddlers, often with an emphasis on workforce development. Despite the developmental importance of the first years in a child's life, infant and toddler teachers in family child care and centers remain greatly under-studied in the research literature. This descriptive study seeks to help fill that gap by comparing the characteristics and views of family child care and center-based infant and toddler teachers in the context of New York City, where ambitious policies to promote the quality of infant and toddler programs have focused on workforce development in both settings. Quantitative and qualitative data were collected in 2019 via online surveys of 32 center-based and 30 family child care teachers, and then analyzed quantitatively to identify similarities and differences between the two groups. The results can inform the design of policies in New York City, other cities, and states that seek to promote the quality of infant and toddler care in different settings. [ABSTRACT FROM AUTHOR]

The Division for Early Childhood (DEC) clearly outlined recommended practices for the provision of Part C services. However, there may be challenges in rural areas associated with services aligning with these recommended practices. Therefore, this study focuses on how families experience Part C services and the extent to which services align with specific areas the DEC recommended practices in the large, rural state of Montana. We interviewed parents ( N = 30) about their children's Part C services. Deductive qualitative content analysis was used. Parents' reports suggest that while some aspects of their Part C services align with specific recommended practices, others do not. There were some meaningful differences regarding alignment with these recommended practices depending on type of provider being described. The environments in which services take place are discussed, as these may influence aspects of collaboration and building family capacity., Competing Interests: Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: We sought to determine the frequency and patterns of delayed medical care seeking for young children with skull fractures., Methods: We identified accidental skull fractures <4 years old, 2011-2012. Child abuse paediatricians abstracted retrospective data and paediatric radiologists re-reviewed images. 'Delays' were defined as presentation at ≥6 h. 'Minor accidents' included falls <4 feet and low force trauma, while 'major accidents' included higher height falls and major force events. We studied the frequency and duration of care delays, the signs or symptoms leading to care, and the duration of delays after signs or symptoms developed., Results: Two hundred and ten children had accidental skull fractures. Delays were less likely with major accidents (4.9%), than with minor accidents (25.8%) (RR = 0.32 [0.15-0.70]). Children came to care for scalp swelling (STS) (39%), the injury event (36.2%), altered consciousness (15.2%) and vomiting (10.5%). Delayed onset of STS (78.6%) caused most delayed care. Early STS was firm, (17.6%) versus delayed (5.0%), as opposed to soft or fluctuant., Conclusion: Delayed care seeking is common for minor, but not major accidental infant and toddler skull fractures. Most followed delayed onset of signs and symptoms. Delayed care seeking alone should not imply child abuse., (© 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions. Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0-6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups. Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2003, 2007, 2010, 2011, 2019, 2020, 2021 The Regents of The University of California.)

Introduction: The purpose of the present paper is to provide step-by-step guidelines for dental healthcare providers to manage dental caries based upon caries risk assessment (CRA) for ages 0-6 years and 6 years through adult. The manuscript reviews and updates the CAMBRA (caries management by risk assessment) system which includes CRA and caries management recommendations that are guided by the assessed risk level. Caries Risk Assessment: CAMBRA CRA tools (CRAs) have been evaluated in several clinical outcomes studies and clinical trials. Updated CAMBRA CRAs for ages 0-6 years and 6 years through adult are provided. These CRAs have been refined by the addition of a quantitative method that will aid the health care provider in determining the caries risk of individuals. Caries Management Based Upon Risk Assessment: Guidelines for individualized patient care are provided based upon the caries risk status, results of clinical exams and responses of the patient to questions in the CRA. These guidelines are based upon successful outcomes documented in several clinical outcomes studies and clinical trials. The paper includes a review of successful caries management procedures for children and adults as previously published, with additional emphasis on correct use of silver diamine fluoride (SDF) for children. The caries management plan for each individual is based upon reducing the caries risk factors and enhancing the protective factors with the additional aid of behavior modification. Beneficially altering the caries balance is coupled with minimal intervention restorative dentistry, if appropriate. These methods are appropriate for the management of dental caries in all patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2003, 2007, 2010, 2011, 2019, 2020, 2021 The Regents of The University of California.)

The study aimed to evaluate the effectiveness of sustained interventions in children with cleft lip and palate (CLP) for preventing early childhood caries (ECC). This prospective, nonrandomized interventional cohort study was conducted in infants aged 0-12 months with congenital CLP. Interventions were given to parents/primary caregivers in the form of combined oral health-care measures (sterile wet gauze piece, finger brush, toothbrush, and toothpaste) by a motivational interviewing approach. Education of primary caregivers on oral hygiene was provided by audiovisual aids and demonstration. Reinforcement of the prescribed regimen was done through daily short message services in caregivers' preferred language and bimonthly telephone calls. Participants were followed up for 9-32 months from the time of recruitment, with a mean period of 18.3 ± 5.1 months. Rates of dental caries were represented as prevalence rates, incidence density, and transitional probability. The distribution of the International Caries Detection and Assessment System (ICDAS) scores on different tooth surfaces affected in the intervention group was compared descriptively with that of the age- and sex-matched historical control groups. On analysis of surface-wise distribution of the ICDAS scores in the intervention group (n = 1,919), 1.2% (n = 24) had noncavitated lesions (ICDAS codes 1 and 2), 0.88% (n = 17) had cavitated lesions (ICDAS codes 3-6), and 0.26% (n = 5) had both cavitated and noncavitated lesions (ICDAS codes 1-6). The incidence density of caries-affected children observed at the first and last follow-ups was 1.2 persons/100 person-months and 1.3 persons/100 person-months of observation, respectively. The incidence density of new caries-affected tooth surfaces at the first and last follow-ups was 0.163 surfaces/100 surface-months and 0.062 surfaces/100 surface-months, respectively. Maxillary first molars had the maximum transition from sound to the cavitated lesion (11.5%), followed by maxillary incisors from sound to noncavitated (7.5%) at the last follow-up. Based on the newly developed assessment criteria in our study, sustained interventions proved to be significantly effective in preventing ECC in children with CLP., (© 2021 S. Karger AG, Basel.)

Aim: This survey assessed the attitude of paediatric dental EAPD members toward using "knee-to-knee" positioning for dental examinations and minor procedures in infants and toddlers., Methods: An anonymous electronic online questionnaire was distributed among EAPD members. The survey consisted of 12 questions and assessed demographic characteristics, professional experience and attitudes toward the use of the "knee-to-knee" position., Results: Of the 162 respondents, 148 (91%) reported using "knee-to-knee" positioning for dental examination. In addition, 97 (63%) reported performing other procedures in the "knee-to-knee" position. Fluoride application and oral hygiene instructions were the most common procedures performed in the "knee-to-knee" position., Conclusions: Most of the paediatric dentists who responded to this survey reported performing dental examinations in toddlers up to 2 years old using the "knee-to-knee" position. Majority of respondents also used this position to instruct parents regarding oral hygiene and to apply fluoride varnish.