Project description:Sleep plays a significant role in the mental and physical development of children. Emerging evidence in animals and human adults indicates a relationship between sleep and the gut microbiota; however, it is unclear whether the sleep of preschoolers during a key developmental period, associates with features of their gut microbiota. The objective of this study was to assess the relationship between sleep and gut microbiota in preschool-aged children (4.37 ± 0.48 years, n = 143). Sleep measures included total night-time sleep (TST), sleep efficiency (SE), and wake-time after sleep onset (WASO) assessed using actigraphy. Beta-diversity differences between children with low and high TST (p = .048) suggest gut microbiota community differences. Particularly, relative abundance of Bifidobacterium was higher in the high TST group and Bacteroides, was higher in children who had greater SE and less WASO (LDA score >2). In contrast, some Lachnospiraceae members including Blautia and Coprococcus 1 were associated with shorter night-time sleep duration and less efficiency, respectively. We also found a group of fecal metabolites, including specific neuroactive compounds and immunomodulating metabolites were associated with greater sleep efficiency and less time awake at night. Notably, tryptophan and its metabolizing products were higher in children who had higher SE or lower WASO (LDA score >2); concentration of propionate was higher in children with less WASO (p = .036). Overall, our results reveal a novel association between sleep and gut microbiota in preschool-aged children. Longer night-time sleep and greater sleep efficiency were associated with specific commensal bacteria that may regulate sleep through modulating neurotransmitter metabolism and the immune system.
Project description:BackgroundA growing literature indicates that the Child Behavior Checklist-Dysregulation Profile (CBCL-DP) identifies youths with heightened risk for severe psychopathology, comorbidity, and impairment. However, this work has focused on school-age children and adolescents; no studies have examined whether preschool-aged children with the CBCL-DP exhibit a similar constellation of problems.MethodUsing a community sample of preschoolers, we compared children with (N = 61) and without (N = 488) the CBCL-DP on a broad range of variables assessed using multiple methods.ResultsUnivariate analyses revealed numerous differences between children with the CBCL-DP and their peers on psychiatric symptomatology, temperament, parenting behavior, and parental personality, psychopathology, and marital functioning. In multivariate analyses, children with the CBCL-DP exhibited greater temperamental negative affectivity and lower effortful control. They also had more depressive and oppositional defiant symptoms, as well as greater functional impairment. Parents of CBCL-DP children reported engaging in more punitive, controlling parenting behavior than parents of non-profile children.ConclusionsIn a non-clinical sample of preschoolers, the CBCL-DP is associated with extensive emotional and behavioral dysregulation and maladaptive parenting.
Project description:BackgroundRecent studies have suggested an association between prenatal paracetamol exposure and adverse neurodevelopmental outcomes in children. However, these findings may be confounded by unmeasured factors related to maternal use of paracetamol and child outcomes.ObjectiveTo examine the association between duration and timing of prenatal paracetamol exposure on parent-reported communication skills, behaviour, and temperament in preschool-aged children, with focus on the role of unmeasured confounding.MethodsWe used data from the Norwegian Mother and Child Cohort Study. Linear and generalised linear models with inverse probability weights and robust standard errors were used to quantify the association between prenatal paracetamol exposure and continuous and categorical outcomes.ResultsOf the 32 934 children included in our study, 8374 (25.4%), 4961 (15.1%), and 1791 (5.4%) were prenatally exposed to paracetamol in one, two, and three trimesters, respectively. Children exposed to paracetamol in two trimesters scored lower on shyness compared with unexposed children (β -0.62, 95% confidence interval [CI] -1.05, -0.19). Children exposed to paracetamol in three trimesters had a moderate increased risk of internalising behaviour problems (relative risk (RR) 1.36, 95% CI 1.02, 1.80) and borderline externalising behaviour problems (RR 1.22, 95% CI 0.93, 1.60) compared with unexposed children. Children exposed to paracetamol in 2nd/3rd trimester scored lower on shyness (β -0.32, 95% CI -0.66, 0.02) compared with unexposed children. Sensitivity analyses indicated that unmeasured confounders play an important role and may potentially bias the effect estimates away from the null.ConclusionsTiming of exposure and short-term use of paracetamol during pregnancy do not seem to pose any substantial risk of the outcomes examined. Although we found an association between paracetamol use in multiple trimesters and lower shyness and greater internalising behaviour in preschool-aged children, we cannot rule out chance or unmeasured confounding as possible explanations for these findings.
Project description:ImportanceChild-directed mobile applications (apps) have been found to collect digital identifiers and transmit them to third-party companies, a potential violation of federal privacy rules. This study seeks to examine the differences in app data collection and sharing practices by evaluating the sociodemographic characteristics of the children who play them.ObjectiveTo examine data collection and sharing practices of 451 apps played by young children and to test associations with child sociodemographic characteristics.Design, setting, and participantsThis study used data from the baseline phase of the Preschooler Tablet Study, a prospective cohort study conducted from August 2018 to January 2020. This study used a population-based sample. A convenience sample of the parents of preschool-aged children was recruited from pediatric offices, childcare centers, social media posts, and an online participant registry. Eligibility criteria included (1) parent or guardian of a child aged 3 to 5 years, (2) parent or guardian who lived with the child at least 5 days per week, (3) participants who spoke English, and (4) a child who used an Android (Google LLC) device. All interactions with participants were through email, online surveys, and mobile device sampling.ExposuresSociodemographic characteristics were assessed by parental report.Main outcomes and measuresThis study tested the hypothesis that data transmissions to third-party domains are more common in apps played by children from low-socioeconomic-status homes. Child app usage was assessed via a mobile sampling app for an average of 9 days. Persistent identifier data transmissions to third-party domains were quantified for each app using an instrumented Android environment with monitoring of network traffic; for each child, the counts of total data transmissions were calculated, and the total third-party domains were detected for the apps they played.ResultsOur sample comprised 124 children who used Android devices (35 tablets, 89 smartphones; 65 girls [52%]; mean [SD] age, 3.85 [0.57] years; 87 non-Hispanic White [71%]). One hundred twenty of participating parents (97%) were women. Of 451 apps tested, 303 (67%) transmitted persistent identifiers to 1 to 33 third-party domains. Child data transmission counts ranged from 0 to 614 (median [interquartile range], 5.0 [1-17.5]) and third-party domain counts from 0 to 399 (4.0 [1-12.5]). In multivariable negative binomial regression models, higher transmission and third-party domain rates per app were positively associated with older age (rate ratio, 1.67 [95% CI, 1.20-2.33]; P = .002 and 1.69 [95% CI, 1.26-2.27]; P < .001, respectively) and lower parent educational attainment (eg, high school or General Educational Development or less rate ratio, 2.29 [95% CI, 1.20-4.39]; P = .003 and 2.05 [95% CI, 1.13-3.70]; P < .02, respectively), but not with household income.Conclusions and relevanceThis study found that apps used by young children had a high frequency of persistent identifier transmissions to third-party companies, suggesting that federal privacy rules are not being enforced. Older children, those with their own devices, or those from lower-education households may be at higher risk of potential privacy violations.
Project description:Little is known about needs of grandparents of young children with autism in family and community settings. This study investigated perceived needs of grandparents of preschool-aged children diagnosed with ASD in the cultural context of Sweden. Participants were 120 grandparents of children enrolled into autism intervention programs provided by the public disability services in Stockholm. The Grandparents' Needs Survey and the SDQ Impact supplement were used to collect data. Grandparents expressed most needs in topic areas of information and childcare. No significant relations were found between grandparents' demographics and perceptions of needs; grandparents' needs were predicted by their perceived burden. The findings provide insight into understanding of grandparents' needs essential for planning and provision of quality family-centered early intervention services.
Project description:ImportanceSleep disturbances and mental health problems are highly comorbid and bidirectionally correlated across childhood. The association between the natural history of sleep disturbances and the transition of mental health problems has not been quantified.ObjectiveTo examine the association between the natural history of sleep disturbances and resolved and incident emotional and behavioral difficulties (EBDs).Design, setting, and participantsThis cohort study used data from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P), a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China, from November 10 to 24, 2016. A total of 20 324 children aged 3 to 4 years were recruited from the junior class of 191 kindergartens, of whom 17 233 (84.8%) participated in the 2-year follow-up. A multilevel regression model was used to evaluate the association between the development of sleep disturbances and the occurrence of resolved and incident EBDs. The data analysis spanned from August 4, 2021, to October 31, 2023.ExposuresSleep disturbances were assessed using the Children's Sleep Habit Questionnaire; EBDs were assessed using the Strengths and Difficulties Questionnaire.Main outcomes and measuresOccurrence of incident and resolved EBDs at the 2-year follow-up.ResultsThe cohort included 17 182 participants, with a mean (SD) age of 3.73 (0.29) years at enrollment; 52.0% were boys. The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively. Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances. After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50 [95% CI, 0.41-0.62]; P < .001) and stable sleep disturbance (SSD) group (OR, 0.47 [95% CI, 0.40-0.56]; P < .001) compared with the group with no sleep disturbances. The ORs for incident EBDs among the ISD group (OR, 2.58 [95% CI, 2.22-3.01]; P < .001) and SSD group (OR, 2.29, [95% CI, 1.98-2.64]; P < .001) were higher than among the group with no sleep disturbances.Conclusions and relevanceIn this prospective cohort study, the natural history of sleep disturbances among preschool-aged children was associated with both resolved and incident EBDs. Routine screening and precise intervention for sleep disturbances may benefit the psychosocial well-being of this population.
Project description:Unhealthy dietary choices are associated with poor sleep in children through adults. Yet, how diet and sleep are related in early childhood, when diet is reliant on parent choices around food availability, is unknown. The authors aimed to explore how frequency of fruit, vegetable, fast food, and soda consumption are associated with preschool children's sleep quality. They also considered how parenting factors may impact the relationship between children's sleep and diet. Actigraphy data were collected from 383 children 33-70 months old. Caregivers reported on child food and beverage frequency, demographics, and health items. Parenting strategies were assessed using the Parenting Scale. Multiple linear regression was used to examine associations between sleep and dietary measures with socioeconomic status, race-ethnicity, physical activity, and body mass index as covariates. Shorter nap duration was associated with more frequent consumption of fruits and vegetables (B = -3.6, p = .03). Shorter nighttime and 24-hr sleep durations were associated with more frequent consumption of fast food (B = -6.5, p = .01; B = -5.8, p = .01). Shorter nighttime sleep and later sleep onset were associated with more frequent soda consumption (B = -9.2, p = .01; B = 0.23, p = .001). Use of ineffective parenting strategies was negatively associated with fruit and vegetable consumption (r = -.29, p = .01) and positively associated with soda consumption (r = .25, p = .02) but was unrelated to sleep measures. Thus, ineffective parenting strategies may underlie child access to unhealthy foods, which, in turn, contributes to poor sleep. Encouraging healthier dietary habits and educating caregivers on how to reinforce such practices may lead to better sleep outcomes in early childhood.
Project description:The COVID-19 lockdown affected children, especially those with autism spectrum disorder, due to the disruption in rehabilitation and educational activities. We conducted a cross-sectional study of 315 preschool-aged children, 35 of which had autism, to investigate this impact. A questionnaire was administered to explore socio-demographic status, familiar/home environment, and COVID-19 exposure. The clinical features of autistic subjects were also examined. Seven variables were considered to describe the effect of pandemic: Remote learning, Behavior changes, Home activities, Sleep habits, Night awakenings, Physical activity, Information about the virus. The lockdown had a significant impact on Remote learning, Behavior changes, and Information about the virus in participants with autism. Moreover, we found a worsening in repetitive movements, echolalia, restricted interests, and aggressive behaviors.
Project description:IntroductionEnvironmental factors are closely associated with pediatric epistaxis. Whether this association differs according to age has not been previously reported. Therefore, we tried to evaluate the differences in associations between environmental factors and epistaxis in children of different ages.MethodsA total of 20,234 patients with epistaxis who visited the hospital between January 1, 2002, and December 31, 2015, were enrolled in this study. The patients were divided into two groups according to their ages: preschool-aged (<6 years) and school-aged children (6-18 years). Daily, monthly, and yearly data on environmental factors were collected. We performed a stepwise logistic regression to identify the potential environmental risk factors for epistaxis in each age group.ResultsThe mean number of epistaxis cases per month in both groups was highest in September. The cases were lowest in February in preschool-aged children and in November in school-aged children. Temperature, humidity, maximum wind speed, and sunshine duration were associated with epistaxis in preschool-aged children. Average wind speed, particulate matter (>10 μm diameter), temperature, humidity, sunshine duration, and sulfur dioxide concentration were associated with epistaxis in school-aged children.ConclusionThis study indicates that the differences in environmental risk factors for epistaxis are associated with the patient's age.
Project description:BackgroundAlthough sleep duration is a risk factor for obesity in young children, less is known about other aspects of sleep health, including bedtime, on obesity risk.ObjectiveTo determine whether bedtime is associated with body mass index (BMI) z-score or obesity risk in children ages 2 to 5 years, and to determine if associations are independent of sleep duration.MethodsCohort analyses were undertaken using three early life obesity prevention trials (POI, INSIGHT, Healthy Beginnings) and a longitudinal cohort study (HOME). Bedtime was assessed by questionnaire and BMI through clinical measurement between 2 and 5 years in 1642 children. Adjusted regression models examined whether BMI z-score and obesity (BMI z-score ≥ 2) were associated with bedtime, nocturnal sleep time and 24-hour sleep time. A discrete mixture model categorized children into bedtime trajectory groups across time points.ResultsBedtime was inconsistently associated with BMI z-score. Although each hour later of bedtime was associated with greater odds of obesity at ages 3 (OR; 95% CI: 1.05; 1.003, 1.10) and 5 (1.35; 1.08, 1.69) years, odds were attenuated after adjustment for nocturnal or 24-hour sleep time. Longer nocturnal sleep duration at 2 years was associated with lower odds of obesity (OR 0.90; 0.86, 0.94), as was longer 24-hour sleep duration at 3 years in girls (0.70; 0.62, 0.78). BMI z-score and odds of obesity were not significantly different between 'early to bed' and 'late to bed' trajectory groups.ConclusionsTiming of bedtime appears inconsistently related to obesity in young children, possibly via influencing overall sleep duration.