Mutual relationships between head injury and conduct problems in children aged 9 months to 14 years in the UK Millennium Cohort Study

Background: Research suggests a link between acquired head injury and signs of conduct disorder, with a majority of findings based on retrospective reports and comparison samples. The relationship between head injuries and conduct problems and how they may influence one another during development is currently unclear. This study aimed to investigate direct and indirect associations between head injury and conduct problems through to early adolescence. Methods: Data from the UK Millennium Cohort Study was used to investigate the relationship between conduct problems as assessed by the Strengths and Difficulties Questionnaire and parent reported head injury over time, at ages 9 months, 3, 5, 7, 11 and 14 years, using a cross-lagged path analysis. This is data from 18,552 children, participating in a UK cohort study that is representative of the UK population. We included 7,041 (3,308 male) children, who had full information about head injuries and conduct problems at age 14. Results: We found a mutual association between childhood head injuries and conduct problems but with distinct timings: Head injury between 5-7 years predicted greater chance of conduct problems at age 11 and 14 years, while greater conduct problems at 5 years predicted a significantly greater chance of a head injury at age 7-11 years. Conclusions: These findings have important implications for the timing of preventive and ameliorative interventions. Prior to school entry, interventions aiming to reduce conduct problems would appear most effective at reducing likelihood of head injuries in future years. However, equivalent interventions targeting head injuries would be better timed either as children are entering formal primary education, or soon after they have entered.

Clinical characteristics of attention-deficit/hyperactivity disorder in children and adolescents: association with quality of life and behavioral aspects

Objective: To identify associations between clinical characteristics of children with attention-deficit/hyperactivity disorder (ADHD) and their sociodemographic aspects, quality of life, and results from the strengths and difficulties questionnaire. Methods: This is an observational analytical cross-sectional study with a non-probabilistic sample consisting of 72 children diagnosed with ADHD, aged 6 to 13 years, treated at 2 neuropediatric outpatient clinics. The instruments used were the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder – Swanson, Nolan, and Pelham, version IV (MTA-SNAP-IV), the Strengths and Difficulties Questionnaire (SDQ), the Brazilian Economic Classification Criteria (CCEB), and the Quality of Life Assessment Scale for Children and Adolescents (AUQEI). We performed descriptive, bivariate, and multivariate analyses, considering a 5% significance level. Results: SDQ results were associated with abnormal MTA-SNAP-IV results (inattentive/hyperactive/combined). A 1-point increment in the SDQ score increased by 36.5% the likelihood of the child having an abnormal MTA-SNAP-IV classification. Regarding AUQEI, 30.6% of participants perceived their quality of life as poor and 69.4% as good. Conclusions: A higher SDQ score increased the child's chance of having an abnormal MTA-SNAP-IV result.

Mental Health of Siblings of Children with Rare Congenital Surgical Diseases during the COVID-19 Pandemic

Introduction The COVID-19 pandemic has affected every aspect of our society, particularly vulnerable groups, such as families with children suffering from rare diseases. However, the psychosocial influences of COVID-19 on the healthy siblings of children with rare diseases have not been investigated yet. Thus, the study aimed to evaluate the mental health of healthy siblings of children with rare congenital surgical diseases during the COVID-19 pandemic. Material and methods Siblings of children with rare congenital surgical diseases were investigated cross-sectionally between April 2020 and April 2021. Data on mental health were collected using the parent-version of the Strengths and Difficulties Questionnaire (SDQ). Results Out of 104 families, 81 (77.88%) participated in the survey. Healthy siblings presented with comparable levels of emotional and behavioral difficulties compared with population norms before the COVID-19 pandemic. Compared with studies that surveyed child and adolescent mental health during the COVID-19 pandemic, parents of siblings in this study reported a significantly lower impairment rate. Psychosocial and disease-specific risk factors of the respective outcomes in healthy siblings were identified through regression analysis models. Conclusion In general, health-care professionals should be aware of the possibility of siblings' mental health being at risk. Therefore, screening for psychosocial deficits may be essential in preventing psychiatric disorders in this population, especially during pandemics. Trial registration ClinicalTrials.gov: NCT04382820 (registered April 8, 2020)

Patterns of parent screen use, child screen time, and child socioemotional problems at 5 years

Background: Digital media screens have become an essential part of our family life. While most studies focus on children’s screen use, we know less about parental screen use patterns and how these affect children’s socio-emotional development.Method: 867 Canadian parents of 5-year old children from the TARGet Kids! Cohort (73.1% mothers, mean age=38.88±4.45 years) participated from 2014 to 2020. Parents reported parental and child time on TV and handheld devices and completed the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis (LPA) was used to identify groups of parents with similar patterns of screen use and link these profiles with child screen time and SDQ.Results: We identified six latent profiles of parent screen use: low users (P1, reference; n=323), more TV than handheld (P2; n=261), equal TV and handheld (P3; n=177), more handheld than TV (P4; n=57), high TV and handheld (P5; n=38) and extremely high TV and handheld (P6; n=11). P6 were more likely to be living in single parent households compared to P1 (estimate=-1.49(0.70), p=0.03). P2 (estimate=-0.67(0.32), p=0.04) and P4 (estimate=-1.42(0.40), p<0.001) were more likely to have lower household income compared to P1. P4 (χ2=12.32, p<0.001) and P5 (χ2=9.54, p=0.002) have higher total child screen time compared to P1. P6 (χ2=6.82, p=0.009) had higher total SDQ compared to P1.Discussion: Patterns of parent screen use were associated with child screen use and child socioemotional problems. The link between parental screen use profiles and child behaviours suggests a need for guidelines on parental screen time.

Utility of Psychometric and Dynamic Assessments for Identifying Cognitive Characteristics of Twice-Exceptional Students

The purpose of this research was to examine the utility of psychometric and dynamic assessment for the identification of a twice-exceptional (2E) group of students who showed both mathematical high abilities and specific learning disabilities. Of a population of 800 students, 30 (14 boys and 16 girls) ages 10 to 12 years were selected and identified as twice-exceptional at three public elementary schools in Amman, the capital of Jordan. A combination of three psychometric tests and one dynamic math assessment tool was used to recognize the cognitive and perceptual characteristics strengths and difficulties among students. Both psychometric and dynamic assessment models were found important and complementary to one another for the identification of cognitive and perceptual characteristics of twice-exceptional children. The findings were reported and discussed.

Tobacco Prevention Using Social Skills Education and Puppet Scripts in an After-School Program

The purpose of this study was to explore the feasibility of implementing a tobacco use prevention intervention using social skills education and puppet scripts in an afterschool program. A total of 75 K-2 students attending an afterschool program in a rural Midwest area participated in a 4-lesson youth development tobacco prevention curriculum and completed a pre-post tobacco knowledge quiz. Additionally, 10 program mentors completed a pre-post program strengths and difficulties (SDQ) questionnaire on their assigned students. A series of t-tests were computed to examine differences in the pre and post scores of participants on the SDQ subscales, and total scales and descriptive statistics were computed on the tobacco knowledge quiz. Statistically significant differences were noted on 4 pre–post subscales scores of the SDQ and the total SDQ. Use of youth development curriculum using interactive puppet-based strategies implemented in afterschool settings may be a feasible health education strategy.

Below Average Cognitive Ability—An under Researched Risk Factor for Emotional-Behavioural Difficulties in Childhood

Children with below average cognitive ability represent a substantial yet under-researched population for whom cognitive and social demands, which increase in complexity year by year, may pose significant challenges. This observational study examines the longitudinal relationship between early cognitive ability and emotional-behavioral difficulties (EBDs) between the age of three and nine. Participants include 7134 children from the population-based cohort study growing up in Ireland. Cognitive ability was measured at age three using the Picture Similarities Scale. A t-score one to two standard deviations below the mean was defined as below average cognitive ability (n = 767). EBDs were measured using the Strengths and Difficulties Questionnaire (SDQ) at three, five, and nine years of age. Generalized linear mixed models and logistic regression were used to examine the relationship. Below average cognitive ability was an independent predictor of higher longitudinal SDQ scores. After adjustment, children with below average cognitive ability were 1.39 times more likely (AOR 1.39, 95% CI 1.17–1.66, p < 0.001) to experience a clinically significant EBD between the ages of three to nine years. This study demonstrates the increased risk of EBDs for children with below average cognitive ability. A scalable method of early identification of at-risk children should be a research priority for public health, enabling early intervention for cognitive and adaptive outcomes.

Alcohol Misuse among English Youth, Are Harms Attributable to Alcohol or to Underlying Disinhibitory Characteristics?

Introduction Alcohol use by young people is associated with a range of psychological and physical harms. However, similar harms are also reported with disinhibitory conditions such as conduct problems that are said to precede and predispose to alcohol misuse. We explored whether alcohol use or indicators of underlying disinhibition predict psychological and physical harms in a cohort of young people. Methods We used data from a randomised controlled intervention trial that identified young people who consumed alcohol (n = 756), mean age = 15.6 years, attending emergency departments (EDs) in England. Disinhibition was measured by the self-report Strengths and Difficulties Questionnaire hyperactivity and conduct problem items, and alcohol-related harms by questions from the ESPAD, a major European school survey. We conducted a mediation analysis with a primary outcome of frequency of engaging in alcohol-related harms 12 months after screening in ED, exploring for the mediating influence of alcohol consumed at six months. We included age, gender, allocated group and baseline consumption as covariates and adjusted for the multi-level nature of the study, where young people were nested within EDs. Results Conduct problems and to a lesser extent hyperactivity predicted harms at twelve months. This effect was not mediated by alcohol consumed at 6 months. Conclusions Among young drinkers underlying behavioural attributes predict harm independently of alcohol use. This suggests that the harms associated with alcohol use are attributable more to underlying disinhibitory characteristics than the quantity of alcohol consumed.

Cutaneous allodynia in pediatric and adolescent patients and their mothers: A comparative study

Background Allodynia in adults with migraine is related to disease duration. In pediatric patients with migraine, the same proportion reported allodynia in the first six months of migraine presentation as in prolonged disease. This study examined a possible association between migraine pediatric allodynia and maternal allodynia. Methods We interviewed children with migraine first, and then their mothers, regarding allodynia and headache symptoms. We reviewed hospital charts on pediatric medical background and headache symptoms. Mothers and children older than 11 years filled the Strengths and Difficulties Questionnaire. Results Ninety-eight children with migraine, mean age 13.49 ± 3.1 years, and their mothers, mean age 43.5 ± 6.2 years were recruited to the study. Pediatric allodynia was associated with maternal allodynia; the latter was reported in 82.8% of children with allodynia versus 35.3% of children without allodynia (p < 0.001). Maternal migraine was reported in 44 (68.7%) of children with allodynia versus 16.3% without allodynia, p < 0.001. No difference was found in Strengths and Difficulties Questionnaire scores, between children with and without allodynia. Conclusions Pediatric allodynia is associated with maternal migraine. Genetic and environmental factors such as maternal behavior may contribute to reduced pain threshold.