Two-stage window screening and development trajectories in early identification of autism spectrum disorder among Han Chinese children

Objective An understanding of the trajectory and norm of development in children is needed in order to understand the concept of the spectrum in the diagnosis of autism spectrum disorder (ASD). Children’s developmental growth trajectory was measured from six to 66 months in the Taiwan Birth Cohort Study dataset (N = 11,145). Additionally, over 4 years of follow-up, the negative predictive value of using the Parental Concern Checklist and Taiwan Birth Cohort Study Developmental Instrument was also investigated as the first stage of screening in a two-stage window screening method for ASD diagnosis. Results The growth trajectory showed that children’s language development began to increase at 18 months, and peaked at 36 months. On the other hand, social development showed steady growth from 18 to 66 months. The increase in the trajectory of children’s language development prior to age three, when compared with other developmental dimensions, may increase the difficulty of diagnosing ASD. The two-stage window screening method can be used in settings where the screening sample is large, such as in community or primary care settings, and has been found to be time- and cost-efficient. Better understanding of children’s developmental trajectory can enhance detection and intervention for ASD.

Determinants of child resilience in poverty: findings from the Taiwan Birth Cohort Study

Background Poverty has adverse effects on child health. While children in poverty face greater health challenges, some still achieve positive health outcomes. This is in part due to their resilience when facing adversity. Identifying the factors that foster child resilience can aid in developing strategies to promote child resilience and reduce the harmful effects of child poverty. This study aims to identify the biological and social factors of resilience among children in poverty from birth to age 12. Methods Data for the analysis came from the Taiwan Birth Cohort Study, a nationally representative sample of 17,354 children who completed six waves of interview surveys between 2005 and 2017. Our sample included 4,570 children who experienced poverty from birth to age 12. The primary outcome variable was child resilience, defined as impoverished children who maintained good health outcomes over the 12-year survey period. Multiple logistic regression was used to examine the factors of child resilience. Results Of the 4,570 children, 36.1% always had good health despite experiencing poverty before the age of 12. An easy temperament (OR = 2.5, 95% CI: 1.9-3.0), female (OR = 1.1, 95% CI: 1.0-1.3), a birth weight greater than 2,500 grams (OR = 1.6, 95% CI: 1.2-2.1), having a foreign-born mother (OR = 1.5, 95% CI: 1.2-1.7), receiving breast milk after birth (OR = 1.3, 95% CI: 1.1-1.5), and good parent-child interaction at 3 years of age (OR = 1.4, 95% CI: 1.2-1.7) were associated with child resilience. Early parent-child interactions can moderate the effect of children's birth weight on later resilience. Conclusions Our findings indicated the factors associated with child resilience in the context of poverty, suggesting that supporting breastfeeding and nurturing parent-child relationships are effective public health actions to foster child resilience. Future research is needed to unravel the underlying mechanisms of biological factors associated with child resilience. Key messages Breastfeeding after birth and high-quality parent-child interaction can lead to positive adaptations to child poverty. Children with difficult temperaments, boys and those born at low birthweight are more vulnerable to poverty and should be targeted for building resilience against poverty.

Healthy living practices in families and child health: 5-year follow-up of Taiwan Birth Cohort Study

ObjectivesWe have previously developed the Child Healthy Living Practices in Family (CHLPF) Index and found that the CHLPF Index was concurrently associated with the health of children at age 3. In this follow-up study, we aimed to examine whether healthy living practices in family at age 3 predicted health of children at school age.Design and settingData came from the Taiwan Birth Cohort Study designed to assess the development and health of 24 200 children born in 2005.ParticipantsA total of 18 553 cohort members whose mothers or primary caregivers had completed 6-month, 3-year, 5-year and 8-year surveys were included for analysis, representing a response rate of 87.3%.Outcome measuresA multiple logistic regression model was used to test the relationship between mother-rated children’s health at age 8 and the CHLPF Index level, after controlling for sex, birth outcomes, family structure, parental education, residential area, family income and mother-rated child’s health at age 3.ResultsThe percentage of mother-rated good health at age 8 was 79.7%. Compared with the low CHLPF level, the adjusted OR of mother-rated good health was 1.38 (95% CI 1.19 to 1.60), 1.21 (95% CI 1.10 to 1.35) and 1.17 (95% CI 1.07 to 1.29), respectively, for high, high–low and mid-low CHLPF levels. Moreover, the prevalence of mother-rated good health at age 8 with high-level CHLPF Index in the low-income group was similar to that of the high-income group (83.72% vs 84.18%); the prevalence with low-level CHLPF Index in the low-income group was much lower than that of the high-income group (70.21% vs 78.98%).ConclusionsOur study underscores that high level of healthy living practices in early childhood is positively associated with good health at school age, particularly for children from disadvantaged families.

From dissociative experience and internet use to happiness: A Taiwan Birth Cohort Study

Background Functional and excessive use of internet is hard to distinguish, and internet use can affect adolescents’ development of self-identity. The aim of our study was to investigate the pathway relationship of the risk and protective factors of internet use, including mother care, absorptive dissociative trait, having been bullied, exercise, self-perceived depressive mood and happiness of 12-year-old adolescents. Methods The Taiwan Birth Cohort Study dataset, which used a national household probability sampling method and included 17,694 12-years-old adolescents, was used for this study. Results Our results showed 5.3% adolescents reported to spend more than five hours online during schooldays. Additionally, adolescents that spend more than five hours online during schooldays tended to have higher absorptive trait, perceived less care from mothers, more likely to have been bullied, expressed higher level of depressed mood, which leads to lower level of perceived happiness. Conclusions Adolescents that spend more than 5 hours online during schooldays, compared to those that spent less than an hour online, were more likely to have been bullied and affect their level of happiness, showing that they may be a group of higher concern. Since parental care and regular exercise are protective factors for internet addiction, it should be promoted to all adolescents, especially those in the high risk group, to prevent them from being addicted online.