The Cellie Coping Kit for children with Eosinophilic Esophagitis: Feasibility, acceptability, and preliminary outcomes

Children with eosinophilic esophagitis (EoE) are faced with ongoing treatments that can impact their wellbeing. There are no evidence-based resources that families can implement independently to cope with EoE-related stressors. This study aimed to examine acceptability, feasibility, and preliminary outcomes of the newly developed Cellie Coping Kit for Children with EoE intervention. Forty child-caregiver dyads completed a baseline assessment (T1) and initiated the intervention; 30 (75%) child participants and 33 (82.5%) caregivers were retained to follow-up (T2). Of those who completed the T2 assessment, most reported that the intervention was easy to use (>90%) and would recommend the intervention to others (>90%). The intervention was feasible: >70% used the kit, and most indicated they would use it again (>75%). More than half of families reported learning new information and/or coping strategies. No statistically significant changes were identified in comparing T1 and T2 coping and health-related quality of life. These findings suggest that the Cellie Coping Kit for Children with EoE is a promising intervention in that it was well accepted, feasible, and helped many families learn novel strategies on how to manage EoE challenges. Future research should examine how to strengthen the intervention to achieve longer-term targeted outcomes.

Knowledge of caregivers and factors associated with neuropsychomotor development in children

ABSTRACT Objectives: to analyze the knowledge of caregivers and the factors associated with neuropsychomotor development in children. Methods: a cross-sectional study, with a quantitative approach, was conducted with 220 child-caregiver binomials attended in the public health services of the municipality of Parnaíba, State of Piauí. The study used the “Denver Test II” and the “Inventory of Child Development Knowledge”. Results: the study classified 197 children with natural development and 23 with suspicious development. Caregivers with a higher level of knowledge about child development were associated with children with better development. The study considered caregiver knowledge, gestational age, and exclusive breastfeeding as protective factors for appropriate neuropsychomotor development when used the regression model. Conclusions: actions aimed at indicators that presented positive associations must be implemented to improve child development, such as educational activities to increase the level of knowledge of caregivers, improvement of prenatal monitoring, and encouragement of breastfeeding.

Caregiver Perceptions of Child Diet Quality: What Influenced Their Judgment

This study aimed at assessing the correctness of a caregiver’s perception of their child’s diet status and to determine the factors which may influence their judgment. 815 child-caregiver pairs were recruited from two primary schools. 3-day 24-h recall was used to evaluate children’s dietary intake, Chinese Children Dietary Index (CCDI) was used to evaluate the dietary quality. Multivariate logistic regression models were used to explore the factors that could influence the correctness of caregiver’s perception. In the current study, 371 (62.1%) children with “high diet quality” and 35 (16.1%) children with “poor diet quality” were correctly perceived by their caregivers. Children who were correctly perceived as having “poor diet quality” consumed less fruits and more snacks and beverages than those who were not correctly perceived (p < 0.05). Obese children were more likely to be correctly identified as having “poor diet quality” (OR = 3.532, p = 0.040), and less likely to be perceived as having “high diet quality”, even when they had a balanced diet (OR = 0.318, p = 0.020). Caregivers with a high level of education were more likely to correctly perceive children’s diet quality (OR = 3.532, p = 0.042). Caregivers in this study were shown to lack the ability to correctly identify their children’s diet quality, especially amongst children with a “poor diet quality”. Obesity, significantly low consumption of fruits or high consumption of snacks can raise caregivers’ awareness of “poor diet quality”.

Families Matter: A Cross-Sectional Study of Parent and Child Mental Health During COVID-19 (Preprint)

BACKGROUND Background: The pandemic has disrupted all aspects of children’s lives and has increased children’s exposure to adversity and traumas known to increase the risk of mental health challenges. Recent studies have reported increased rates of mental health challenges in youth during the pandemic, yet few studies have examined the impact of the pandemic on the mental health of toddlers, preschoolers, and elementary school-age children. The pandemic has also adversely impacted caregiver mental health and other indirect factors, including economic instability, known to increase children’s risk for impairing mental health challenges. OBJECTIVE Objective: This study aimed to characterize the social-emotional challenges of children ages 2 to 12 years old during the pandemic and identify modifiable child, caregiver, and family-related risk factors that contribute to risk and are additional targets for intervention. METHODS Methods: Caregivers (N = 676) of children ages 2-12 completed an online survey in early fall 2021 using standardized screening tools to assess child social-emotional challenges and caregiver anxiety and depression. We used a new 16 scale to assess the impact of the pandemic at the child, caregiver, and family levels. We used hierarchical linear regression and logistic regression to explore the relationship between children’s mental health and caregivers’ mental health. We used path analysis to explore direct and indirect effects of the impact of pandemic stress on child emotional and peer challenges, mediated by caregiver anxiety and depression. RESULTS Results: Eighty-seven percent of the children were ages 2-8 years old (n=588) with 13% (n=88) between 9-12 years old. Caregivers endorsed significant child emotional and peer challenges with 80% (n = 536) of children at risk for clinically-significant emotional challenges and 57% (n = 388) at risk for clinically-significant peer social challenges. Emotional challenges increased with age (r = .20, P <.001). 50% (n=330) of caregivers screened positive for generalized anxiety and 24% (n=160) screened positive for depression. Cumulative COVID-19 impact was directly associated with increased child emotional challenges (r=.29, P<.001), peer challenges (r=.29, P<.001), caregiver anxiety (r = .32, P<.001), and caregiver depression (r = .42, P<.001). Caregiver anxiety accounted for 31% of the total effect of COVID-19 impact on child emotional challenges and 18% of the total effect on peer challenges. CONCLUSIONS Conclusions: The results of our study show that the COVID-19 pandemic is having direct and indirect adverse impacts on the social-emotional health of children ages 2 to 12 years old with impacts on very young children similar to impacts for older children. Only with an integrated, family-focused approach that includes young children will we be able to mitigate the current pediatric mental health crisis. CLINICALTRIAL n/a

Childhood Abuse and Caregiving for Perpetrating Parents: Impacts on Adult Child Well-Being

Combining the stress process model of caregiving and life course perspective, this study examined the long-term influences of childhood abuse on perpetrating parent-adult child relationships and adult child well-being in the context of caregiving. Using a sample of family caregivers from the Wisconsin Longitudinal Study (969 caregivers of mothers; 280 caregivers of fathers), we investigated whether contact frequency and emotional closeness with an abusive parent mediate the longitudinal effects of parental childhood abuse on adult child caregivers’ depressive symptoms and the moderating effects of self-acceptance and mastery on this mediational association. Key findings indicate that maternal childhood abuse may negatively affect emotional closeness between an adult child caregiver and perpetrating mother (b = -0.24, p &lt; .001). This could lead the adult child caregiver to experience increased depressive symptoms (b = 0.02, p &lt; .05). Although the mediation paths for the effect of maternal childhood abuse on depressive symptoms via emotional closeness with mothers did not differ by caregivers’ level of psychological resources, we found that psychological resources significantly moderated the association between maternal childhood abuse and depressive symptoms (b = -0.08, p &lt; .05). Further research may explore this phenomenon in light of the heterogeneity of contemporary families. Practitioners working with adults with a history of parental childhood abuse who are caregiving for their perpetrator are encouraged to employ a trauma-informed approach to maximize the caregivers’ health and well-being.

Parent-mediated social communication therapy for young children at risk for neurodevelopmental difficulties living in poverty in Brazil: study protocol for a randomized controlled trial

Background: Exposure to adverse environments such as socioeconomic disadvantage and psychosocial deprivation are risk-factors for neurodevelopmental problems in childhood. Children exposed to such environments may benefit from interventions that target social-communication abilities, since these are protective factors for healthy neurodevelopment in vulnerable children. One intervention that has shown efficacy in improving early social-communication development is Paediatric Autism Communication Therapy (PACT). However, the efficacy of PACT has not been tested for vulnerable children exposed to environmental risk-factors in Latin American countries. This randomized controlled trial will test the efficacy of PACT in improving social-communication development in young children at risk for neurodevelopmental difficulties living in poverty in Brazil.Methods: Participants will be 160 children aged 2 years 0 months to 4 years 11 months with low social-communication abilities and their primary caregivers. Child-caregiver dyads will be recruited from public early childhood education centers in impoverished urban regions of the city of São Paulo, Brazil. Low social-communication abilities will be defined by Standard Scores &lt;84 on the Socialization and/or Communication domains of the Vineland Adaptive Behavior Scales. Child-caregiver dyads will be randomized to receive 12 sessions (five months) of the PACT intervention (N=80) or five months of community support as usual plus psychoeducation (N=80). The primary outcome (parent-child interaction) and secondary outcomes (parent-reported social-communication abilities, neurophysiological activity during a live social interaction) will be measured pre- and post-intervention. Discussion: This study may lead to new interventions for vulnerable young children in Brazil and better understanding of the neural mechanisms of PACT.

Large-scale study of speech acts' development in early childhood

Studies of children's language use in the wild (e.g., in the context of child-caregiver social interaction) have been slowed by the time- and resource- consuming task of hand annotating utterances for communicative intents/speech acts. Existing studies have typically focused on investigating rather small samples of children, raising the question of how their findings generalize both to larger and more representative populations and to a richer set of interaction contexts. Here we propose a simple automatic model for speech act labeling in early childhood based on the INCA-A coding scheme (Ninio, Snow, Pan, &amp; Rollins, 1994). After validating the model against ground truth labels, we automatically annotated the entire English-language data from the CHILDES corpus. The major theoretical result was that earlier findings generalize quite well at a large scale. Further, we introduced two complementary measures for the age of acquisition of speech acts which allows us to rank different speech acts according to their order of emergence in production and comprehension.Our model will be shared with the community so that researchers can use it with their data to investigate various question related to language use both in typical and atypical populations of children.

Vocalisations and the Dynamics of Interpersonal Arousal Coupling in Caregiver-Infant dyads

We currently understand little about how autonomic arousal influences early vocal development. To examine this, we used wearable microphones and autonomic sensors to collect multimodal naturalistic datasets from 12-month-olds and their caregivers. We observed that clusters of vocalisations occurred during elevated infant and caregiver arousal, but the relationship is stronger in infants than caregivers. Caregivers show greater functional flexibility, and their vocal production is more influenced by the infant’s arousal than their own. Negative affect vocalisations occur following reduced arousal stability and lead to increased child-caregiver arousal coupling, and decreased infant arousal. Positive vocalisations also occur at elevated arousal, but lead to increases in arousal, and elicit more parental speech. Our results point to important bi-directional associations between vocalisations and arousal regulation across caregiver-infant dyads.