The prevalence of toddlers at risk for developmental delay during the Covid-19 pandemic in the National Capital Region, Philippines: A single tertiary hospital study

Background@#With the COVID-19 lockdown restrictions, toddlers had significantly reduced environmental stimulus, leading to missed opportunities for learning and play, evidenced by declining developmental assessment scores.@*Objectives@#This was the first study in the Philippines to describe the prevalence of toddlers at risk for developmental delay during the COVID- 19 pandemic. Using the Early Childhood Care and Development (ECCD) Checklist, factors correlated with increased risk of developmental delay were identified.@*Methods@#A descriptive cross sectional study was done among toddlers aged 12 to 36 months. The ECCD Checklist was administered to determine the children's risk of developmental delay. Chi-square and Multiple Logistic Regression were used to identify factors correlated with risk of developmental delay.@*Results@#145 toddlers (u=25.28±7.078 months) were included in the study, and among which, 25.5% (n=145) were noted to be at risk for delays in one or more developmental domains, with prevalence odds increased by two-fold among those with daily screen time of an hour or longer (p=0.033, OR=3.055). It was also found that 73.1% (n=145) of toddlers had daily screen time of an hour or longer, contrary to AAP recommendations.@*Conclusion@#During the COVID-19 pandemic, more toddlers were found to be at risk for developmental delay, with prevalence odds increased with longer screen time. Findings may guide educational sectors in formulating interventions to prevent developmental delays as the country moves through the new normal.

New model for the prediction of visual outcomes in young children with mechanical ocular conditions and comparison with other models

Purpose: Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract. Methods: This prospective, interventional study recruited consecutive children undergoing operation for traumatic cataracts caused by mechanical eye injuries at Drashti Netralaya. The following details were obtained from their medical files: the circumstance and time of injuries, penetrating injury type, initial and final visual acuity (VA), time of operation, and associated eye diseases. Specific variables were employed to determine the OTS, TOTS, and POTS. For all patients, the final and predicted VA determined using all scores were compared using Fischer’s exact test. Accuracy, specificity, and sensitivity were evaluated for all the scores by using the area under receiver operating characteristic curve. Results: We enrolled 124 eyes. Patients’ mean value for age was 4.6 ± 1.29 years; 44 (35.41%) and 74 (64.5%) were female and male patients, respectively. Visual outcomes significantly improved after operation, and the outcomes did not differ between closed? and open?globe injuries (P = 0.162). The actual and predicted VA did not exhibit a statistically significant difference among the three scores. TOTS and POTS were more suitable for evaluating low?risk injuries, whereas the OTS could more efficiently examine high?risk cases. Conclusion: TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. TOTS and POTS were more suitable for evaluating low?risk injuries, whereas the OTS could more efficiently examine high?risk cases. All the examined scores can be helpful in estimating VA following treatment

Effect comparison of lateral-rectus approach and ilioinguinal approach in the treatment of toddlers with Torode-Zieg type IV pelvic fracture / 中华创伤杂志

Objective:To compare the clinical efficacy of lateral-rectus approach and ilioinguinal approach in the treatment of Torode-Zieg type IV pelvic fracture in toddlers.Methods:A retrospective cohort study was used to analyze the clinical data of 12 toddlers with Torode-Zieg type IV pelvic fracture admitted to Affiliated Hospital of Youjiang Medical College for Nationalities and Third Affiliated Hospital of Southern Medical University from June 2012 to June 2019. There were 6 males and 6 females, aged 13-36 months [(23.9±7.4)months]. Treatment via ilioinguinal approach was performed for 5 patients (ilioinguinal group), and via lateral-rectus approach for 7 patients (lateral-rectus group). Operation duration, intraoperative blood loss and postoperative complications were compared between the two groups. At the last follow-up, pelvic function was evaluated by Majeed function score, and fracture reduction was evaluated according to Mears-Velyvis radiological evaluation criterion.Results:All patients were followed for 24-72 months [(46.0±18.5)months]. In ilioinguinal group and lateral-rectus group, the operation time was (295.0±95.3)minutes and (165.1±52.2)minutes, respectively ( P<0.05), and the intraoperative blood loss was (190.0±65.2)ml and (225.7±92.0)ml, respectively ( P>0.05). In ilioinguinal group, the development of bilateral iliac wings was asymmetric in 3 patients. In lateral-rectus group, fracture-dislocation of epiphyseal plate together with abnormal development of iliac wing occurred in 1 patient, but had no effects on the function of lower limbs. According to Majeed function score at the last follow-up, the pelvic function in ilioinguinal approach group was rated as excellent in 1 patient, good in 2, fair in 1 and poor in 1, with the excellent and good rate of 60%, while the pelvic function in lateral-rectus group was excellent in 4 patients, good in 1, fair in 2 and poor in none, with the excellent and good rate of 71% ( P>0.05). According to Mears-Velyvis radiological evaluation criterion at the last follow-up, the fracture reduction in ilioinguinal group was rated as satisfied in 3 patients and dissatisfied in 2 patients, with the satisfaction rate of 60%, while the fracture reduction in lateral-rectus group was satisfied in 7 patients and dissatisfied in none, with the satisfaction rate of 100% ( P>0.05). Conclusions:For Torode-Zieg type IV pelvic fracture in toddles, both surgical approaches can complete the reduction and fixation. However, the lateral-rectus approach has shorter operation time and less damage to the epiphyseal structure around the pelvis than the ilioinguinal approach.

Phenomenological study on the needs of gestational diabetes mellitus mothers for nurturing care of 0-3 years old offspring / 中国实用护理杂志

Objective:To understand the needs of mothers with gestational diabetes mellitus(GDM) for nurturing care for 0-3 years old offspring, so as to provide reference for constructing gestational diabetes mothers′ foster care framework.Methods:Purposive sampling method was used to select 10 GDM mothers from January to August 2021 in the outpatient department of children′s health care, the First Affiliated Hospital of Shandong First Medical University. Using phenomenological research methods semi-structured interviews were used to collect data, and Colaizzi content analysis was used to analyze the data.Results:The nursing needs of GDM mothers can be divided into 4 themes: disease risk guidance needs, professional care guidance needs, accessible child care service needs and emotional and psychological support needs.Conclusions:It is great important to pay attention to the care needs of GDM mothers for their 0-3 years old offspring. At the same time, Understanding the care needs of GDM mothers can promote the physical and mental health of offspring of gestational diabetes mothers, provide them with professional and personalized care guidance and services. Effectively improve the nurturing and caring ability of GDM mothers, so as to better promote the health of infants and young children.

Classes de Estímulos por Bebês de até 24 Meses de Idade, / Stimulus Classes to Infants up to 24 Months Old

Resumo Neste estudo investigou-se a emergência de classes de equivalência generalizada, com inclusão de reforçadores específicos em bebês de 24 meses. Relações auditivo-visuais (AB e AC) foram ensinadas, com consequências específicas (D), para 5 bebês entre 18 e 20 meses de idade. Testes de nomeação e de relações emergentes foram realizados (BC, CB, AD, DE e EB, com semelhança física dos estímulos E e B). Três participantes formaram de classes de equivalência, incluindo os reforçadores específicos (ABCD), e dois deles apresentaram nomeação consistente. Dois participantes apresentaram desempenho correspondente à equivalência generalizada. Os resultados indicaram (a) a inédita formação de classes de equivalência generalizada com inclusão de reforçadores específicos em bebês, e (b) que a nomeação pode não ser condição necessária para a formação de classes.

Abstract This study assessed the emergence of generalized equivalence classes, with the inclusion of specific reinforcers, by infants up to 24 months old. Auditory-visual relations (AB and AC) were taught, with specific consequences (D), for five infants aged between 18 and 20 months. Naming and emergent relations tests (BC, CB, AD, DE and EB, with B and E stimuli physically similar). Three participants demonstrated equivalence classes formation, including specific reinforcers (ABCD), and two of them presented consistent naming. Two participants demonstrated generalized equivalence classes. The results indicated the unprecedented formation of generalized equivalence classes with the inclusion of specific reinforcers in babies, and that naming may not be a necessary condition for the formation of classes.

Toddlers as social actors in early education / Los niños pequeños como actores sociales en la educación infantil temprana / Crianças como atores sociais na educação infantil

Abstract: This article focuses on interaction among young toddlers during their second year of life in a Swedish preschool, with the view of toddlers as social actors. The overall aim is to explore interaction, communication, and the creation of friendship between the young children during self-initiated play activities. Play is looked upon as a rich arena for observing toddler interaction. The theoretical framework for the study is phenomenology, the view of the child as a social person and a child-oriented perspective. This article will also address the important concepts of methodology and research ethics, in relation to an ethnographic early childhood study, intended to investigate toddler's life worlds. A close analysis of their worlds may reveal what was not visible before - like a kaleidoscope. Six one-year old girls and boys in a setting, in a total of 15 children, were the focus of this study's observations for nine months. Participatory methods, photos, field notes and video-recordings, were used for the data collection. The findings of the ethnographic study recognise theoretically the competence of the toddler as a social actor, the child as an active participant, and the strategic nonverbal and verbal actions of children to initiate friendship. Mutual awareness, joint attention, shared smiles, coordinated movements, as well as other types of synchronized actions are understood as parts of nonverbal elements in emerging friendship. The competencies of attunement, taking others' perspectives and turn-taking were found in play among the young toddlers.

Resumen: Este artículo se centra en la interacción entre los niños pequeños durante su segundo año de vida en un preescolar sueco, desde la perspectiva de los niños pequeños como actores sociales. El objetivo general es explorar la interacción, la comunicación y la creación de amistad entre los niños pequeños durante las actividades de juego iniciadas por ellos mismos. El juego se considera un campo rico para observar la interacción de los niños pequeños. El marco teórico para el estudio es la fenomenología, la visión del niño como una persona social y desde un enfoque centrado en el niño. Este artículo también abordará las categorías centrales de metodología y ética de la investigación, con relación al estudio etnográfico de la primera infancia, destinado a investigar los mundos de la vida de los niños pequeños. Un análisis detallado de sus mundos puede revelar -como un caleidoscopio- lo que antes no era visible. En un grupo de quince niños, se enfocó el estudio de seis niñas y niños de un año en el entorno preescolar mediante observaciones desarrolladas durante nueve meses. Para la recolección de datos se utilizaron métodos participativos, fotografías, notas de campo y grabaciones de video. Los hallazgos del estudio etnográfico reconocen teóricamente la competencia del niño pequeño como actor social, el niño como participante activo, y las acciones estratégicas no verbales y verbales de los niños para iniciar la amistad. La conciencia mutua, la atención conjunta, las sonrisas compartidas, los movimientos coordinados, así como otros tipos de acciones sincronizadas, se entienden como parte de elementos no verbales en la amistad emergente. Las competencias de sintonía, considerar las perspectivas de los demás y tomar turnos, fueron halladas en el juego entre los niños pequeños.

Resumo: Este artigo enfoca a interação entre crianças pequenas durante o segundo ano de vida em uma pré-escola sueca, com a visão das crianças como atores sociais. O objetivo geral é explorar a interação, a comunicação e a criação de amizade entre as crianças pequenas durante as atividades lúdicas autoiniciadas. As brincadeiras são vistas como uma arena rica para observar a interação das crianças. O referencial teórico do estudo é a fenomenologia, a visão da criança como pessoa social e uma perspectiva orientada para a criança. Este artigo também abordará os conceitos importantes de metodologia e ética em pesquisa, em relação a um estudo etnográfico da primeira infância, destinado a investigar o mundo da vida de crianças pequenas. Uma análise detalhada de seus mundos pode revelar o que não era visível antes - como um caleidoscópio. Em um grupo de quinze crianças, o estudo de seis meninas e meninos de um ano de idade no ambiente pré-escolar foi focado por meio de observações desenvolvidas ao longo de nove meses. Métodos participativos, fotos, notas de campo e gravações de vídeo, foram utilizados para a coleta de dados. Os resultados do estudo etnográfico reconhecem teoricamente a competência da criança como ator social; a criança como um participante ativo, e as ações não-verbais e verbais estratégicas das crianças para iniciar a amizade. Consciência mútua, atenção conjunta, sorrisos compartilhados, movimentos coordenados, bem como outros tipos de ações sincronizadas são entendidos como partes de elementos não-verbais na amizade emergente. As competências de sintonização, assumir a perspectiva dos outros e dar turnos foram encontradas em brincadeiras entre as crianças pequenas.

Analysis of 7 cases of macrophage activation syndrome secondary to systemic juvenile idiopathic arthritis in infants and toddlers / 中华风湿病学杂志

Objective:To investigate the clinical features, diagnosis and treatment of systemic juvenile idiopathic arthritis (SJIA) complicated with macrophage activation syndrome (MAS).Methods:From January 1st, 2018 to January 1st, 2020, 7 cases of SJIA-MAS were diagnosed. Their clinical and laboratory data were collected and summarized.Results:In these 7 cases, 2 were males and 5 were females, the ratio of male to female was 2∶5. The age range was 11 months to 2 years old. The course of disease was 14 to 32 days. The clinical manifestations included fever and rash in 7 without arthritis; hepatomegaly, splenomegaly and lymphadenopathy in 7; hematological involvement in 7; nervous system involvement in 2; digestive system involvement in 7; respiratory system involvement in 7; cardiovascular involvement in 3. White blood cell was decreased in 1 case, platelet was decreased in 1 case and hemoglobin was decreased in 7 cases. Ferritin, triglyceride, alanine transaminas and aspartate aminotransferase were increased in 7 cases, fibrinogen was significantly decreased in 7 cases, and direct bilirubin was increased in 4 cases. IL-2R was significantly increased. Hemophagocytosis was observed in bone marrow of 4 cases. Cerebrospinal fluid protein was 2 005 mg/L in 1 case. All the 7 cases were tested for exon genes, and no pathogenic mutation was found. All of the 7 cases showed lung lesions in chest CT scan. Multiple demyelinating lesions were found in 1 case by head magnetic resonance imaging. One case was treated with high-dose intravenous methylprednisolone combined with IL-6 receptor antagonist(tocilizumab). The other 6 cases were treated with high-dose intravenous methylprednisolone combined with cyclosporine A (CsA). Two cases were treated with Janus kinases inhibitor(tofacitinib). After treatment, 7 cases got relieved, no death, no recurrence oocurred during the follow-up.Conclusion:Acute onset, multiple organ involvement and no joint inflammation are prominent in MAS of infants and toddlers. High fever, proressive reduction of blood cells and increase of SF are significant in SJIA-MAS. High dose glucocorticoid combined with CsA can benefit in most cases, and some severe cases need to be treated with biological agents.

Diferencias por género en las prácticas de lactancia materna y alimentación complementaria en lactantes de 15 a 24 meses de la zona metropolitana de guadalajara, méxic / Gender differences in breastfeeding and complementary feeding practices in infants aged 15 to 24 months in the metropolitan area of Guadalajara, Mexico

El lactante de 12 a 24 meses es un foco de atención debido a que se encuentra en un periodo de edad de gran vulnerabilidad a la mala nutrición y/o al establecimiento de malos hábitos de alimentación; en consecuencia, es crucial identificar las prácticas de alimentación de los infantes durante los primeros 24 meses de edad. En este estudio, transversal analítico, se reportan las prácticas de lactancia materna y alimentación complementaria de 211 lactantes, de 15 a 24 meses de edad, separados por género. Se obtuvieron las características del lactante, las prácticas de lactancia materna y de alimentación complementaria, el consumo de bebidas azucaradas y de alimentos ultraprocesados. Se utilizaron las pruebas t de Student no pareada, chi cuadrada y se estimó la razón de momios (IC95%). Las madres prolongaron más la lactancia materna en varones. En 99% de los lactantes se observó una ingestión excesiva de alimentos ultraprocesados, y los mismos se consumían con mayor frecuencia (seis veces/semana). La frecuencia de consumo de bebidas azucaradas fue de cinco veces por semana en ambos géneros. La cantidad de bebidas azucaradas consumidas al día fue significativamente mayor en varones y tenían cuatro veces mayor probabilidad de consumir las mismas [RM= 4.9 (IC95% 1.22, 19.5), p=0.02] y mayor probabilidad de consumir jugos procesados [RM=1.94 (IC 95% 0.92, 4.09), p=0.078] que las niñas. En la población estudiada se observó un consumo excesivo de alimentos ultra-procesados y bebidas azucaradas, especialmente entre los varones(AU)

Infants aged 12 to 24 months are a focus of attention because they are in an age period of great vulnerability to poor nutrition and/or the establishment of bad eating habits; consequently, it is crucial to identify infant feeding practices during the first 24 months of age. In this analytical, cross-sectional study, breastfeeding and complementary feeding practices of 211 infants, aged 15 to 24 months, separated by gender, are reported. Infant characteristics, breastfeeding and complementary feeding practices, consumption of sugary drinks and ultra-processed foods were obtained. The unpaired Student t-tests, chi-square were used and the odds ratio (95% CI) was estimated. Mothers prolonged breastfeeding in boys. Excessive ingestion of ultra-processed foods was observed in 99% of infants, and they were consumed more frequently (six times / week). The frequency of consumption of sugary drinks was five times a week in both genders. The amount of sugary drinks consumed per day was, not only significantly higher in boys, but also they were four times more likely to consume this kind of beverages [RM = 4.9 (95% CI 1.22, 19.5), p = 0.02], as well as processed juices [RM = 1.94 (95% CI 0.92, 4.09), p = 0.078] than girls. In this studied population excessive consumption of ultra-processed and sugary drinks was observed, especially among males(AU)

Funcionamientos Inferenciales en Niños Caminadores: un Acercamiento al Microdesarrollo en una Tarea de Resolución de Problemas / Inferential Functioning in Toddlers: An Approach to Micro-development in a Problem-solving Task / Funcionamentos Inferenciais em Crianças Pequenas: uma Aproximação ao Microdesenvolvimento em uma Tarefa de Resolução de Problemas

Resumen Se exponen los resultados de un estudio sobre la emergencia de la capacidad de niños caminadores para resolver problemas, centrado en la manera como niños de 25 meses de edad acceden a la comprensión de un problema de compuertas, cuya solución les exige funcionamientos inferenciales distintos. Se aplicó una metodología microgenética, en la cual se utiliza una situación de resolución de problemas (SRP), en tres ensayos de una misma sesión de observación. El análisis se dirige a las variaciones interindividuales, a partir de las cuales se identifican tendencias en los desempeños de los niños. Los resultados ponen en evidencia la capacidad resolutoria de niños caminadores, manifestada en acciones sistemáticas, organizadas, automotivadas y en el uso de procesos inferenciales complejos.

Abstract The article presents the findings of a research on the emergence of toddlers' capacity to solve problems. The study focused on how 25-month-old children come to understand a safety gate problem, whose solution requires different inferential functions. A micro-genetic methodology was applied, using a problem-solving situation (PSS), in three trials during the same observation session. The analysis focused on inter-individual variations that allowed identifying tendencies in children's performance. The results are evidence of the problem-solving capacity of toddlers, expressed in systematic, organized, self-motivated actions and in the use of complex inferential processes.

Resumo Expõe-se os resultados de um estudo sobre a emergência da capacidade de crianças pequenas para resolver problemas, centrado na maneira como crianças de 25 meses de idade acessam à compreensão de um "problema de comportas", cuja solução lhes exige funcionamentos inferenciais distintos. Aplicou-se uma metodologia microgenética, na qual se utiliza uma situação de resolução de problemas (SRP), em três ensaios de uma mesma sessão de observação. A análise dirige-se às variações interindividuais, a partir das quais são identificadas tendências nos desempenhos das crianças. Os resultados evidenciam a capacidade resolutória de crianças pequenas, manifestada em ações sistemáticas, organizadas, automotivadas e no uso de processos inferenciais complexos.

Risk Assessment of Dietary Exposure to Acrylamide in the Norwegian Population

Request from the Norwegian Food Safety Authority The Norwegian Food Safety Authority (NFSA) requested the Norwegian Scientific Committee for Food Safety (VKM) to assess whether Norwegians in general or subgroups in the population could be expected to have different dietary exposure to acrylamide than reported for other European population groups, and if found to be different to calculate their exposure. Furthermore, VKM was asked to identify food categories with a high potential to increase acrylamide exposure; both for the whole population and for specific groups. Finally, VKM was asked to characterise the risk of acrylamide exposure to the Norwegian population compared to the rest of the European population. The Norwegian Food Safety Authority intends to use this risk assessment as a basis for the Norwegian contribution to the ongoing legislative work in the EU and to consider the necessity to adjust the existing national dietary advices or to issue new ones. How VKM has addressed the request VKM appointed a working group consisting of members of the Panel on Contaminants to answer the request. The Panel on Contaminants has reviewed and revised the draft prepared by the working group and finally approved the risk assessment on dietary acrylamide exposure in the Norwegian population. What acrylamide is and its toxicity to humans Acrylamide is a water-soluble organic chemical formed in carbohydrate-rich foods from naturally present carbohydrates and amino acids during cooking or other heat processing at temperatures above 120°C. Acrylamide is a widely used industrial chemical and is also formed in tobacco smoke. Acrylamide is known to be neurotoxic in humans and is classified as a probable human carcinogen. Concerns about exposure to acrylamide in the general population arose in 2002 when it was discovered in heat-treated foods. Dietary acrylamide exposure in Europe and Norway Dietary acrylamide exposure has been assessed by combining food consumption data and acrylamide concentration data and by biological markers of exposure both in Norway and different European countries. In the EFSA 2015 Scientific Opinion on acrylamide in food, chronic dietary exposure was calculated for 61,338 individuals from 28 surveys and 17 different European countries covering the following age groups: infants (<1 year old), toddlers (≥1 year to <3 years old), other children (≥3 years to <10 years old), adolescents (≥10 years to <18 years old), adults (≥18 years to <65 years old), elderly (≥65 years to <75 years old) and very elderly (≥75 years old). The estimation of human exposure to acrylamide revealed that infants, toddlers and other children were the most exposed groups, but EFSA concluded that dietary acrylamide represents a health concern for all age groups. In previous Norwegian studies reporting dietary acrylamide exposure, the mean and median exposure in adolescents and adults were in the range of 0.3-0.5 μg/kg bw per day. These estimates are in the same range as the mean daily exposures estimated by EFSA for adolescents (0.4-0.9 μg/kg bw) and adults (0.4-0.5 μg/kg bw). Taking into consideration the results from previous exposure estimates and knowledge about food consumption patterns in recent consumption surveys in Norway, VKM concludes that Norwegian adults, adolescents and children older than three years of age are not likely to have a different exposure to acrylamide than corresponding age groups in other European countries. VKM therefore decided not to perform a new exposure assessment in these age groups. No previous studies in Norway have assessed acrylamide exposure in infants and children less than three years of age. Information from national and European dietary surveys shows that Norwegian 1-year-olds, but not 2-year-olds, have higher consumption of infant porridge than other European toddlers. VKM therefore decided to conduct a full exposure estimate in 1-year-old toddlers. The comparison of data on acrylamide occurrence in food reported by EFSA (2015) and in foods sampled in Norway showed that acrylamide concentrations in the main food categories do not differ essentially, with the exception of three categories. The category “Potato crisps and snacks” has higher acrylamide concentrations in Norwegian samples than in those reported by EFSA, while the categories “Baby foods, other than cereal-based” and “Processed cereal-based baby food” (i.e. infant porridge) have lower concentrations in Norwegian samples than in those reported by EFSA. VKM considered that Norwegian analytical values were sufficient for exposure calculations if the concentrations were analysed in 16 samples or more. Infant porridge had 52 analysed samples and VKM considered that the brands sampled are representative for infant porridge on the Norwegian market. VKM calculated acrylamide exposure based on food consumption in Norwegian 1-year-olds by two approaches: one using EFSA concentration data only; and the other using Norwegian concentration data for food categories including 16 samples or more, and EFSA data for the remaining categories. Both approaches resulted in acrylamide exposures within the exposure range for toddlers reported by EFSA (2015). When using EFSA concentration data only the calculated daily exposure (mean: 1.6 μg/kg bw and P95: 3.2 μg/kg bw) is in the upper range calculated by EFSA for toddlers (mean range: 0.9-1.9 μg/kg bw, P95 range: 1.2-3.4 μg/kg bw). When using Norwegian concentration data for food categories including 16 Norwegian samples or more and EFSA data for the remaining categories, the calculated daily exposure (mean: 0.9 μg/kg bw, P95: 1.6 μg/kg bw) is in the lower range of what EFSA has calculated for toddlers. The dietary exposure for acrylamide in Norwegian 1-year-olds is within the same range as reported by EFSA for European toddlers. Although the acrylamide-concentration was lower in infant porridge (i.e. “Processed cereal-based baby food”) sampled in Norway than in those reported by EFSA, Norwegian 1-year-olds have higher consumption of infant porridge than European toddlers. In addition to infant porridge, soft bread is a major source of acrylamide in Norwegian 1-year-olds. Food categories with high potential to increase acrylamide exposure Baby food and soft bread contributed most to acrylamide exposure in the 1-year-olds, while food items contributing the most to acrylamide exposure in adults are fried potato products, coffee, biscuits, crackers and crisp breads, and soft bread. Previous Norwegian studies and EFSA (2015) showed that in all populations groups except toddlers, ‘fried potato products’ is a food group with high potential to increase acrylamide exposure. Acrylamide is also contributed by food items commonly consumed such as coffee and bread, and this is of concern in Norway as well as in the rest of Europe. The EFSA risk assessment included exposure scenarios addressing the potential impact of home-cooking habits, locations of consumption, and preferences for particular food products. These scenarios showed that food preparation, and particularly conditions of potato frying, resulted in large variations and a possible increase of acrylamide exposure by as much as 80%. VKM considers that these scenarios carried out by EFSA are equally relevant for the Norwegian population. The temperature and browning of fried potato products will have a considerable impact on the exposure to acrylamide. VKM calculated three simplified scenarios to illustrate the influence of consumption of particular food items on acrylamide exposure. These scenarios confirmed that potato crisps, French Fries and coffee are food items with high potential to increase acrylamide exposure. Risk characterisation of dietary acrylamide exposure in Norway VKM used the same reference points as EFSA (2015), and calculated Margin of Exposures (MOEs) for assessing health risk. MOE is the ratio between a reference value and the estimated dietary exposure. The MOE approach provides an indication of the level of safety but it does not quantify the risk as such. For non-neoplastic effects, EFSA used a BMDL10 value of 0.43 mg/kg bw/day as the reference point based on animal studies of neurotoxicity, and considered a substance-specific MOE of 125 or above as a sufficient safety margin for no health concern. For neoplastic effects, EFSA used a BMDL10 value of 0.17 mg/kg bw/day as the reference point based on animal studies, and taking into account overall uncertainties in the interpretation, EFSA concluded that a MOE of 10 000 or higher would be of low concern for public health. The EFSA risk assessment concluded that the MOEs for non-neoplastic effects were above 125 for all age groups indicating no health concern, whereas the MOEs for non-neoplastic effects were substantially lower than 10 000, indicating a health concern for all age groups. The dietary acrylamide exposure in Norwegian adolescent and adults reported in previous studies were within the range calculated by EFSA for these age groups. VKM therefore concludes that the resulting MOEs for non-neoplastic and neoplastic effects of acrylamide for adolescent and adults will be similar to those calculated by EFSA. VKM calculated acrylamide exposure based on food consumption in Norwegian 1-year-olds by two approaches: one using EFSA concentration data only; and the other using Norwegian concentration data for food categories including 16 samples or more, and EFSA data for the remaining categories. Both approaches resulted in comparable MOEs. For both non-neoplastic and neoplastic effects, MOEs for 1-year-olds were similar to those reported in EFSA 2015. For non-neoplastic effects of dietary acrylamide exposure, VKM reached the same conclusion as EFSA, which is that the MOEs across all age groups indicate no health concern. For neoplastic effects of dietary acrylamide exposure, VKM reached the same conclusion as EFSA, whi

Reliability and Validity of the Korean Translation of Quantitative Checklist for Autism in Toddlers: A Preliminary Study

OBJECTIVES: We aimed to assess the test-retest reliability, internal consistency, and validity of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT). METHODS: The Korean version of the Q-CHAT and the Korean version of the Child Behavior Checklist (CBCL) 1.5-5 were completed by parents of 24 toddlers and preschoolers with autism spectrum disorder (ASD) and 80 unselected toddlers and preschoolers. Parents of the ASD group also completed the Social Communication Questionnaire (SCQ), and Childhood Autism Rating Scale (CARS) scores were obtained from medical records. RESULTS: The ASD group scored higher on the Q-CHAT than the unselected group. The Cronbach's alpha coefficient of the Q-CHAT was 0.658, and test-retest reliability was calculated to be 0.836. The estimated area under the curve was 0.793. The total scores of the Q-CHAT in the ASD group demonstrated significant positive correlations with findings regarding pervasive development problems in the CBCL, SCQ, and CARS. A total score of 33.5 may be a useful cutoff point to use when identifying toddlers at risk of ASD. CONCLUSION: The Korean version of the Q-CHAT has good reliability and validity and can be used as a screening tool in order to identify toddlers and preschool children at risk of ASD.

Cognitive and behavioral profile of Williams Syndrome toddlers / Perfil cognitivo comportamental de crianças pré-escolares com Síndrome de Williams

ABSTRACT Purpose To verify indicators of cognitive development, receptive language skills and adaptive behavioral patterns in toddlers with Williams syndrome (WS). Methods The sample comprised 8 children of both sex, aged between 48 and 72 months with WS. Instruments of data collection were Denver Developmental Screening Test II; Peabody Picture Vocabulary Test; Vineland Adaptive Behavior Scale; Child Behavior Checklist for Ages 1½-5and 6 to 18; Columbia Mental Maturity Scale (CMMS), and Behavior Problems Inventory-01. Results The major developmental impairments were associated with fine motor skills and personal care abilities. Deficits in receptive language and communication skills were reported according to the PPVT and Denver II, respectively. The caregivers reported behavioral and emotional problems associated to anxiety and depression, and attention problems scales of CBCL. Conclusion The toddlers demonstrated deficits in adaptive functioning and behavioral, motor and cognitive difficulties such as inattention and hyperactivity, stereotypies and aggressive behavior.

RESUMO Objetivo Verificar indicadores de desenvolvimento cognitivo, habilidades de linguagem receptiva e padrões comportamentais adaptativos em pré-escolares com Síndrome de Williams (SW). Método A amostra foi composta por 8 crianças de ambos os sexos, com idade entre 48 e 72 meses com SW. Os instrumentos de coleta de dados utilizados foram Denver Developmental Screening Test II; Peabody Picture Vocabulary Test; Escala de comportamento adaptativo Vineland; Child Behavior Checklist (CBCL) para as idades 1½-5 e 6 a 18; Inventário de Problemas de Comportamento (BPI-01) e Escala de Maturidade Mental Columbia. Resultados Os principais prejuízos de desenvolvimento foram associados a habilidades motoras finas e habilidades de cuidados pessoais. Os déficits em linguagem receptiva e habilidades de comunicação foram relatados de acordo com o PPVT e Denver II, respectivamente. Os cuidadores relataram problemas comportamentais e emocionais associados às escalas de ansiedade e depressão e de problemas de atenção do CBCL. Conclusão Os pré-escolares demonstraram déficits no funcionamento adaptativo e dificuldades comportamentais, motoras e cognitivas, como desatenção e hiperatividade, estereotipias e comportamento agressivo.

A review of autism spectrum disorder early screening tools for infants and young children / 中国心理卫生杂志

The development and clinical application of early screening tools for autism spectrum disorder (ASD) has aroused general interest these years.This paper reviews the major early signs and several international common used ASD screening tools which is suitable for infants and young children.Maintaining the reliability and validity,the usage and scoring methods of screening tools are now simplified to meet the clinical needs.The introduction of ASD early screening in children routine care is becoming a new trend.

Model Structure for Mother-Child Relationship for Korean Infants and Toddlers and Their Mothers

PURPOSE: The purpose of this study was to set up a hypothetical model to explain causal relationships among influential variables in the mother-child relationship for Korean infants and toddlers and their mothers. The research was based on Barnard's (1978) mother-child relations model, and goodness-of-fit was examined. METHODS: The participants were 207 mothers with infants or toddlers. Data were analyzed using SPSS and AMOS programs. RESULTS: Regarding the influence of the variables on the mother-child relationship between infants and toddlers and their mothers, social support had a 75% explanation of mother-child relationships, and attachment had a 58% explanation of social support. Attachment had both direct and indirect effects on the mother-child relationships, and social support had direct and total effects on the mother-child relationships. Among child-related variables, child temperament had a moderating effect on the mother-child relationships. CONCLUSION: The findings indicate that the model has utility in developing effective nursing intervention methods to boost mother-child relationships between infants and toddlers and their mothers.

The New Rome IV Criteria for Functional Gastrointestinal Disorders in Infants and Toddlers / 대한소아소화기영양학회지

Functional gastrointestinal disorders (FGIDs) are common worldwide and cover a wide range of disorders attributable to the gastrointestinal tract that cannot be explained by structural or biochemical abnormalities. The diagnosis of these disorders relies on the symptom-based Rome criteria. In 2016 the Rome criteria were revised for infants/toddlers and for children and adolescents. In this review, we discuss the novel Rome IV criteria for infants and toddlers. The criteria for infant colic were drastically changed, whereas only minor changes were made for regurgitation, cyclic vomiting syndrome, functional diarrhea, infant dyschezia and functional constipation. In addition to this, the new Rome IV discusses underlying mechanisms of pain in infants and toddlers, including the neuro-development of nociceptive and pain pathways, the various factors that are involved in pain experience, and methods of pain assessment in infants and toddlers is essential for the clinician who encounters functional pain in this age group. Overall, the Rome IV criteria have become more distinctive for all disorders in order to improve the process of diagnosing pediatric FGIDs.

Funciones sensoriales en niños menores de 3 años diagnosticados con trastorno del espectro autista (TEA) / Sensory processing in toddlers diagnosed with autism spectrum disorder (ASD)

Las dificultades de procesamiento sensorial en niños con Trastorno del Espectro Autista (TEA) están ampliamente descritos en la literatura principalmente mediante el uso de encuestas a padres y observaciones. Con menor frecuencia se han descrito las dificultades de procesamiento sensorial en niños menores de 3 años de edad que han sido posteriormente diagnosticados con TEA. Este estudio retrospectivo está basado en 84 niños (28 diagnosticados con TEA, 28 con retraso en el desarrollo, y 28 niños con desarrollo típico) entre 18 y 36 meses de edad que asistieron a un programa de intervención temprana y cuyos padres completaron el cuestionario Infant Toddler Sensory Profile (Dunn & Daniels, 2002). Los resultados obtenidos en esta encuesta revelan que los niños menores de edad con TEA muestran un patrón específico de procesamiento sensorial en comparación con niños con otros retrasos en el desarrollo.

Sensory processing difficulties of children with Autism Spectrum Disorder (ASD) are extensively described in the literature using parent surveys and observations. The sensory processing difficulties of children under 3 years of age who are later diagnosed with ASD have seldom been described. This retrospective study is based on 84 children (28 diagnosed with ASD, 28 with developmental disabilities, and 28 typically developing children) between 18 and 36 months of age attending an early intervention program and whose parents completed the Infant Toddler Sensory Profile questionnaire (Dunn & Daniels, 2002). The results obtained in this survey reveals that toddlers with ASD exhibit a distinct pattern of sensory processing as compared to children with other developmental delays.

Sleep Patterns among South Korean Infants and Toddlers: Global Comparison

The purpose of this study was to examine sleep patterns in a large sample of infants and toddlers (ages birth to 36 months) in Korea, and to compare sleep patterns, sleep problems, sleep ecology, and parental behaviors to global sleep data on young children in both predominately Asian (P-A) and predominately Caucasian (P-C) countries/regions. We additionally examined parent and child demographic information, parental behaviors, and aspects of the sleep ecology as predictors of sleep patterns among infants and toddlers in Korea. Parents/caregivers of 1,036 Korean infants and toddlers completed an expanded, internet-based version of the brief infant sleep questionnaire. Consistent with other studies of sleep in early childhood, sleep/wake patterns became increasingly consolidated with older child age for the Korea sample. Compared to both P-A and P-C infants and toddlers, children in Korea had the latest bedtimes, shortest total sleep and daytime sleep durations, and the least frequent rates of napping. Even though half of parents perceive their children's sleep problematic, parental perceptions of severe child sleep problems were the lowest. Within Korea, breastfeeding and bottle-feeding at sleep resumption were associated with increased nocturnal awakenings. Evening television viewing was associated with later bedtimes, which may have implications for sleep hygiene recommendations in clinical practice. The current study provides important information about sleep/wake patterns, parental behaviors, and aspects of the sleep ecology for infants and toddlers for physicians to support healthy sleep in Korea.

¿QUÉ HAY DE NUEVO EN LOS ESTUDIOS SOBRE SOLUCIÓN DE PROBLEMAS EN NIÑOS CAMINADORES? Balance y perspectivas / What's new about studies in problem solving in Infants and Toddlers? Balance and perspectives

Este artículo muestra una revisión del estado del arte de la investigación en solución de problemas en niños hacia el final del primer año hasta los dos y tres años (niños caminadores), en el que se destacan aspectos metodológicos relacionados con el diseño, el tipo de tareas utilizadas y resultados a los que conducen. En contraste, se presenta una opción metodológica para el estudio del desarrollo cognitivo en niños, centrada en el uso de Situaciones de Resolución de Problemas (SRP), con un abordaje microgenético en una versión desarrollada por el Grupo C&DR**, y cuya principal fortaleza radica en comprender cómo emerge en tiempo real la comprensión del problema por parte del niño. Se ponen en consideración sus bondades como herramienta flexible y poderosa para describir cambios en funcionamientos cognitivos en niños pequeños...

This paper presents a review of previous research on problem solving in children at the end of the first year through the third year of age ('toddlers'), which highlights methodological issues associated with the design, type of tasks used and results to which they lead. In contrast we present a methodological option for the study of cognitive development in children, focusing on the use of Problem Solving Situations (SRP) with an approach microgenetic, in a version developed by the Group C&DR, and whose main strength is to understand how the child's problem comprehension emerges in real-time. We take into consideration its benefits as a flexible and powerful tool to describe changes in cognitive performances in young children...

Nuclear abnormalities in cells from nasal epithelium: a promising assay to evaluate DNA damage related to air pollution in infants / Anormalidades nucleares em células do epitélio nasal: uma técnica promissora para avaliar dano no DNA relacionado à poluição atmosférica em neonatos

OBJECTIVES: This study intends to provide a quick, easy, and inexpensive way to assess nuclear abnormalities such as micronuclei and bud frequencies; binucleated, karyorrhectic, karyolytic, pycnotic, and condensed chromatin cells in nasal scrapings of infants, which are particularly important for conducting genotoxic studies related to the inhaled atmosphere in pediatric populations. METHODS: Nasal swab samples were collected from 40 infants under 12 months of age using a small cytobrush. 2,000 cells from each infant sample were analyzed and classified according to the frequency of nuclear abnormalities. RESULTS: Rates of nuclear abnormalities found agree with values reported in other studies of neonates and children. This study found 0.13% of cells with micronuclei; 1.20% karyorrhexis; 0.03% pyknosis; 10.85% karyolysis; 1.11% condensed chromatin; 0.54 binucleated cells; and 0.02% nuclear bud. Differences were not observed between genders or environmental passive smoking, nor was any age correlation found. CONCLUSION: The assay proposed here is suitable for assessing the frequency of nuclear abnormalities from nasal cells in infants. .

OBJETIVOS: Este estudo pretendeu fornecer uma forma rápida, fácil e barata de avaliar anormalidades nucleares, como frequências de micronúcleos e gêmea, células binucleadas, cariorréticas, cariolíticas, picnóticas e com cromatina condensada, em esfregados nasais de neonatos, o que é particularmente importante para a realização de estudos genotóxicos relacionados ao ar inalado nas populações pediátricas. MÉTODOS: Foram coletadas amostras de esfregaço nasal de 40 neonatos com menos de 12 meses de idade, utilizando uma pequena escova citológica. Foram analisadas 2.000 células da amostra de cada neonato e classificadas de acordo com a frequência de anormalidades nucleares. RESULTADOS: As taxas de anormalidades nucleares encontradas neste estudo são compatíveis com os valores relatados em outros estudos de neonatos e crianças. Encontramos 0,13% de células com micronúcleos, 1,20% com cariorrexe, 0,03% com picnose, 10,85% com cariólise, 1,11% com cromatina condensada, 0,54 com células binucleadas e 0,02% com células nucleares gêmeas. Não observamos diferenças entre os gêneros, tabagismo passivo e nenhuma correlação entre idades. CONCLUSÃO: O ensaio proposto neste estudo é adequado para avaliar a frequência de anormalidades nucleares de células nasais em neonatos. .

A Comparison of Receptive-Expressive Language Profiles between Toddlers with Autism Spectrum Disorder and Developmental Language Delay

PURPOSE: It is well known that expressive language impairment is commonly less severe than receptive language impairment in children with autism spectrum disorder (ASD). However, this result is based on experiments in Western countries with Western language scales. This study tries to find whether the result above is applicable for toddlers in a non-Western country; more specifically, in Korea with non-Western language scales. MATERIALS AND METHODS: The participants were 166 toddlers aged between 20 months and 50 months who visited the clinic from December 2010 to January 2013. The number of toddlers diagnosed as ASD and developmental language delay (DLD) was 103 and 63, respectively. Language development level was assessed using Sequenced Language Scale for Infants (SELSI), a Korean language scale. Using SELSI, each group was divided into 3 sub-groups. Moreover, the group difference by age was observed by dividing them into three age groups. Chi-square test and linear-by-linear association was used for analysis. RESULTS: Receptive language ability of the DLD group was superior to that of the ASD group in all age groups. However, expressive language ability in both groups showed no difference in all age groups. A greater proportion of expressive dominant type was found in ASD. The 20-29 months group in ASD showed the largest proportion of expressive language dominant type in the three age groups, suggesting that the younger the ASD toddler is, the more severe the receptive language impairment is. CONCLUSION: These findings suggest that receptive-expressive language characteristics in ASD at earlier age could be useful in the early detection of ASD.