Early language outcomes in Argentinean toddlers: Associations with home literacy, screen exposure and joint media engagement.

This study aimed to analyse the contribution of mothers' home literacy beliefs and practices and the quantity and quality of screen media exposure on Argentinean toddler's language. In addition, we considered parent-child joint engagement, as well as adult scaffolding behaviours during the use of electronic devices. A total of 465 mothers of 18-36 months old children completed an online survey including: the MacArthur Bates CDI, home literacy, screen exposure, joint engagement and scaffolding questionnaires. We observed positive effects of literacy beliefs, PC times and verbal scaffolding on language outcomes. TV exposure contributed negatively to vocabulary and, along with educational content, to sentence use. Shared reading and screen media experiences can be an opportunity for language stimulation, provided there is dialogue and joint engagement. Passive screen exposure and inadequate content may be detrimental for toddlers' language outcomes, probably by displacement of socially significant interactions.

Negative affectivity moderated by preterm birth predicted toddlers' behavior problems.

OBJECTIVE: The present study aimed to examine the predictive effect of temperament moderated by preterm childbirth on behavioral problems in toddlerhood. METHOD: The sample comprised 100 toddlers of 18-36 months of chronological age and their mothers. They were divided into two groups: 50 toddlers born preterm and admitted to the Neonatal Intensive Care Unit (PT group), and 50 toddlers born full-term (FT group) and recruited from day-care centers. Mothers completed questionnaires about toddlers' temperament and behavior. The Early Childhood Behavior Questionnaire was used to assess temperament, and the Child Behavior Checklist (CBCL 1¹/²-5) to evaluate the total, internalizing, and externalizing behavior problems. Multiple regression analysis was performed to examine the moderation effects of preterm childbirth and temperament factors after controlling for toddlers' age and socioeconomic level. RESULTS: There was a moderation effect between preterm childbirth and temperament. Temperament with more Negative Affectivity, moderated by preterm birth, and less Effortful Control explained the total, internalizing, and externalizing behavior problems. CONCLUSION: The findings contribute to a better understanding of the impact of preterm childbirth and the dispositional traits of temperament on behavioral problems of toddlers born preterm.

Neonatal and temperament variables predict behavior problems of preterm children at toddlerhood / Variáveis neonatais e de temperamento que predizem problemas de comportamento em crianças nascidas pré-termo na idade pré-escolar

BACKGROUNG: Children born preterm are at high risk for behavior problems at different ages. To better understand these problems, we examine the predictive biopsychosocial variables OBJECTIVE: To examine the predictive effects of neonatal clinical status and the temperament of the children and mothers on the behavior problems of children born preterm. : Longitudinal predictive study METHODS: The sample was composed of 40 children born preterm at 18 to 36 months of age and their mothers. The temperament of the children was assessed using the Early Childhood Behavior Questionnaire, which comprises the negative affect, extroversion and effortful control factors and their domains. Behaviors were assessed using the Child Behavior Checklist 1 ½-5 (total, internalized, and externalized problems scores and classifications). The temperament of the mothers was assessed using the Adult Temperament Questionnaire. All instruments were applied through interviews with mothers. Descriptive and the hierarchical multiple linear regression statistical analyses were performed. The level of significance adopted in the study was p ≤ 0.05 RESULTS: The prediction analysis revealed that the internalized behavior problems were explained significantly by children's temperaments with more fear (negative affect) and less by mothers' temperament with inhibitory control (effortful control factor). The externalized behavior problems were explained significantly by greater time spent in the neonatal intensive care unit, less effortful control of children's temperament and less mothers` temperament inhibitory control CONCLUSION: The behavior problems of children at toddlerhood who were born preterm were explained by high neonatal clinical risk as well as by the temperament dispositional traits of both the children and the mothers

Normative Trends in Physically Aggressive Behavior: Age-Aggression Curves from 6 to 24 Months.

OBJECTIVE: To investigate age-related trends in physically aggressive behaviors in children before age 2 years. STUDY DESIGN: A normative US sample of 477 mothers of 6- to 24-month-old children reported on the frequency of 9 interpersonally directed aggressive child behaviors, and hurting animals, in the past month. RESULTS: Almost all (94%) of the children were reported to have engaged in physically aggressive behavior in the past month. Based on 2-part regression models, the prevalences of kicking (OR, 1.70; P = .023), pushing (OR, 3.22; P < .001), and swiping (OR, 1.78; P = .018) increased with years of age, but the prevalence of hair pulling decreased with age (OR, 0.55; P = .020). The prevalences of hitting and throwing increased initially, then plateaued at age 18-20 months, and then decreased (quadratic aOR, 0.13 and 0.16; P < .001 and .010, respectively). The frequencies of hitting (R2 = .05; P < .001) and throwing (R2 = .03; P = .030) increased, and the frequencies of hair pulling (R2 = .07; P < .001) and scratching (R2 = .02; P = .042) decreased with age (P values adjusted for false discovery rate). CONCLUSIONS: Physically aggressive behavior in the 6- to 24-month age range appears to be nearly ubiquitous. Most, but not all, forms of physical aggression increase with age. These results can guide pediatricians as they educate and counsel parents about their child's behavior in the first 2 years of life.

Gaps and Factors Related to Receipt of Care within a Medical Home for Toddlers Born Preterm.

OBJECTIVE: To characterize gaps and factors related to receipt of care within a medical home for toddlers born preterm. STUDY DESIGN: Participants were 202 caregivers of children born at <35 weeks of gestation. At 10-16 months of corrected age, caregivers completed the National Survey of Children's Health (2011/2012) medical home module and a sociodemographic profile. Care within a medical home comprised having a personal doctor/nurse, a usual place for care, effective care coordination, family-centered care, and getting referrals when needed. Gestational age and neonatal follow-up clinic attendance were abstracted from the medical record. The Bayley Scales of Infant and Toddler Development, Third Edition assessed developmental status. Log-binomial regression examined factors related to receiving care within a medical home. RESULTS: Fifty-three percent (n = 107) of the children received care within a medical home. Low socioeconomic status (young caregiver: risk ratio [RR] = 0.73; 95% CI 0.55, 0.97; low education: RR= 0.69; 95% CI 0.49, 0.98) and delayed language (RR = 0.63; 95% CI 0.42, 0.95) were associated with a lower likelihood of receiving care within a medical home. Degree of prematurity and neonatal clinic follow-up participation were unrelated to receipt of care within a medical home. CONCLUSIONS: Receipt of care within a medical home was lacking for nearly one-half of preterm toddlers, especially those with lower socioeconomic status and poorer developmental status. Discharge from a neonatal intensive care unit may be an optimal time to facilitate access to a primary care medical home and establish continuity of care. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01576783.

Maternal sociodemographic factors differentially affect the risk of behavioral problems in Brazilian and Italian preterm toddlers.

The main aim of the present study was to examine differences in behavioral problems in toddlers born very preterm in Brazil and Italy. The sample comprised 154 toddlers (18-24 months of age) born very preterm, including 76 toddlers from Brazil and 78 toddlers from Italy. The Child Behavior Checklist was used to assess behavioral problems. Specific sociodemographic factors (i.e., maternal age at childbirth and maternal education) and neonatal factors (i.e., gestational age, sex, and length of hospitalization) were tested as potential mediators of country-related differences in behavioral problems. Brazilian toddlers presented more internalizing, externalizing, and total behavioral problems compared with their Italian counterparts. The effect of country on the toddlers' internalizing and total behavioral problems was mediated by maternal age at childbirth and education. Independent effects of country, maternal age at childbirth, and maternal education emerged for externalizing behavioral problems. No significant effect emerged for neonatal variables. These findings suggest that sociodemographic factors, in addition to country-related differences, should be considered when assessing the risk of behavioral problems in preterm toddlers.

Impact of neonatal risk and temperament on behavioral problems in toddlers born preterm.

Children born preterm are at risk for later developmental disorders. The present study examined the predictive effects of neonatal, sociodemographic, and temperament characteristics on behavioral outcomes at toddlerhood, in children born preterm. The sample included 100 toddlers born preterm and with very-low-birth-weight, and their mothers. Neonatal characteristics were evaluated using medical records. The mothers were interviewed using the Early Childhood Behavior Questionnaire for temperament assessment, and the Child Behavior Checklist for behavioral assessment. Multiple linear regression analyses were performed. Predictors of 39% of the variability of the total behavioral problems in toddlers born prematurely were: temperament with more Negative Affectivity and less Effortful Control, lower family socioeconomic status, and younger mothers at childbirth. Temperament with more Negative Affectivity and less Effortful Control and lower family socioeconomic status were predictors of 23% of the variability of internalizing behavioral problems. Additionally, 37% of the variability of externalizing behavioral problems was explained by temperament with more Negative Affectivity and less Effortful Control, and younger mothers at childbirth. The neonatal characteristics and stressful events in the neonatal intensive care unit did not predict behavioral problems at toddlerhood. However, temperament was a consistent predictor of behavioral problems in toddlers born preterm. Preventive follow-up programs could assess dispositional traits of temperament to provide early identification of preterm infants at high-risk for behavioral problems.