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The development of audiovisual speech perception in tone-language-speaking children remains debated, and this study addressed this issue by examining Cantonese-speaking children, extending prior work on Mandarin speakers to a tone language with greater phonological complexity. Using the McGurk paradigm, 82 typically developing Cantonese-speaking children (42 girls, 40 boys; aged 4-11 years) and 21 adults (11 females, 10 males) from Hong Kong completed audiovisual speech perception tasks in quiet, moderate background noise (10 dB speech-to-noise ratio, SNR), and severe background noise (-10 dB SNR). Results showed developmental shifts in sensory dominance among Cantonese-speaking children around age 10: from relying mainly on auditory cues to integrating auditory and visual cues in quiet and 10 dB conditions, and from audiovisual-integrated to visual-dominant processing in the -10 dB condition. This developmental pattern aligns with the predictions of the Statistically Optimal Hypothesis. These findings also indicate that Cantonese-speaking children undergo this shift later than Mandarin-speaking peers, highlighting the adaptive nature of this developmental process. Understanding speech involves hearing sounds and seeing a speaker's mouth movements. This study examined how Cantonese-speaking children aged 4 to 11 develop this ability and how it changes in noisy environments. Younger children relied mainly on what they heard. Around age 10, they began to combine sound and visual information more effectively in quiet and moderately noisy settings. In very noisy conditions, both children and adults depended more on visual cues because sound became less reliable. This developmental shift occurs later than previously reported for children speaking Mandarin. The findings suggest that children gradually learn to use the most reliable source of information depending on listening conditions and highlight how language background and noise shape speech perception development.

Introduction. Psychomotor development is an essential indicator of child growth that integrates cognitive, motor, linguistic, and socio-emotional dimensions. Objective. To evaluate the association between the type of educational institution and psychomotor development in preschoolers. Population and methods. A cross-sectional analytical study was conducted in 2019 among children aged 2 to 4 years attending public and private preschools. Psychomotor development was assessed using the Test of Child Learning and Development (TADI, by its Spanish acronym), validated in Chile. Multinomial logistic regression was performed, adjusting for socioeconomic status, maternal education, and the child's age, sex, and nutritional status. Results. A total of 151 children were included; 52.7% of the participants were girls, and the mean age was 40 &#xb1; 8.1 months. An association was observed between attending public facilities and a classification of risk or delay in global psychomotor development (OR = 7.34; 95%CI: 1.65-32.58; p <0.05) and cognitive development (OR = 10.83; 95%CI: 1.64-71.59; p <0.05), compared with private facilities. Male gender was associated with increased risk of, or delay in, global psychomotor development (OR = 6.53; 95%CI: 1.94-22.08), cognitive development (OR = 4.45; 95%CI: 1.41-13.99), and motor development (OR = 3.07; 95%CI: 1.17-8.08). Conclusion. The type of educational setting and gender were associated with differences in psychomotor development among preschoolers. The findings should be interpreted with consideration of possible sociodemographic and contextual factors that were not fully captured. Introducci&#xf3;n. El desarrollo psicomotor es un indicador esencial del crecimiento infantil que integra dimensiones cognitivas, motoras, ling&#xfc;&#xed;sticas y socioemocionales. Objetivo. Evaluar la asociaci&#xf3;n entre el tipo de establecimiento educativo y el desarrollo psicomotor en preescolares. Poblaci&#xf3;n y m&#xe9;todos. Estudio anal&#xed;tico de corte transversal realizado en 2019 en ni&#xf1;os de 2 a 4 a&#xf1;os pertenecientes a establecimientos p&#xfa;blicos y privados. El desarrollo psicomotor se evalu&#xf3; mediante el Test de Aprendizaje y Desarrollo Infantil (TADI), validado en Chile. Se aplic&#xf3; regresi&#xf3;n log&#xed;stica multinomial ajustada por nivel socioecon&#xf3;mico, edad y educaci&#xf3;n materna, edad y sexo del ni&#xf1;o, y estado nutricional. Resultados. Se incluyeron 151 ni&#xf1;os. El 52,7 % de los participantes eran ni&#xf1;as y la edad media fue de 40 &#xb1; 8,1 meses. Se observ&#xf3; asociaci&#xf3;n entre asistir a establecimientos p&#xfa;blicos y la clasificaci&#xf3;n de riesgo o retraso en el desarrollo psicomotor global (OR = 7,34; IC95% 1,65-32,58; p <0,05) y cognitivo (OR = 10,83; IC95% 1,64-71,59; p <0,05), en comparaci&#xf3;n con establecimientos privados. El sexo masculino se asoci&#xf3; con riesgo o retraso en el desarrollo psicomotor global (OR = 6,53; IC95% 1,94-22,08), cognitivo (OR = 4,45; IC95% 1,41-13,99) y motor (OR = 3,07; IC95% 1,17-8,08). Conclusi&#xf3;n. El tipo de establecimiento educativo y el sexo se asociaron con diferencias en el desarrollo psicomotor en preescolares. Los hallazgos deben interpretarse considerando posibles factores sociodemogr&#xe1;ficos y contextuales no completamente capturados.

Evidence comparing toothbrush designs and the influence of children's developmental abilities on brushing performance is limited. To compare the plaque-removal efficacy of three toothbrush types in 7-year-old children and to assess whether developmental characteristics affect brushing performance. This single-blind, randomized, three-period crossover clinical trial included 60 typically developing 7-year-old children. Participants used a conventional manual, triple-headed manual, and rechargeable powered toothbrush in randomized order with washout periods. Plaque was assessed using the modified Quigley-Hein Plaque Index and the Approximal Plaque Index. Developmental characteristics were evaluated using the parent-reported Five-to-Fifteen questionnaire. Mean plaque reduction differed significantly among toothbrush types. Powered (1.833&#x2009;&#xb1;&#x2009;0.705) and triple-headed manual toothbrushes (1.802&#x2009;&#xb1;&#x2009;0.678) achieved greater plaque reduction than the conventional manual toothbrush (1.310&#x2009;&#xb1;&#x2009;0.563; both p&#x2009;<&#x2009;0.001), with no difference between powered and triple-headed brushes (p&#x2009;=&#x2009;0.963). Approximal plaque removal was highest with the powered toothbrush, reaching 75% complete removal on posterior vestibular surfaces (p&#x2009;&#x2264;&#x2009;0.016). Children with gross motor difficulties showed lower reduction with the powered toothbrush than children without such difficulties (p&#x2009;=&#x2009;0.048). Powered and triple-headed toothbrushes are more effective than conventional manual brushes in 7-year-old children, with equivalent efficacy. Exploratory analyses suggest gross motor skills may influence powered toothbrush performance, warranting confirmation in adequately powered studies. The study was registered retrospectively with the Australian New Zealand Clinical Trials Registry (ANZCTR; ACTRN12626000023358).

This multi-method, multi-informant, quasi-experimental study examines trajectories of child psychopathology over an 8-year period pre-and post-COVID-19 pandemic. We examined parenting as a moderator of the COVID-19 impact. Participants were 310 low-to-middle-income families from the United States with a target child followed over 6 waves (Wave 1, Mage = 2.97, SD = 0.38; 55.3% girls; 55.2% White, 21.3% African American, 16.2% mixed race; Wave 6: Mage = 9.32, SD = 0.76). Findings indicated that children exhibit significant linear growth and COVID-related growth above and beyond the linear growth in internalizing problems. Pre-COVID parenting moderated this effect, such that low paternal structure and consistency and low parental secure-base provision strengthened the association between COVID impact and the growth of internalizing problems, yielding greater increases under high impact and lower increases under low impact. This prospective study tracked children's mental health over 8 years. To rigorously assess the pandemic effects, we designed and implemented three targeted waves of data collection following early lockdowns. We found that pandemic disruptions generally increased children's emotional struggles, such as sadness and anxiety. Importantly, parenting shaped these reactions. Children receiving fewer consistent rules and less emotional reassurance were highly sensitive to their environment. Under severe pandemic stress, these children developed the most emotional problems; under low stress, however, they showed fewer problems.

This study investigated the development of young children's normative stances and moral self-concept (MSC) over 1 year and their relations with sharing behavior. Five hundred children in Germany (approximately 5 years at T1, mostly White, 51% girls) were assessed at 3 measurement points. Latent profile and transition analyses identified 7 distinct profiles of normative stances-MSC: (1) low-moderate, (2) moderate-exceptionally low, (3) high-moderate, (4) moderate-low, (5) moderate-high, (6) moderate-moderate, and (7) moderate-exceptionally high. Only the low-moderate profile was found across all 3 measurement points. MSC increased over time, while normative stances remained stable or declined. Children who transitioned from high-moderate (T1) to moderate-low (T2) to moderate-moderate (T3) shared more at T3 than those who remained at low-moderate levels. Gender and socioeconomic differences were found, highlighting the role of individual and family characteristics on moral development. Overall, no consistent pattern was found between profiles and sharing behavior, emphasizing the complex nature of moral development and prosocial behavior in early childhood. The development of preschoolers&#x2019; normative stances (understanding how to behave in sharing situations) and moral self-concept (preferring prosocial and avoiding antisocial behavior) was investigated. Five hundred children in Germany, about 5 years old, were assessed three times. A latent profile analysis identified seven subgroups of children with different patterns in normative stances and moral self-concept. A latent transition analysis tracked movement between groups over time. Moral self-concept increased over time, while normative stances were stable or declined. Children who remained at low normative stances and moderate moral self-concept shared less than other groups. Groups differed in gender and socioeconomic status. Overall, stronger normative stances or moral self-concept were not always linked to more sharing, showing the complexity of moral development.

Emotion inference is not purely reactive but is supported by conceptual priors that contribute to active sampling of meaningful cues as social events unfold, yet how children learn to anticipate when and where such cues will emerge remains unclear. This study examined whether conceptual emotion knowledge serves as a prior supporting developmental increase in anticipatory attention, and whether such attention facilitates more adult-like emotion inferences. Children aged 5-11 years (N = 180, Mage = 8.02 years, 84 female; data collected 2024-2025) from China viewed videos while eye movements were simultaneously recorded and continuously rated the target character's emotion on a valence-arousal grid. Anticipatory attention was indexed by the extent to which children's saccades were directed toward regions about to contain meaningful information. Conceptual emotion knowledge was assessed with a composite that combined emotion granularity, diversity, and performance on a standardized emotion understanding test. Multilevel, moderated mediation models revealed that conceptual emotion knowledge mediated age-related increases in anticipatory saccades toward meaningful regions, which in turn predicted more adult-like emotion judgments. Together, these findings suggest that conceptual knowledge acts as a developmental mechanism bridging children's prior experience and growing attentional strategies, enabling more mature emotion understanding in social environments. Successfully navigating social life requires understanding others' emotions as situations unfold, yet how children learn to predict when and where emotionally meaningful information will appear in real-world contexts remains unclear. Using movies combined with eye tracking and mouse tracking, we show that children increasingly learn where and when to look for emotionally meaningful information before it appears, which in turn predicts more adult-like emotion judgments. Critically, this developmental improvement is driven by children's growing emotion knowledge. These findings suggest that emotion understanding develops through an active, predictive process in which conceptual knowledge contributes to attention allocation in real time.

Children's ability to self-regulate varies across days and contextual demands. However, the predominant approach in developmental science is to assess self-regulation at a single timepoint in one context, limiting our understanding of how and why children's self-regulation skills vary intra- and inter-individually. The present study addresses this gap by repeatedly observing children's self-regulation in the classroom 10 times during two different classroom activities. The sample consisted of N&#xa0;=&#xa0;201 Swiss kindergarteners (47.8% female, M&#xa0;=&#xa0;5.4y., SD&#xa0;=&#xa0;0.6). We assessed children's self-regulation using an observational measure that captures two self-regulation dimensions: attention control and inhibitory control. To analyze self-regulation variability, we used multilevel location-scale models in a dynamic structural equation modeling framework. The findings indicated substantial intra-individual variability in self-regulation across the 10 classroom observations. Moreover, children differed significantly in the degree of intra-individual variability. When controlling for class membership, differences in attention control variability were related to the teacher-student relationship closeness. Differences in inhibitory control variability were associated with children's gender, with boys showing higher variability than girls. Overall, the present findings indicate that young children's self-regulation skills can vary substantially across days and classroom activities. These findings emphasize the importance of considering the role of momentary regulatory demands in children's self-regulation capacities.

Maternal pre-pregnancy overweight/obesity and gestational hyperglycemia are linked to adverse offspring neurodevelopment, but the role of oral glucose tolerance test (OGTT) response patterns remains unclear. We investigated the independent and combined effects of maternal pre-pregnancy BMI and OGTT response patterns on neurodevelopment in 2-year-old offspring. This cohort study included 2639 mother-child pairs from Wuhan, China. A 75-g OGTT was performed at 24-28 gestational weeks, with glucose measured at fasting, 1 and 2&#x2009;h. Group-based trajectory modeling identified distinct OGTT response patterns. Offspring neurodevelopment was assessed at 2&#x2009;years using the Bayley Scales of Infant Development. Associations were examined with generalized linear and logistic regression models, and additive interaction was evaluated using RERI and AP. Three OGTT response patterns were identified; pattern 3 showed the most pronounced glycemic response. Maternal pre-pregnancy overweight/obesity alone showed nominal associations with lower MDI scores in the overall population and in girls, but these associations did not remain significant after FDR correction. In girls exposed to both maternal overweight/obesity and pattern 3, MDI was markedly lower (&#x3b2;&#x2009;=&#x2009;-13.73, 95% CI: -23.06 to -4.39), and the risk of suboptimal mental development was higher (OR&#x2009;=&#x2009;2.88, 95% CI: 1.03 to 8.09), with significant additive interaction (RERI&#x2009;=&#x2009;0.76; AP&#x2009;=&#x2009;0.42). Maternal pre-pregnancy overweight/obesity and OGTT response patterns alone showed limited independent associations with offspring neurodevelopment. However, combined exposure may be associated with poorer mental developmental performance, with more consistent evidence in girls.

Exposure to stressors during early childhood has been linked to irritability and subsequent mental health problems; however, little work has examined the unique and combined effects of distinct stress exposures on trajectories of childhood irritability or adolescent mental health symptoms. Six components of family stress were assessed via maternal report at child age 5. Irritability was measured longitudinally at ages 7, 9, and 11. Adolescents self-reported on anxiety, depression, and externalizing symptoms at age 13-20. Latent growth mixture modeling examined classes of irritability. Bayesian kernel machine regression (BKMR) examined unique and shared effects of stress components on class assignment and to continuously measured irritability at individual age points (N&#xa0;=&#xa0;472). Causal mediation tested if irritability mediated any stress-related mental health problems. Latent growth mixture modeling identified high and low irritability classes. A positive joint mixture effect of stressors on irritability was detected, with additive contributions from intimate partner violence, material hardship, perceived stress, and maternal demoralization. Intimate partner violence independently predicted high irritability over time and irritability at age 7, and maternal perceived stress independently predicted irritability at age 11. Neither childhood irritability nor early stress predicted self-reported adolescent mental health symptoms. Early exposure to familial stressors are risk markers for childhood irritability. Interventions targeting intimate partner violence and co-occurring stressors could help mitigate persistent irritability, a well-known public health concern related to children's development.

Obesity is a chronic disease resulting from the interaction of genetic, environmental, socioeconomic, and behavioral factors, and is associated with the development of numerous comorbidities. Its prevalence is increasing worldwide, making obesity one of the most significant public health challenges. The aim of the present study was to investigate the relationship between obesity and the cortisol levels and periodontal status in children. Ninety eligible children aged 8-12 years were enrolled in the study and allocated into 3 groups: normal-weight; overweight; and obesity. After the parents completed a demographic questionnaire, the children underwent periodontal examinations and saliva collection. The salivary cortisol levels were measured using the ELISA method. Data were analyzed using ANOVA, Pearson's correlation test, the &#x3c7;2 test, linear regression, and the Kruskal-Wallis test. The children's body mass index (BMI) was significantly associated with the salivary cortisol levels and the gingival index (GI), bleeding on probing (BoP) and periodontal probing depth (PPD) (p = 0.010, p < 0.001, p < 0.001, and p = 0.005, respectively). However, BMI was not significantly associated with father's education, mother's education, the parental smoking addiction status, total family income, the frequency of mouthwash use per week, toothbrushing frequency per day, or daily study duration (p = 0.599, p = 0.143, p = 0.480, p = 0.875, p = 0.884, p = 0.203, and p = 0.338, respectively). The salivary cortisol levels were also significantly associated with age and GI, BOP and PPD (p = 0.010, p = 0.001, p = 0.018, and p = 0.016, respectively). In the multivariable linear regression analysis, the salivary cortisol levels remained significantly associated with age (&#x3b2; = 0.276; p = 0.004), obesity (&#x3b2; = 0.269; p = 0.006), father's education level (&#x3b2; = 0.393; p < 0.001), and the parental smoking addiction status (&#x3b2; = 0.238; p = 0.026). The salivary cortisol levels and periodontal indices were higher in overweight and obese children. Therefore, encouraging children and adolescents to adopt a healthier lifestyle and achieve weight reduction may help reduce the salivary cortisol levels and improve periodontal health.

Depression and anxiety occur in about 10% of pregnancies. Selective serotonin reuptake inhibitors (SSRIs) are often prescribed, but their potential effects on fetal neurodevelopment remain uncertain. Because serotonin influences brain maturation, prenatal SSRI exposure may affect later cognition, language, or motor function. This systematic review and meta-analysis evaluated whether prenatal SSRI exposure is associated with differences in child cognitive, language, or psychomotor development. PubMed and Scopus were searched through June 2025 for cohort, case-control, or randomized studies reporting standardized neurodevelopmental outcomes in children (0-18 years) with documented in utero SSRI exposure compared with unexposed controls. Two reviewers independently screened studies, extracted data, and assessed bias (Newcastle-Ottawa Scale; RoB-2). Random-effects meta-analyses estimated standardized mean differences (SMDs) with 95% confidence intervals (CIs). Of 250 records identified, 17 studies met inclusion criteria, and 9 contributed to meta-analysis. For general cognition, pooled SMD = -0.20 (95% CI -0.50 to 0.10) showed no significant difference between groups. Sensitivity analyses restricted to SSRI-only cohorts and Bayley-specific instruments yielded similar findings. Secondary outcomes also showed no differences: receptive language (SMD = 0.04; 95% CI -0.16 to 0.23), expressive language (SMD = -0.17; 95% CI -0.40 to 0.06), and psychomotor development (SMD = -0.18; 95% CI -0.67 to 0.31). Current evidence does not support a clinically meaningful impact of prenatal SSRI exposure on early cognitive, language, or psychomotor development. Observed effects were small, imprecise, and diminished when analyses were limited to SSRI-only cohorts and harmonized outcome measures.

Lemierre's syndrome (LS) is a rare but potentially fatal condition characterized by septic thrombophlebitis of the internal jugular vein (IJV) following oropharyngeal infection, with an estimated incidence of 3.6 cases per million population. It primarily affects healthy adolescents and young adults; pediatric presentations, particularly in children under ten, are exceedingly rare and frequently atypical, with a heightened risk of diagnostic delay and multisystem morbidity. Although orbital cellulitis and intracranial venous extension have each been individually described in pediatric LS, their combined occurrence together with culture-negative status and a prolonged, indolent clinical course remains sparsely documented in children under ten years of age. We report a case of a previously healthy 6-year-old Asian male who presented to a tertiary pediatric hospital after approximately one year of intermittent fever and progressive left-sided facial swelling. Over the preceding 15 days, his illness acutely worsened, with the development of necrotic periorbital and facial lesions and chest pain, prompting emergency referral. On admission, generalized edema, hypoalbuminemia, and nephrotic-range proteinuria raised an initial working diagnosis of nephrotic syndrome, which reflected a true concurrent glomerular process, a hypercoagulable cofactor, or an epiphenomenon of prolonged systemic inflammation that could not be definitively resolved, as the family left the hospital before a complete nephrological work-up could be completed. Contrast-enhanced MRI of the brain and orbits demonstrated preseptal, periorbital, and facial soft tissue inflammation with diffusion restriction, along with loss of flow-void signal in the left sigmoid sinus and left IJV, indicative of thrombosis. Subsequent contrast-enhanced CT of the neck and chest confirmed left IJV thrombosis with septic pulmonary embolization, fulfilling the imaging criteria for Lemierre's syndrome with intracranial venous extension in the likely but not histologically or microbiologically confirmed setting of an oropharyngeal or dental portal of entry. Serial blood cultures yielded no bacterial growth, consistent with culture-negative LS in a child with probable prior antibiotic exposure, although the details of any treatment administered before referral could not be retrieved. The patient was managed with broad-spectrum intravenous antibiotics, subcutaneous enoxaparin, intravenous immunoglobulin, fresh frozen plasma, packed red cell transfusion, and albumin supplementation delivered through a multidisciplinary care pathway. Despite ongoing management, the family elected to leave against medical advice on day 19 of admission before a full antimicrobial and anticoagulation course could be completed. This case illustrates an unusually indolent, culture-negative pediatric presentation at the interface of Lemierre-spectrum disease and complicated sepsis, combining a one-year prodrome, nephrotic-range proteinuria of uncertain primary etiology, orbital/facial and intracranial venous thrombosis, and septic pulmonary embolization in a 6-year-old child. Because several features deviate from the classic acute, oropharyngeal-onset picture of LS, we present this as a diagnostically challenging, atypical case rather than a textbook example, and we highlight how a superimposed hypercoagulable state, whether inflammatory, septic, or renal in origin, can blur the boundary between 'clean' LS and complicated pediatric sepsis. Maintaining a high index of suspicion for LS-spectrum vascular and septic complications in children with atypical, protracted facial or orbital disease, along with early imaging, prompt broad-spectrum antibiotic therapy, and coordinated multidisciplinary management, remains essential, even when the presentation departs from classic teaching.

Motor health and long-term development of pre-school children is a pressing issue that requires urgent attention. While motor health is critically important for the early growth stage of pre-school children, establishing a multi-dimensional health evaluation indicator weighting system using an integrated subjective-objective weighting method remains a cutting-edge challenge in current research. WPS Office 6.4 and IBM&#xae; SPSS&#xae; Statistics 26.0 were used to analyze the data, with the significance threshold set at P-value < 0.05. The integrated subjective-objective weighting method mainly consists of four steps: (i) the Delphi subjective weighting method, including A i , A s , A a , W i , W i ' &#x3c9;; (ii) the entropy objective weighting method, including X ij , P ij , E j , d j , and W j ; (iii) the comprehensive weighting method, including relevant parameters W j * , among others; (iv) IBM&#xae; SPSS&#xae; Amos (TM) 24.0 was used to conduct further data analysis. The total combined weight of the six primary indicators is 1.0, with individual weights ranging from 0.109 to 0.213. The corresponding weights of the 26 secondary indicators range from 0.014 to 0.215. Regarding the weighting of first-level indicators, no significant correlation was found between the comprehensive weighting method and the Delphi method (r = 0.771, P = 0.072), nor between the comprehensive weighting method and the entropy weight method (r = 0.600, P = 0.208). Similarly, no significant correlation was observed between the Delphi method and the entropy weight method (r = 0.143, P = 0.787). In contrast, for second-level indicators, the comprehensive weighting method demonstrated a strong correlation with both the Delphi method (r = 0.917, P < 0.001) and the entropy weight method (r = 0.558, P = 0.003). However, no significant correlation was detected between the Delphi method and the entropy weight method (r = 0.268, P = 0.185). By adopting an integrated subjective-objective weighting method, this study establishes evaluation indicator weights based on two foundations: the intrinsic patterns within the data and expert experience. The weights derived through this dual-foundation approach therefore exhibit improved rationality and credibility, providing important reference value for the comprehensive assessment of pre-school children's motor health.

Turn-taking, the coordinated exchange of communicative signals between infants and caregivers, is vital for child communicative development. While it is considered a human universal, most research has focused on mother-infant dyads. Given fathers' increasing caregiving involvement, understanding their contribution to early communication is essential. Thus, we have examined early infant-father turn-taking and the role of fathers' mentalizing abilities, which may support turn prediction, and paternal involvement, as it may shape the frequency and quality of exchanges. We observed 39 father-infant dyads in natural interactions at 7&#xa0;weeks and 6&#xa0;months postpartum. Vocalizations were micro-coded and turn-taking was defined as a vocal response by one partner within 3000&#xa0;ms of the other's vocalization. Mentalizing was measured via the Reflective Functioning Scale of the Parent Development Interview, while involvement was indexed by weeks of paternity leave. Results showed little change in turn-taking over time, except for a slight decline in infant turns and increase in paternal overlaps. Mixed effect models revealed significant between-dyad variability; higher mentalizing was associated with fewer paternal overlaps, and greater involvement was linked to shorter overlap durations. Findings suggest that infants are active turn-takers from early on and paternal mentalizing may support attuned coordination. Despite a relatively homogenous sample, results underscore fathers' importance in early communicative development.

Since 2015, the Norwegian government has prioritized early prevention of social inequities and child maltreatment. As part of this, it has commissioned an evaluation of the Nurse-Family Partnership programme (NFP) adapted for Norway. NFP is a manualized, intensive nurse home-visiting programme to support families experiencing disadvantage from early pregnancy until the child is 2 years old. The Mother in Norway Study (MiNS) is a parallel-group randomized controlled trial evaluating the effectiveness of the NFP programme versus standard care in improving maternal and child outcomes. A total of 700 participants is being recruited between 2023 and 2026 at least 12 weeks before their due date, screened for eligibility, and individually randomly assigned (1:1) to standard care alone or NFP plus standard care. Both groups may access usual community services. Primary outcomes are maternal-reported intimate partner violence and child maltreatment risk, assessed at baseline and 24 months postpartum using the Composite Abuse Scale - Revised Short Form (CASr-SF) and the Brief Child Abuse Potential Inventory (BCAPI), respectively. Secondary outcomes include maternal mental health, parenting, child socioemotional development, parent-child interaction, and health-related outcomes assessed through questionnaires and linked administrative data. Analyses will follow the intention to treat principle, with statisticians blinded to allocation. Cost-effectiveness analyses will estimate the cost per quality-adjusted life year (QALY) gained. This trial will generate evidence on the effectiveness and cost-effectiveness of the NFP in Norway, inform policymaking for early prevention of child health inequities, and establish a foundation for longer-term follow-up.

Children with special health care needs (CSHCN) often rely on cross-sectoral care networks involving medical, therapeutic, educational, and social services. However, key dimensions of integrated care, including cross-sectoral communication and attention to family impact, remain challenging. Understanding factors that shape caregiver-reported experience of integrated care can inform program development to strengthen integrated care. We aimed (1) to quantify caregiver-reported experience of integrated care and (2) to examine associations between dimensions of caregiver-reported experience of integrated care and sociodemographic, health- and network-related correlates. We analyzed cross-sectional data from the nationwide PART-CHILD cohort. Caregivers of CSHCN with predominantly neurological, developmental, and behavioral conditions were recruited in specialized outpatient facilities in Germany and completed questionnaires. Caregiver-reported experience of integrated care was assessed using the German Pediatric Integrated Care Survey, yielding composite scores for Team quality and communication and Attention to family impact. Associations with sociodemographic characteristics, reason for seeking care, unmet needs, and care network size were examined using multivariable linear regression models. Caregivers of CSHCN (n&#x2009;=&#x2009;459) reported moderate Team quality and communication (mean 4.1&#x2009;&#xb1;&#x2009;1.1) and low Attention to family impact (2.3&#x2009;&#xb1;&#x2009;1.1). Higher unmet needs were associated with lower Team quality and communication (1-4 unmet needs: &#x3b2; = -0.28, 95% CI: -0.52 to -&#x2009;0.04; &#x2265;5 unmet needs: &#x3b2; = -0.83, 95% CI: -1.28 to -&#x2009;0.38; reference: none). Cognitive impairment (&#x3b2;&#x2009;=&#x2009;0.36, 95% CI: 0.03 to 0.69; reference: physical impairment) and larger care networks (4&#x2009;- 5 providers: &#x3b2;&#x2009;=&#x2009;0.33, 95% CI: 0.08 to 0.58; 6&#x2009;-&#x2009;10 providers: &#x3b2;&#x2009;=&#x2009;0.38, 95% CI: 0.07 to 0.70; reference: 2-3 providers) were associated with higher Attention to family impact. Strengthening integrated care for CSHCN may require greater attention to family-level concerns, which were rated low in this sample. The association between unmet needs and Team quality and communication suggests a close link between perceived integration and needs-based service delivery. Correlates of Attention to family impact, including impairment type and care network size, warrant further investigation and may help identify target groups for interventions to strengthen family-centered services. The study was prospectively registered in the German Clinical Trials Register on 16 November 2018 (ID: DRKS00015054).

The widespread use of mobile phones among children and the growing popularity of games in this age group have led to the development of mobile learning applications, including educational health games. However, many of these games either fail to present healthcare topics in an engaging way for children or are still in early development stages. Although there is increasing research interest in serious educational health games for children, their appeal, such as enjoyment, engagement, and intention to play, is often not properly evaluated. However enjoyment is what motivates the use of games for learning especially for children, and educational games must be engaging and rewarding, as this fosters greater persistence, achievement, and completion outcomes among students. This research presents an evaluation of the appeal of a mobile educational game, Edugames4all MicrobeQuest!, designed to promote hygiene and responsible antibiotic use among primary school children. The evaluation focuses on three dimensions of appeal: enjoyment, engagement, and intention to play, and relationship between them. The study included 19 participants. The findings indicate that the game was generally appealing to children across all three evaluated dimensions. It also shows a strong and positive correlation between enjoyment, engagement and intention to play. Evaluating the appeal of educational health games is important, as it cannot be assumed that children will enjoy them simply because they are games. The study shows that the evaluated game successfully achieved a good level of appeal among its target audience. The three constructs are positively correlated.

This study investigated the associations of prematurity, retinopathy of prematurity (ROP), and ocular geometry with the macular curvature coefficient in children and adolescents. The Gutenberg Prematurity Study Young is a retrospective cohort study of preterm and full-term participants aged 4 to 17 years with a prospective ophthalmologic examination. The macular curvature coefficient in the foveal scan imaged with optical coherence tomography (OCT) and its associations with gestational age (GA), birth weight (BW) percentile, ROP occurrence and treatment, and other perinatal factors were investigated. These were evaluated in linear regression analyses. A second analysis assessed the association with ocular geometry. In the present study, 453 eyes of 234 term-born participants and 906 eyes of 469 preterm-born participants were examined (mean age = 11.8 years, 375 girls). In multivariable analyses for perinatal parameters, ROP treatment (B = -57.82, P < 0.001) and perinatal adverse events (B = -15.3, P = 0.01) showed a negative association with the macular curvature coefficient. Regarding ocular geometry, spherical equivalent was negatively associated with the macular curvature coefficient after adjustment for age and sex (B = -6.19, P = 0.004). In a sensitivity analysis, subfoveal choroidal thickness was negatively associated with the macular curvature coefficient (B = -0.10, P = 0.001). Our study showed that ROP treatment and perinatal adverse events were independently linked to a flatter macular shape in childhood and adolescence. The age-related growth of axial length leads to a larger macular curvature coefficient. Subfoveal choroidal thickness is involved in macular shape development at this age.

Retinopathy of prematurity (ROP) is a neurovascular disorder that may affect not only the retina but also the brain structures involved in visual processing. The relationship between ROP severity and the volumetric development of these regions remains unclear. A total of 157 children aged 6-16&#x2009;years, born preterm (24-36&#x2009;weeks gestational age), were assessed. Perinatal&#xa0;data&#xa0;and&#xa0;comorbidities were collected. Brain MRI (3&#x2009;T) data were analysed using FreeSurfer to obtain the volumes of the thalamus, fusiform gyrus, cuneus, lingual gyrus, lateral occipital gyrus, optic chiasm and calcarine sulcus. Cognitive performance was evaluated using the WISC-V. Multivariate regression analyses were adjusted for significant perinatal variables. The children with severe ROP had significantly smaller bilateral thalamic volumes (left Th: 6665&#x2009;&#xb1;&#x2009;672&#x2009;mm3 vs. 7492&#x2009;&#xb1;&#x2009;820&#x2009;mm3; p&#x2009;<&#x2009;0.005) and a reduced right fusiform gyrus volume (p&#x2009;=&#x2009;0.041) compared with those without ROP or only mildly affected. Severe ROP was also associated with lower full-scale IQ scores and reduced verbal comprehension, visuospatial reasoning, and working memory indices (p&#x2009;<&#x2009;0.008). Severe ROP is associated with reduced thalamic and fusiform gyrus volumes as well as with lower cognitive performance, suggesting that ROP reflects a broader neurovascular disruption affecting central visual pathways.