How effective is family counselling on screen exposure of pre-school children?

BACKGROUND: Excessive screen viewing and background TV exposure are common problems all over the world. Therefore, intervention studies have gained importance. This study aims to investigate the effectiveness of family-based, developmental pediatrics clinic setting counseling in reducing screen time in typically developing children and to compare them with neurodevelopmental disorders. METHODS: Children (aged 24-62 months) who were exposed to screen viewing for at least 2 hours/day were included. Parents were given three counseling sessions to reduce excessive screen time. Parents reported daily screen time, co-viewing, background TV exposure, the duration of reading books and playing with their child. RESULTS: The study included 105 children (median age: 34 months IQR:28-41). Before counseling, the screen viewing time and the percentage of co-viewing among typically developing children (n=22) and children with a neurodevelopmental disorder (n=83) were similar. There was a statistically significant decrease in screen time in both groups after the intervention. A higher impact was shown in the neurodevelopmental disorder group. The increase in percentages of co-viewing, as well as the increase in the time spent playing with their children, were statistically significant in the neurodevelopmental disorder group. CONCLUSIONS: The study demonstrated that three pediatric office-setting counseling sessions including media use recommendations of the American Academy of Pediatrics are effective to decrease screen time for children who are either typically developing or with a neurodevelopmental disorder.

Screening traumatic life events in preschool aged children: cultural adaptation of Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 years version.

BACKGROUND: Given the high prevalence of potentially traumatic events (PTEs), pediatric providers are in a novel position in early identification and referral of the children with PTEs. Yet paucity of culturally adapted instruments to screen PTEs and related symptoms in preschool-aged children limits pediatric providers. This multicenter study aimed to screen the traumatic life events of preschool-aged children admitted to pediatric outpatient clinics at four different cities of Turkey and to determine the socio-demographic risk factors associated with PTEs. Moreover, it was also intended to develop the cultural adaptation of the Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 Years version to Turkish and to analyze its reliability. METHODS: Participants of this multicenter study were collected from four different hospitals in three different regions (Central Anatolia, Black Sea, and Southeastern Anatolia regions) of Turkey. All parents of children at the age of 3-6 years who were admitted to the hospital for a clinical visit (sick-child or well-child visits) were invited to the study. In total, 188 preschool-aged children were included in the study. Socio-demographic characteristics of the child and the family were questioned and parents were asked to fill out the Turkish version of the CATS Caregiver-report. RESULTS: Internal consistency (Cronbach`s alpha) of the Turkish version of the CATS Caregiver-report 3-6 Years was found as 0.86. This study revealed that half of the participating children had experienced at least one PTE and more than one fourth experienced more than one event. Strikingly, no association between sociodemographic risk factors and PTE exposure was identified suggesting that PTE exposure is indeed widespread in our study population. CONCLUSION: The findings of this study manifest the importance of routine screening of PTEs and related symptoms in children.

Wernicke encephalopathy due to thiamine deficiency after surgery on a child with duodenal stenosis.

BACKGROUND: Wernicke encephalopathy is rare in children and is caused by thiamine deficiency. It is characterized by acute or subacute ataxia, altered consciousness, and ophthalmoparesis. Gastroenterological surgery, total parenteral nutrition for short bowel syndrome, and alcoholism are common risk factors for Wernicke encephalopathy. Typical magnetic resonance imaging features include selective symmetrical signal changes in the mammillary bodies, medial thalamus, tectum, periaqueductal region, cranial nerves, cerebellum, red nucleus, dentate nucleus, fornix, splenium, cerebral cortex, and putamen. If left undiagnosed and untreated, the disease may be fatal. PATIENT DESCRIPTION: We describe a 13-year-old boy who developed acute cerebellar findings while receiving total parenteral nutrition after gastroduodenostomy for duodenal stenosis. RESULTS: The diagnosis of Wernicke encephalopathy was based on his clinical history, neurological examination, and imaging results. We immediately started intravenous thiamine replacement therapy. Two weeks later, the patient's clinical signs had resolved except for mild clumsiness, which was observed during his tandem gait examination. CONCLUSION: Our report emphasizes the importance of clinical and magnetic resonance imaging pattern recognition in timely diagnosis, as well as the importance of prompt thiamine replacement therapy. We also demonstrate the importance of thiamine supplementation during total parenteral nutrition after gastrointestinal surgery.