Links Between Objectively-Measured Hourly Smartphone Use and Adolescent Wake Events Across Two Weeks.

PURPOSE: Psychosocial and bioregulatory pressures threaten sleep during adolescence. Although recent work suggests that the ubiquity of smartphone use throughout adolescence may also relate to poorer sleep outcomes, most existing research relies upon self-report and retrospective measures. This study drew upon objective measures of smartphone use and sleep at the hourly level to understand how smartphone use was associated with the duration of wake events during sleeping hours. METHODS: Across a 14-day daily study, 59 racially and ethnically diverse adolescents ages 15 to 18 had their sleep assessed via Fitbit Inspire 2 devices and uploaded screenshots of their screen time, pickups, and notifications as logged by their iPhone's iOS. Multi-level modeling was performed to assess hourly level associations between adolescent smartphone use and wake-events during their sleep sessions (N = 4,287 hourly cases). RESULTS: In hours during adolescents' sleep session with more screen time or pickups, adolescents had longer wake event duration. More notifications in a given hour were not associated with wake event duration in the same hour. CONCLUSIONS: Using objectively measured smartphone and sleep data collected at the hourly level, we found that during sleeping hours, when adolescents are actively engaging with their smartphones, their sleep is disrupted, such that their wake events are longer in that hour.

Cortisol response marks biological sensitivity to kindergartners' social hierarchies for emerging school engagement.

This longitudinal study investigated how kindergartners' position in the classroom social hierarchy and cortisol response relate to their change in school engagement across the first year of kindergarten (N = 332, M = 5.3 years, 51% boys, 41% White, 18% Black). We used naturalistic classroom observations of social hierarchy positions, laboratory-based challenges to elicit salivary cortisol response, and teacher, parent, and child reports of emotional engagement with school. Robust, clustered regression models revealed that in the fall, lower cortisol response (but not social hierarchy position) was associated with greater school engagement. However, by spring, significant interactions emerged. Highly reactive, subordinate children showed increases in school engagement from fall to spring of the kindergarten year, whereas highly reactive, dominant children showed decreases in school engagement. This is some of the first evidence that higher cortisol response marks biological sensitivity to early peer-based social contexts.

A meta-analysis of mother-child synchrony in respiratory sinus arrhythmia and contextual risk.

Biobehavioral frameworks of attachment posit that mother-child dyads engage in physiological synchrony that is uniquely formative for children's neurobiological, social, and emotional development. Much of the work on mother-child physiological synchrony has focused on respiratory sinus arrhythmia (RSA). However, the strength of the existing evidence for mother-child RSA synchrony during interaction is unclear. Using meta-analysis, we summarized results from 12 eligible studies comprising 14 samples and 1201 children ranging from infancy to adolescence (Mage  = 5.68 years, SD = 4.13, range = 0.4-17 years) and their mothers. We found that there was a statistically significant, albeit modest, positive within-dyad association between mother and child fluctuations in RSA. There also was evidence for significant heterogeneity across studies. Less mother-child RSA synchrony was observed in high-risk samples characterized by clinical difficulties, history of maltreatment, or socioeconomic disadvantage. We did not find that mother-child RSA synchrony significantly differed by task context, mean child age, or by epoch length for computing RSA. Collectively, these findings suggest that mother-child dyads show correspondence in their fluctuations in RSA, and that RSA synchrony is disrupted in high-risk contexts. Future directions and implications for the study of parent-child physiological synchrony are discussed.

Linking video chatting, phone calling, text messaging, and social media with peers to adolescent connectedness.

For 14 days three times per day (6072 observations), adolescents (N = 207, Mage = 15.45 years) reported their digital (i.e., video chatting, texting, social media, and phone calling) communication with peers and their social connectedness. Controlling for in-person interactions, adolescents felt more connected in hours when they had communicated with peers by video chatting, texting, or social media, but not phone calling. Girls communicated with peers via text and social media more than boys, and boys talked on the phone more than girls. Boys who talked, texted, or video chatted more on average reported higher connectedness on average, whereas girls did not. As the links with connectedness were only found at the hourly- and not the daily level, results highlight that a sense of connectedness from digital media may be fleeting in nature.

Increased Residential Clustering of COVID-19 Cases Associated With SARS-CoV-2 Variant of Concern B.1.1.7.

BACKGROUND: The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.7 variant in England in 2020 and subsequent global spread emphasized the need to understand epidemiologic characteristics of SARS-CoV-2 variants. A diagnostic proxy for this variant, referred to as S-gene target failure, provided a rich dataset to assess transmissibility of the variant in an analysis of clustering in residential settings. METHODS: We used a pair-matched case-control study design to estimate odds of onward transmission within households with S-gene target failure index cases versus nontarget failure index cases. We defined cases as the index in a household cluster (clustered case) and controls as a case with no subsequent household cluster (sporadic). We matched clustered and sporadic cases one-to-one on specimen week, geography, and property type. We used conditional logistic regression, adjusting for age, sex, ethnicity, and symptom status, to assess odds of residential clustering. RESULTS: Our study population comprised 57,244 individuals with specimen dates from 23 November 2020 to 4 January 2021. Crude analysis yielded 54% increased odds (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.5, 1.6) of residential clustering associated with S-gene target failure; the association remained in the fully adjusted model (OR = 1.6, 95% CI = 1.5, 1.6). Stratified analyses by region showed increased odds of residential clustering associated with target failure in all regions apart from the Southwest, where we observed lower precision. Similar adjusted odds ratios with precise confidence intervals remained in stratified analyses by property category. CONCLUSION: We observed increased odds in all property types, consistent with greater transmissibility of the B.1.1.7 variant in this high-risk setting.

Adolescents Are More Likely to Help Others on Days They Take Risks and Crave Social Connections.

This study examined how adolescents' risk-taking behaviors were related to their prosocial behaviors on a daily level and how this association differed depending on adolescents' daily and average levels of sensation seeking and social craving. Adolescents (N = 212; Mage = 15 years) completed daily diaries for 14 days. Adolescents were more likely to engage in prosocial behavior on days when they also took risks, but only when they also felt high levels of social craving. The daily link between risk-taking and prosocial behavior did not vary based on daily or individual differences in sensation seeking. Results suggest that when adolescents feel highly motivated to connect with others, their risk-taking and prosocial tendencies co-occur on a daily basis.

The effects of language preference and home resources on foundational literacy retention during school holiday closures in Ghana: Lessons from the Complementary Basic Education Programme.

This article assesses the extent to which children's language preference and their home environment matter for literacy retention. Using data from the Complementary Basic Education (CBE) program in Ghana, the authors found that large numbers of disadvantaged students reverted to not even being able to read a single word following school closures over a four-month holiday period. Widening literacy gaps were found for girls who reported they did not receive instruction in a language that they understood or did not have the resources, support, or activities at home to enable them to continue to learn while schools were closed. For boys, widening literacy gaps were only influenced by resources, support, or activities at home, but not by language preferences. The article findings suggest that schools and teachers must pay closer attention to language preference, particularly for girls, in order to ensure that language of instruction is not a barrier to literacy retention. The article also provides further evidence to support the growing claims that home supports are essential for reducing inequities in learning outcomes during school closures.

ß-Adrenergic Contributions to Emotion and Physiology During an Acute Psychosocial Stressor.

OBJECTIVE: ß-Adrenergic receptor signaling, a critical mediator of sympathetic nervous system influences on physiology and behavior, has long been proposed as one contributor to subjective stress. However, prior findings are surprisingly mixed about whether ß-blockade (e.g., propranolol) blunts subjective stress, with many studies reporting no effects. We reevaluated this question in the context of an acute psychosocial stressor with more comprehensive measures and a larger-than-typical sample. We also examined the effects of ß-blockade on psychophysiological indicators of sympathetic and parasympathetic nervous system reactivity, given that ß-blockade effects for these measures specifically under acute psychosocial stress are not yet well established. METHODS: In a double-blind, randomized, placebo-controlled study, 90 healthy young adults received 40 mg of the ß-blocker propranolol or placebo. Participants then completed the Trier Social Stress Test, which involved completing an impromptu speech and difficult arithmetic in front of evaluative judges. Self-reported emotions and appraisals as well as psychophysiology were assessed throughout. RESULTS: Propranolol blunted Trier Social Stress Test preejection period reactivity (b = 9.68, p = .003), a marker of sympathetic nervous system activity, as well as salivary α-amylase reactivity (b = -0.50, p = .006). Critically, propranolol also blunted negative, high arousal emotions in response to the stressor (b = -0.22, p = .026), but cognitive appraisals remained intact (b values < -0.17, p values > .10). CONCLUSIONS: These results provide updated experimental evidence that ß-adrenergic blockade attenuates negative, high arousal emotions in response to a psychosocial stressor while also blunting sympathetic nervous system reactivity. Together, these findings shed light on the neurophysiological mechanisms by which stressors transform into the subjective experience we call "stress."Trial Registration: ClinicalTrials.gov Identifier: NCT02972554.

Young Children's Prosocial Behavior Protects Against Academic Risk in Neighborhoods With Low Socioeconomic Status.

Children raised in neighborhoods with low socioeconomic status (SES) are at risk for low academic achievement. Identifying factors that help children from disadvantaged neighborhoods thrive is critical for reducing inequalities. We investigated whether children's prosocial behavior buffers concurrent and subsequent academic risk in disadvantaged neighborhoods in Bradford, UK. Diverse children (N = 1,175) were followed until age seven, with measurements taken at four times. We used governmental indices of neighborhood-level SES, teacher observations of prosocial behaviors, and direct assessments of academic achievement. Neighborhood SES was positively associated with academic achievement among children with low levels of prosocial behavior, but not among children with high levels of prosocial behavior. Prosocial behavior may mitigate academic risk across early childhood.

Parent-child physiological synchrony: Concurrent and lagged effects during dyadic laboratory interaction.

This study investigated whether parents and kindergarten children show concurrent and time-lagged physiological synchrony during dyadic interaction. Further, we tested whether parent-child behavioral co-regulation was associated with concurrent and time-lagged synchrony, and whether synchrony varied by the type of interaction task. Participants were 94 children (Mage  = 5.6 years, 56% female) and their parents. We simultaneously measured parent and child respiratory sinus arrhythmia (RSA) during four dyadic interaction tasks: free play, clean up, problem-solving, and puzzle teaching. We found that synchrony varied by task. Concurrent synchrony occurred only during the puzzle teaching task, such that parent and child RSA were significantly and positively associated with each other simultaneously. Time-lagged synchrony occurred only during the problem-solving task, such that parent RSA was positively associated with child RSA 30 seconds later, and child RSA was negatively associated with parent RSA 30 seconds later. Although behavioral co-regulation and physiological synchrony have been conceptualized as markers of responsive parent-child interactions, our study finds no evidence that physiological synchrony is associated with between-dyad differences in behavioral co-regulation.

Taking a few deep breaths significantly reduces children's physiological arousal in everyday settings: Results of a preregistered video intervention.

This preregistered, randomized field experiment tested the effectiveness of a brief deep breathing intervention on children's concurrent physiological arousal in naturalistic settings (N  = 342; Mage  = 7.48 years; 46% female; 53% Asian, 26% White; 21% other race/ethnicity). The treatment consisted of an animated video that introduced deep breathing as a self-regulation strategy and scaffolded the child in taking a few slow-paced breaths, while the control group watched an informational video featuring similar animated images. Respiratory sinus arrhythmia (RSA) and heart rate (HR) were measured while children were sitting still (baseline) and subsequently while watching 1-min videos. Relative to baseline arousal, RSA increased and HR decreased only in response to the deep-breathing treatment video. Effects were larger in the second 30-s epoch of the video, which included most of the deep breathing practice. RSA fully mediated the intervention's effects on HR. By analyzing all children exposed to intervention video regardless of their engagement in the deep breathing practice (intention-to-treat design) and by using easily scalable treatment videos, the study identifies an effective and pragmatic approach to reducing children's physiological arousal in everyday, group settings. Implications for advancing applied developmental psychophysiological research are discussed.

Daily provision of instrumental and emotional support to friends is associated with diurnal cortisol during adolescence.

This study investigates how adolescents' daily prosocial behaviors to friends are related to diurnal cortisol using between- and within-subject analyses. Further, we examine whether role fulfillment (i.e., feeling like a good friend) moderates links between prosocial behaviors and cortisol. Ethnically diverse adolescents (N = 370; ages 11-18) reported whether they provided instrumental and emotional support to friends for 5 days, and provided four saliva samples/day for 4 days. On the daily level, providing emotional support predicted lower cortisol awakening response the next day, and providing instrumental assistance to friends was associated with a flatter cortisol slope the same day (a cardiovascular risk factor). Adolescents also provided more emotional support on days they had lower CAR and steeper cortisol slopes. On the average level, providing more instrumental support was associated with steeper cortisol slopes among adolescents who felt high levels of role fulfillment, but not among adolescents who felt low levels of role fulfillment. Providing instrumental support may be physiologically taxing from day to day but, across the long term, linked to lower cardiovascular risk for adolescents who experience helping as highly fulfilling.

Prior night sleep moderates the daily spillover between conflict with peers and family and diurnal cortisol.

We investigated whether daily experiences of conflict with family and peers were associated with fluctuations in diurnal cortisol, and whether sleep buffers the associations between conflict and diurnal cortisol. A racially diverse sample of 370 adolescents (ages 11-18; 57.3% female) provided daily diaries for 5 days and saliva samples for 4 days. Hierarchical linear models tested how peer and family conflict were associated with diurnal cortisol (i.e., total cortisol output, cortisol slope, and cortisol awakening response) the next day, and whether these associations were moderated by sleep duration the previous night. When adolescents experienced peer conflict, they showed higher area under the curve (AUC) the next day if they had slept less the night prior to conflict, but relatively lower cortisol awakening response (CAR) and flatter cortisol slope the next day if they had slept more the night prior to conflict. When adolescents experienced family conflict, they also showed higher AUC the next day if they had slept less the night prior to conflict, but higher CAR the next day if they had slept more the night prior to conflict. Family conflict and sleep were not directly or interactively related to cortisol slope.

Family Assistance Spills Over Into Prosocial Behaviors Toward Friends and Positive Academic Behaviors.

We investigate how daily family assistance predicts prosocial behaviors toward friends and positive academic behavior. Adolescents (N = 375, 57% girls, Mage = 14.57) completed diary checklists for 14 days, reporting whether they provided instrumental assistance or emotional support to family and friends, and their positive academic behaviors (e.g., studied). When adolescents provided emotional support to family, they were more likely to provide instrumental support to friends the next day. When adolescents provided emotional support to family, they were more likely to also provide emotional support to friends the next day, and vice versa (a bidirectional association). When adolescents provided instrumental support to the family, they were more likely to have at least one positive academic experience the next day.

Examining a new prosocial risk-taking scale in a longitudinal sample of ethnically diverse adolescents.

INTRODUCTION: This longitudinal study designed and tested the validity of a new measure of prosocial risk taking - risks that individuals take in order to help others. METHODS: The sample was racially and ethnically diverse adolescents in the rural Southeastern United States (N = 867; Mage = 12.82 years, 10-14 years at Wave 1; 50% Girls, 33% White non-Latinx, 27% Latinx, 20% Black, 20% Mixed/Other race/ethnicity). Adolescents completed self-report measures of the new prosocial risk-taking scale at baseline and one- and two-year follow-ups. RESULTS: Confirmatory factor analysis demonstrated excellent model fit with a 6-item single factor score. Further, the scale demonstrated good test-retest reliability at one and two-year follow ups. The scale also demonstrated convergent validity, such that prosocial risk taking was positively correlated with prosocial tendencies, empathy, and sensation seeking, and negatively correlated with negative risk-taking behavior and risk tolerance. Finally, we found significant differences by race/ethnicity (but not by gender) in prosocial risk taking, which were not attributable to measurement invariance, and should be interpreted in the context of ongoing societal inequalities between youth. CONCLUSIONS: The new Prosocial Risk-Taking Scale yielded reliable scores in our sample. It may be used in future research to investigate individual differences in adolescents' prosocial risk taking, developmental change in prosocial risk taking, and the significance of prosocial risk taking for adolescents' emotional and social adaptation.

Dazed and Confused: Altered Mental Status in an Adolescent Male.

BACKGROUND: Absence status epilepticus (ASE) is a form of generalized nonconvulsive status epilepticus. ASE is characterized by impairment in consciousness, which can vary widely, making the diagnosis more difficult. The typical patient with ASE will be confused yet responsive and in a "trance-like state" with delayed speech, clumsy gait, and the ability to perform simple tasks after prompting. With treatment, typical ASE has an excellent prognosis and does not appear to be associated with significant neuronal damage. CASE PRESENTATION: An 11-year-old boy with history of febrile seizures presented to the emergency department (ED) with altered mental status without trauma or ingestion. His vital signs and physical examination were normal, with the exception of appearing intoxicated with sparse verbalization and inappropriate emotional responses. All laboratory results and imaging were unremarkable. While in the ED, his neurologic examination trended toward normal, returning almost to baseline. He was admitted to the hospital for video electroencephalogram, which revealed status epilepticus. After benzodiazepine therapy, epileptic electrical activity ceased and the patient's symptoms resolved. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ASE is a rare condition that is uncommonly described in the pediatric population. These patients are frequently misdiagnosed on initial presentation as their alteration in mental status can be easily confused with ingestion, trauma, psychiatric illness, or infectious etiologies. Overturning the long-standing emergency dogma of "if they're talking to you, it's not a seizure" is undoubtedly difficult, but both pediatric and adult providers should be aware of this clinical entity.

Using educational transitions to estimate learning loss due to COVID-19 school closures: The case of Complementary Basic Education in Ghana.

Learning loss is expected for millions of children who have been out of school as a result of the current COVID-19 pandemic. Unfortunately, it is uncertain how much learning will be lost and how wide the gaps may be for disadvantaged children. This paper uses a unique longitudinal dataset to estimate learning loss during a three-month transition from Complementary Basic Education to government schools in Ghana. Our results show an average learning loss of 66 % of previous learning gains in foundational numeracy during this transition period. More importantly, we estimate widening gaps in learning loss according to lack of home learning support, as well as lack of home learning resources. Our results have implications for the provision of learning activities and support at home, not just during current school closures due to COVID-19, but also during transitions between academic years.

The Earliest Origins of Genetic Nurture: The Prenatal Environment Mediates the Association Between Maternal Genetics and Child Development.

Observed genetic associations with educational attainment may be due to direct or indirect genetic influences. Recent work highlights genetic nurture, the potential effect of parents' genetics on their child's educational outcomes via rearing environments. To date, few mediating childhood environments have been tested. We used a large sample of genotyped mother-child dyads (N = 2,077) to investigate whether genetic nurture occurs via the prenatal environment. We found that mothers with more education-related genes are generally healthier and more financially stable during pregnancy. Further, measured prenatal conditions explain up to one third of the associations between maternal genetics and children's academic and developmental outcomes at the ages of 4 to 7 years. By providing the first evidence of prenatal genetic nurture and showing that genetic nurture is detectable in early childhood, this study broadens our understanding of how parental genetics may influence children and illustrates the challenges of within-person interpretation of existing genetic associations.

Role Fulfillment Mediates the Association Between Daily Family Assistance and Cortisol Awakening Response in Adolescents.

Family assistance (helping the family) is associated with both positive and negative psychological and biological outcomes during adolescence. However, the association between family assistance and the hypothalamic-pituitary-adrenal (HPA) axis remains unstudied. Thus, we assess how helping the family relates to adolescents' diurnal cortisol, an index of HPA activity, and psychological outcomes. Three hundred and seventy ethnically diverse adolescents (ages 11-18) reported daily helping behaviors and psychological experiences for 14 days and provided four saliva samples per day for 4 days. Multilevel modeling revealed that cortisol awakening response was lower the day after adolescents helped their families more. This association was explained, in part, by perceived role fulfillment (feeling like a good son, daughter, and sibling). Results highlight a possible psychological and biological benefit of assisting the family during adolescence.

Addressing educational inequalities and promoting learning through studies of stress physiology in elementary school students.

To be ready to learn, children need to be focused, engaged, and able to bounce back from setbacks. However, many children come to school with heightened or diminished physiological arousal due to exposure to poverty-related risks. While stress physiology plays a role in explaining how adversity relates to processes that support students' cognitive development, there is a lack of studies of physiological stress response in educational settings. This review integrates relevant studies and offers future directions for research on the role of stress physiology in the school adaptation of elementary school students, focusing on these important questions: (a) What are the links between physiological stress response and learning-related skills and behaviors, and do they vary as a function of proximal and distal experiences outside of school? (b) How are school experiences associated with students' physiological stress response and related cognitive and behavioral adaptations? (c) How can we leverage measures of students' physiological stress response in evaluations of school-based interventions to better support the school success of every student? We hope to stimulate a new wave of research that will advance the science of developmental stress physiology, as well as improve the application of these findings in educational policy and practice.