School readiness among vulnerable children: a systematic review of studies using a person-centered approach

Abstract Background Research has consistently shown that some children are more vulnerable at the time of school readiness. Better understanding the characteristics of these children is therefore important. Most studies have used a variable-based approach, which may mask the presence of small but important subgroups of children with mixed patterns of readiness strengths and weaknesses. Identifying subgroups with mixed readiness patterns using a person-centered approach matters because their developmental trajectories might differ in important ways from children with broader difficulties across all readiness domains. Objective This systematic review attempts to synthesize existing profiles of school readiness conducted on preschool-aged children and to describe how these various profiles are associated with children's academic achievement and social adjustment during their school years. Specifically, we described how the school readiness profiles vary in number of profiles identified and differences in the specific domains of school readiness. We further describe the school readiness profiles and how they predict later academic and social outcomes. Furthermore, we focus on profile differences between at-risk and non-at-risk preschoolers. Methods Longitudinal studies published between 2005 and 2022 on profiles of school readiness before school entry and at least one subsequent academic and/or social outcomes were extracted from five databases. Eight articles were included in this systematic review out of the 117 screened peer-reviewed articles. Results All the studies incorporated both the cognitive and socioemotional domains of school readiness in their profiles. Fifteen profiles of school readiness at preschool age were identified based on the child level of cognitive and socioemotional skills, with 7 profiles at risk of later academic and social difficulties. Despite variation, children in these at-risk profiles of school readiness shared similar features. Conclusion This literature review provides an exhaustive summary on the number of profiles and domains of school readiness most frequently reported in studies using a person-centered approach. Yielding an in-depth description of at-risk profiles of school readiness can help designing early preventive intervention for these children.

Reducing harm and promoting positive media use strategies: new perspectives in understanding the impact of preschooler media use on health and development

Abstract Most children grow up in homes with easy access to multiple screens. Screen use by children between the ages of 0 to 5 has become a worldwide preoccupation. In the present narrative review, we examine child and parent screen use and its contribution to physical, cognitive, and social developmental outcomes. As research has mostly focused on the adverse consequences of screen media, we aim to depict both the negative and the positive influences of screen usage. To provide a more nuanced portrait of the potential benefits and harms of screen use, we examine how consequences of media use vary according to the content of media (ex., educational, violent), context (ex., using screens during mealtimes), and the nature (ex., passive vs active use) of child screen use. Our review supports existing screen time guidelines and recommendations and suggests that media content, the context of use, and the nature of child use, as well as the parent's own screen use, be considered clinically. Future research should seek to clarify how these dimensions jointly contribute to child screen use profiles and associated consequences. Finally, child sex, behavioral/temperamental difficulties, and family adversity appear to contribute to child screen use and its consequences and should be considered in future research. Suggestions for harm-reduction approaches are discussed.

Characteristics of Canadian Youth Adhering to Physical Activity and Screen Time Recommendations.

The purpose of the study was to describe adherence to screen time (ST) and physical activity (PA) recommendations among Canadian youth. The present study was based on a representative sample of Canadian students from Grades 7 through 12 (N = 47,203). ST and PA as well as demographic (gender, ethnicity, grade, and province of residence) and individual (alcohol, tobacco and cannabis usage, school connectedness) correlates were self-reported by youth. In total, 49.2% (99% confidence interval [CI] = [46.3%, 52.2%]) of participants respected none of the recommendations, while 40.2% (99% CI [37.0%, 43.3%]) and 20.8% (99% CI [19.2%, 22.4%]) respected PA or ST recommendations, respectively. In terms of the correlates of health-related behavior, White ethnicity, alcohol use, and feeling more connected to school were positively correlated with adherence. Attending school in Quebec and smoking cannabis increased risk of poor compliance. The present findings may help the design of school-based health promotion strategies designed to increase PA and reduce ST.

Early Childhood Household Smoke Exposure Predicts Less Task-Oriented Classroom Behavior at Age 10.

Secondhand tobacco smoke is considered a developmental neurotoxicant especially given underdeveloped vital systems in young children. An ecological test of its negative influence on brain development can be made by examining the prospective association between early childhood household smoke exposure and later classroom behavior. Using a longitudinal birth cohort, we examined the unique contribution of household tobacco smoke exposure to children's subsequent classroom engagement at age 10. From child ages 1.5 to 7 years, parents of 2,055 participants from the Quebec Longitudinal Study of Child Development reported on household smoking by themselves and other home occupants. At age 10, fourth-grade teachers reported on the child's classroom engagement. In terms of prevalence, 58% of parents reported that their children were never exposed to smoke in the home, while 34% and 8% of children were exposed to transient and continuous household smoke, respectively. Compared with never exposed children, those who were exposed to transient and continuous household smoke scored 13% and 9% of a standard deviation lower on classroom engagement in fourth grade, standardized B = -.128 (95% confidence interval = -.186, -.069) and standardized B = -.093 (95% confidence interval = -.144, -.043), respectively. Compared with their never exposed peers, children exposed to transient and continuous early childhood household smoke showed proportionately less classroom engagement, which reflects task-orientation, following directions, and working well autonomously and with others. This predisposition poses risks for high school dropout, which from a population health perspective is closely linked with at-risk lifestyle habits and unhealthy outcomes.

Prospective Associations Between Early Long-Term Household Tobacco Smoke Exposure and Subsequent Indicators of Metabolic Risk at Age 10.

INTRODUCTION: Although there are established risks associated with gestational tobacco smoke exposure, few studies have addressed the metabolic hazards of domestic exposure in early childhood. This study prospectively examines the long-term relationship between early childhood exposure to household smoke and two adiposity-related measures at age 10. METHODS: Participants from the Quebec Longitudinal Study of Child Development birth cohort were categorized into one of three groups of early childhood household exposure to tobacco smoke over four time points (from ages 1 to 7 years): never-exposed; transient exposure; and continuous exposure. Follow-up measures of body mass index and waist circumference were independently assessed at age 10. RESULTS: Compared to being never exposed, transient and continuous household smoke exposure predicted increases of 0.93 cm (95% confidence interval [CI] between 0.05 and 1.82 cm; P = .03) and 1.56 cm (95% CI between 0.07 and 3.05 cm; P = .04) in children's waist circumference, respectively. Children exposed to transient and continuous household smoke, compared to unexposed children, also showed 0.48 and 0.81 point increases in their body mass index, respectively, both Ps = .005. Once adjusted, for confounding variables, only transient household smoke remained associated with 43% greater odds of belonging to the overweight/obese category (95% CI between 1.12 and 1.81 cm; P < .01). CONCLUSIONS: We found significant long-term prospective associations between home-based secondhand smoke exposure and unhealthy body fat distribution. Waist circumference in youth has become an important risk factor for obesity-related diseases in adulthood. Our findings emphasize the importance public health initiatives and parental sensitization aimed at domestic exposure reductions during the critical early childhood years.

Parental bad habits breed bad behaviors in youth: exposure to gestational smoke and child impulsivity.

In utero exposure to cigarette smoke has been shown to have an adverse effect on healthy brain development in childhood. In the present study, we examine whether fetal exposure to mild and heavy smoking is associated with lower levels of impulsivity and cognitive control at age 10. Using a sample of 2120 children from the Québec Longitudinal Study of Child Development, we examine the association between gestational cigarette smoke exposure and fourth grade teacher reports of impulsivity and classroom engagement which represent behavioral indicators of executive functions. When compared to children of non-smokers, children of mothers who reported smoking heavily during pregnancy (10 or more cigarettes per day) were rated by their fourth grade teachers as displaying higher levels of impulsive behavior, scoring.112 standard deviation units higher than children of non-smokers. Children of mothers who smoked heavily were also less engaged in the classroom, scoring.057 standard deviation units lower than children of women who did not smoke. These analyses were adjusted for many potentially confounding child and family variables. Exposure to perinatal nicotine may compromise subsequent brain development. In particular, fetal nicotine may be associated with impairment in areas recruited for the effortful control of behavior in later childhood, a time when task-orientation and industriousness are imperative for academic success.

Prospective associations between early long-term household tobacco smoke exposure and antisocial behaviour in later childhood.

BACKGROUND: Using a prospective birth cohort design, we estimate the relative contribution of long-term postnatal nicotine exposure from 17 to 86 months on children's subsequent antisocial behaviour by the end of fourth grade. METHOD: Parents reported the amount of household smoke exposure (at 17, 41, 65 and 86 months) for all 2055 children from the Quebec Longitudinal Study of Child Development. Main outcome measures include teacher- and child-reported antisocial and physically aggressive behaviour (at 121 months). RESULTS: In terms of prevalence, 58% of parents reported that their children were never exposed to secondhand smoke in the home, while 34% and 8% of parents reported transient and continuous levels of secondhand smoke, respectively. When compared with never exposed children, children exposed to continuous secondhand smoke scored higher on self-reported aggressive behaviour and teacher-rated antisocial behaviour in fourth grade, B=0.336 (95% CI 0.155 to 0.517) and B=0.319 (95% CI 0.107 to 0.531), respectively. Similarly, children exposed to transient levels of secondhand smoke scored higher on aggressive and antisocial behaviour, B=0.714 (95% CI 0.456 to 0.972) and B=0.566 (95% CI 0.260 to 0.872), respectively. CONCLUSIONS: The observed prevalence is concordant with worldwide estimates of children's exposure to secondhand smoke. In comparison with their never exposed peers, children continuously and intermittently exposed to secondhand smoke in childhood showed an increased propensity toward physical aggression and antisocial behaviour by the end of fourth grade. We found no evidence of dose-dependence.

Prospective associations between early childhood television exposure and academic, psychosocial, and physical well-being by middle childhood.

OBJECTIVE: To estimate the influence of early childhood television exposure on fourth-grade academic, psychosocial, and lifestyle characteristics. DESIGN: Prospective longitudinal study. SETTING: Institut de la Statistique du Québec, Québec, Canada. PARTICIPANTS: A total of 1314 (of 2120) children. Main Exposure Parent-reported data on weekly hours of television exposure at 29 and 53 months of age. We conducted a series of ordinary least-squares regressions in which children's academic, psychosocial, and lifestyle characteristics are linearly regressed on early and preschool television exposure. OUTCOME MEASURES: Parent and teacher reports of academic, psychosocial, and health behaviors and body mass index measurements (calculated as weight in kilograms divided by height in meters squared) at 10 years of age. RESULTS: Adjusting for preexisting individual and family factors, every additional hour of television exposure at 29 months corresponded to 7% and 6% unit decreases in classroom engagement (95% confidence interval [CI], -0.02 to -0.004) and math achievement (95% CI, -0.03 to 0.01), respectively; 10% unit increases in victimization by classmates (95% CI, 0.01 to 0.05); 13% unit decreases in time spent doing weekend physical activity (95% CI, 0.81 to 2.25); 9% unit decreases in activities involving physical effort (95% CI, -0.04 to 0.00); higher consumption scores for soft drinks and snacks by 9% and 10% (95% CI, 0.00 to 0.04 and 95% CI, 0.00 to 0.02), respectively; and 5% unit increases in body mass index (95% CI, 0.01 to 0.05). Preschool increments in exposure also made a unique contribution to developmental risk. CONCLUSIONS: The long-term risks associated with higher levels of early exposure may chart developmental pathways toward unhealthy dispositions in adolescence. A population-level understanding of such risks remains essential for promoting child development.