Metacognition as a mediator of the relation between family SES and language and mathematical abilities in preschoolers.

The effect of family socioeconomic status (SES) on academic achievement in literacy and numeracy has been extensively studied with educational inequalities already witnessed in preschoolers. This is presumably explained by the effect of family SES on cognitive and socioemotional abilities associated with academic achievement. Metacognition which refers to knowledge and regulation skills involving reflexivity about one's own cognitive processes is one of these abilities. However, most of the studies investigating the association between metacognition and academic achievement have focused on school-aged students and studies with younger students are only emerging. Meanwhile, the association between family SES and metacognition abilities has surprisingly received little attention regardless of participants' age. The aim of this study was to explore the associations between family SES, metacognition, language and mathematical abilities in preschoolers aged 5 to 6. We provide the first evidence that the effect of family SES on preschoolers' language and mathematical abilities is mediated by the effect of family SES on their metacognitive abilities. The implications for future research, education and policies aiming at reducing educational inequalities are discussed.

Reliability and validity of rapid assessment tools for measuring 24-hour movement behaviours in children aged 0-5 years: the Movement Behaviour Questionnaire Baby (MBQ-B) and child (MBQ-C).

BACKGROUND: The development of validated "fit-for-purpose" rapid assessment tools to measure 24-hour movement behaviours in children aged 0-5 years is a research priority. This study evaluated the test-retest reliability and concurrent validity of the open-ended and closed-ended versions of the Movement Behaviour Questionnaire for baby (MBQ-B) and child (MBQ-C). METHODS: 300 parent-child dyads completed the 10-day study protocol (MBQ-B: N = 85; MBQ-C: N = 215). To assess validity, children wore an accelerometer on the non-dominant wrist (ActiGraph GT3X+) for 7 days and parents completed 2 × 24-hour time use diaries (TUDs) recording screen time and sleep on two separate days. For babies (i.e., not yet walking), parents completed 2 × 24-hour TUDs recording tummy time, active play, restrained time, screen time, and sleep on days 2 and 5 of the 7-day monitoring period. To assess test-retest reliability, parents were randomised to complete either the open- or closed-ended versions of the MBQ on day 7 and on day 10. Test-retest intraclass correlation coefficients (ICC's) were calculated using generalized linear mixed models and validity was assessed via Spearman correlations. RESULTS: Test-retest reliability for the MBQ-B was good to excellent with ICC's ranging from 0.80 to 0.94 and 0.71-0.93 for the open- and closed-ended versions, respectively. For both versions, significant positive correlations were observed between 24-hour diary and MBQ-B reported tummy time, active play, restrained time, screen time, and sleep (rho = 0.39-0.87). Test-retest reliability for the MBQ-C was moderate to excellent with ICC's ranging from 0.68 to 0.98 and 0.44-0.97 for the open- and closed-ended versions, respectively. For both the open- and closed-ended versions, significant positive correlations were observed between 24-hour diary and MBQ-C reported screen time and sleep (rho = 0.44-0.86); and between MBQ-C reported and device-measured time in total activity and energetic play (rho = 0.27-0.42). CONCLUSIONS: The MBQ-B and MBQ-C are valid and reliable rapid assessment tools for assessing 24-hour movement behaviours in infants, toddlers, and pre-schoolers. Both the open- and closed-ended versions of the MBQ are suitable for research conducted for policy and practice purposes, including the evaluation of scaled-up early obesity prevention programs.

The emergence of young children's tolerance for inequality: With age, children stop showing numerically sensitive fairness.

One persistent and pernicious feature of outstanding social inequality is that even relatively extreme forms of inequality can be justified with reference to merit-based considerations. One key feature of fairness with respect to resource allocation is that it is numerically sensitive; greater (more extreme) inequalities are generally seen as less fair than less extreme ones. This work sought to document the emergence of numerically sensitive fairness in children aged 4 to 8 years. A total of 81 4- to 8-year-olds completed a series of within-participants fairness judgment trials in which they observed two characters receive either equitable or inequitable shares of resources-ranging from 50/50 (completely fair) to 0/100 (completely unfair)-in two contexts: one in which the two characters were described as working the same amount (equality context) and one in which one character was described as working harder than the other character (merit context). Children of all ages showed numerically sensitive fairness in the equality context. However, whereas younger children continued to show numerically sensitive fairness in the merit context, older children approved even relatively extreme inequalities when one person was described as working harder. This effect emerged with age, suggesting a double-edged sword to acquiring beliefs in merit-based fairness; as children get older, they may begin to accept even relatively extreme forms of inequality when presented in a merit context. Results are discussed with respect to the acquisition of meritocracy as a normative belief of fairness.

The Norwegian CDI-III as an assessment tool for lexical and grammatical development in preschoolers.

Parental report instruments are a non-invasive way to assess children's language development and have proved to give both valid and reliable results when used with children under the age of 2;6 (and in some cases up to 3). In this study we examine the newly developed Norwegian edition of a language assessment tool for older preschoolers: MacArthur-Bates Communicative Development Inventory III (CDI-III), investigating whether this parental report tool can be used for assessing the language of monolingual Norwegian-speaking children between 2;6 and 4 years. NCDI-III results for 100 children between 2;6 and 4.0 are presented. All sections were significantly intercorrelated. All sections except Pronunciation showed growth with age. Internal consistency was measured both in terms of Cronbach's alpha and corrected item-scale correlation, and the results are discussed considering features of item difficulty distribution. Methodological considerations are discussed, as well as implications relevant both for possible later revisions and for CDI-III adaptations to new languages.

Urinary antibiotic concentrations in preschool children from eastern China and health risk assessment.

Despite limited biomonitoring studies suggesting extensive antibiotic exposure in general population, the body burden of antibiotics in young children and their potential health risks remain unclear. To assess the antibiotic exposure levels in young children, 508 preschoolers aged 3-6 years were recruited from eastern China in 2022, and a total of 50 representative antibiotics from 8 categories, including 17 human antibiotics (HAs), 4 antibiotics preferred as HAs (PHAs), 16 veterinary antibiotics (VAs), and 13 antibiotics preferred as VAs (PVAs), were analyzed by UPLC-MS/MS. Hazard quotient (HQ) and hazard index (HI) were calculated to evaluate the health risks, and multivariate logistic regression was applied to examine diet with antibiotic exposure. Our results showed that there were 41 antibiotics detected in children's urine, and the overall detection frequency was as high as 100%. Sulfonamides, macrolides, ß-lactams, quinolones, and azoles were the predominant categories of antibiotic detected. Among the studied children, 6.5% had a sum of estimated daily intake (EDI) of all VAs and PVAs larger than 1 µg/kg/day. Notably, 10.0% of the children had a microbiological HI value exceeding 1, primarily contributed by ciprofloxacin. Children with higher consumption of seafood had a relatively increased exposure to multiple categories of antibiotics, including HAs, VAs, quinolones, azoles, and others. Principal component analysis suggested that "Aquatic products and viscera preferred dietary pattern" scores were positively correlated with the exposure levels of ciprofloxacin (OR: 1.23; 95% CI: 1.02-1.47) and carbadox (OR: 1.32; 95% CI: 1.10-1.59), and a relatively increased exposure of PHAs was realized in children with higher "Meat-egg preferred dietary pattern" scores (OR: 1.24; 95% CI: 1.03-1.50). In conclusion, there was a widespread exposure to antibiotics among preschool children from eastern China, and children who consumed more animal-derived foods may had an increased exposure to antibiotics.

Overweight/obesity and socio-demographic disparities in children's motor and cognitive function.

Fundamental motor skills (FMS) and cognitive function are important indicators of development in early childhood. Using a cross-sectional design, the purpose of this study was to investigate obesity (healthy weight vs. overweight/obese) and socio-demographic (i.e., gender, SES) disparities in FMS (locomotor and ball skills) and cognitive function (reaction time [RT] and movement time [MT]), in preschoolers. There were 74 preschoolers (girl = 38; Mage = 4.02 ± 0.73) recruited from two childcare centers and were categorized into healthy weight (n = 58, BMI percentile < 85%) and overweight/obese (n = 16, BMI percentile ≥ 85%) categories. Children's FMS were assessed using the TGMD-3; cognitive function was assessed by the iPad-based CANTAB™ software using the Reaction Time Task (RTI), including reaction time (RT; Simple RT [SRT], choice RT [CRT]) and movement time (MT; simple MT [SMT], choice MT [CMT]). Children presented less FMS proficiency compared to recent data. Both weight groups performed comparably in FMS (ps > 0.05; ball skill Cohen's d = 0.40; locomotor Cohen's d = 0.02). Children in the overweight/obese group performed significantly worse on all cognitive tests compared to healthy weight peers (ps < 0.05; Cohen's d range from -0.93 to -1.43). No significant gender or SES disparities were observed. Maintaining healthy weight status is critical for cognitive development among preschoolers, which may influence their developmental trajectory and school readiness.

Performance-based neuropsychological assessment tools for executive function among preschoolers in China: A systematic review.

Objective: There is an increasing demand for the assessment of executive function (EF) among Chinese preschoolers. However, there exists methodological and cross-cultural challenges of performance-based EF assessment. The current review aims to 1) identify and summarize the current application of performance-based EF assessment tools for Chinese preschoolers in China and 2) offer recommendation guidelines for different application scenarios, such as clinical or scientific research, and for related personnel.Method: A literature search was conducted from Web of Science, PubMed, PsycInfo, Scopus and China National Knowledge Infrastructure databases. We focused exclusively on performance-based tools assessing EF among children aged three to six years, encompassing tasks of inhibition, working memory, cognitive flexibility, reasoning, problem solving, and/or planning. Clinical (e.g. children with autism spectrum disorders) and multilingual populations residing outside of China (e.g. Chinese Americans) were excluded. Two authors independently screened, extracted, and evaluated each tool for characteristics (e.g. name, domain, type, version, language, approach of administration, and scoring) and sample information (e.g. sample size, age, and region). Results: A total of 98 articles were included, with 255 tools being identified that were further classified into 44 unique types, covering nine EF domains. Most tools were original or informally sinicized, with notable variations in tool selection, administration, and interpretation process. Given that a complete set of EF tools has not been identified as perfectly suitable for Chinese preschoolers, we also offered recommendations based on empirically adapted evaluation criteria. Conclusions: Our findings highlighted the need for appropriate adaptation, administration, and interpretation of the current EF tools.

Early intervention and special education in New York City: Patterns of service use and disparities affecting children of colour.

BACKGROUND: Compliance with the requirements of the Individuals with Disabilities Education Act (IDEA) in the United States is monitored through review of cross-sectional reports from three discrete, age-defined programmes (early intervention [EI], early childhood special education [ECSE)] and school-age special education [SE]) to promote the timely, efficient and effective delivery of appropriate services to all eligible children. Analysis of longitudinal data is required to discern how children use services across programmes to provide the necessary context for IDEA oversight and to identify areas for programme or policy interventions to reduce barriers to service use and promote equity. METHODS: We applied sequence analysis to a data linkage across five public record systems among 15 626 New York City children born in 1998 who had records from birth through third grade. RESULTS: Five predominant patterns of service use were identified: (1) multiple therapies across EI/ECSE/SE (13%), (2) EI without transition to Department of Education schools or services (24%), (3) EI and intermittent ECSE/SE (16%), (4) older entry into EI and both speech and occupational therapy throughout ECSE/SE (9%) and (5) limited EI use and mostly speech therapy in ECSE/SE (38%). Each pattern had distinct demographics (e.g., pattern 2 was disproportionately White and from low poverty neighbourhoods; pattern 4 was disproportionately male and Black; pattern 5 was disproportionately Latino) and academic outcomes (e.g., pattern 1 had largest proportion in a SE school and not tested in third grade; pattern 3 had third grade tests scores that were similar to overall citywide mean scores). CONCLUSIONS: The differences in demographic profiles across the five patterns of service use illustrate the systemic inequities in the delivery of these important services. Delayed entry and limited use of EI services among children of colour underscore the need for equity goals to increase early referral and optimize service use.

Habilidades de comprensión y producción narrativa en niños montevideanos de 5 años. Una comparación por nivel socioeconómico / Narrative abilities in a group of Uruguayan preschoolers from different socioeconomic backgrounds

Resumen Este estudio caracteriza y compara las habilidades narrativas y el vocabulario receptivo de 54 preescolares montevideanos de nivel socioeconómico medio (NSM) y bajo (NSB). Los niños realizaron tareas de vocabulario receptivo, producción narrativa (en dos condiciones: manipulando títeres al contar la historia y sin manipularlos), y comprensión narrativa (recuento oral y preguntas posteriores a la reconstrucción). Las narrativas fueron transcritas, codificadas y analizadas en términos de super y macroestructura siguiendo la gramática de historias de Stein y Glenn (1979) (coherencia) y de microestructura (productividad y complejidad). Los niños de ambos grupos tuvieron un desempeño acorde a su edad en comprensión y producción narrativa, a pesar de que el grupo de NSM tuvo un mejor desempeño en vocabulario receptivo. Hubo diferencias en comprensión (cantidad de episodios recuperados y en la respuesta a preguntas) que favorecieron al NSM, pero no en la cantidad de categorías recuperadas ni en la extensión y complejidad del recuento. Para producción narrativa no hubo diferencias en secuencia narrativa, ni en la cantidad de episodios completos en ninguna de las condiciones, pero sí en cuanto a la complejidad sintáctica en la condición sin títeres. Los resultados muestran una relación compleja entre vocabulario y habilidades narrativas, dado que diferencias importantes en vocabulario no se reflejaron de manera homogénea en el desempeño narrativo. Estos resultados aportan a los debates actuales sobre el papel del vocabulario en el desarrollo de habilidades narrativas, así como a pensar la validez ecológica de las evaluaciones en el desarrollo cognitivo y lingüístico.

Abstract Narrative abilities are an important part of communication, academic success, and healthy relationships. These abilities involve complex language and cognitive skills, such as precise vocabulary, control of the coherence markers, relations of cause-effect, and planning. They are also relevant during the elementary school years and interact with the socio-emotional skills necessary to understand different points of view. Oral narrative production develops dramatically from 3 to 5 years of age and is a key factor in a child's ability to communicate about the world. During this period narratives are a product of increasing linguistic sophistication over the preschool period and there is a complex relationship between early narratives and language proficiency. So far, most research about this topic has been pursued in populations other than Latin American preschoolers. At the same time, a considerably lesser number of studies about narrative abilities development have been carried out comparing typically developing children from different socioeconomic backgrounds. To our knowledge, there are no studies in Uruguay that assess the narrative abilities development in typically developing preschool children who grow up in vulnerable contexts. It is therefore of the utmost relevance to produce empirical evidence for this population. For these reasons, this study aimed at characterizing and comparing narrative abilities and receptive vocabulary in a group of a total of 54 Uruguayan preschoolers from different socioeconomic backgrounds (middle and low socioeconomic status, SES). Children were assessed in receptive vocabulary and narrative abilities across two task conditions: (1) narrative comprehension through a story retelling task which included some final questions about the story; (2) narrative production elicited from a set of thematically related puppets. The examiner gives a child a puppet set and asks him/her to elaborate a narrative using them. After that, puppets are removed and the child is asked to retell the story without puppets. Children's oral productions were video-taped and then transcribed and categorized using the ELAN software (Max Planck Institute for Psycholinguistics, 2019). The verbal information was categorized according to Stein and Glenn's (1979) story grammar and considering the microstructural aspects (productivity and complexity). Analyses showed that both groups performed according to their stage of development in both narrative task conditions. With regards to the narrative comprehension task, no differences in the number of recovered categories, extension, or narrative complexity were observed. Concerning the narrative production task, there were no differences between the groups in narrative sequences, nor in the number of completed episodes in conditions neither with puppets nor without puppets. Results showed that children who grow up in poverty perform more poorly than their peers from middle-income families in receptive vocabulary, in the number of recovered episodes, ask-answer items of narrative comprehension tasks. Moreover, concerning the microstructural parameters analyses showed that children from middle socioeconomic backgrounds scored better in syntactic complexity in the without puppets condition. No differences between the groups were observed in syntactic complexity in the puppets condition. Taken together these results indicate a complex link between vocabulary and narrative abilities. It is worth noting that important differences in vocabulary did not reflect in the children's narrative performance. These findings are also relevant as a contribution to an ongoing debate about the role of vocabulary in the development of narrative abilities. Furthermore, these results could inform the discussion about the ecological validity of the test of cognitive and linguistic development. Finally, to provide some additional evidence to Uruguayan Spanish language about the relationships between oral language and cognitive development allows to carry out early interventions before formal schooling sets children for success in school and life.

Systematic review of accelerometer-based methods for 24-h physical behavior assessment in young children (0-5 years old).

BACKGROUND: Accurate accelerometer-based methods are required for assessment of 24-h physical behavior in young children. We aimed to summarize evidence on measurement properties of accelerometer-based methods for assessing 24-h physical behavior in young children. METHODS: We searched PubMed (MEDLINE) up to June 2021 for studies evaluating reliability or validity of accelerometer-based methods for assessing physical activity (PA), sedentary behavior (SB), or sleep in 0-5-year-olds. Studies using a subjective comparison measure or an accelerometer-based device that did not directly output time series data were excluded. We developed a Checklist for Assessing the Methodological Quality of studies using Accelerometer-based Methods (CAMQAM) inspired by COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). RESULTS: Sixty-two studies were included, examining conventional cut-point-based methods or multi-parameter methods. For infants (0-12 months), several multi-parameter methods proved valid for classifying SB and PA. From three months of age, methods were valid for identifying sleep. In toddlers (1-3 years), cut-points appeared valid for distinguishing SB and light PA (LPA) from moderate-to-vigorous PA (MVPA). One multi-parameter method distinguished toddler specific SB. For sleep, no studies were found in toddlers. In preschoolers (3-5 years), valid hip and wrist cut-points for assessing SB, LPA, MVPA, and wrist cut-points for sleep were identified. Several multi-parameter methods proved valid for identifying SB, LPA, and MVPA, and sleep. Despite promising results of multi-parameter methods, few models were open-source. While most studies used a single device or axis to measure physical behavior, more promising results were found when combining data derived from different sensor placements or multiple axes. CONCLUSIONS: Up to age three, valid cut-points to assess 24-h physical behavior were lacking, while multi-parameter methods proved valid for distinguishing some waking behaviors. For preschoolers, valid cut-points and algorithms were identified for all physical behaviors. Overall, we recommend more high-quality studies evaluating 24-h accelerometer data from multiple sensor placements and axes for physical behavior assessment. Standardized protocols focusing on including well-defined physical behaviors in different settings representative for children's developmental stage are required. Using our CAMQAM checklist may further improve methodological study quality. PROSPERO REGISTRATION NUMBER: CRD42020184751.

Neighbourhood Income Inequality and General Psychopathology at 3-Years of Age.

Background: Several studies have linked neighbourhood environment to preschool-aged children's behavioural problems. Income inequality is an identified risk factor for mental health among adolescents, however, little is known as to whether this relationship extends to younger children. Objective: To explore the association between neighbourhood-level income inequality and general psychopathology problems among preschool-aged children. Methods: We analyzed data from the All Our Families (AOF) longitudinal cohort located in Calgary, Canada at 3-years postpartum. The analytical sample consisted of 1615 mother-preschooler dyads nested within 184 neighbourhoods. Mothers completed the National Longitudinal Survey of Children and Youth Child Behaviour Checklist (NLSCY-CBCL), which assessed internalizing and externalizing symptoms. Income inequality was assessed via the Gini coefficient, which quantifies the unequal distribution of income in society. Mixed effects linear regression assessed the relationship between neighbourhood income inequality and preschooler's general psychopathology. Results: The mean Gini coefficient across the 184 neighbourhoods was 0.33 (SD = 0.05; min, max: 0.20-0.56). In the fully adjusted model income inequality was not associated with general psychopathology in children ß = 0.07 (95%CI: -0.29, 0.45). Neighbourhood environment accounted for 0.5% of the variance in psychopathology in children. Conclusion: The lack of significant findings may be due to a lack of statistical power in the study. Future studies should investigate this relationship with appropriately powered studies, and over time, to assess if income inequality is a determinant of preschooler psychopathology in Canada.

Contexte: Plusieurs études ont relié l'environnement du quartier aux problèmes de comportement des enfants d'âge préscolaire. L'inégalité du revenu est un facteur de risque identifié pour la santé mentale chez les adolescents, pourtant, on ne sait pas encore si cette relation s'étend aux enfants plus jeunes. Objectif: Explorer l'association entre l'inégalité du revenu au niveau du quartier et les problèmes de psychopathologie générale chez les enfants d'âge préscolaire. Méthodes: Nous avons analysé les données de la cohorte longitudinale All Our Families (AOF) située à Calgary, Canada, à 3 ans de postpartum. L'échantillon analytique consistait en 1615 dyades mère-enfant d'âge préscolaire logées dans 184 quartiers. Les mères ont rempli l'Enquête longitudinale nationale sur les enfants et les jeunes et la liste de contrôle du comportement de l'enfant (ELNEJ-LCCE), qui évaluaient les symptômes d'internalisation et d'externalisation. L'inégalité du revenu était évaluée par le coefficient Gini, qui quantifie la distribution inégale du revenu dans la société. La régression linéaire à effets mixtes a évalué la relation entre l'inégalité du revenu du quartier et la psychopathologie générale de enfants d'âge préscolaire. Résultats: Le coefficient Gini moyen dans les 184 quartiers était de 0,33 (ET = 0,05; min, max : 0,20­0,56). Dans le modèle complétement ajusté, l'inégalité du revenu n'était pas associée à la psychopathologie générale des enfants ß = 0,07 (IC à 95 % −0,29 à 0,45). L'environnement du quartier représentait 0,5 % de la variance de psychopathologie chez les enfants. Conclusion: L'absence de résultats significatifs peut être attribuable au manque de puissance statistique de l'étude. Les futures études devraient investiguer cette relation avec des études d'une puissance appropriée, et avec le temps, évaluer si l'inégalité du revenu est déterminante de la psychopathologie des enfants d'âge préscolaire au Canada.

Structural validity of a test battery for assessment of fundamental movement skills in Norwegian 3-6-year-old children.

Fundamental movement skills (FMS) are building blocks of more advanced movements, including subdomains of locomotion, object control and balance skills, but limited evidence exists for this three-factor structure. The aim of this study was to examine the structural validity of a three-factor modified test battery of FMS across age and sex in two large samples of preschoolers aged 3-6 years (sample 1: n = 1213, mean age 4.8 (.09); sample 2: n = 1198, mean age 4.3 (.09)). We used a test battery of FMS consisting of movement tasks for locomotion (run, horizontal jump and hop) and object control (catch, overhand throw and kick) from the Test of Gross Motor Development and balance skills (single-leg standing, walking line backward and walking line forward) from the Preschoolers Gross Motor Quality Scale. Confirmatory factor analysis was used to analyse the data. We found support for both a three-factor and a two-factor structure. Measurement invariance testing showed invariance over age and partial scalar invariance over sex. We conclude that our modified test battery is an appropriate measure of young children's FMS across the domains of locomotion, object control and balance, but that locomotion and object control subdomains provide limited unique information.

Cost-effectiveness of probiotics and fluoride varnish in caries prevention in preschool children.

OBJECTIVES: The purpose of this study was to evaluate the cost-effectiveness of two preventive interventions aimed at increasing the proportion of caries-free preschool children of low socioeconomic status using a decision analytic model. METHODS: Two scenarios were tested, one with a school milk program (SMP) and one without (non-SMP). Fluoride varnish (FV) and a probiotic (PB) were compared to a do-nothing alternative among children in public nurseries/schools over a 4-year period. FV was applied biannually and a PB (Lactobacillus rhamnosus) added to milk powder prepared daily. A Markov decision tree model was utilized. Several sources of data were used to populate the model. Probabilistic and deterministic sensitivity analyses were performed, and a public provider perspective was used. RESULTS: In the SMP scenario, PB was more effective and less costly than FV and, compared with do-nothing, increased the proportion of caries-free children by 14.5%, with a cost of USD 12.5 per child (June 2018). PB presented an incremental cost-effectiveness ratio (ICER) or cost per extra caries-free child of USD 86.2. In the non-SMP scenario, both interventions were cost-effective. FV (compared with do-nothing) increased the percentage of caries-free children by 8.3% with an ICER of USD 338.3 and PB (compared with FV) increased the effect by 6.2% with an ICER of USD 1400.2. CONCLUSIONS: The findings showed that PB was most effective and less costly than FV in the SMP scenario only. This type of analysis and its results provide essential information for decision-makers to improve the oral health of preschool children.

Antipsychotic Medications for Low-Income Preschoolers: Long Duration and Psychotropic Medication Polypharmacy.

OBJECTIVE: This study aimed to evaluate prescribing patterns of antipsychotic medication and factors that predict duration of use among low-income, preschool-age children. METHODS: State Medicaid claims from 2012 to 2017 were used to identify antipsychotic medication use for children <6 years old. ICD-9 and ICD-10 codes were used to describe child diagnoses. Descriptive and multivariable analyses were used to determine patterns of antipsychotic medication use and factors that predicted duration of use. RESULTS: In 2012, 316 children <6 years of age started an antipsychotic medication in a southeastern state. Most were non-Hispanic White (N=202, 64%) and boys (N=231, 73%). Diagnoses included attention-deficit hyperactivity disorder (N=288, 91%), neurodevelopmental disorders (N=208, 66%), anxiety and trauma-related diagnoses (N=202, 64%), and autism spectrum disorders (ASDs) (N=137, 43%). The mean±SD duration of exposure to antipsychotic medication for children in the cohort was 2.6±1.7 years, but 86 children (27%) had >4 years of exposure. Almost one-third (N=97, 31%) received polypharmacy of four or more medication classes, and 42% (N=131) received metabolic screening. Being male, being in foster care, and having a diagnosis of ASD or disruptive mood dysregulation disorder were significantly associated with duration of use of antipsychotic medications; race-ethnicity was not significantly associated with duration of use. Emergency department visits (N=277, 88%) and inpatient hospitalizations (N=107, 34%) were observed during the study period. CONCLUSIONS: Many preschoolers received antipsychotic medications for substantial periods. Further research is needed to identify evidence-based practices to reduce medication use and improve outcomes.

Links between socioeconomic disadvantage, neural function, and working memory in early childhood.

Children reared in socioeconomically disadvantaged environments are at risk for academic, cognitive, and behavioral problems. Mounting evidence suggests that childhood adversities, encountered at disproportionate rates in contexts of socioeconomic risk, shape the developing brain in ways that explain disparities. Circuitries that subserve neurocognitive functions related to memory, attention, and cognitive control are especially affected. However, most work showing altered neural function has focused on middle childhood and adolescence. Understanding alterations in brain development during foundational points in early childhood is a key next step. To address this gap, we examined functional near-infrared-spectroscopy-based neural activation during a working memory (WM) task in young children aged 4-7 years (N = 30) who varied in socioeconomic risk exposure. Children who experienced greater disadvantage (lower income to needs ratio and lower Hollingshead index) exhibited lower activation in the lateral prefrontal cortex than children who experienced less to no disadvantage. Variability in prefrontal cortex activation, but not behavioral performance on the WM task, was associated with worse executive functioning in children as reported by parents. These findings add to existing evidence that exposure to early adversity, such as socioeconomic risk, may lead to foundational changes in the developing brain, which increases risk for disparities in functioning across multiple cognitive and social domains.

Interoception in preschoolers: New insights into its assessment and relations to emotion regulation and stress.

Interoception may play an important role for emotion regulation and stress, thereby affecting mental health in children and adults. Yet, little is known on interoception in preschool children. Therefore, we investigated interoceptive accuracy using the adapted Jumping Jack Paradigm (JJP) and its relationship with emotion regulation and stress. In Study I, 40 preschoolers completed the JJP and an emotion regulation task, demonstrating a positive relationship between interoceptive accuracy and emotion regulation at trend level (R² = 0.231, p = .023; ß = .278, p = .073). In Study II, 31 preschoolers completed the adapted JJP before and after an acute laboratory stress test. Higher total cortisol output following acute stress induction was associated with reduced interoceptive accuracy (r = -0.670, p = .017). Extending earlier findings in adults and school-children, the relationship of interoceptive accuracy with emotion regulation and stress highlights the importance to investigate interoception in early childhood.

Necesidades educativas sobre salud bucodental en el grado prescolar / Educational needs related to oral health in the preschool grade

Introducción: La caries dental y la enfermedad periodontal son las enfermedades bucodentales más prevalentes, con una tendencia al aumento de las maloclusiones. Se considera la promoción de salud como un proceso educativo a través del cual la comunidad logra ejercer control de su salud. Objetivo: Identificar las necesidades educativas sobre salud bucodental en el grado prescolar, en Sagua la Grande, Villa Clara, durante el curso escolar 2017-2018. Método: Investigación descriptiva transversal en Sagua la Grande, durante el curso 2017-2018. La población quedó constituida por 326 niños, 24 docentes y 326 familias. La variable estudiada fue necesidades educativas sobre salud bucodental en el grado preescolar. Resultados: Se evidenció que no se realizan acciones educativas sobre salud bucodental. No existen proyectos ni un programa de capacitación sobre salud bucodental para los docentes que la sustente. No es concebida la salud bucal dentro del sistema de trabajo metodológico del sector. No se analizan contenidos de salud bucodental en consejos de dirección y preparaciones metodológicas Los docentes realizan escasas acciones educativas sobre salud bucodental. El nivel de conocimientos sobre salud bucodental fue evaluado de mal en los niños (74,23 por ciento), en docentes (41,67 por ciento) y familias (47,24 por ciento). Conclusiones: Se evidenció que no se realizan acciones educativas sobre salud bucodental y predominó el nivel de conocimientos sobre salud bucodental evaluado de mal en niños, docentes y familias(AU)

Introduction: Dental caries and periodontal disease are the most prevalent oral conditions, with a tendency to an increase in malocclusions. Health promotion is considered to be an educational process by which the community gains control of their health. Objective: Identify the educational needs related to oral health in the preschool grade. Method: A descriptive cross-sectional study was conducted in Sagua la Grande during the school year 2017-2018. The study population was 326 children, 24 teachers and 326 families. The variable analyzed was educational needs related to oral health in the preschool grade. Results: It was found that educational actions related to oral health are not performed, nor is there an oral health training program for teachers or projects supporting it. Oral health is not included in the system of methodological work for the sector. Oral health contents are not discussed in management meetings or methodological preparation sessions. Teachers conduct a scant number of oral health educational actions. Knowledge about oral health was evaluated as poor in 74.23 percent of the children, 41.67 percent of the teachers and 47.24 percent of the families. Conclusions: It was found that oral health educational actions are not performed and knowledge about oral health is poor among children, teachers and families(AU)

Hot Executive Function Assessment Instruments in Preschool Children: A Systematic Review.

The study aimed to systematically analyze the empirical evidence that is available concerning batteries, tests or instruments that assess hot executive functions (EFs) in preschoolers, identifying which are the most used instruments, as well as the most evaluated hot EFs. For the review and selection of articles, the systematic review methodology PRISMA was used. The article search considered the EBSCO, Web of Science (WoS), SciELO and PubMed databases, with the keywords "Hot executive function", "Assessment", "test", "evaluation", using the Boolean operators AND and OR indistinctly, between 2000 and April 2021. Twenty-four articles were selected and analyzed. The most commonly used instruments to assess hot EFs in preschool children were the Delayed Gratification Task, the Child's Play Task, and the Delayed Reward Task. Amongst those analyzed, 17 instruments were found to assess hot EFs in preschoolers. The accuracy and conceptual clarity between the assessment of cognitive and emotional components in EFs is still debatable. Nevertheless, the consideration of affective temperature and reward stimulus type, could be an important influence when assessing EFs in this age range. Evidence of the possible involvement of cortical and subcortical structures, as well as the limbic system, in preschool executive functioning assessment has also been incorporated.

Adherence to the Japanese Physical Activity Guideline During Early Childhood Among Rural Preschoolers: A Cross-sectional Study.

BACKGROUND: Physical activity (PA) guidelines for early childhood have been established worldwide, and adherence to PA guidelines has been utilized to assess the effectiveness of policies regarding PA promotion. Although there is a Japanese PA guideline for preschoolers, little is known about adherence to this recommendation. This study examined and compared proportions of meeting the Japanese PA guideline among preschoolers. METHODS: Participants comprised 821 children aged 3-6 years from all 21 preschools and childcare facilities (hereafter collectively "preschools") within Unnan City, Shimane Prefecture, Japan. Data on PA levels were collected through a parent-report questionnaire in accordance with the Japanese PA guideline. This guideline recommends that preschoolers perform PA for at least 60 minutes every day. Analyses included descriptive statistics, chi-squared, and Mann-Whitney's tests to compare adherence to the PA guideline. RESULTS: Data of 441 participants from 20 preschools were analyzed. Of these, 292 (66.2%) preschoolers met the PA guideline. Boys (70.2%) showed a significantly higher proportion of meeting the PA guideline than girls (61.2%; P = 0.048). Proportions of meeting the PA guideline among preschool grades were not statistically different. Prevalence rates of meeting the PA guideline among 20 preschools considerably varied from 14.3% to 100% (P = 0.007). CONCLUSIONS: Two-thirds of preschoolers met the Japanese PA guideline, while adherence to PA recommendations differed between genders. Moreover, there were distinct variations of adherence to PA guideline among preschools. Possible determinants that cause the differences in adherence to the PA guideline at the individual and preschool-levels should be further evaluated.

Spatial orientation assessment in preschool children: Egocentric and allocentric frameworks.

Spatial orientation is an important function in daily life because it allows us to reach a target place when moving through our environment, using self-centered (egocentric) or environmental information (allocentric). Compared to other cognitive functions, spatial orientation has been studied less in preschool ages. Some brain areas, such as the hippocampus and the temporal as well as the parietal and frontal cortices, are involved in spatial orientation. Therefore, when these brain regions are altered in neurological conditions or in atypical development in children, we would expect impairment of spatial abilities. The aim of this study is to review studies, published in recent years, that use egocentric and allocentric spatial orientation tasks for assessing spatial memory in preschool children, with the final goal of finding out which tests could be included in a clinical neuropsychological evaluation. We observed that although egocentric spatial orientation emerges first during development, allocentric spatial orientation tasks are employed at very early ages. Most of these tasks are performed in real environments, allowing children's self-movements and using environmental modifications, but technologies such as virtual or augmented reality are increasingly used. Other aspects are discussed, such as the lack of consensus in the nomenclature, the difficulty of tracing the course of development of spatial orientation, or the ecological validity of the tests used. We finally observed that there is greater interest in studying the allocentric framework than the egocentric one, which makes it difficult to compare the use of the two frames of reference during a neuropsychological evaluation in preschool-aged children.