Learning by parenting: How do mothers respond to their children's developmental declines?

Children's developmental processes are not always linear. During the childhood period, children usually experience ups and downs in their skills, and how parents respond to these changes can crucially condition the subsequent process of child development. This paper examines (1) how children's developmental declines impact the level of cognitive stimulation implemented by the mothers, and (2) whether these effects vary by socioeconomic groups. Using longitudinal NLSY79-CYA data from the US, I implement a series of two-way fixed effects and fixed effects counterfactual models. Findings show that mothers respond negatively to the declines in their children's mathematical skills by decreasing their levels of cognitive stimulation, although the effects are relatively small, approximately one-tenth of a standard deviation. This effect is concentrated among mothers with low levels of education or those at the bottom part of the income distribution. Additionally, it's observed that mothers in the sample do not modify their behaviours in response to declines in their children's reading skills. All in all, this evidence suggests that mothers might be reinforcing existing disadvantages by decreasing their cognitive stimulation when their children show developmental declines and that this mechanism could be responsible for broadening the developmental gap between children from low- and high-socioeconomic backgrounds.

Evaluation of apparently healthy Egyptian infants and toddlers on the bayley-III scales according to age and sex.

BACKGROUND: Child development is shaped throughout the first years of life through the interaction of genetics and the environment. Bayley-III is valuably used to determine early developmental delay (DD). The aim of this study was to detect the differences in performance of a sample of apparently healthy Egyptian infants and toddlers on the Bayley-III scales in relation to their age and gender. METHODS: This was a cross-sectional study. Bayley scales were applied to 270 of the 300 recruited children following the inclusion criteria; to avoid potential risk factors affecting development. Assessment included cognitive, language and motor skills. Engaged children aged 18-42 months were divided into 4 age groups with six-month intervals. RESULTS: Approximately 78.4%, 76.2%, and 72% of the participants had average and above average scores in the cognitive, motor, and language domains, respectively. The language domain was characteristically impacted. The oldest age group (36-42 months) scored the highest means composite scores, while the 2nd group aged 24 - <30 months, scored the lowest means in the three evaluated domains. In general, girls had non-significantly higher composite scores than boys, with a small effect size (d = 0.2-0.4). In the language domain, girls aged 30 to < 36 months scored significantly higher composite scores than boys (p < 0.05), with a medium effect size (d = 0.73). CONCLUSION: The study indicates that the performance of apparently healthy Egyptian children on the Bayley III evaluation differs in relation to age and sex. The most vulnerable age group at potential risk of DD was children aged 24-30 months. Efforts must be directed to investigate the nutritional, physical, psychological and safety needs of this group. Attention must be paid to early childhood intervention programs that stimulate development, especially language development, and they must be tailored on the basis of age and gender. Gender-specific norms may be needed in the evaluation of language development.

Association between the COVID-19 pandemic and childhood development aged 30 to 36 months in South Korea, based on the National health screening program for infants and children database.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the neurodevelopment of children. However, the precise effects of the virus and the social consequences of the pandemic on pediatric neurodevelopment are not yet fully understood. We aimed to compare the neurodevelopment of children between before and during the COVID-19 pandemic, as well as examine the impact of socioeconomic status (SES) and regional differences on the development. METHODS: The study used the Korean Developmental Screening Test to compare the difference in the risk of neurodevelopmental delay between before and during the COVID-19 pandemic. Multivariable logistic regression analysis was conducted to identify the relationship between experiencing the COVID-19 pandemic and the risk of neurodevelopmental delay. Stratified analyses were performed to determine whether the developmental delays caused by the pandemic's impact varied depending on SES or regional inequality. RESULTS: This study found an association between the experience of COVID-19 and a higher risk of neurodevelopmental delay in communication (adjusted OR [aOR]: 1.21, 95% confidence interval [CI]: 1.19, 1.22; P-value: < 0.0001) and social interaction (aOR: 1.15, 95% CI: 1.13, 1.17; P-value: < 0.0001) domains among children of 30-36 months' ages. Notably, the observed association in the Medicaid group of children indicates a higher risk of neurodevelopmental delay compared to those in the non-Medicaid group. CONCLUSIONS: These findings highlight the need to be concerned about the neurodevelopment of children who experienced the COVID-19 pandemic. The study also calls for increased training and support for Medicaid children, parents, teachers, and healthcare practitioners. Additionally, policy programs focused on groups vulnerable to developmental delays are required.

Reduction in limb-movement complexity at term-equivalent age is associated with motor developmental delay in very-preterm or very-low-birth-weight infants.

Reduced complexity during the writhing period can be crucial in the spontaneous movements of high-risk infants for neurologic impairment. This study aimed to verify the association between quantified complexity of upper and lower-limb movements at term-equivalent age and motor development in very-preterm or very-low-birth-weight infants. Video images of spontaneous movements at term-equivalent age were collected from very-preterm or very-low-birth-weight infants. A pretrained pose-estimation model and sample entropy (SE) quantified the complexity of the upper- and lower-limb movements. Motor development was evaluated at 9 months of corrected age using Bayley Scales of Infant and Toddler Development, Third Edition. The SE measures were compared between infants with and without motor developmental delay (MDD). Among 90 infants, 11 exhibited MDD. SE measures at most of the upper and lower limbs were significantly reduced in infants with MDD compared to those without MDD (p < 0.05). Composite scores in the motor domain showed significant positive correlations with SE measures at most upper and lower limbs (p < 0.05). The results show that limb-movement complexity at term-equivalent age is reduced in infants with MDD at 9 months of corrected age. SE of limb movements can be a potentially useful kinematic parameter to detect high-risk infants for MDD.

Examining the relationship between intimate partner violence and child development program attendance in young children: A cross-sectional study.

The aim of the present study was to determine the association between different types of intimate partner violence against women and nonattendance at the Growth and Development Control Program (CRED or well-child visits) of their children under 5 years of age. This was an analytical cross-sectional study that comprised a secondary analysis of data from the Demographic and Family Health Survey (ENDES in Spanish) of Peru, 2019. Data from 19,647 mothers (aged 15-49 years) and their children under 5 years were analyzed. The independent variables were the types of intimate partner violence = emotional, physical, and sexual. The outcome variable was nonattendance at CRED in the last 6 months. The mean maternal age was 30.47 ±â€…6.66 years; 66.1% of children were between 25 and 60 months of age; the prevalence of nonattendance at CRED was 29.9%. A relationship was found between partner violence against the mother and nonattendance at CRED. Specifically, there was a higher probability of nonattendance in the children of women who experienced partner violence (sexual = aPR = 1.25 [95% CI = 1.07-1.44]; physical = aPR = 1.17 [95% CI = 1.08-1.26]; emotional = aPR = 1.12 [95% CI = 1.03-1.21]). This study showed an association indicating that children born to mothers experiencing intimate partner violence exhibit an elevated likelihood of nonattendance at CRED when compared to children of mothers not subjected to such violence. Therefore, emphasizing the promotion and monitoring of child development, especially for those with a history of maternal violence, should be a primary priority, particularly in primary care.

Cost-effectiveness of a radio intervention to stimulate early childhood development: protocol for an economic evaluation of the SUNRISE trial in Burkina Faso.

INTRODUCTION: Approximately 250 million children under 5 years of age are at risk of poor development in low-income and middle-income countries. However, existing early childhood development (ECD) interventions can be expensive, labour intensive and challenging to deliver at scale. Mass media may offer an alternative approach to ECD intervention. This protocol describes the planned economic evaluation of a cluster-randomised controlled trial of a radio campaign promoting responsive caregiving and opportunities for early learning during the first 3 years of life in rural Burkina Faso (SUNRISE trial). METHODS AND ANALYSIS: The economic evaluation of the SUNRISE trial will be conducted as a within-trial analysis from the provider's perspective. Incremental costs and health outcomes of the radio campaign will be compared with standard broadcasting (ie, 'do nothing' comparator). All costs associated with creating and broadcasting the radio campaign during intervention start-up and implementation will be captured. The cost per child under 3 years old reached by the intervention will be calculated. Incremental cost-effectiveness ratios will be calculated for the trial's primary outcome (ie, incremental cost per SD of cognitive gain). A cost-consequence analysis will also be presented, whereby all relevant costs and outcomes are tabulated. Finally, an analysis will be conducted to assess the equity impact of the intervention. ETHICS AND DISSEMINATION: The SUNRISE trial has ethical approval from the ethics committees of the Ministry of Health, Burkina Faso, University College London and the London School of Hygiene and Tropical Medicine. The results of the economic evaluation will be disseminated in a peer-reviewed journal and presented at a relevant international conference. TRIAL REGISTRATION NUMBER: The SUNRISE trial was registered with ClinicalTrials.gov on 19 April 2019 (identifier: NCT05335395).

Do improvements in infant and young child feeding (IYCF) practices endure the test of time?

BACKGROUND: Reducing malnutrition is a key priority for governments in low- and middle-income countries given its lasting effects on child development, health, income, and economic growth. Strategies to improve recommended infant and young child feeding (IYCF) practices, especially during the first two years of life, are considered among the most effective. METHODS: In this paper, we evaluate the long-run impacts of an innovative education strategy based on interactive play and performing arts implemented in El Alto, Bolivia on caregivers' IYCF knowledge and practices. Two thousand and fifteen households were randomly assigned to intervention and control groups. Two rounds of data were collected approximately 30 and 42 months after baseline. We estimate short-term (30 month) and longer-term (42 month) intent-to-treat effects using multivariate linear regression analysis, with and without controlling for covariates. RESULTS: The program significantly increased caregiver IYCF knowledge by 0.13 SDs in the short run, and this effect grew over time. The program also improved adherence to recommended IYCF practices by 0.23 standard deviations (SDs) in the short term, but the effect on practices dissipated over time, and no longer-term impacts were detected. Caregivers with above median baseline knowledge, number of children, and age appear to have benefited most from the program. CONCLUSIONS: Our findings suggest that entertainment-education interventions are a promising model for improving and maintaining IYCF knowledge. However, their ability to sustain more permanent changes in IYCF practices is less certain. Further evidence is needed to identify other avenues for producing long-term, sustainable behavior change, especially among indigenous populations in Latin America, where literature on education and behavior-change interventions related to IYCF practices is limited.

Examining the quality and population representativeness of linked survey and administrative data: guidance and illustration using linked 1958 National Child Development Study and Hospital Episode Statistics data.

Introduction: Recent years have seen an increase in linkages between survey and administrative data. It is important to evaluate the quality of such data linkages to discern the likely reliability of ensuing research. Evaluation of linkage quality and bias can be conducted using different approaches, but many of these are not possible when there is a separation of processes for linkage and analysis to help preserve privacy, as is typically the case in the UK (and elsewhere). Objectives: We aimed to describe a suite of generalisable methods to evaluate linkage quality and population representativeness of linked survey and administrative data which remain tractable when users of the linked data are not party to the linkage process itself. We emphasise issues particular to longitudinal survey data throughout. Methods: Our proposed approaches cover several areas: i) Linkage rates, ii) Selection into response, linkage consent and successful linkage, iii) Linkage quality, and iv) Linked data population representativeness. We illustrate these methods using a recent linkage between the 1958 National Child Development Study (NCDS; a cohort following an initial 17,415 people born in Great Britain in a single week of 1958) and Hospital Episode Statistics (HES) databases (containing important information regarding admissions, accident and emergency attendances and outpatient appointments at NHS hospitals in England). Results: Our illustrative analyses suggest that the linkage quality of the NCDS-HES data is high and that the linked sample maintains an excellent level of population representativeness with respect to the single dimension we assessed. Conclusions: Through this work we hope to encourage providers and users of linked data resources to undertake and publish thorough evaluations. We further hope that providing illustrative analyses using linked NCDS-HES data will improve the quality and transparency of research using this particular linked data resource.

Commentary on the power of predictability: patterns of signals in early life shape neurodevelopment and mental health trajectories.

As Davis and Glynn observe in the introduction to their review, early life adversity is a significant impediment to healthy child development. Whereas some theoretical accounts emphasize the sheer number of physical and psychosocial risk factors children experience (Evans, Li, & Whipple, Psychological Bulletin, 2013, 139, 1342), Davis and Glynn review a program of research that is aligned with models highlighting the types of adversity children encounter. They expand on accounts that differentiate threat from deprivation (McLaughlin & Sheridan, Current Directions in Psychological Science, 2016, 25, 239) to draw attention to the role of unpredictability in children's development.

My favourite part was learning different ways to play: qualitatively evaluating a socially prescribed creative play programme.

OBJECTIVES: Social prescription is classically thought of as an initiative for older people. This qualitative study aimed to evaluate the first socially prescribed creative play programme for families of 0-3-year-old children in the UK, examining the experience of the parents throughout the stages of the programme. STUDY DESIGN: The evaluation ran longitudinally over 5 weeks using interviews, field notes, and questionnaire data. METHODS: The evaluation was carried out over 5 weeks in 2022 using intervention leaders' and researcher's field notes, nine parent semi-structured interviews, and 17 parent questionnaires on their experiences. Data were analysed using inductive interpretive thematic analysis. RESULTS: After analysis of the corpus of data, three themes that interacted with each other were identified: Support Systems that Parents Trust, Calming in Chaos, and Practical Parenting Utility. Parents said that they were more likely to sign up for the programme when they trusted the recommender and the organisation running the programme. They found the socially prescribed group more relaxed and calm than other groups, and their daily lives. The knowledge about health behaviours and modelling of play were the main take-home skills reported. CONCLUSION: In order for parents to be receptive to practical parenting knowledge the SP aimed to foster, parents must first establish trust in a calming atmosphere. Social links and child development were the key factors parents identified linking to well-being. This research could inform public health policy on social prescription for families.

Examining concept development classroom interaction quality and children's developmental progress in state pre-K/head start programs using pre-K CLASS and LAP-3.

Concept Development [CD] in the early years cannot be complete without teachers' support. However, limited research exists. This research aimed to assess CD classroom interactional quality and its relationship with other quality dimensions/domains and children's overall development using the data collected in State Pre-K/Head Start classrooms with Pre-K CLASS and LAP-3. Data collected from 171 classrooms underwent analysis with Python and SPSS. Pre-K CLASS scores showed that with the exception of one high-quality classroom, all other classrooms were categorized as either mid-quality or low-quality CD. Moreover, most teachers showed lower interactional quality not only in the CD dimension but also in the Quality of Feedback [QF] and Language Modeling [LM] dimensions of Instructional Support [IS], than in the dimensions of Emotional Support [ES] and Classroom Organization [CO] domains. The results indicated that CD, QF, and LM quality dimensions did not differ across the classrooms or districts. However, ES, CO, and IS domains differed significantly. While the observed differences for ES and CO were similar between the two districts, District 1 had higher mean IS scores than District 2. Furthermore, LAP-3 scores of 2514 children showed that 26.7 % of children scored below the expected level in cognitive development and 35.5 % scored below in language development by the end of the school year, with a higher proportion of male children falling in this category. Nonetheless, children attending State Pre-K/Head Start classrooms demonstrated an average gain of 4 months beyond their chronological age. The multi-level regression analysis of Pre-K CLASS and those LAP-3 scores showed no statistically significant relationship between interactional quality and children's developmental progress. Children in mid-quality CD classrooms showed slightly more progress in all areas of development, except in personal/social, compared to children in low-quality CD classrooms. Similarly, children in mid-quality IS classrooms outperformed those in low-quality IS classrooms in all LAP-3 areas except personal/social and pre-writing as well. In conclusion, the current research suggests that many teachers struggle not only to effectively provide high-quality CD teacher-child interactions but also high-quality IS teacher-child interactions in their classrooms. Comprehensive in-service training on CD and an alternative assessment tool that extends beyond the 72-month age limit are strongly recommended. This is important to ensure that teachers are equipped with the necessary skills and motivation to provide high-quality education to young children to prevent developmental delays in children.

Comparison between the KARVI scale and the Child Development Evaluation test (EDI) as a screening tool for suspected neurodevelopmental delay.

BACKGROUND: Early detection of suspected neurodevelopmental delay allows for timely diagnosis and appropriate intervention, for which numerous screening tests have been developed. However, most are complex and impractical for health-care workers at the community level. This study aimed to validate the KARVI scale in the neurodevelopment assessment of children under 1 year of age. METHODS: We conducted an observational, longitudinal, comparative, inferential, and prospective study. Healthy children without risk factors for developing neurodevelopmental delay from 0 to 12 months of age were evaluated remotely using the Zoom® application. The Child Development Evaluation Test and the KARVI scale were applied once a month for four consecutive months. RESULTS: Fifty individuals were analyzed, with a predominance of males in 52%. Adequate percentages for a screening test were obtained in the first evaluation with a sensitivity of 70% (confidence interval [CI] 95% 34.75-93.33) and a specificity of 75% (CI 95% 58.8-87.31), and in the fourth evaluation with a sensitivity of 100% (CI 95% 29.4-100) and a specificity of 78.72% (CI 95% 64.34-89.3), being significant in both evaluations (p = 0.007 and p = 0.001, respectively). CONCLUSIONS: The KARVI scale has the elements to be an effective screening test for suspected neurodevelopmental delay, but more extensive studies are needed to obtain more reliable results.

INTRODUCCIÓN: La identificación temprana de retraso en el neurodesarrollo permite un diagnóstico oportuno y una intervención apropiada. Para ello, se han creado diversas pruebas de tamizaje; sin embargo, la mayoría son complejas y poco prácticas para el personal de la salud a nivel comunitario. El objetivo del estudio fue realizar la validación de la escala KARVI en la valoración del neurodesarrollo en niños menores de un año. MÉTODOS: Se realizó un estudio observacional, longitudinal, comparativo inferencial y prospectivo, en el cual se evaluaron, vía remota mediante la aplicación Zoom®, niños sanos de 0 a 12 meses de edad sin factores de riesgo para desarrollar retraso en el neurodesarrollo. Se aplicaron la prueba EDI (Evaluación del Desarrollo Infantil) y la escala KARVI una vez al mes por cuatro meses consecutivos. RESULTADOS: Se analizaron 50 individuos, con predominio del sexo masculino en el 52%. Se obtuvieron porcentajes adecuados para una prueba de tamizaje tanto en la primera evaluación, con sensibilidad de 70% (IC 95% 34.75-93.33) y especificidad de 75% (IC 95% 58.8-87.31), como en la cuarta, con sensibilidad de 100% (IC 95% 29.4-100) y especificidad de 78.72% (IC 95% 64.34-89.3), con significación estadística en ambas evaluaciones (p = 0.007 y p = 0.001, respectivamente). CONCLUSIONES: Se considera que la escala KARVI cuenta con los elementos para considerarla como una prueba de tamizaje efectiva para detectar retraso del neurodesarrollo, sin embargo. Sin requieren estudios más extensos para obtener resultados más confiables.

Sex-Specific Developmental Scales for Surveillance.

BACKGROUND: Developmental surveillance, conducted routinely worldwide, is fundamental for early detection of children at risk for developmental delay. We aimed to explore sex-related difference in attainment rates of developmental milestones and to evaluate the clinical need for separate sex-specific scales. METHODS: This is a cross-sectional, natiowide retrospective study, utilizing data from a national child surveillance program of ∼1000 maternal child health clinics. The main cohort, used for constructing sex-specific developmental scales, included all children born between January 2014 to September 2020, who visited maternal child health clinics from birth to 6 years of age (n = 839 574). Children with abnormal developmental potential were excluded (n = 195 616). A validation cohort included all visits between 2020 and 2021 (n = 309 181). The sex-differences in normative attainment age of 59 developmental milestones from 4 domains were evaluated. The milestones with a significant gap between males and females were identified, and the projected error rates when conducting unified versus sex-specific surveillance were calculated. RESULTS: A new sex-specific developmental scale was constructed. In total, females preceded males in most milestones of all developmental domains, mainly at older ages. Conducting routine developmental surveillance using a unified scale, compared with sex-specific scales, resulted in potential missing of females at risk for developmental delay (19.3% of failed assessments) and over-diagnosis of males not requiring further evaluation (5.9% of failed assessments). CONCLUSIONS: There are sex-related differences in the normative attainment rates of developmental milestones, indicating possible distortion of the currently used unified scales. These findings suggest that using sex-specific scales may improve the accuracy of early childhood developmental surveillance.

Environmental Exposure to Pesticides and the Risk of Child Neurodevelopmental Disorders.

Background and Objectives: Neurodevelopment is a fragile brain process necessary for learning from the beginning of childhood to adulthood. During the procedure, several risks could affect it, including environmental factors such as neurotoxic chemicals or environmental pollutants and, within them, exposure to pesticides. Materials and Methods: This ecological descriptive study attempted to assess the association between environmental exposure to pesticides and neurodevelopmental disorders. This study was conducted on 4830 children diagnosed for 11 years in a total population of 119,897 children in three areas: high, medium, and low greenhouse concentrations. Results: Chromosomal abnormalities were the most common prenatal disorder (28.6%), while intrauterine physical factors were the least common (0.5%). Among perinatal diagnoses, gestational age less than 32 weeks was the most common (25%), while hyperbilirubinemia requiring exchange transfusion and birth complications was the least common (0.4%). Brain damage was the most common problem detected in postnatal diagnosis (36.7%), while unspecified postnatal abnormalities were the least common (3.1%). Conclusions: The areas with the highest greenhouse concentration had higher incidences of neurodevelopmental disorders, particularly in boys, and lower age of referral. Chromosomal abnormalities were prevalent for prenatal diagnoses, gestational age below thirty-two weeks for perinatal diagnoses, and brain damage for postnatal diagnoses. Future studies should analyze the connection between pesticide exposure and neurodevelopmental disorders using spatial point pattern analysis.

Child development and the role of visual experience in the use of spatial and non-spatial features in haptic object perception.

Previous work has suggested a different developmental timeline and role of visual experience for the use of spatial and non-spatial features in haptic object recognition. To investigate this conjecture, we used a haptic ambiguous odd-one-out task in which one object needed to be selected as being different from two other objects. The odd-one-out could be selected based on four characteristics: size, shape (spatial), texture, and weight (non-spatial). We tested sighted children from 4 to 12 years of age; congenitally blind, late blind, and adult participants with low vision; and normally sighted adults. Given the protracted developmental time course for spatial perception, we expected a shift from a preference for non-spatial features toward spatial features during typical development. Due to the dominant influence of vision for spatial perception, we expected congenitally blind adults to show a similar preference for non-spatial features as the youngest children. The results confirmed our first hypothesis; the 4-year-olds demonstrated a lower dominance for spatial features for object classification compared with older children and sighted adults. In contrast, our second hypothesis was not confirmed; congenitally blind adults' preferred categorization criteria were indistinguishable from those of sighted controls. These findings suggest an early development, but late maturation, of spatial processing in haptic object recognition independent of visual experience.

Effectiveness of Postnatal Maternal or Caregiver Interventions on Outcomes among Infants under Six Months with Growth Faltering: A Systematic Review.

The care of infants at risk of poor growth and development is a global priority. To inform new WHO guidelines update on prevention and management of growth faltering among infants under six months, we examined the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants between 0 and 6 months. We searched nine electronic databases from January 2000 to August 2021, included interventional studies, evaluated the quality of evidence for seven outcome domains (anthropometric recovery, child development, anthropometric outcomes, mortality, readmission, relapse, and non-response) and followed the GRADE approach for certainty of evidence. We identified thirteen studies with preterm and/or low birth weight infants assessing effects of breastfeeding counselling or education (n = 8), maternal nutrition supplementation (n = 2), mental health (n = 1), relaxation therapy (n = 1), and cash transfer (n = 1) interventions. The evidence from these studies had serious indirectness and high risk of bias. Evidence suggests breastfeeding counselling or education compared to standard care may increase infant weight at one month, weight at two months and length at one month; however, the evidence is very uncertain (very low quality). Maternal nutrition supplementation compared to standard care may not increase infant weight at 36 weeks postmenstrual age and may not reduce infant mortality by 36 weeks post-menstrual age (low quality). Evidence on the effectiveness of postnatal maternal or caregiver interventions on outcomes among infants under six months with growth faltering is limited and of 'low' to 'very low' quality. This emphasizes the urgent need for future research. The protocol was registered with PROSPERO (CRD42022309001).

[Epilepsy and pregnancy]. / Epilepsie und Schwangerschaft.

BACKGROUND: Regarding treatment of women of childbearing potential with epilepsy, several aspects of family planning and desire to have children have to be taken into account. OBJECTIVE: Overview of current data on mutual implications of epileptic seizures, antiseizure medication (ASM), pregnancy and child development. METHOD: Review of the current literature, discussion and presentation of resulting treatment recommendations. RESULTS: Many ASMs bear the potential for clinically relevant interactions with both contraceptives and altered concentrations of sexual hormones and modified pharmacokinetics during pregnancy. All ASMs show an increased risk for congenital malformations; however, due to seizure-related risks for the mother and child effective ASM treatment during pregnancy is crucial. CONCLUSION: When considering the special aspects of consultation and treatment of women of childbearing potential with epilepsy most pregnancies are uncomplicated.

Large language models are able to downplay their cognitive abilities to fit the persona they simulate.

This study explores the capabilities of large language models to replicate the behavior of individuals with underdeveloped cognitive and language skills. Specifically, we investigate whether these models can simulate child-like language and cognitive development while solving false-belief tasks, namely, change-of-location and unexpected-content tasks. GPT-3.5-turbo and GPT-4 models by OpenAI were prompted to simulate children (N = 1296) aged one to six years. This simulation was instantiated through three types of prompts: plain zero-shot, chain-of-thoughts, and primed-by-corpus. We evaluated the correctness of responses to assess the models' capacity to mimic the cognitive skills of the simulated children. Both models displayed a pattern of increasing correctness in their responses and rising language complexity. That is in correspondence with a gradual enhancement in linguistic and cognitive abilities during child development, which is described in the vast body of research literature on child development. GPT-4 generally exhibited a closer alignment with the developmental curve observed in 'real' children. However, it displayed hyper-accuracy under certain conditions, notably in the primed-by-corpus prompt type. Task type, prompt type, and the choice of language model influenced developmental patterns, while temperature and the gender of the simulated parent and child did not consistently impact results. We conducted analyses of linguistic complexity, examining utterance length and Kolmogorov complexity. These analyses revealed a gradual increase in linguistic complexity corresponding to the age of the simulated children, regardless of other variables. These findings show that the language models are capable of downplaying their abilities to achieve a faithful simulation of prompted personas.