Developmental impairment in children exposed during pregnancy to maternal SARS-COV2: A Brazilian cohort study.

OBJECTIVES: To determine the effects of in-utero exposure to maternal SARS-CoV-2 infection on offspring's neurodevelopment during the first year of life. METHODS: We performed a prospective cohort of babies exposed to SARS-CoV-2 during pregnancy, and a control group (CG) of unexposed babies in a low-income area in Brazil. Children's neurodevelopment was assessed using the guide for Monitoring Child Development in the Integrated Management of Childhood Illness context for both groups (at 1,2,3,4,5,6, 9, and 12 months), and the Ages & Stages Questionnaire (ASQ-3) for the exposed group (EG) (at 4, 6 and 12 months). RESULTS: We followed 137 children for 1 year, 69 in the COVID-19-EG, and 68 in the CG. All mothers were unvaccinated at the time of cohort inclusion, and maternal demographics were similar in the two groups. 20.3% of EG children and 5.9% of the CG received a diagnosis of neurodevelopmental delay within 12 months of life (P = 0.013, relative risk = 3.44; 95% confidence interval, 1.19- 9.95). For the EG, the prevalence of neurodevelopment impairment using Ages & Stages Questionnaire was 35.7% at 4 months, 7% at 6 months, and 32.1% at 12 months. CONCLUSION: SARS-CoV-2 exposure was associated with neurodevelopmental impairment, and specific guidelines are needed for the follow-up of these high-risk children to mitigate the long-term effects on children's health.

Maternal self-efficacy and emotional well-being in Chilean adolescent mothers: the relationship with their children's social-emotional development.

Background: Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children's social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children's social-emotional development; and (c) describe the effects of maternal self-efficacy on children's social-emotional development, mediated by maternal well-being. Methods: A sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers' anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children's social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships. Results: A bivariate analysis showed that maternal self-efficacy was negatively related to the mother's anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children's self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children's self-regulation. Conclusions: The results confirm the importance of adolescent mothers' emotional well-being and maternal self- efficacy with respect to their children's social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother's role in the development of her children.

Small-quantity lipid-based nutrient supplements for children age 6-24 months: a systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifiers.

BACKGROUND: Small-quantity (SQ) lipid-based nutrient supplements (LNSs) provide many nutrients needed for brain development. OBJECTIVES: We aimed to generate pooled estimates of the effect of SQ-LNSs on developmental outcomes (language, social-emotional, motor, and executive function), and to identify study-level and individual-level modifiers of these effects. METHODS: We conducted a 2-stage meta-analysis of individual participant data from 14 intervention against control group comparisons in 13 randomized trials of SQ-LNSs provided to children age 6-24 mo (total n = 30,024). RESULTS: In 11-13 intervention against control group comparisons (n = 23,588-24,561), SQ-LNSs increased mean language (mean difference: 0.07 SD; 95% CI: 0.04, 0.10 SD), social-emotional (0.08; 0.05, 0.11 SD), and motor scores (0.08; 95% CI: 0.05, 0.11 SD) and reduced the prevalence of children in the lowest decile of these scores by 16% (prevalence ratio: 0.84; 95% CI: 0.76, 0.92), 19% (0.81; 95% CI: 0.74, 0.89), and 16% (0.84; 95% CI: 0.76, 0.92), respectively. SQ-LNSs also increased the prevalence of children walking without support at 12 mo by 9% (1.09; 95% CI: 1.05, 1.14). Effects of SQ-LNSs on language, social-emotional, and motor outcomes were larger among study populations with a higher stunting burden (≥35%) (mean difference: 0.11-0.13 SD; 8-9 comparisons). At the individual level, greater effects of SQ-LNSs were found on language among children who were acutely malnourished (mean difference: 0.31) at baseline; on language (0.12), motor (0.11), and executive function (0.06) among children in households with lower socioeconomic status; and on motor development among later-born children (0.11), children of older mothers (0.10), and children of mothers with lower education (0.11). CONCLUSIONS: Child SQ-LNSs can be expected to result in modest developmental gains, which would be analogous to 1-1.5 IQ points on an IQ test, particularly in populations with a high child stunting burden. Certain groups of children who experience higher-risk environments have greater potential to benefit from SQ-LNSs in developmental outcomes.This trial was registered at www.crd.york.ac.uk/PROSPERO as CRD42020159971.

Depressive Symptomatology and Parenting Stress: Influence on the Social-Emotional Development of Pre-Schoolers in Chile.

(1) Background: The preschool stage is a period of great psychological changes that requires the support of parents and significant adults for optimal development. Studies show that maternal mental health can be a risk factor in parenting, affecting the social-emotional development of children. (2) Methods: The present study seeks to shed light on the relation between depressive symptoms, parental stress in mothers and social-emotional development of their preschool children, using a total of 123 mother-child dyads with low Social-economic Status (SES). In mothers, depressive symptomatology and level of parental stress were evaluated, as well as social-emotional development in children. A possible mediation effect between maternal depressive symptoms and parenting stress is expected. (3) Results: The results indicate that higher levels of depressive symptoms and parenting stress in mothers relate to greater difficulties in social-emotional development of their preschool children. (4) Conclusions: These results are clinically relevant from the perspective of family therapy: Parents need support to decrease their levels of parenting stress in order not to jeopardise their children's social-emotional development.

Validación y puntos de corte de la versión en español del Cuestionario de Edades y Etapas: Social-emocional, 2da edición (ASQ:SE-2), en un entorno ambulatorio urbano de Lima-Perú / Validation and cut-off values of the Spanish version of Ages & Stages Questionnaires: Social-Emotional 2nd edition (ASQ:SE-2) in an urban outpatient setting at Lima-Perú

RESUMEN Objetivos: Determinar la confiabilidad, validez y puntos de corte de la versión en español del Cuestionario de Edades y Etapas, 2da edición (del inglés Ages & Stages Questionnaires: Social-Emotional, 2nd Edition (ASQ: SE-2). Material y Métodos: Mediante muestreo por conveniencia se aplicaron formas del cuestionario ASQ: SE-2 a padres de niños entre 15 y 48 meses de edad. La confiabilidad se determinó por medio de la consistencia interna del coeficiente alfa ordinal (α) y la validez de contenido mediante la correlación ítem-test (r). Los puntos de corte para establecer zonas de riesgo se determinaron empleando el percentil 65 y la curva ROC. Resultados: De un total de 236 cuestionarios aplicados, el coeficiente alfa ordinal se ubicó entre aceptable y bueno (α = 0.73-0.87) para los 5 cuestionarios de intervalos de edad entre 18 y 48 meses. El índice de correlación de prueba de ítems mostró un buen poder discriminatorio para la mayoría de los ítems (r> 0.30), con la excepción de un ítem para los meses 30, 36 y 48. Nuevos puntos de corte para los intervalos de edad entre 15 y 48 meses fueron determinados. Conclusiones: La versión en español de ASQ: SE-2 aplicada a padres de niños de 15 a 48 meses de edad en un entorno ambulatorio y en un área urbana de Lima-Perú, demostró ser una herramienta confiable y válida para la vigilancia y detección de etapas del desarrollo emocional.

SUMMARY Objectives: A study was carried out to determine the reliability, validity and cut-off points of the Spanish version of Ages & Stages Questionnaires: Social-Emotional, 2nd Edition (ASQ:SE-2). Material and Methods: Questionnaire forms of ASQ:SE-2 between 15 to 48 months were applied to parents of children chosen by convenience sampling. Reliability was determined by the internal consistency through Ordinal alpha coefficient (α), and validity of content through Item-test correlation (r). The cut-off points to establish risk zones were determined using the 65th percentile and ROC curve. Results: Two hundred thirty-six questionnaires were applied. The Ordinal alpha coefficient reached a between acceptable to good level (α = 0.73-0.87) for all 5 age-intervals questionnaires between 18 to 48 months. The Item-test correlation index pointed a good discriminatory power for most items (r > 0.30), with the exception of one item for the months 30, 36 and 48. New cut-off points for the intervals-age between 15 - 48 months were determined. Conclusions: The Spanish version of ASQ: SE-2, applied to parents of children from 15 to 48 months of age in an outpatient setting from an urban area of Lima-Peru proved to be a reliable and valid tool for surveillance and screening of steps of social-emotional development.

Healthy Lifestyle Behaviors and Their Association with Self-Regulation in Chilean Children.

BACKGROUND: Self-regulation comprises a series of important competencies, such as the ability to control inner states or responses toward thoughts, attention, emotions, or even performance. The relationship between self-regulation and different healthy lifestyle behaviors among children has not been examined in depth to date. The aim of this study was to explore the association between physical activity, screen time levels, and/or Mediterranean Diet adherence and self-regulation in Chilean children. METHODS: A total of 1561 children aged 8-12 years from eight public schools with low socioeconomic status were included. Physical activity, screen time, Mediterranean Diet, and self-regulation were assessed with validated questionnaires. RESULTS: Children who were classified as active or those who reported less than 2 h per day of screen time had higher self-regulation than those who were classified as inactive or counterparts with 2 h per day or more of screen time, respectively. Using joint categories, active children both with low and high screen time showed higher self-regulation compared to inactive/high screen time peers. Additionally, active groups with adherence or non-adherence to the Mediterranean Diet had higher self-regulation compared to inactive and non-adherence peers. CONCLUSION: Having a greater number of healthy habits, mainly regular physical activity, was associated with higher self-regulation, which might be one potential strategy to promote child social-emotional development.

Triadic interactions, parental reflective functioning, and early social-emotional difficulties.

Early childhood is a critical period for social-emotional development; during this period, the child's immediate family is the system with the greatest influence on his or her development. The parents' capacity to reflect on the children's ability to process and interact within a social environment, called parental reflective functioning (RF), is considered an important factor in protecting children from highly prevalent social-emotional difficulties and may have a strong influence on children's long-term development. OBJECTIVE: To describe and analyze the relationships among parents' RF, the quality of the mother-father-child triadic interaction, and children's social-emotional difficulties. METHOD: A nonexperimental, cross-sectional, correlational study was conducted. Fifty mother-father-child triads, each in a current relationship that included at least one child aged 12-36 months, were evaluated. Sociodemographic background, triadic interaction, parental RF, and social-emotional difficulties were assessed. RESULTS: Triadic interaction was found to have a significant effect on the child's social-emotional difficulties, explaining 9% of the variance. In addition, the mothers' RF had a significant influence on triadic interaction, explaining 19% of the variance. An exploratory finding showed that triadic interaction mediates the relationship between mothers' RF and children's social-emotional difficulties.

La temprana niñez es un período crítico para el desarrollo socio-emocional; durante este período, el núcleo familiar del niño es el sistema con la mayor influencia en su desarrollo. La capacidad de los padres de reflexionar sobre la habilidad del niño de procesar e interactuar dentro del ambiente social, llamada la función reflexiva de los padres (RF), es considerada un factor importante en la protección del niño en cuanto a dificultades socio-emocionales altamente prevalentes y pudiera tener una fuerte influencia en el desarrollo del niño a largo plazo. OBJETIVO: Describir y analizar la relación entre la función reflexiva de los padres (RF), la calidad de la interacción tríadica entre mamá, papá y niño, y las dificultades socio-emocionales de los niños. MÉTODO: Se llevó a cabo un estudio no experimental, transversal y correlacional. Se evaluaron cincuenta tríadas de mamá, papá y niño, cada una de ellas en una relación presente que incluía por lo menos un niño de edad entre 12 y 36 meses. Se evaluaron el trasfondo demográfico, la interacción tríadica, la RF de los padres, así como las dificultades socio-emocionales. RESULTADOS: Se encontró que las interacciones tríadicas tenían un efecto significativo en las dificultades socio-emocionales del niño, lo cual explica el 9% de la variación. Adicionalmente, la RF de las mamás tuvo una influencia significativa en la interacción tríadica, lo cual explica el 19% de la variación. Un resultado exploratorio mostró que la interacción tríadica sirve de mediadora en la relación entre la RF de la mamá y las dificultades socio-emocionales de los niños.

La petite enfance est une période critique pour le développement socio-émotionnel. Durant cette période la famille proche de l'enfant est le système ayant la plus grande influence sur son développement. La capacité des parents à réfléchir à la capacité des enfants à traiter et à interagir avec l'environnement social, appelée le fonctionnement de réflexion parentale (abrégé en anglais RF), est considérée comme étant un facteur important qui protège les enfants de difficultés socio-émotionnelles extrêmement prévalente et qui peut avoir une forte influence sur le développement long-terme des enfants. OBJECTIF: Décrire et analyser les relations entre le RF des parents, la qualité de l'interaction triadique mère-père-enfant, et les difficultés socio-émotionnelles des enfants. MÉTHODE: Une étude non-expérimentale, corrélationnelle, avec une coupe transversale a été effectuée. Cinquante triades mère-père-enfant, chacune dans la relation actuelle qui incluait au moins un enfant âgé de 12 à 36 mois, ont été évaluées. Le contexte sociodémographique, l'interaction triadique, le RF parents, et les difficultés socio-émotionnelles ont été évalués. RÉSULTATS: On a trouvé que l'interaction triadique avait un effet important sur les difficultés socio-émotionnelles de l'enfant, expliquant 9% de l'écart. De plus, le RF des mères s'est avéré avoir une influence importante sur l'interaction triadique, expliquant 19% de l'écart. Un résultat exploratoire a montré que l'interaction triadique affecte la relation entre es le RF des mères et les difficultés socio-émotionnelles des enfants.

Desenvolvimento socioemocional de crianças surdas com implante coclear / Social-emotional development of deaf children with cochlear implant

Certos progressos científicos vêm possibilitando melhoria na qualidade de vida de pessoas profundamente surdas, promovendo-lhes audição em nível adequado para poderem penetrar no mundo dos sons, inclusive captarem a especificidade da voz humana. O implante coclear constitui um desses importantes avanços. O presente trabalho vem contribuir para o conhecimento da área socioemocional de crianças afetadas de surdez profunda, que são beneficiadas por este procedimento. Estudam-se contribuições bibliográficas próximas ao tema, uma vez que não se dispõe de literatura específica. Seleciona-se e homogeneiza-se um grupo de dez pré-escolares, submetidos ao implante coclear. Realizam-se individualmente avaliações psicológicas contextualizadas (criança x ambiente), utilizando-se de entrevistas específicas, que acrescidas de outros dados adicionais, permitem a elaboração da anamnese junto com o exame direto da criança, por meio da observação participante e da administração do Jogo Estruturado de Lynn (Lynn's Structured Doll Play Test). Além de algumas comparações bibliográficas, o trabalho apresenta inovações sobre o processo evolutivo socioemocional dessas crianças com suas famílias. Os resultados vislumbram um perfil socioemocional desses meninos e meninas. Analisam-se a influência da época do implante e o período de seu uso, além do tipo de educação que os pais prodigalizam aos seus filhos em tais condições, como também os conflitos familiares detectados. A conclusão principal é a de que estes últimos são mais relevantes do que a idade de aplicação do implante coclear e seu uso como variável interveniente(AU)

A number of scientific progresses have been improving the quality of life of profoundly deaf people, offering them high levels of auditory information in order to introduce them to the world of sound, as well as to detect the specificity of the human voice. The cochlear implant is one of these important advances. The present work contributes to the knowledge on the social-emotional area of profoundly deaf children benefited by such procedure. Approximate bibliographic contributions are to be studied, as there is no specific literature available. A group of ten preschool children, who received the cochlear implant, are selected and assimilated. Psychological contextualized evaluations (child versus environment) are individually performed by means of specific interviews which, with additional data, elaborate the anamnesis, together with the child examination, using participant observation and the application of Lynn's Structured Doll Play Test. Besides a few bibliographic comparisons, the work presents innovations on the social-emotional evolutionary process of the children and their families. The results glimpse a social-emotional profile of these children.The influence of the time of the implant and the age of its use is analysed, besides the educational modality the parents offer in profusion to their children under such conditions, and also the family conflicts detected. The main conclusion is that these conflicts are more relevant than the time of the application of the cochlear implant and its utilization as an intervenient variable(AU)