Mobile Media Content Exposure and Toddlers' Responses to Attention Prompts and Behavioral Requests.

Importance: With personalized touch-screen tablets, young children can choose content and engage in play-like activities. However, tablets may also reduce shared engagement as the action of viewing or touching the screen is often not visible to nearby adults. This may impact communicative gazing and pointing, which is critical to the formation of shared awareness and in turn supports language development. Objective: To assess the association of tablet media content with toddlers' responses to joint attention prompts and behavioral requests. Design, Setting, and Participants: This cohort study took place at a behavioral research laboratory and included toddlers who were aged 18 to 32 months with neurotypical development who were recruited from a volunteer and community sample. Toddlers engaged with a real toy or 3 different types of tablet content (ie, viewing video of toy play, playing with a digital toy, or playing a commercial game) while an experimenter delivered joint attention prompts. Data were acquired from June 2021 November XX 2022, and data analysis occurred from January 2023 to May 2024. Main Outcomes and Measures: Main outcomes included child response to joint attention (number of prompts with joint attention response per number of prompts delivered) and child response to behavioral request (ie, the prompt on which the child responded to the behavioral request). Measures included crossed random effects, Wald tests, and likelihood ratio tests. Results: In this study, 63 toddlers were enrolled, and data from 62 were included (31 female [49%]; mean [SD] age, 26.1 [3.4] months; median [IQR] age, 25.0 [18.6-32.6] months). When toddlers were playing a commercial game on a tablet, they responded to fewer joint attention prompts (crossed random effects model, -0.15; 95% CI, -0.24 to -0.06 prompts) and male toddlers took longer to acknowledge a behavioral request (interaction of content and sex, -0.75; 95% CI, -1.36 to -0.17). The negative impact of the tablet game was larger as child age increased (τ = -2.30; 95% CI, -0.05 to 0; P = .03). Greater media use at home was associated with decreased responding to joint attention prompts during the tablet game (ρ = -0.47; P < .001), while better language skills were associated with more joint attention during play with a real toy (ρ = 0.31; P = .02). Conclusions and Relevance: In this cohort study, a touch-screen tablet game was associated with decreased joint attention among toddlers and they were less likely to respond to a behavioral request. In a laboratory setting, it was difficult for toddlers to engage in social-communicative interactions with adults when using a tablet media device.

A Curiosity Estimation in Storytelling with Picture Books for Children Using Wearable Sensors.

Storytelling is one of the most important learning activities for children since reading aloud from a picture book stimulates children's curiosity, emotional development, and imagination. For effective education, the procedures for storytelling activities need to be improved according to the children's level of curiosity. However, young children are not able to complete questionnaires, making it difficult to analyze their level of interest. This paper proposes a method to estimate children's curiosity in picture book reading activities at five levels by recognizing children's behavior using acceleration and angular velocity sensors placed on their heads. We investigated the relationship between children's behaviors and their levels of curiosity, listed all observed behaviors, and clarified the behavior for estimating curiosity. Furthermore, we conducted experiments using motion sensors to estimate these behaviors and confirmed that the accuracy of estimating curiosity from sensor data is approximately 72%.

Assessing the efficacy of a brief universal family skills programme on child behaviour and family functioning in Gilgit-Baltistan, Pakistan: protocol for a feasibility randomised controlled trial of the Strong Families programme.

PURPOSE: The global burden of mental health difficulties among children underscores the importance of early prevention. This study aims to assess the efficacy, feasibility and acceptability of the Strong Families programme in enhancing child behaviour and family functioning in low-resource settings in Gilgit-Baltistan, Pakistan. METHODS AND ANALYSIS: This is a two-arm, multisite feasibility randomised controlled trial with an embedded process evaluation in three districts of Gilgit-Baltistan, namely Gilgit, Hunza and Skardu. 90 families living in these challenged settings, comprising a female primary caregiver aged 18 or above, and at least one child aged 8-15 years, will participate. Participants will be randomly assigned to either receive the Strong Families programme or to the waitlist group. Strong Families is a 7-hour family skills group intervention programme attended by children and their primary caregivers over 3 weeks. The waitlist group will be offered the intervention after their outcome assessment. Three raters will conduct blind assessments at baseline, 2 and 6 weeks postintervention. The primary outcome measures include the feasibility of Strong Families, as determined by families' recruitment and attendance rates, and programme completeness (mean number of sessions attended, attrition rates). The secondary outcomes include assessment of child behaviour, parenting practices, parental adjustment and child resilience. Purposefully selected participants, including up to five caregivers from each site, researchers and facilitators delivering the intervention, will be interviewed. Descriptive statistics will be used to analyse primary and secondary outcomes. The process evaluation will be conducted in terms of programme context, reach, fidelity, dose delivered and received, implementation, and recruitment. ETHICS AND DISSEMINATION: This study has been approved by the UNODC Drug Prevention and Health Branch in the Headquarters office of Vienna and the National Bioethics Committee of Pakistan. Findings will be disseminated through publication in reputable journals, newsletters and presentations at conferences. TRIAL REGISTRATION NUMBER: NCT05933850.

"Nobody Here Likes Her"-The Impact of Parental Verbal Threat Information on Children's Fear of Strangers.

Parental verbal threat (vs. safety) information about strangers may induce fears of these strangers in adolescents. In this multi-method experimental study, utilizing a within-subject design, parents provided standardized verbal threat or safety information to their offspring (N = 77, Mage = 11.62 years, 42 girls) regarding two strangers in the lab. We also explored whether the impact of parental verbal threat information differs depending on the social anxiety levels of parents or fearful temperaments of adolescents. Adolescent's fear of strangers during social interaction tasks was assessed using cognitive (fear beliefs, attention bias), behavioral (observed avoidance and anxiety), and physiological (heart rate) indices. We also explored whether the impact of parental verbal threat information differs depending on the social anxiety levels of parents or fearful temperaments of adolescents. The findings suggest that a single exposure to parental verbal threat (vs. safety) information increased adolescent's self-reported fears about the strangers but did not increase their fearful behaviors, heart rate, or attentional bias. Furthermore, adolescents of parents with higher social anxiety levels or adolescents with fearful temperaments were not more strongly impacted by parental verbal threat information. Longitudinal research and studies investigating parents' naturalistic verbal expressions of threat are needed to expand our understanding of this potential verbal fear-learning pathway.

Impact of family and caregiver factors on development and behaviours in maltreated young children.

Introduction: This study aimed to evaluate the prevalence of developmental and emotional/ behavioural concerns in maltreated children and to examine the impact of adverse family/caregiver risk factors on these outcomes. Method: We analysed family demographic and baseline data of 132 maltreated children and their caregivers from a family support programme in Singapore. We examined the associations of 3 main risk factors (i.e., caregiver mental health, educational attainment, and family socio-economic status [SES]) with developmental/behavioural outcomes using multivariable logistic regression, controlling for caregiver relationship to the child. Caregiver mental health was assessed using the Patient Health Questionnaire 9 (PHQ-9) and General Anxiety Disorder 7 (GAD-7) tools. Developmental/behavioural outcomes were assessed using the Ages and Stages Questionnaires (ASQ-3), ASQ-Social-Emotional (ASQ-SE), and the Child Behaviour Checklist (CBCL). Results: The children ranged in age, from 2 months to 3 years 11 months (median age 1.7 years, interquartile range [IQR] 0.9-2.6). Among caregivers, 86 (65.2%) were biological mothers, 11 (8.3%) were biological fathers, and 35 (26.5%) were foster parents or extended family members. Low family SES was associated with communication concerns on the ASQ-3 (adjusted odds ratio [AOR] 3.04, 95% CI 1.08-8.57, P=0.04). Caregiver mental health concerns were associated with increased behavioural concerns on the CBCL (AOR 6.54, 95% CI 1.83-23.33, P=0.004) and higher scores on the ASQ-SE (AOR 7.78, 95% CI 2.38-25.38, P=0.001). Conclusion: Maltreated children with caregivers experiencing mental health issues are more likely to have heightened emotional and behavioural concerns. Those from low SES families are also at increased risk of language delay, affecting their communication.

Evaluation of child's behavior during the pit and fissure sealant administration using the rubber dam and MiniDam: A randomized clinical trial.

BACKGROUND: Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive treatment for addressing teeth with deep pits and fissures in children. The purpose of the present study was to evaluate the behavior of the child when administering the pit and fissure sealant using the rubber dam and MiniDam. METHODOLOGY: Fifty-two children in the age range of 9-12 years were randomly allocated into two groups: Group I, rubber dam and Group II, MiniDam. The children were randomly assigned into two groups with 26 members in Group 1 (rubber dam isolation) and 26 members in Group 2 (MiniDam isolation). Children's anxiety was assessed using the modified Venham scale and heart rate. The children's pain intensity was assessed using Memojis Pain Scale. The data collected were tabulated and statistically analyzed using SPSS software. The level of significance was established at 0.05. RESULTS: Intergroup comparison of heart rates showed a statistically significant difference for both the groups at various intervals (P value 0.05), that is, before placing the dam, with the dam, and during treatment. Pain and anxiety scores showed a statistically significant difference in both the groups before and after the procedure (P < 0.05). CONCLUSIONS: The use of MiniDam can offer a better option for the pit/fissure sealant procedure due to its unique qualities, including simplicity of placement, improved behavior management, and less chair time in children.

Comparative evaluation of intranasal dexmedetomidine, intranasal midazolam, and nitrous oxide for conscious sedation of anxious children undergoing dental treatment: A randomized cross-over trial.

BACKGROUND: Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments. AIM: The aim of this study was to compare 1 m/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects. MATERIALS AND METHODS: In this cross-over trial, 15 children aged 6-8 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week. RESULTS: All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 ± 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post-treatment. CONCLUSION: 0.3 mg/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 m/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg/kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children.

Emotional and behavioural functioning in children with tyrosinaemia type 1.

INTRODUCTION: Tyrosinaemia type I is a rare hereditary metabolic disease caused by deficiency of the enzyme involved in the breakdown of tyrosine. Since the use of nitisinone in addition to diet in 1992, survival rates have increased significantly, but more and more socio-emotional problems have become apparent. The aim of the study was the assessment the relationship between variations in serum tyrosine and phenylalanine levels and measurements of socio-emotional functioning and determination of patients' IQs. THE AIM OF THE STUDY: was the assessment the relationship between variations in serum tyrosine and phenylalanine levels and measurements of socio-emotional functioning and determination of patients' IQs. MATERIAL AND METHODS: Twelve children were studied, from a single centre, born between 1994 and 2012, treated with nitisinone and a low-phenylalanine and -tyrosine diet. The psychological evaluation was conducted using the parent form of the Child Behaviour Checklist (CBCL)/4-18. Additionally, the patients' IQs were measured using the Stanford-Binet 5 (SB5) Intelligence Scale. Statistical analyses were performed using PAWS software suite version 26. We found that phenylalanine variability over time correlated with measures of emotional and behavioural functioning. This relationship holds true for externalising behaviour, associated with the experience of maladjustment and aggression. Total score intellectual and cognitive function was within the norm for all patients. CONCLUSIONS: To maintain better quality of life for patients and their families in terms of emotional and behavioural functioning, it may be important to avoid spikes (significant fluctuations) in phenylalanine levels. Regular, detailed psychological evaluations are recommended to detect potential problems and implement interventions aimed at achieving the best possible individual development and realise the intellectual and behavioural potential, thereby improving the patient's and her family's quality of life.

Cortical thickness and childhood eating behaviors: differences according to sex and age, and relevance for eating disorders.

PURPOSE: This study investigated the association between childhood eating behaviors and cortical morphology, in relation to sex and age, in a community sample. METHODS: Neuroimaging data of 71 children (mean age = 9.9 ± 1.4 years; 39 boys/32 girls) were obtained from the Nathan Kline Institute-Rockland Sample. Emotional overeating, food fussiness, and emotional undereating were assessed using the Children's Eating Behavior Questionnaire. Cortical thickness was obtained at 81,924 vertices covering the entire cortex. Generalized Linear Mixed Models were used for statistical analysis. RESULTS: There was a significant effect of sex in the association between cortical thickness and emotional overeating (localized at the right postcentral and bilateral superior parietal gyri). Boys with more emotional overeating presented cortical thickening, whereas the opposite was observed in girls (p < 0.05). Different patterns of association were identified between food fussiness and cortical thickness (p < 0.05). The left rostral middle frontal gyrus displayed a positive correlation with food fussiness from 6 to 8 years, but a negative correlation from 12 to 14 years. Emotional undereating was associated with cortical thickening at the left precuneus, left middle temporal gyrus, and left insula (p < 0.05) with no effect of sex or age. CONCLUSIONS: Leveraging on a community sample, findings support distinct patterns of associations between eating behaviors and cortical thickness, depending on sex and age.

The bidirectional relationship between peer relationships and bullying: Evidence from cross-lagged analyses among Chinese children.

BACKGROUND: In the digital age, bullying manifests in two distinct forms: traditional bullying and cyberbullying. Children's peer relationships are important predictors of bullying, and bullying in turn predicts peer relationships. However, few researchers have noted the bidirectional relationship between peer relationships and bullying. METHODS: The present study used a two-wave cross-lagged longitudinal design to fill this gap. The potential sex differences were also examined in this relationship. The sample consisted of 527 Chinese children aged 8 to 12 years (M = 9.69, SD = .96; 53.5% female). Participants completed peer nominations for peer acceptance, peer rejection and social dominance, as well as self-reports of traditional bullying and cyberbullying. RESULTS: Results showed that peer rejection at the first time point (T1) significantly and positively predicted traditional bullying perpetration, cyberbullying perpetration and cyberbullying victimization at the second time point (T2). Traditional bullying victimization at T1 significantly and negatively predicted peer acceptance and social dominance at T2. The results also revealed significant male and female differences. For instance, among boys, peer acceptance at T1 significantly and negatively predicted cyberbullying victimization at T2. In contrast, this relationship was not observed among girls. The present findings have important implications for understanding the cyclical relationship between peer relationships and bullying and providing practical guidance for improving peer relationships and reducing bullying.

Effectiveness of a program to lower unwanted media screens among 2-5-year-old children: a randomized controlled trial.

Background: Limited interventions exist on reducing unwanted screen time (ST) among children from low- and middle-income countries (LMICs), so we developed and assessed the effectiveness of the program to lower unwanted media screen time (PLUMS) among children aged 2-5 years in Chandigarh, Union Territory, North India. Methods: An open-label randomized control parallel group trial per CONSORT guidelines was conducted among randomly selected 340 families with children aged 2-5 (±3 months) years in Chandigarh, India. PLUMS was implemented at the family level with a focus on modifying the home media environment and targeted individual-level interventions using parent and child modules for 2 months. A post-intervention (immediately) and a follow-up assessment after 6 months was done. During the follow-up period, the interaction was done passively via WhatsApp groups. The control group received routine healthcare services. Validated and standardized tools, including a digital screen exposure questionnaire with a physical activity component, preschool child behavior checklist, and sleep disturbance scale for children, were used to collect data at baseline, post-intervention, and follow-up periods. The primary outcome was the mean difference in ST (minutes/day) among children in the intervention group versus the control group. Generalized estimating equation (GEE) analysis was performed to adjust for clustering. Results: An equal number of families (n = 170) were randomly assigned to the intervention and control arms. In the post-intervention assessment, 161 and 166 families continued while, at the follow-up assessment, 154 and 147 were in the intervention and control arm, respectively. The mean difference in ST on a typical day [27.7 min, 95% Confidence Interval (CI) 5.1, 50.3] at the post-intervention assessment significantly (p < 0.05) decreased in the intervention (102.6 ± 98.5 min) arm as compared with the control (130.3 ± 112.8 min) arm. A significant reduction in ST (ß = -35.81 min, CI -70.6, -1.04) from baseline (ß = 123.1 min) to follow-up phase (ß = 116 min) was observed in GEE analysis. The duration of physical activity increased both at post-intervention (ß = 48.4 min, CI = +6.6, +90.3) and follow-up (ß = 73.4 min, CI = 36.2, 110.5) assessments in the intervention arm. Conclusion: The PLUMS intervention significantly reduced the children's mean ST on a typical day and increased the physical activity immediately post-intervention and during the 6-month follow-up period. These results might guide the policymakers to include strategies in the national child health programs in the Southeast Asia Region to reduce unwanted ST.Clinical trial registration: https://clinicaltrials.gov/, identifier CTRI/2017/09/009761.

Academic and behavior combined support: A single-case practice-based replication study.

The purpose of this research was to conduct a practice-based replication of Academic and Behavior Combined Support (ABC Support), a previously developed and experimentally evaluated supplemental intervention that merges a combined focus on reading fluency and academic engagement. In the present study, a school-based interventionist and data collector had access to implementation resources online and participated in virtual training and coaching. Four Grade 2 students received the ABC Support intervention for 6 weeks in their school. Students' oral fluency on training and non-training reading passages, as well as occurrence of engagement and disruptive behaviors during universal reading instruction, were measured repeatedly across baseline, intervention, and follow-up phases in a multiple-baseline design. In concert with prior empirical findings on ABC Support, analyses revealed improvement from baseline to intervention for both reading and behavior outcomes, as well as from baseline to follow-up assessments. Empirical contributions of the study are offered within the context of replication research and an implementation science perspective. We also emphasize the importance of telecommunication for practice-based research evaluation of interventions.

Evaluation of "Cognitive Behavioral Intervention for Trauma in Schools" (CBITS) in child welfare programs in Germany: study protocol of a randomized controlled trial.

BACKGROUND: Children and adolescents growing up in child welfare institutions have been frequently exposed to traumatic events and psychosocial stress and show elevated rates of mental disorders. Yet, there is a lack of empirically supported treatments to provide adequate mental health care for children in care suffering from trauma-related mental disorders such as posttraumatic stress disorder (PTSD), depression, and anxiety. The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is an evaluated trauma-focused cognitive-behavioral group intervention, which has proven to be effective in reducing symptoms of PTSD, depression, and anxiety for traumatized children in group settings. The trial will evaluate the effectiveness of the CBITS intervention as an outreach treatment compared with an enhanced treatment-as-usual condition (TAU +) within the German mental health and child welfare system. METHODS: In a randomized controlled trial (RCT) involving N = 90 children and adolescents, we will compare CBITS with TAU + . Participants between 8 and 16 years, reporting at least one traumatic event and moderate posttraumatic stress symptoms (PTSS), will be randomized within their child welfare institution to either one of the conditions using a CATS-2 severity-stratified block randomization. Assessments will take place at baseline, as well as 4 months and 10 months after baseline. The primary outcome is the severity of PTSS after 4 months. Secondary outcomes are depression, anxiety, irritability/anger, quality of life, and global functioning level. DISCUSSION: The results of our trial will provide evidence regarding effective treatment options for traumatized children in care, which represent an understudied population with limited access to mental health care. Additionally, it could serve as a blueprint for implementing trauma-focused outreach group treatments for children in care and increase the accessibility to appropriate treatment. TRIAL REGISTRATION: Clinical Trials.gov NCT06038357 D. September 13, 2023.

Early parent-child intervention with Dialogic Book-Sharing: effects on child communicative and socio-emotional development and on parenting. Study protocol for a multicentre randomised controlled trial in Italy.

BACKGROUND: Research in the neurosciences has highlighted the importance of intersubjective relationships in promoting neuromental development of the child. Children's learning in early childhood occurs mainly in a dyadic context of an interaction with their parents: from this perspective, good dialogic parent-child communication is required to be promoted also through good educational practices. Dialogic Book-Sharing (DBS), a dialogic form of parent-child communication through the use of wordless picture books, provides a privileged 'intersubjective' space and is highly effective in promoting communication, language, attention, behavioural development and the parent-child relationship. DBS programme, successfully previously trialled in South Africa and the UK, will be applied for the first time in Italy for research purposes in Italian health, educational and maternal-child centres. METHODS: A multicentre randomised controlled trial is being conducted to evaluate DBS parenting intervention for children aged between 14 and 20 months. Parent-child dyads are randomly allocated to a book-sharing intervention group or to a wait-list control group. In the intervention, parents are trained in supportive book-sharing with their children by local staff of the centres. DBS intervention is carried out in small groups over a period of 4 weeks. Data are collected at baseline, post-intervention and at 6 months post-intervention with a questionnaire and video recording of parent-child interaction. DISCUSSION: DBS programme in early childhood could enhance the educational resources offered by Italian health, educational and maternal-child centres, in support of child's development and parenting. DBS represents a strategic opportunity for bringing about positive effects, also in terms of prevention of socio-emotional and cognitive difficulties. As such it represents a promising response to the new social, health and educational needs of the post-COVID-19 pandemic era caused by the social isolation measures. Furthermore, the application of the DBS methodology is a way to promote the use of books, and thereby counteract the excessive use of technological devices already present in early childhood. TRIAL REGISTRATION: The trial is registered on the International Standard Randomised Controlled Trial Number database, registration number ISRCTN11755019 Registered on 2 November 2023. This is version 1 of the protocol for the trial.

The relationship between video games and social-emotional delay in Chinese rural preschoolers: A comparison of five types of media video games and social-emotional delay.

BACKGROUND: Recent studies have revealed a negative relationship between children's digital media use and social-emotional development. However, few studies distinguish between different digital devices and the different functions they provide that may lead to different outcomes. METHODS: This study explored the relationship between young children's time spent on various digital devices and their social-emotional delay based on a survey of 1182 preschoolers (3 to 6 years old) in rural China. Children's social-emotional delay was assessed through a validated screening tool (ASQ-SE II). RESULTS: Children's time spent on television, computers, tablets, or smartphones was not associated with their social-emotional delay. However, their risk of social-emotional delay increased as their time spent on game consoles increased. This relationship was reflected in five of the seven behavioural areas of children's social-emotional development (i.e., self-regulation, compliance, affect, social communications, and interactions with people). Moreover, it did not vary between children with different socioeconomic statuses. CONCLUSIONS: This study suggests a possible relationship between children's social-emotional delay and video games, which might need to be paid more attention to than other media types.

Modeling trajectories of physical aggression from infancy to pre-school age, their early predictors, and school-age outcomes.

This study identified latent trajectories of physical aggression (TPA) from infancy to preschool age and evaluated (a) effects of early parent, parenting and child predictors on TPA as well as on social, behavioral, and academic functioning in Grade 2, and (b) TPA effects net of early predictor effects on Grade 2 functioning. We used data from the Behavior Outlook Norwegian Developmental Study (BONDS), which included 1,159 children (559 girls). Parents reported on risk and protective factors, and on physical aggression from 1 to 5 years of age; teachers reported on Grade 2 outcomes. We employed latent class growth curve analyses and identified nine TPA. In fully adjusted models simultaneously testing all associations among predictors, trajectories, and outcomes, maternal and paternal harsh parenting, child gender, and sibling presence predicted TPA, which significantly predicted externalizing and academic competence in Grade 2. Child gender had a pervasive influence on all outcomes as well as on TPA. To our knowledge, this is the first trajectory study to determine which predictors are most proximal, more distal, or just confounded, with their relative direct effect sizes, and to link early paternal as well as maternal harsh parenting practices with children's TPA. Our findings underscore the need to include fathers in developmental research and early prevention and intervention efforts.

Mother-infant interaction characteristics associate with infant falling reactivity and child peer problems at pre-school age.

This longitudinal study investigated the associations between mother-infant interaction characteristics at 9 months of age, maternal mental health, infant temperament in the first year postpartum, and child behaviour at 3 years of age. The infants (N = 54, 22 females) mainly had White British ethnic backgrounds (85.7%). Results showed that i) mother-infant dyadic affective mutuality positively correlated with infant falling reactivity, suggesting that better infant regulatory skills are associated with the dyad's ability to share and understand each other's emotions; and ii) maternal respect for infant autonomy predicted fewer child peer problems at 3 years of age, suggesting that maternal respect for the validity of the infant's individuality promotes better social and emotional development in early childhood.

An evaluation model for interactive gaming furniture design based on parent-child behavior.

This study takes the parent-child game behavior of children aged 3~6 and their parents as the research object, and extracts and summarizes the user behavioral needs of parents and children when they use game-based furniture together by using the questionnaire research method, observation method, and interview method. Based on the KJ method, 16 behavioral demand indicators were compiled by five furniture design students to construct a user behavioral demand system. In addition, AHP and entropy weight method were used to solve the user behavioral demand weights from subjective and objective perspectives in this study. Twenty experts and designers in this research field scored the indicators two by two and solved the subjective weights of user behavioral requirements according to the AHP algorithm. A seven-level Likert scale was used to design the questionnaire and distribute it to the parents of children aged 3-6 to fill in, and the 121 valid questionnaires obtained were used as raw data for entropy weighting to obtain the objective weights of user behavioral needs representing the opinions of interactive game-based furniture users. Finally, with 0.4 as the proportion coefficient of subjective weights, the subjective and objective weights were weighted to get the comprehensive weight value of each demand. The results show that the eight items with higher weights for user behavioral needs include: firm and stable, safe in use, comfortable for both parents and children, holding behavior by human-machine dimensions, able to sit on the ground and play, able to play face-to-face, easy to find for picking up, and sufficient operating space. In general, parent-child interactive game furniture firstly needs to meet the user's needs for safety and comfort, and secondly needs to meet the user's needs for the state of the game posture and the furniture size to meet the needs of the fetching and storage posture and the game space. The fuzzy comprehensive evaluation model established based on these needs can take into account the opinions of design experts and users at the same time and put the needs of children and parents in an equally important position so that the design of children's play furniture can tend to meet the needs of parents and children when they use it together, and to promote parent-child interaction and the healthy growth of children.

Maternal concern and perception about child overweight risk, maternal feeding practices, and child eating behaviors: A cross-sectional study.

Abundant efforts have been directed to understand the global obesity epidemic and related obesogenic behaviors. However, the relationships of maternal concern and perception about child weight with child eating behaviors in Saudi Arabia have not been investigated. Therefore, this study aimed to examine the associations of maternal concern and perception about child overweight risk with maternal feeding practices and child eating behaviors among mothers and their children in Saudi Arabia. Mothers of 115 children aged 3-5 years old were recruited from eight preschools. Child eating behaviors (enjoyment of food, responsiveness to foods, food fussiness, satiety responsiveness, and slowness in eating) and maternal feeding practices (restriction, monitoring, and using food as a reward), maternal concern about child weight, and maternal perception about child overweight risk were assessed using validated questionnaires. Multiple linear regression models, adjusted for maternal body mass index (BMI) and child's BMI-z score and sex, were tested to examine the independent associations of maternal concern and perception about child overweight risk with child eating behaviors and maternal feeding practices. Maternal concern about child weight was positively associated with food enjoyment in children (B = 0.14 [95% confidence intervals = 0.02,0.27]) and responsiveness to food (B = 0.16 [0.03,0.29]), whereas a negative association with child food fussiness was observed (B = -0.19 [-0.33, -0.04]). Maternal perception about child overweight risk and child slowness in eating were negatively associated (B = -0.72 [-0.16 to -0.28]). Maternal concern and perception about child overweight risk were not associated with maternal feeding practices. In conclusion, maternal concern and perception about child overweight risk were found to be associated with food approach eating behavior traits but not with maternal feeding practices. Mothers who are concerned about child weight or perceive their children as overweight may need guidance and support to promote healthy eating behaviors among their children. Future cross-cultural studies are needed to understand the underlying mechanisms for the influence of maternal concern and perception about child overweight risk on maternal feeding practices, child eating behaviors, and weight status of children.

The Effects of Breastfeeding on Childhood Behavioral and Emotional Development: A Prospective Cohort Study in China.

BACKGROUND: Breastfeeding could improve a child's health early on, but its long-term effects on childhood behavioral and emotional development remain inconclusive. We aimed to estimate the associations of feeding practice with childhood behavioral and emotional development. METHODS: In this population-based birth cohort study, data on feeding patterns for the first 6 mo of life, the duration of breastfeeding, and children's emotional and behavioral outcomes were prospectively collected from 2489 mother-child dyads. Feeding patterns for the first 6 mo included exclusive breastfeeding (EBF) and non-exclusive breastfeeding (non-EBF, including mixed feeding or formula feeding), and the duration of breastfeeding (EBF or mixed feeding) was categorized into ≤6 mo, 7-12 mo, 13-18 mo, and >18 mo. Externalizing problems and internalizing problems were assessed with the Child Behavior Checklist (CBCL) and operationalized according to recommended clinical cutoffs, corresponding to T scores ≥64. Multivariable linear regression and logistic regression were used to evaluate the association of feeding practice with CBCL outcomes. RESULTS: The median (interquartile range) age of children at the outcome measurement was 32.0 (17.0) mo. Compared with non-EBF for the first 6 mo, EBF was associated with a lower T score of internalizing problems [adjusted mean difference (aMD): -1.31; 95% confidence interval (95% CI): -2.53, -0.10], and it was marginally associated with T scores of externalizing problems (aMD: -0.88; 95% CI: -1.92, 0.15). When dichotomized, EBF versus non-EBF was associated with a lower risk of externalizing problems (aOR: 0.54, 95% CI: 0.34, 0.87), and it was marginally associated with internalizing problems (aOR: 0.75, 95% CI: 0.54, 1.06). Regarding the duration of breastfeeding, breastfeeding for 13-18 mo versus ≤6 mo was associated with lower T scores of internalizing problems (aMD: -2.50; 95% CI: -4.43, -0.56) and externalizing problems (aMD: -2.75; 95% CI: -4.40, -1.10), and breastfeeding for >18 mo versus ≤6 mo was associated with lower T scores of externalizing problems (aMD: -1.88; 95% CI: -3.68, -0.08). When dichotomized, breastfeeding for periods of 7-12 mo, 13-18 mo, and >18 mo was associated with lower risks of externalizing problems [aOR (95% CI): 0.96 (0.92, 0.99), 0.94 (0.91, 0.98), 0.96 (0.92, 0.99), respectively]. CONCLUSIONS: Exclusive breastfeeding for the first 6 mo and a longer duration of breastfeeding, exclusively or partially, are beneficial for childhood behavioral and emotional development.