Environmental Conditions to Promote Healthy Childhood Brain/Behavioral Development: Informing Early Preventive Interventions for Delivery in Routine Care

Interplay between prenatal bisphenol exposure, postnatal maternal care, and offspring sex in predicting DNA methylation relevant to anxiety-like behavior in rats

Prenatal exposure to endocrine disrupting chemicals, such as bisphenols, can alter neurodevelopmental trajectories and have a lasting neurobehavioral impact through epigenetic pathways. However, outcomes associated with prenatal bisphenol exposure may also be shaped by the postnatal environment and collectively these environmental effects may be sex-specific. Thus, an integrative research design that includes multiple early life exposures and considers sex differences may be essential for predicting outcomes. In the current study, we use a multivariate approach to examine the contributions of prenatal bisphenol exposure, postnatal maternal care, and offspring sex to variation in DNA methylation of well-studied candidate genes (NR3C1, BDNF, OXTR) in the ventral hippocampus and amygdala of adult Long-Evans rats. Main effects of postnatal maternal care and interactions with prenatal bisphenol exposure were consistently found for DNA methylation within the NR3C1 gene (ventral hippocampus) and within the BDNF and OXTR genes (amygdala). Sex-specific effects were also found across all analyses. Overall, our findings suggest that both early-life factors (prenatal and postnatal) and offspring sex contribute to variation in DNA methylation in genes and brain regions relevant for the expression of anxiety-like behavior. These results highlight the need to consider the brain region-specific effects of multiple exposures in males and females to understand the lasting effects of early environments.

Automatic Movement Recognition for Evaluating the Gross Motor Development of Infants

OBJECTIVE

The objective of this study was to early-detect gross motor abnormalities through video detection in Taiwanese infants aged 2-6 months.

BACKGROUND

The current diagnosis of infant developmental delays primarily relies on clinical examinations. However, during clinical visits, infants may show atypical behaviors due to unfamiliar environments, which might not truly reflect their true developmental status.

METHODS

This study utilized videos of infants recorded in their home environments. Two pediatric neurologists manually annotated these clips to identify whether an infant possessed the characteristics of gross motor delays through an assessment of his/her gross motor movements. Using transfer learning techniques, four pose recognition models, including ViTPose, HRNet, DARK, and UDP, were applied to the infant gross motor dataset. Four machine learning classification models, including random forest, support vector machine, logistic regression, and XGBoost, were used to predict the developmental status of infants.

RESULTS

The experimental results of pose estimation and tracking indicate that the ViTPose model provided the best performance for pose recognition. A total of 227 features related to kinematics, motions, and postures were extracted and calculated. A one-way ANOVA analysis revealed 106 significant features that were retained for constructing prediction models. The results show that a random forest model achieved the best performance with an average F1-score of 0.94, a weighted average AUC of 0.98, and an average accuracy of 94%.

Adherence to the Singapore Integrated 24 h Activity Guidelines for Pre-Primary School Children Before, During and After the COVID-19 Lockdown in Singapore

The COVID-19 pandemic has significantly disrupted the lives of pre-primary school children in Singapore where increased infection rates prompted lockdown measures that altered children's daily routines. This study aimed to evaluate the impact of the pandemic on the lifestyle behaviours and health quality of 3134 children aged 5 to 6 years across three periods: pre-COVID, COVID-19 lockdown, and COVID-19 endemicity. Data were collected using the Surveillance of Digital Media Habits in Early Childhood Questionnaire (SMALLQ®) to measure on- and off-screen media habits of children and the Pediatric Quality of Life Inventory (PaedQL) to assess children's health quality. Adherence to physical activity (PA) guidelines dropped from 32.7% pre-COVID to 27.4% during lockdown but improved to 34.4% in endemicity (p < 0.05). Sleep (SL) adherence followed a similar pattern, decreasing from 33.4% to 27.9% before rising to 40.6% (p < 0.05). Screen time (ST) adherence significantly declined during lockdown (16.7% to 10.8%, p < 0.001). Weak positive correlations with all PaedQL metrics were observed across periods, except during endemicity (p < 0.05). Concerted efforts involving key stakeholders must be made to mitigate the negative effects of the pandemic on children's lifestyle behaviours and QoL, ensuring they are better prepared for the transition to primary school.

Centre-based childcare in early childhood and child obesity: systematic review and meta-analysis protocol

OBJECTIVES

Centre-based childcare has been identified as a promising environment for obesity prevention in early childhood, but the longitudinal relationships between attending centre-based childcare and child obesity are not well understood. The objective of this systematic review is to evaluate the longitudinal associations between centre-based childcare attendance in early childhood and child body mass index compared with other childcare settings or parental care. Subgroup analyses will also be conducted to determine if socioeconomic factors and characteristics of the childcare setting modify the relationships.

METHODS

Databases that will be searched include MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Database and Web of Science. Longitudinal prospective cohort studies, retrospective cohort studies, case-control studies and intervention trials conducted in middle-income and high-income countries will be included in the search strategy. Sensitivity and subgroup analyses will be conducted to explore factors that may modify the findings. Study selection, data extraction, risk of bias and quality of evidence assessments will be conducted independently and in duplicate by two reviewers. Risk of bias will be assessed using the Risk Of Bias In Non-randomized Studies - of Exposure tool. Meta-analysis will be conducted using random effects models to account for between-study variation. Heterogeneity across included studies will be estimated using the I2 statistic. If meta-analysis is not possible, a narrative summary will be provided. The quality of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.

ETHICS AND DISSEMINATION

Ethical approval is not required for this study since no data will be collected. Findings aim to inform interventions and guide efforts in childcare settings to support optimal child growth. Results will be published in a peer-reviewed journal. Results may be of relevance for childcare and public health policy, researchers, parents and healthcare practitioners.

PROSPERO REGISTRATION NUMBER

CRD42023436911.

Sociocultural Risk and Resilience in the Context of Adverse Childhood Experiences

Importance

Knowledge about childhood resilience factors relevant in circumstances of marginalization and high numbers of adverse childhood experiences (ACEs) can improve interventions.

Objective

To identify sociocultural resilience factors in childhood that are associated with better young adult mental health in the context of ACEs.

Design, Setting, and Participants

This cohort study examined 4 waves of data from the Boricua Youth Study, which included Puerto Rican children from the South Bronx, New York, and San Juan, Puerto Rico. Participants were aged 5 to 17 years at waves 1 through 3 (2000-2003) and aged 15 to 29 years at wave 4 (2013-2017). Linear and logistic regression models tested the associations of 7 childhood resilience factors and their interaction with ACEs on young adult mental health outcomes. Data were analyzed from June 2021 to October 2023.

Main Outcomes and Measures

Perceived stress, major depressive disorder and/or generalized anxiety disorder (MDD/GAD), and substance use disorder (SUD) in young adulthood.

Results

Among a total 2004 participants, the mean (SD) age at wave 4 was 22.4 (2.9) years; 1024 participants (51.1%) were female, and 980 (48.9%) were male. Positive parent-child relationships and nonparental adult support during childhood were associated with both lower perceived stress (β = -0.14; SE = 0.02; P < .001; β = -0.08; SE = 0.03; P = .003, respectively) and lower odds of MDD/GAD (adjusted odds ratio [aOR], 0.84; 95% CI, 0.73 to 0.97; aOR = 0.81; 95% CI, 0.69 to 0.95, respectively) in young adulthood. Maternal warmth reported during childhood was also associated with lower young adult perceived stress (β = -0.11; SE = 0.02; P < .001). None of the resilience factors were associated with SUD. The resilience factors familism, friendships, and family religiosity were not associated with any of the mental health outcomes. ACEs were associated with poorer mental health outcomes; however, none of the resilience factors exhibited interactions consistent with being protective for ACEs. Unexpectedly, higher family religiosity was associated with more perceived stress in the presence of higher ACEs.

Conclusions and Relevance

The results of this study suggest that promoting positive relationships with adults during childhood may reduce later young adulthood stress and MDD/GAD. However, there is still a need to identify sociocultural childhood protective factors for ACEs. Caution should be taken in assuming what resilience factors are relevant for a given group, as higher family religiosity (one postulated resilience factor) was unexpectedly associated with a stronger, rather than a weaker, association between ACEs and perceived stress in young adulthood.

Leveraging the interpersonal context of child development to promote family resilience: A universal prevention approach from preconception through early childhood

Significant mental health problems affect one in five youth in the United States; in tandem with the child mental health epidemic, parents in the United States report high and rising rates of burnout and mental health challenges of their own. Multiple well-established theoretical perspectives demonstrate the high degree of interdependence between children's and their parents' mental health, including intergenerational transmission, prenatal programming, attachment, and temperament and self-regulation theories. Drawing on these perspectives, we argue that a universal prevention approach that centers the development of psychopathology within the context of the parent-child dyad can promote resilience and arrest emerging mental health problems for children and their parents, during sensitive developmental windows (e.g., preconception through early childhood). Derived from this integrated theoretical framework, we review empirical support for the following targets to promote family resilience: screening for current and historical parent risk factors and resilience resources; strengthening healthy, reciprocal social ties; and supporting youth socioemotional skill acquisition. Our review of the literature highlights how improvements in these areas can have cascading benefits across development, for both parents and their children, as well as for future generations. We conclude with actionable, empirically-supported recommendations that can have profound impacts on these targets through changes in federal and state policies, community healthcare settings, and early childhood education and care programs. To achieve enduring, multigenerational impacts, societal and community-level policies, programs, and practices must interweave efforts to support child mental health with efforts to promote parent adjustment and wellbeing.

Early Emotion Development Intervention Improves Mental Health Outcomes in Low-Income, High-Risk Community Children

Children living in poverty and facing related forms of adversity are at higher risk for experiencing concurrent and later psychopathology. Although negative psychological outcomes can be improved by enhancing sensitive and responsive caregiving early in development, interventions targeting the caregiver-child dyad are not readily accessible. The present study investigated the feasibility and effectiveness of delivering a shortened eight-session form of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) in-person or remotely as an early intervention for 3-6-year-old children (N = 62) at elevated risk for psychopathology who were growing up in low-income communities. Caregiver-child dyads were randomized to eight-sessions of PCIT-ED or online parenting education. Relative to parenting education, children receiving PCIT-ED exhibited lower externalizing symptoms and functional impairment and more positive peer relationships following the intervention. Findings support the effectiveness of this shortened form of PCIT-ED, delivered in-person or remotely, as an early intervention to improve symptoms of psychopathology and functioning in high-risk children living in poverty.Trial registration Clinicaltrials.gov; NCT04399629.

Editorial: Environmental conditions for growing healthy children

The deleterious developmental effects of exposure to early adversity have been well documented in the scientific literature. The finding that poverty in early childhood is among the most robust predictors of a range of poor developmental outcomes has been well known for decades. More recently, evidence that early experiences of poverty and related forms of adversity negatively impact the function and structure of the developing brain have also emerged. Retrospective studies linking poor physical health outcomes to adverse childhood experiences (ACES) highlighted the more global nature of these risk factors to wellbeing and follow-up prospective studies have since confirmed these findings (Brown et al., 2009). Alternatively, it has become increasingly clear that early experiences of stimulation, nurturance, and caregiver support promote positive development outcomes with emerging evidence for tangible impacts on neurodevelopment in humans (Luby et al., 2021). However, the scientific and public health community has yet to synthesize these related bodies of data and develop a plan of action related to their over-reaching and global importance to protecting and promoting childhood health and development more generally despite numerous calls to do just that (Farah, 2018; Luby et al., 2020).