Relationship between oral health literacy of caregivers and the oral health-related quality of life of children: a cross-sectional study

Background

Oral health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate oral health decisions. However, scientific evidence about the oral health literacy of caregivers and the children’s oral health-related quality of life. The purpose of this study was to verify the relationship between the level of oral health literacy of caregivers and the children's oral health-related quality of life (OHRQOL).

Methods

This study was conducted with children aged 2 to 4 in Diadema, São Paulo, Brazil. Six hundred thirty children were examined to assess the prevalence of dental caries (dmft index). Parents were interviewed to obtain sociodemographic status, oral conditions, and oral health literacy (OHL). The variable outcome was the children's OHRQOL as assessed by the Early Childhood Oral Health Impact Scale (ECOHIS). We fitted zero-inflated negative binomial regression (ZINB) models to evaluate associations between the study outcome and covariates in terms of PR (Prevalence Ratios), RR (Rate Ratios), and their respective Confidence Intervals (95% CI).

Results

Children's OHRQOL was not associated with OHL. Dental caries had a negative impact on the children's quality of life (p < 0.05). A reduced impact on OHRQOL is also associated with having siblings (PR = 0.70, 95% CI 0.52–0.95). A higher age of the mother reduced OHRQOL impacts (PR = 0.72, 95% CI 0.52–0.98).

Conclusions

The factors associated with children's OHRQOL were the number of siblings, the mothers' age, and dental caries. This study observed no association between parental OHL and children's OHRQOL.

Prevalence of soil-transmitted helminths infections among preschool and school-age children in Ethiopia: a systematic review and meta-analysis

BACKGROUND

There is a lack of comprehensive national data on prevalence, geographical distribution of different species, and temporal trends in soil-helminthiasis (STHs). Therefore, this study aimed to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia.

METHODS

The search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar on data published between 1997 to February 2020 for studies describing the rate of STHs infection among preschool and school-age in Ethiopian. We followed the Patient, Intervention, Comparison, and Outcome (PICO) approach to identify the studies. Meta-regression was performed to understand the trends and to summarize the prevalence using the "metaprop" command using STATA software version 14.0 RESULTS: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48% (95% CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95% CI: 31-58%) in SNNPR, 34% (95% CI: 28-41%) in Amhara region, 31% (95% CI: 19-43%) in Oromia region and 10% (95% CI: 7-12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI: 30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI: 25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A lumbricoides was the predominant species with a prevalence of 17%.

CONCLUSION

Southern Nations Nationalities and Peoples Region, Amhara, and Oromia regions carry the highest-burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring MDA once annually with Albendazole or Mebendazole. The prevalence of STHs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia. The high prevalence of STHs observed in this review, underscores the need for better control and prevention strategies in Ethiopia.

How active can preschoolers be at home? Parents' and grandparents' perceptions of children's day-to-day activity, with implications for physical activity policy

BACKGROUND

The importance of physical activity in early childhood for establishing long-term health is well understood, yet with the exception of recent WHO guidelines, public health initiatives rarely focus on children below school age. Moreover, little is known about how domestic spaces and day-to-day caring activities influence preschool-age children's physical activity. To examine this, we explore caregivers' perceptions of young children's activities within and outside the home, and we consider how lived experiences of caregiving align (or not) with current physical activity policy.

METHODS

Semi-structured interviews with 49 parents and grandparents from 16 families were conducted in Oregon, USA; each family had a child aged 3-5 years. Questions focused on caregivers' perceptions of and involvement with children's body weights, activities, and food practices. The interviews were analysed using thematic analysis. Our analysis drew on a materialities framework, attending to relationships between children, caregivers, spaces in and around the home, and everyday activities.

RESULTS

Four themes were developed: appropriateness of outside versus inside spaces for physical activity; making accommodations for physical activity in the home; active spaces of care, referring to relationships among space, activity type, and caregiver attention; and mundane movement, or the low-intensity movement of everyday life. Together, the results highlight that children's day-to-day activities cut across a spectrum of movement, mediated by available spaces and caregiving affordances.

CONCLUSIONS

Attending to the full spectrum of children's movements highlights how children's activities interlink with family routines, available indoor and outdoor spaces, and the intended uses of these spaces. These interplays between space, care, and physical activity enacted at the household level should inform an integrated, systems-level public health approach to increasing health and well-being for preschool-age children. Suggestions for improvement include coordinating policy development across multiple fields (e.g., housing design, urban planning) that structure the activities of children and their caregivers across 'home' and 'outside' spaces.

Persistence of anaemia among Samoan preschool age children: a longitudinal study

OBJECTIVE

To characterise the prevalence and persistence of anaemia among Samoan children over a 2-3-year period.

DESIGN

Data were from two consecutive waves (2015 and 2017-2018) of the Ola Tuputupua'e 'Growing up' study. Anaemia (Hb < 11·0 or 11·5 g/dl for 2-4 and ≥ 5 years old, respectively) was considered 'transient' when it occurred at only one wave or 'persistent' if it was present at two consecutive waves. Child, maternal and household correlates of anaemia were examined using log-binomial and modified Poisson regressions.

SETTING

Eleven Samoan villages.

PARTICIPANTS

Mother-child pairs (n 257) recruited in 2015 and reassessed in 2017-2018.

RESULTS

Anaemia prevalence was 33·9 % in 2015 and 28·0 % in 2017-2018; 35·6 % of cases identified in 2015 were persistent. Risk of anaemia at only one wave was lower among children who were older in 2015 (age 4 v. 2 years, adjusted relative risk (aRR) = 0·54, (95 % CI 0·35, 0·84), P = 0·007), had older mothers (≥ 40 v. 18-29 years, aRR = 0·61, (95 % CI 0·39, 0·95), P = 0·029) and had higher daily sodium intake (for every 100 mg/d, aRR = 0·97, (95 % CI 0·95, 0·99), P = 0·003) than children with no anaemia. Children whose anaemia persisted were more likely to have had a mother with anaemia (aRR = 2·13, (95 % CI 1·17, 3·89), P = 0·013) and had higher daily dietary iron intake (for every 10 mg/d, aRR = 4·69, (95 % CI 1·33, 16·49), P = 0·016) than those with no anaemia.

CONCLUSIONS

Alongside broadly targeted prevention efforts, which are warranted given the moderate-high anaemia prevalence observed, specific attention should be paid to children with risk factors for persistent anaemia. Routine screening of children whose mothers have anaemia should be encouraged.

Systematic Review on the Application of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for Preschool-Aged Children

Trauma-focused cognitive behavioral therapy (TF-CBT) is one of the most widely studied and disseminated treatments for posttraumatic stress disorder (PTSD) and other comorbid conditions, and has been identified as a "level one" or "well-established" intervention for school-aged children and adolescents. The present systematic review examined the literature on the application of TF-CBT within a preschool-aged population (i.e., children ages three to six), as well as the developmental literature that could increase the efficacy of TF-CBT for preschool-aged children. Information on the use of TF-CBT with preschool-aged children was extracted from randomized controlled trials, case studies, meta-analyses, and other forms of empirical evidence, as part of the evidence-based practice in psychology framework. In comparison to research with school-aged children and adolescents, fewer studies have directly assessed the efficacy of TF-CBT for preschool-aged children who have been exposed to trauma. Given the few studies published to date and difference in treatment protocols for TF-CBT used with preschool-age children, TF-CBT appears to meet criteria as a "level two" or "probably efficacious" intervention for preschool-aged children specifically. According to the available literature, language and cognitive abilities, family context, culture, and clinician expertise are considered as potential variables to address when contemplating the use of TF-CBT for preschool-aged children with symptoms of post-traumatic stress.

Time trend of axial length and associated factors in 4- and 5-year-old children in Shanghai from 2013 to 2019

Purpose

To evaluate the time trend of axial length (AL) and associated factors in 4- and 5-year-old children in Shanghai from 2013 to 2019.

Methods

This was a 7-year observational study of 985 four-year-old and 1059 five-year-old children in Shanghai. AL, horizontal and vertical corneal curvature, spherical equivalent (SE), and body height and weight were measured. Furthermore, a questionnaire was collected, including time outdoors and bad eyesight habits.

Results

In 4-year-old children, no significant difference was found in AL (P = 0.526), but significant differences were observed in SE (P = 0.001), horizontal corneal curvature (P = 0.006), vertical corneal curvature (P = 0.004), height (P < 0.001), and weight (P = 0.022) from 2013 to 2019. In 5-year-old children, no significant differences were found in AL (P = 0.304), SE (P = 0.200), or weight (P = 0.292), but significant differences were observed in horizontal corneal curvature (P = 0.040), vertical corneal curvature (P = 0.015), and height (P < 0.001) from 2013 to 2019. Multivariate analyses revealed that AL was mainly significantly associated with boys and time outdoors in the 4- and 5-year-old children.

Conclusions

The AL of 4- and 5-year-old children remained relatively stable in Shanghai from 2013 to 2019. Longitudinal studies are needed to confirm the relationship between AL elongation and environmental risk factors.

Examination of the associations between young children's trauma exposure, trauma-symptomatology, and executive function

The present study used a bioecological framework to examine associations between trauma exposure, trauma-related symptomatology, and executive function (EF) in an urban sample of 88 predominantly ethnic-minority, low-income preschoolers (age 2-5) exposed to interpersonal trauma. Contrary to hypotheses based on past literature documenting associations between trauma exposure and EF deficits in childhood, in regressions adjusting for child gender, family income, and caregiver education, neither trauma exposure or trauma-related symptoms (post-traumatic stress symptoms, internalizing behaviors, or externalizing behaviors) were significantly associated with children's EF performance. Associations between child trauma exposure, symptomatology, and executive function were not moderated by parental PTSD symptomatology; and EF was not differentially predicted by type of trauma. Results suggest that, within an ethnically-diverse sample of preschool-aged children exposed to multiple traumas, associations between trauma exposure, symptomatology, and EF may be particularly nuanced. Keywords: child trauma, posttraumatic stress, executive function, preschool-age children, child mental health.

Residential pyrethroid insecticide use, urinary 3-phenoxybenzoic acid levels, and attention-deficit/hyperactivity disorder-like symptoms in preschool-age children: The Environment and Development of Children study

Previous animal studies have reported that pyrethroids can cause dopamine system abnormalities and attention-deficit/hyperactivity disorder (ADHD) phenotypes. However, epidemiological studies investigating the associations between pyrethroid exposure and ADHD are limited. We aimed to investigate the association between pyrethroid exposure and ADHD-like symptoms among preschool-age children. We used data from 385 children at 4 years of age participating in the Environment and Development of Children (EDC) study. We evaluated pyrethroid exposure through questionnaires and urinary 3-phenoxybenzoic acid (3-PBA) concentrations. We assessed ADHD-like symptoms using the Korean ADHD rating scale (K-ARS). We conducted negative binomial regressions to evaluate the associations between pyrethroid exposure and ADHD-like symptoms. Residential use of insecticide adhesive (β = 0.42, 95% CI: 0.11, 0.74) and insecticide spray (β = 0.33, 95% CI: 0.08, 0.59) was associated with an increase in log-transformed creatinine-adjusted urinary 3-PBA concentrations. Residential insecticide adhesive use was associated with a 51.6% increase in K-ARS scores (95% confidence interval [CI]: 6.3, 116.1) among boys, when compared with non-users. When compared with creatinine-adjusted 3-PBA levels <0.50 μg/g creatinine, creatinine-adjusted 3-PBA levels ≥3.80 μg/g creatinine were associated with a 58% increase in K-ARS scores (95% CI: 0.1, 150.5) among boys. We found associations of residential pyrethroid insecticide use and urinary 3-PBA concentrations with K-ARS scores among preschool-age boys. Since the present study explored cross-sectional associations in preschool-age children, the possibility of reverse causality cannot be dismissed. Further studies implementing a cohort study design are warranted.

Epidemiology of intestinal parasitic infections in preschool and school-aged Ethiopian children: a systematic review and meta-analysis

BACKGROUND

Numerous studies have been carried out on assessing the prevalence of intestinal parasites infections (IPIs) amongpreschool and school-age children in Ethiopia, but there is lack of study systematically gathered and analyzedinformation for policymakers. Therefore, the aim of this systematic review and meta-analysis was to provide a summary on prevalence, geographical distribution and trends of IPIs among preschool and school-age childrenin Ethiopia.

METHODS

The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar from 1996to July2019 for studies describing prevalence of IPIs among preschooland school-age children. We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using 'metaprop' command using STATA software version 14.

RESULTS

Eighty-three(83) studies examining 56,786 fecal specimens were included. The prevalence of IPIs was 48%(95%CI: 42 to 53%) and showedsignificantly decreasing trends 17% (95% CI: 2.5 to 32%) for each consecutive 6 years) and was similar in males and females. The pooled prevalence in years 1997-2002, 2003-2008, 2009-2014 and > 2014 was 71% (95% CI: 57 to 86%), 42% (95% CI: 27 to 56%), 48% (95% CI: 40 to 56%) and 42% (95% CI: 34 to 49%), respectively. Poly-parasitism was observed in 16% (95% CI: 13 to 19%,) of the cases.

CONCLUSION

Intestinal parasite infections are highly prevalent among preschool and school-age children and well distributed across the regional states of Ethiopia. Southern and Amhara regional states carry the highest burden. We observed significant decreasing trends in prevalence of IPIs among preschool and school-ageEthiopian children over the last two decades. Therefore, this study is important to locate the geographical distribution and identified high risk areas that should be prioritized further interventions, which complement global efforts towards elimination of IPIs infections by 2020.

The effects of supplementing maternal and infant diets with lipid-based nutrient supplements on physical activity and sedentary behaviour at preschool age in Ghana

Evidence on whether nutritional supplementation affects physical activity (PA) during early childhood is limited. We examined the long-term effects of lipid-based nutrient supplements (LNS) on total PA, moderate-to-vigorous PA (MVPA) and sedentary behaviour (SB) of children at 4-6 years using an accelerometer for 1 week. Their mothers were enrolled in the International Lipid-based Nutrient Supplement-DYAD randomised controlled trial in Ghana, assigned to daily LNS or multiple micronutrients (MMN) during pregnancy through 6 months postpartum or Fe and folic acid (IFA) during pregnancy and placebo for 6 months postpartum. From 6 to 18 months, children in the LNS group received LNS; the other two groups received no supplements. Analysis was done with intention to treat comparing two groups: LNS v. non-LNS (MMN+ IFA). Of the sub-sample of 375 children fitted with accelerometers, 353 provided sufficient data. Median vector magnitude (VM) count was 1374 (interquartile range (IQR) 309), and percentages of time in MVPA and SB were 4·8 (IQR 2) and 31 (IQR 8) %, respectively. The LNS group (n 129) had lower VM (difference in mean -73 (95 % CI -20, -126), P = 0·007) and spent more time in SB (LNS v. non-LNS: 32·3 v. 30·5 %, P = 0·020) than the non-LNS group (n 224) but did not differ in MVPA (4·4 v. 4·7 %, P = 0·198). Contrary to expectations, provision of LNS in early life slightly reduced the total PA and increased the time in SB but did not affect time in MVPA. Given reduced social-emotional difficulties in the LNS group previously reported, including hyperactivity, one possible explanation is less restless movement in the LNS group.

A qualitative study of the multi-level influences on oral hygiene practices for young children in an Early Head Start program

BACKGROUND

Individual child-level risk factors for Early Childhood Caries (ECC) have been studied, but broader family- and community-level influences on child oral hygiene behaviors are less well understood. This study explored multiple levels of influence on oral hygiene behaviors for young children in Early Head Start (EHS) to inform a future behavioral intervention targeting children from low-income families.

METHODS

Twenty-four semi-structured interviews were conducted with mothers of children under 4 years old, enrolled in the home visitor (HV) component of one EHS program in Los Angeles, CA, who participated in the BEhavioral EConomics for Oral health iNnovation pilot study (BEECON) in 2016-7. Audio-recordings of interviews were translated if needed, and transcribed in English, and coding and analysis was facilitated by Dedoose qualitative software. This investigation used general thematic analysis guided by the Fisher-Owens child oral health conceptual framework to identify influences on oral hygiene behaviors for the young children.

RESULTS

Many mothers reported brushing their children's teeth twice/day, and concern that most children frequently resisted brushing. They identified children being sick or tired/asleep after outings as times when brushing was skipped. Several child-, family-, and community-level themes were identified as influences on child oral hygiene behaviors. At the child-level, the child's developmental stage and desire for independence was perceived as a negative influence. Family-level influences included the mother's own oral hygiene behaviors, other family role models, the mother's knowledge and attitudes about child oral health, and mothers' coping skills and strategies for overcoming challenges with brushing her child's teeth. Overall, mothers in the EHS-HV program were highly knowledgeable about ECC risk factors, including the roles of bacteria and sugar consumption, which motivated regular hygiene behavior. At the community-level, mothers discussed opportunities to connect with other EHS-HV families during parent meetings and playgroups that HV coordinated. A few mothers noted that EHS-HV playgroups included brushing children's teeth after snacking, which can be a potential positive influence on children's hygiene practices.

CONCLUSION

Child-, family- and community-level factors are important to consider to inform the development of tailored oral health preventive care programs for families in EHS-HV programs.

The effect of content and tone of maternal evaluative feedback on self-cognitions and affect in young children

Feedback that young children receive from others can affect their emotions and emerging self-views. The current experiment tested the effect of negative content (criticism) and negative tone (hostile) of the feedback on children's affect, self-evaluations, and attributions. We also explored whether maternal history of depression and children's temperament moderated these relations. Participants were 152 mothers and children (48% girls) aged 4 and 5 years (M = 61.6 months, SD = 6.83). The task involved three scenarios enacted by dolls; a child doll made something (e.g., picture, house, numbers) that had a mistake (e.g., no windows on the house) and proudly showed it to the mother doll, who then gave feedback (standardized, audio recorded) to the child. Children were randomized to one of four maternal feedback conditions: negative or neutral content in either a negative or neutral tone. Negative content (criticism) produced significantly more negative affect and lower self-evaluations than neutral content. When the tone of the feedback was hostile, children of mothers who had been depressed during the children's lifetimes were significantly more likely to make internal attributions for mistakes than children of nondepressed mothers. In addition, among children with low temperamental negative affectivity, in the presence of negative tone, negative content significantly predicted more internal attributions for the errors. Findings are discussed in terms of understanding the role of evaluative feedback in children's emerging social cognitions and affect.

Child development center-based sentinel surveillance of soil-transmitted helminthiases in preschool-age children in selected local government units in the Philippines

Soil-transmitted helminthiasis (STH) remains a public health concern in developing countries, such as the Philippines. Preschool-age children (PSAC) are among the high-risk groups for STH. Data on the status of STH in PSAC are needed to help guide policy formulation and program implementation; however, in the usual setting, such data may remain limited. This study aimed to describe the parasitologic status of PSAC in selected local government units (LGUs) in the Philippines through sentinel surveillance methodology in a child-development center (CDC)-based setting. This cross-sectional study, which included 1732 PSAC in selected barangays (a village or the smallest administrative unit in the country) in the provinces of Cavite, Guimaras, Iloilo, Negros Occidental, and Davao del Norte and cities of Iloilo and Lapu-Lapu in the Philippines, utilized Kato-Katz technique to determine parasitologic status. A single Kato-Katz smear was prepared from the adult-thumb sized stool sample submitted by each participant. Ten percent of Kato-Katz slides examined by field microscopists were re-examined by a reference microscopist as part of quality control. Results showed a prevalence of any STH infection and a moderate-heavy ((M-H)) intensity prevalence of 24.9% and 10.3%, respectively. Five cases of schistosomiasis were found in Lapu-Lapu City and Davao del Norte. While the Philippines' Department of Health (DOH) - Integrated Helminth Control Program (IHCP) target for prevalence of any STH of less than 50% was attained, none of the barangays or villages met the World Health Organization (WHO) target for (M-H) intensity STH prevalence of less than 1%, despite the program being implemented for almost a decade. Sentinel surveillance in PSAC, possibly adopting a CDC-based approach, may be implemented biannually in the Philippines and other countries where a similar early child care development system exist to generate data needed to guide policy formulation and program implementation. Preventive chemotherapy through facility-based mass drug administration (MDA), such as CDC-based MDA, may be explored to improve the mode of MDA delivery and coverage in PSAC.

Prevalence, intensity and factors associated with soil-transmitted helminths infections among preschool-age children in Hoima district, rural western Uganda

Background

Over 80% of morbidity due to soil-transmitted helminthiasis (STH) occurs in low-income countries. Children under 5 account for 20–30% of the burden in endemic areas. This study assessed the prevalence, intensity and factors associated with STH infections among preschool-age children (PSAC) in Hoima district, Uganda. The PSAC are particularly vulnerable because the chronicity of this condition usually affects their physical and mental growth and development.

Methods

A cross-sectional study was carried out among 562 PSAC (1–5 years old) in 6 counties of Hoima district using Expanded Program on Immunization (EPI) method. Stool samples from children were examined using the formol ether concentration technique for STH egg detection. Egg counts were represented as egg per gram (EPG). A structured questionnaire was used to collect information on factors associated with STH infection. Generalized linear models were used to analyze relationships between STH infection and associated factors.

Results

Overall STH prevalence was 26.5%. Hookworm infection was the most prevalent (18.5%), followed by A.lumbricoides (9.8%) and T.trichiura (0.5%). Prevalence of STH infection was significantly higher in children aged 5 years (Pearson chi-square test, p = 0.009) than in children aged 1 year. The general geometric mean (GM) counts for Hookworm infection was (696.1 EPG; range (530.3–913.8)) with girls having a higher GM (789.8 EPG; range (120–13,200)) than boys. Eating uncooked or unwashed vegetables (adj. Prevalence Ratio (PR) = 1.9, 95% CI: 1.3–2.7) and fruits (adj.PR = 1.8, 95% CI: 1.1–2.8), indiscriminate disposal of young children’s faeces (adj.PR = 1.5, 95% CI: 1.1–2.0); not washing hands after defecation (adj.PR = 2.6, 95% CI: 1.9–3.6); and not deworming children regularly (adj.PR = 1.4, 95% CI: 1.1–1.8) were significantly associated with STH infection.

Conclusion

The prevalence of Soil transmitted helminths infection among preschool-age children in Hoima district significantly increased with age. Poor hygiene, inadequate sanitation and irregular deworming were associated with STH infections among PSAC in the study area. Intense health education on the importance of hygienic practices, improved sanitation and regular deworming of PSAC should be integrated into prevention and control programs.

Electronic supplementary material

The online version of this article (10.1186/s12879-018-3289-0) contains supplementary material, which is available to authorized users.

Expressed parental concern regarding childhood stuttering and the Test of Childhood Stuttering

PURPOSE

The purpose of the present study was to determine whether the Test of Childhood Stuttering observational rating scales (TOCS; Gillam et al., 2009) (1) differed between parents who did versus did not express concern (independent from the TOCS) about their child's speech fluency; (2) correlated with children's frequency of stuttering measured during a child-examiner conversation; and (3) correlated with the length and complexity of children's utterances, as indexed by mean length of utterance (MLU).

METHOD

Participants were 183 young children ages 3:0-5:11. Ninety-one had parents who reported concern about their child's stuttering (65 boys, 26 girls) and 92 had parents who reported no such concern (50 boys, 42 girls). Participants' conversational speech during a child-examiner conversation was analyzed for (a) frequency of occurrence of stuttered and non-stuttered disfluencies, and (b) MLU. Besides expressing concern or lack thereof about their child's speech fluency, parents completed the TOCS observational rating scales documenting how often they observe different disfluency types in speech of their children, as well as disfluency-related consequences.

RESULTS

There were three main findings. First, parents who expressed concern (independently from the TOCS) about their child's stuttering reported significantly higher scores on the TOCS Speech Fluency and Disfluency-Related Consequences rating scales. Second, children whose parents rated them higher on the TOCS Speech Fluency rating scale produced more stuttered disfluencies during a child-examiner conversation. Third, children with higher scores on the TOCS Disfluency-Related Consequences rating scale had shorter MLU during child-examiner conversation, across age and level of language ability.

CONCLUSIONS

Findings support the use of the TOCS observational rating scales as one documentable, objective means to determine parental perception of and concern about their child's stuttering. Findings also support the notion that parents are reasonably accurate, if not reliable, judges of the quantity and quality (i.e., stuttered vs. non-stuttered) of their child's speech disfluencies. Lastly, findings that some children may decrease their verbal output in attempts to minimize instances of stuttering - as indexed by relatively low MLU and a high TOCS Disfluency-Related Consequences scores - provides strong support for sampling young children's speech and language across various situations to obtain the most representative index possible of the child's MLU and associated instances of stuttering.

Validity of a scale of neighbourhood informal social control relevant to pre-schoolers' physical activity: A cross-sectional study

Childhood physical activity (PA) is important for health across the lifespan. Time pre-schoolers spend outdoors, which has been associated with more PA, is likely influenced by parents' perception of neighbourhood informal social control relevant to pre-schoolers' PA, defined as the willingness of neighbours to intervene to ensure social order and a safe community environment for young children's active play. To advance measurement of this construct, we assessed factorial and construct validities of the PA-related neighbourhood informal social control scale for parents of pre-schoolers (PANISC-PP). In 2013-2014, Hong Kong primary caregivers (n=394) of 3-5 year-old children completed a socio-demographic questionnaire, the preliminary version of the PANISC-PP, and self-report measures of theoretical neighbourhood correlates of PA-related neighbourhood informal social control (perceived signs of physical and social disorder, community cohesion, perceived stranger danger, risk of unintentional injury and traffic safety). The fit of the data to an a priori measurement model of the PANISC-PP was examined using confirmatory factor analyses. As the a priori model showed inadequate fit to the data, the factor structure was re-specified based on theoretical considerations. The final measurement models of the PANISC-PP showed acceptable fit to the data and consisted of three correlated latent factors: "General informal supervision", "Civic engagement for the creation of a better neighbourhood environment" and "Educating and assisting neighbourhood children". The internal reliability of the subscales was good (Cronbach's α values 0.82-0.89). Generalised additive mixed models indicated that all subscales were positively associated with community cohesion and scores on the subscale "Educating and assisting neighbourhood children" were related in the expected direction to all indicators of traffic and personal safety, supporting construct validity of the PANISC-PP. This study suggests that the PANISC-PP is a reliable and valid instrument for assessing parents' perceived neighbourhood informal social control related to pre-schoolers' PA.

The effect of deworming on early childhood development in Peru: A randomized controlled trial

Background

There is a knowledge gap on the effect of early childhood deworming on development in low- and middle-income countries. This evidence is important in the critical window of growth and development before two years of age.

Methods

A randomized controlled trial of the benefit, and optimal timing and frequency, of deworming on development was conducted in Iquitos, Peru. Children were enrolled during routine 12-month growth and development visits and randomly allocated to: (1) deworming at the 12-month visit and placebo at the 18-month visit; (2) placebo at the 12-month visit and deworming at the 18-month visit; (3) deworming at the 12 and 18-month visits; or (4) placebo at the 12 and 18-month visits. The Bayley Scales of Infant Development III was used to assess cognitive, language and motor skills at the 12 and 24-month visits. One-way ANOVA analyses used an intention-to-treat approach.

Results

Between September 2011 and June 2012, 1760 children were enrolled. Attendance at the 24-month visit was 88.8% (n=1563). Raw scores on all subtests increased over 12 months; however, cognitive and expressive language scaled scores decreased. There was no statistically significant benefit of deworming, or effect of timing or frequency, on any of the development scores. Baseline height and weight and maternal education were associated with development scores at 24 months.

Conclusions

After 12 months of follow-up, an overall benefit of deworming on cognition, language or fine motor development was not detected. Additional integrated child and maternal interventions should be considered to prevent developmental deficits in this critical period.

•

This is the first and largest deworming trial exclusively in 1-year-old children.

•

We examined the effect of deworming on early childhood development.

•

Deworming did not impact cognition, language or motor skills.

•

Concomitant poverty and malnutrition may obscure the true effect of deworming.

Speech disfluencies of preschool-age children who do and do not stutter

PURPOSE

The goals of the present study were to investigate whether (1) the speech disfluencies of preschool-age children are normally distributed; (2) preschool-age children who do (CWS) and do not stutter (CWNS) differ in terms of non-stuttered disfluencies; (3) age, gender, and speech-language ability affect the number and type of disfluencies children produce; and (4) parents' expressed concern that their child stutters is associated with examiners' judgments of stuttered disfluency.

METHOD

Four hundred and seventy two children participated, of which 228 were CWS (56 girls), and 244 CWNS (119 girls). Participants provided conversational speech samples that were analyzed for frequency of occurrence of (a) stuttered disfluencies, (b) non-stuttered disfluencies, and (c) total disfluencies.

RESULTS

Results indicated that the underlying distributions of preschool-age children's stuttered and non-stuttered disfluency counts followed a negative binomial distribution (i.e., were not normal), with more children "piling up" at the low end [none or few disfluencies] and fewer children scoring in the upper [more severe stuttering] end of the distribution. Findings also indicated that non-stuttered disfluencies significantly predicted CWS/CWNS talker group classification, information that may be helpful to augment, but not supplant, talker group classification criteria based on stuttered disfluencies. Moreover, expressed parental concern about stuttering was strongly associated with frequency of stuttered disfluencies.

CONCLUSION

Findings suggest that the entirety of preschool-age CWS' speech disfluencies - non-stuttered as well as stuttered - differs from that of their CWNS peers and that because these disfluencies are not normally distributed statistical analyses assuming normality of distribution are not the most appropriate means to assess these differences. In addition, certain "third-order" variables (e.g., gender) appear to impact frequency of children's disfluencies and expressed parental concerns about stuttering are meaningfully related to examiners' judgments of stuttered disfluencies.

LEARNING OUTCOMES

The reader will recognize differences in speech disfluencies of preschool-age children who do and do not stutter. The reader will recognize whether age, gender and speech-language ability affect the number and type of disfluencies children produce. The reader will describe whether parental concern about stuttering is associated with examiners' judgments of stuttering.

Speech sound articulation abilities of preschool-age children who stutter

PURPOSE

The purpose of this study was to assess the association between speech sound articulation and childhood stuttering in a relatively large sample of preschool-age children who do and do not stutter, using the Goldman-Fristoe Test of Articulation-2 (GFTA-2; Goldman & Fristoe, 2000).

METHOD

Participants included 277 preschool-age children who do (CWS; n=128, 101 males) and do not stutter (CWNS; n=149, 76 males). Generalized estimating equations (GEE) were performed to assess between-group (CWS versus CWNS) differences on the GFTA-2. Additionally, within-group correlations were performed to explore the relation between CWS' speech sound articulation abilities and their stuttering frequency and severity, as well as their sound prolongation index (SPI; Schwartz & Conture, 1988).

RESULTS

No significant differences were found between the articulation scores of preschool-age CWS and CWNS. However, there was a small gender effect for the 5-year-old age group, with girls generally exhibiting better articulation scores than boys. Additional findings indicated no relation between CWS' speech sound articulation abilities and their stuttering frequency, severity, or SPI.

CONCLUSIONS

Findings suggest no apparent association between speech sound articulation-as measured by one standardized assessment (GFTA-2)-and childhood stuttering for this sample of preschool-age children (N=277).

EDUCATIONAL OBJECTIVES

After reading this article, the reader will be able to: (1) discuss salient issues in the articulation literature relative to children who stutter; (2) compare/contrast the present study's methodologies and main findings to those of previous studies that investigated the association between childhood stuttering and speech sound articulation; (3) identify future research needs relative to the association between childhood stuttering and speech sound development; (4) replicate the present study's methodology to expand this body of knowledge.