Children

12 pages, 242 KiB

Open AccessArticle

Spanish Version of the Measure of Processes of Care (20 Items): Psychometric Properties

by Manuel Pacheco-Molero, Catalina Patricia Morales-Murillo, Irene León-Estrada, Roberto Hernández-Soto and Mónica Gutiérrez-Ortega

Children 2025, 12(7), 871; https://doi.org/10.3390/children12070871 (registering DOI) - 1 Jul 2025

Abstract

Background/Objectives: Family perceptions of family-centered services are important for improving processes and outcomes of services for children with disabilities or developmental risk. The Measure of Processes of Care 20-item version (MPOC-20) assesses family-centered practice from parents’ perspectives. This study examined for the first [...] Read more.

Background/Objectives: Family perceptions of family-centered services are important for improving processes and outcomes of services for children with disabilities or developmental risk. The Measure of Processes of Care 20-item version (MPOC-20) assesses family-centered practice from parents’ perspectives. This study examined for the first time the psychometric properties of the first Spanish version of the MPOC-20 in children with disabilities aged 0–18 years. Methods: A total of 659 families from 51 care services across Spain completed the MPOC-20, with participants randomly divided into two samples: one for exploratory factor analysis (EFA) and the other for confirmatory factor analysis (CFA). Results: The results confirmed a two-factor model, with the best fit for the dimensions of providing comprehensive and supportive care and providing information. Internal consistency analysis indicated strong reliability of the factor scores. Conclusions: The Spanish version of the MPOC-20 demonstrated good psychometric properties and is recommended for assessing the quality of family-centered services. Full article

(This article belongs to the Special Issue Nursing Management in Pediatric Intensive Care)

5 pages, 280 KiB

Open AccessEditorial

Motor Aspects of Handwriting Acquisition and Developmental Dysgraphia

by Caroline Jolly

Children 2025, 12(7), 870; https://doi.org/10.3390/children12070870 (registering DOI) - 30 Jun 2025

Abstract

Handwriting is a complex skill involving perceptual, motor, linguistic, and cognitive processes [...] Full article

(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)

20 pages, 509 KiB

Open AccessReview

Sleep Disorders in Children with Rett Syndrome

by Christopher Harner, Thomas A. Gaffey, Shannon S. Sullivan, Manisha Witmans, Lourdes M. DelRosso and Mary Anne Tablizo

Children 2025, 12(7), 869; https://doi.org/10.3390/children12070869 (registering DOI) - 30 Jun 2025

Abstract

Rett syndrome (RTT) is an X-linked neurodevelopmental disorder marked by neurological regression, autonomic dysfunction, seizures, and significant sleep and breathing abnormalities. About 80% of affected individuals, especially young children, experience sleep disturbances such as insomnia, sleep-disordered breathing, nocturnal vocalizations, bruxism, and seizures. Breathing [...] Read more.

Rett syndrome (RTT) is an X-linked neurodevelopmental disorder marked by neurological regression, autonomic dysfunction, seizures, and significant sleep and breathing abnormalities. About 80% of affected individuals, especially young children, experience sleep disturbances such as insomnia, sleep-disordered breathing, nocturnal vocalizations, bruxism, and seizures. Breathing irregularities during sleep—like apnea, alternating hyperventilation, and hypoventilation—are common, with both obstructive and central sleep apnea identified through polysomnography. This review focuses on the prevalent sleep disorders in children with Rett syndrome and highlights current recommendations for the management of sleep disorders. Full article

(This article belongs to the Special Issue Children and Adolescents with Neurodevelopmental Disabilities: Ecological Assessment Tools and Cognitive Analysis)

13 pages, 546 KiB

Open AccessArticle

The Significance of Elevated sST2 in Children with Kawasaki Disease

by Zhaohua Yang, Yunming Xu, Yanqiu Chu, Jinghao Li and Hong Wang

Children 2025, 12(7), 868; https://doi.org/10.3390/children12070868 (registering DOI) - 30 Jun 2025

Abstract

Objectives: Kawasaki Disease (KD) is an acute vasculitis associated with systemic inflammation. This study aimed to investigate the level and clinical significance of soluble ST2 (sST2) in children with KD. Methods: A retrospective analysis was conducted on 287 pediatric KD patients treated at [...] Read more.

Objectives: Kawasaki Disease (KD) is an acute vasculitis associated with systemic inflammation. This study aimed to investigate the level and clinical significance of soluble ST2 (sST2) in children with KD. Methods: A retrospective analysis was conducted on 287 pediatric KD patients treated at the Pediatric Cardiology Department of Shengjing Hospital, China Medical University, from November 2021 to December 2022. Patients were stratified into subgroups based on the presence of myocardial damage (MD), coronary artery lesions (CAL), multi-organ involvement (MOD; ≥3 organs) and/or intravenous immunoglobulin-resistant KD (IVIG-R KD). In each group, we analyzed the correlation between sST2 levels and various laboratory parameters, including white blood cell count (WBC), hemoglobin (HB), platelet count (PLT), C-reactive protein (CRP), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), N-terminal pro-brain natriuretic peptide (NT-pro BNP), D-dimer, and albumin (ALB). Results: Patients in the CAL group were significantly younger and predominantly male (p < 0.05). In the MD, CAL, MOD, and IVIG-R KD groups, levels of sST2, CRP, NT-pro BNP, and D-dimer were significantly higher than in their respective comparison groups (p < 0.05). sST2 showed weak positive correlations with WBC, CRP, IL-6, NT-pro BNP, and D-dimer, and weak negative correlations with HB and ALB (p < 0.05). sST2, HB, and IL-6 were identified as independent risk factors for MOD (p < 0.05). sST2 and HB were independent risk factors for IVIG-R KD (p < 0.05). Among acute-phase patients, four cases had sST2 levels > 200 ng/mL—all were classified as IVIG-R KD and MOD; three of these also developed coronary artery aneurysms (CAA). Conclusions: Elevated sST2 levels in the acute phase of KD may serve as a clinical indicator of IVIG-R KD, CAA, MOD, and MD. Full article

(This article belongs to the Special Issue Kawasaki Disease in Children: Advance and Challenges)

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14 pages, 223 KiB

Open AccessArticle

Factor Structure and Validity of the Japanese Version of the Emotional Availability Self-Report

by Nozomi Kanehira, Young Ae Kang, Eriko Suwa, Sugako Asaeda, Toshihiko Tsutsumi, Keiko Tsuji, Koudai Fukudome, Mina Nakano and Masamichi Yuzawa

Children 2025, 12(7), 867; https://doi.org/10.3390/children12070867 (registering DOI) - 30 Jun 2025

Abstract

Background/Objectives: Emotional interactions between mothers and children are essential for later developmental outcomes such as children’s health, social competence, and language skills. However, an observational assessment of such interactions cannot reveal how mothers perceive their relationships with their children. Therefore, in this study, [...] Read more.

Background/Objectives: Emotional interactions between mothers and children are essential for later developmental outcomes such as children’s health, social competence, and language skills. However, an observational assessment of such interactions cannot reveal how mothers perceive their relationships with their children. Therefore, in this study, we translated and validated the Japanese version of the Emotional Availability Self-Report (EA-SR-J) and examined its factor structure, reliability, and validity. Methods: The participants were 739 Japanese mothers with children aged from 1 month to 5 years and 11 months. Results: Exploratory factor analysis revealed 19 items and four factors (Affect Quality, Hostility, Mutual Attunement, and Child Involvement with Parent) for the EA-SR-J. However, Intrusiveness was removed, and some items were assigned to different factors compared with the original scale. Cronbach’s alpha of each subscale ranged from 0.81 to 0.88, indicating sufficient internal consistency. The convergent validity of the scale was confirmed with expected correlations with variables related to attachment and child-rearing style. Discriminant validity was confirmed by group differences in variables related to children’s autism spectrum disorder symptoms and mothers’ depression symptoms. Conclusions: Although the EA-SR-J contains fewer items than the original scale, with the Intrusiveness item removed, it remains a reliable and valid tool. Further studies using the Emotional Availability Scale based on observation are needed in the future. Full article

(This article belongs to the Section Pediatric Mental Health)

16 pages, 1513 KiB

Open AccessArticle

From Alginate to Pixel: Comparing the Effect of Two Dental Impression Methods on Children’s Anxiety

by Isabel Cristina Miranda Ataíde, Clara Serna-Muñoz, Cristina Maria Ferreira Guimaraes Pereira Areias, Álvaro Amadeu Ferreira de Azevedo, Romeu Eduardo Pereirinha Henriques Ferreira de Andrade and Antonio José Ortiz-Ruiz

Children 2025, 12(7), 866; https://doi.org/10.3390/children12070866 (registering DOI) - 30 Jun 2025

Abstract

Background/Objectives: Alginate dental impressions are often among the most anxiety-inducing procedures for pediatric patients due to discomfort caused by nausea, gagging, and the vomiting reflex. This technique frequently raises anxiety levels in children. In contrast, intraoral scanners are increasingly used in clinical practice [...] Read more.

Background/Objectives: Alginate dental impressions are often among the most anxiety-inducing procedures for pediatric patients due to discomfort caused by nausea, gagging, and the vomiting reflex. This technique frequently raises anxiety levels in children. In contrast, intraoral scanners are increasingly used in clinical practice and offer a more comfortable alternative. Physiological parameters such as heart rate (HR) and oxygen saturation (SpO₂) are useful, objective indicators of anxiety. This study aimed to evaluate significant changes in HR and SpO₂ during dental impression procedures using two techniques—an analog (alginate) and a digital (intraoral scanner) one—in both dental arches, to determine the method inducing the least anxiety. Methods: A non-interventional clinical study was conducted on a sample of 30 children. A fingertip pulse oximeter was used to measure HR and SpO₂ during impression taking with alginate and with an intraoral scanner. Statistical analysis was performed using SPSS^® (Version 30.0. Amonk, NY, USA: IBM Corp). Descriptive statistics (mean and standard deviation) were calculated, and the Friedman and Wilcoxon tests with Bonferroni correction were applied, using a 5% significance level. The study was approved by the Ethics Committee of the University of Murcia. Results: Alginate impressions produced a statistically significant increase in HR in both the upper [(19 ± 11) bpm] and lower [(18 ± 9) bpm] arches compared to the scanner [(7 ± 5) bpm and (7 ± 4) bpm, respectively] (χ² = 49.30; p < 0.001). SpO₂ levels also dropped more when using alginate for both the upper and lower arches [(−2 ± 2)% and (−2 ± 3)%, respectively] than when using the scanner [(−1 ± 1)% in both arches] (χ² = 21.41; p < 0.001). Conclusions: Alginate impressions triggered a significant anxiety response, as evidenced by significant changes in HR and SpO₂. Intraoral scanners were less invasive, as indicated by the greater proximity of the physiological parameters to the baseline values, making them a promising alternative in pediatric dentistry. Full article

(This article belongs to the Collection Advance in Pediatric Dentistry)

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13 pages, 811 KiB

Open AccessArticle

The Impact of Recess on Chronic Stress Levels in Elementary School Children

by Deborah J. Rhea, Kelsey Kirby, Dennis Cheek, Yan Zhang and G. Kate Webb

Children 2025, 12(7), 865; https://doi.org/10.3390/children12070865 (registering DOI) - 30 Jun 2025

Abstract

Background: Over the last 30 years, stress and anxiety in children have risen exponentially, especially as a result of school expectations. As no studies have examined the effect of increased outdoor recess on children’s chronic stress levels, this preliminary work focused on comparing [...] Read more.

Background: Over the last 30 years, stress and anxiety in children have risen exponentially, especially as a result of school expectations. As no studies have examined the effect of increased outdoor recess on children’s chronic stress levels, this preliminary work focused on comparing hair cortisol concentration (HCC) scores of elementary children who received varied amounts of daily recess. Methods: HCC scores were collected from 4th grade elementary children (N = 130) from three intervention schools (45 min daily recess) (N = 64; M = 35; F = 29) and three control schools (30 min daily recess) (N = 66; M = 31; F = 35). Results: A two-way ANOVA, F(1, 123) = 5.47, p = 0.021, ω² = 0.034, showed that the intervention group reflected lower HCC levels (marginal M = 5.69, 95% CI [−1.92, 13.30]) than the control group (marginal M = 18.22, 95% CI [10.83, 25.61]). Post hoc analysis revealed an estimated marginal mean difference of −12.53 (SE = 5.36, p = 0.021). Sample t-tests compared HCC levels against the pre-COVID normative value of 7.5 pg/mg. The intervention group HCC mean (M = 5.85, SD = 6.26) was significantly lower than the normative value, t(61) = −2.08, p = 0.042. The control group’s mean HCC (M = 18.22, SD = 41.39) was significantly higher than the normative value, t(64) = 2.09, p = 0.041. Conclusions: Increasing daily recess may contribute to lower chronic stress levels among 4th grade children. With obesity and mental health disorders on the rise and American students’ academic performance on the decline, these pilot results cannot be overlooked or dismissed. Full article

(This article belongs to the Section Pediatric Mental Health)

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13 pages, 925 KiB

Open AccessReview

Early Hearing Interventions for Children with Hearing Loss in Africa: A 21-Year Scoping Review (2004–2025)

by Stavros Hatzopoulos, Ludovica Cardinali, Piotr Henryk Skarzynski, Abiodun Adewunmi and Giovanna Zimatore

Children 2025, 12(7), 864; https://doi.org/10.3390/children12070864 (registering DOI) - 30 Jun 2025

Abstract

Background: The objectives of this scoping review were (a) to identify the most recent (in a 21-year span) literature information about hearing intervention programs in Africa and (b) to provide data on the intervention practices, policies and the factors prohibiting the larger diffusion [...] Read more.

Background: The objectives of this scoping review were (a) to identify the most recent (in a 21-year span) literature information about hearing intervention programs in Africa and (b) to provide data on the intervention practices, policies and the factors prohibiting the larger diffusion of the hearing technologies in the African states. Methods: Queries were conducted via the PubMed and Scopus databases for the time window from 2005 to 2025. The mesh terms used were “hearing aids”, “cochlear implants”, and “hearing intervention Africa”. Only research articles and review papers were considered as good candidates. The standard English language filter was not used, so as to also identify information from non-English-speaking scientific communities and groups. Results: Data from eight papers were considered, reflecting the hearing intervention practices of six African states. These reports, although integral in themselves, examine different aspects of children’s hearing identification and grouping the information was not entirely feasible. It is assumed that since there are no organized or centralized NHS programs in the African states, the primary driver of hearing identification appears to be parental vigilance. The cochlear implant intervention is not very diffused mainly due to complex economic factors of the weak African economies. Anecdotal data refer to cultural bias versus hearing intervention technology, but this information needs further elucidation. Conclusions: The information on the African programs on hearing intervention policies is quite scarce, as in the case of African NHS. Within this context, it is very important to convince audiologists and ENTs from the African localized programs to publish their data in mainstream channels so that new information can be assessed. Full article

(This article belongs to the Special Issue Hearing Loss in Children: The Present and a Challenge for Future)

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14 pages, 1209 KiB

Open AccessArticle

A Comparative Study on Pain Perception in Children, After Application of Pre-Cooled and Plain Topical Anaesthetic Gel During Local Anaesthetic Administration—A Parallel Three-Arm Randomised Control Trial

by Prabhadevi C. Maganur, Atiah Abdulrahman Ghawi, Ghadi DuhDuh Arishi, Hammam Ahmed Bahammam, Noura Alessa, Nebras Essam Hamed, Nada Ali Jawhali, Mohammed Sawady, Asim Ibrahim H. Manqari and Satish Vishwanathaiah

Children 2025, 12(7), 863; https://doi.org/10.3390/children12070863 (registering DOI) - 30 Jun 2025

Abstract

Background: Effective pain management in children is essential, particularly when administering local anaesthesia. This study was undertaken to compare pain perception in children after application of pre-cooled and plain topical anaesthetic gel during local anaesthetic administration. Methods: A randomised, single-blinded controlled trial [...] Read more.

Background: Effective pain management in children is essential, particularly when administering local anaesthesia. This study was undertaken to compare pain perception in children after application of pre-cooled and plain topical anaesthetic gel during local anaesthetic administration. Methods: A randomised, single-blinded controlled trial was conducted among 51 children between the ages of 6 and 12, visiting the paediatric clinic, Jazan (REC-45/10/1070). Children were allocated into one of the following three groups using a simple randomisation having a 1:1:1 allocation ratio into Group I (n = 17): Plain topical anaesthetic gel, Group II (n = 17): Pre-Cooled topical anaesthetic gel, and Group III (n = 17). An ice pack was applied for a period of 1 min at the injection site. The intensity of pain and the behaviour of the children were assessed using Face, Leg, Activity, Cry, Consolability (FLACC), the Modified Wong–Baker Scale (WBS) and the Frankel Behaviour Rating Scale (FBRS). Results: A significant difference in FBRS scores was observed during anaesthesia, with the highest median score [3 (3,3)] in the pre-cooled topical anaesthetic gel group (p value < 0.001). FLACC scores varied significantly among groups, with the ice pack group [3 (3, 3)] and [4 (4, 5)] showing the highest median score (p value < 0.001). WBS scores also differed significantly between groups (p value < 0.001) with a lower value in the pre-cooled topical gel group [0 (0, 0), 2 (0, 2)]. Conclusions: This study concluded that, the use of a pre-cooled topical anaesthetic gel before LA administration reduced the pain better than that of plain anaesthetic gel and ice pack application at the injection site during infiltration. Full article

(This article belongs to the Special Issue New Research Progress of Clinical Pediatric Dentistry: 2nd Edition)

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16 pages, 235 KiB

Open AccessArticle

Family Assistance Experiences of Adolescents in Marriage Immigrant Families

by Yeseul Jeong and Kyung-Sook Bang

Children 2025, 12(7), 862; https://doi.org/10.3390/children12070862 (registering DOI) - 30 Jun 2025

Abstract

Background/Objectives: Family assistance by adolescents (e.g., cooking, cleaning, listening to family members) is a common phenomenon. However, the impact of such assistance on adolescent development remains a topic of debate. Increasingly, the importance of adolescents’ own perceptions and interpretations is being emphasized in [...] Read more.

Background/Objectives: Family assistance by adolescents (e.g., cooking, cleaning, listening to family members) is a common phenomenon. However, the impact of such assistance on adolescent development remains a topic of debate. Increasingly, the importance of adolescents’ own perceptions and interpretations is being emphasized in understanding how family assistance influences their development. Adolescents in marriage immigrant families may face unique psychosocial challenges as they support their immigrant parents. This study explores the family assistance experiences of adolescents in marriage immigrant families. Methods: Data were collected through one-on-one in-depth interviews with 10 adolescents aged 13–18 years from currently married marriage immigrant families, all of whom were born in Korea. The interviews were conducted between October and November 2022. The data were analyzed using interpretative phenomenological analysis. Results: The family assistance experiences were categorized into three main themes, namely, “Old enough to help—naturally, and rightly so”, “Foreign mother whom I naturally come to help”, and “Unavoidable family assistance, even under pressure”, and 10 subordinate themes. The adolescents provided support naturally, grounded in familial obligation and empathy toward their immigrant mothers. When the native Korean father shared the responsibilities, the assistance was not perceived as burdensome. However, diminished paternal involvement, traditional gender role expectations, and unmet emotional or academic needs led to more negative perceptions and psychological stress. Conclusions: Support systems are needed to ensure that adolescents do not assume sole responsibility for both the native father’s and the immigrant mother’s roles within marriage immigrant families. Full article

(This article belongs to the Special Issue Parenting and Child/Adolescent Development: Current Updates and Global Perspectives)

11 pages, 481 KiB

Open AccessArticle

The Impact of Social Media Disorder, Family Functioning, and Community Social Disorder on Adolescents’ Psychological Distress: The Mediating Role of Intolerance to Uncertainty

by Héctor Morillo-Sarto, Javier Torres-Vallejos, Pablo Usán, Juan Ramón Barrada and Joel Juarros-Basterretxea

Children 2025, 12(7), 861; https://doi.org/10.3390/children12070861 (registering DOI) - 30 Jun 2025

Abstract

Background/Objectives: Adolescent levels of psychological distress are strongly influenced by community, individual, social, and family factors. Family functioning, social media use, and community disorder have shown high predictive value for psychological distress during this critical stage of development. However, these relationships are not [...] Read more.

Background/Objectives: Adolescent levels of psychological distress are strongly influenced by community, individual, social, and family factors. Family functioning, social media use, and community disorder have shown high predictive value for psychological distress during this critical stage of development. However, these relationships are not always direct and are often mediated by individual-level variables, such as intolerance of uncertainty. Adolescent psychological well-being is not solely determined by contextual factors; the coping skills developed during this critical stage also play a significant role. Our study aims to analyze how these factors are directly and indirectly related by developing a predictive model of psychological distress in adolescents. Methods: The study included 908 adolescents (46.9% female) aged between 14 and 21 years (M = 16.29, SD = 1.5). Participants completed self-administered questionnaires in a school setting. Structural equation modeling was used to estimate total, direct, and indirect effects. Results: The model showed a good fit to the data. Social media disorder and family functioning showed statistically significant direct and indirect effects on psychological distress. Social media disorder was associated with higher psychological distress, while positive family functioning was protective. Community social disorder was only indirectly linked to higher psychological distress through the increase of intolerance of uncertainty. Conclusions: Intolerance of uncertainty is a critical predictor of adolescent distress, often overlooked despite its significant mediating role. Direct effects of family functioning and social media use also strongly influence distress levels. Impaired family functioning and community disorder interact bidirectionally, creating a cycle that exacerbates distress. Adolescents in these contexts face compounded negative effects from these reinforcing environments. Full article

(This article belongs to the Section Pediatric Mental Health)

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14 pages, 257 KiB

Open AccessReview

False-Positive and False-Negative MRD Results in Children with Acute Lymphoblastic Leukemia: Navigating Between Scylla and Charybdis (Brief Review and Clinical Experience)

by Yulia S. Korkina, Timur T. Valiev, Natalia A. Batmanova, Mikhail V. Kiselevskiy, Irina Z. Shubina, Kirill I. Kirgizov and Svetlana R. Varfolomeeva

Children 2025, 12(7), 860; https://doi.org/10.3390/children12070860 (registering DOI) - 30 Jun 2025

Abstract

Background/Objectives: Acute lymphoblastic leukemia (ALL) is the most common malignant disease in children. Contemporary antitumor treatment protocols provide long-term survival rates in over 90% of patients with ALL. High effectiveness of the treatment has been achieved as a result of chemotherapy optimization, use [...] Read more.

Background/Objectives: Acute lymphoblastic leukemia (ALL) is the most common malignant disease in children. Contemporary antitumor treatment protocols provide long-term survival rates in over 90% of patients with ALL. High effectiveness of the treatment has been achieved as a result of chemotherapy optimization, use of targeted drugs, up-to-date genetic information, and detection of minimal residual disease (MRD). Current highly sensitive methods for MRD detection have advantages and disadvantages, and the challenge is to distinguish between false-positive and false-negative tests. Methods: A comprehensive search through MEDLINE, PubMed, Scopus, and ScienceDirect using the MRD-related keywords was performed, and included a final set of 72 academic articles. Results: At present, flow cytometry for MRD detection provides the necessary sensitivity of 10⁻⁴ and allows for reliable prediction of ALL dynamics and effective therapeutic strategies. However, even multicolor flow cytometry (MFC) cannot avoid cases of false-positive or false-negative results. Highly sensitive and productive genomic methods in addition to MFC may enhance the accuracy of MRD evaluation. On the other hand, overwhelming efforts to reach the highest sensitivity of the detection methods may lead to the detection of clinically insignificant manifestations of minimal residual disease and, subsequently, to unjustified escalation of antitumor therapy. Conclusions: The necessary ground for an adequate sensitivity of the MRD detection methods could ensure the fine line between false-positive and false-negative MRD results in patients with childhood ALL to develop an appropriate therapeutic strategy. Full article

(This article belongs to the Special Issue The Diagnosis and Management of Pediatric Leukemia)

19 pages, 2933 KiB

Open AccessSystematic Review

Association of Prenatal and Intrapartum Antibiotic Use with Risk of Childhood Atopic Dermatitis: A Systematic Review and Meta-Analysis

by Yu-Chuan Chang, Hsing-Ju Wu and Meng-Che Wu

Children 2025, 12(7), 859; https://doi.org/10.3390/children12070859 (registering DOI) - 30 Jun 2025

Abstract

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin condition with rising global prevalence. Increasing maternal antibiotic use during pregnancy has raised concerns about its potential link to childhood allergic diseases, including AD. However, existing meta-analyses have yielded inconsistent results. A systematic [...] Read more.

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin condition with rising global prevalence. Increasing maternal antibiotic use during pregnancy has raised concerns about its potential link to childhood allergic diseases, including AD. However, existing meta-analyses have yielded inconsistent results. A systematic review and meta-analysis were conducted to investigate the association between prenatal antibiotic exposure, including intrapartum antibiotic prophylaxis (IAP), and the risk of AD developing in offspring. Methods: A systematic search protocol (PROSPERO ID: CRD42024577804) was conducted up to 29 August 2024, across the PubMed, Embase, and Cochrane databases. Cohort and case–control studies reporting associations between maternal antibiotic exposure during pregnancy or intrapartum and the risk of AD in offspring were included. Data were analyzed using RevMan Web and Comprehensive Meta-Analysis software. Results: Twenty studies involving 3,256,929 mother–child pairs were reviewed. The meta-analysis data demonstrated that prenatal antibiotic exposure was associated with AD in the main analysis (odds ratio [OR]: 1.12, 95% CI 1.03–1.21), but not in a separate analysis with a pooled hazard ratio (HR) (HR: 1.12, 95% CI 0.96–1.31). Trim-and-fill correction for significant publication bias (Egger’s test p = 0.003) in the main analysis resulted in a non-significant effect size (OR: 1.09, 95% CI 0.99–1.20). Subgroup analysis and meta-regression suggested that publication years and sample sizes contributed significant heterogeneity (p < 0.05). Regarding IAP and the risk of AD, no association was found (OR: 1.62, 95% CI 0.87–3.00). Conclusions: Current evidence in the existing literature does not support a positive relationship between antibiotic exposure, either during pregnancy or in the intrapartum period, and the risk of development of AD in offspring. However, substantial heterogeneity and the very low certainty of evidence limit the strength of our findings. Further studies that address confounders more thoroughly are needed to confirm these results. Full article

(This article belongs to the Section Pediatric Dermatology)

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14 pages, 573 KiB

Open AccessArticle

Stress and Coping in Teens with Chronic Physical Health Conditions: A Cross-Sectional Study

by Anne L. Ersig, Rachel Hawn, Niamh Nolan and Roger L. Brown

Children 2025, 12(7), 858; https://doi.org/10.3390/children12070858 (registering DOI) - 28 Jun 2025

Abstract

Background/Objectives: Adolescents with chronic physical health conditions (CHCs) use specific coping strategies to respond to condition-related stressors. However, most studies of CHC-related stress and coping focus on a single condition. The objective of this study was to measure CHC-related stress and identify associated [...] Read more.

Background/Objectives: Adolescents with chronic physical health conditions (CHCs) use specific coping strategies to respond to condition-related stressors. However, most studies of CHC-related stress and coping focus on a single condition. The objective of this study was to measure CHC-related stress and identify associated coping strategies in adolescents with a variety of CHCs. A secondary objective was to examine the relationship between CHC-related stress, coping strategies, health-related quality of life, and perceived severity of chronic illness. Methods: Teens (n = 38, 68.42% female, mean age 17.9 years) with CHCs completed the Responses to Stress Questionnaire (RSQ) for CHC-related stress, the PedsQL to assess health-related quality of life, and the Perceptions of the Severity of Chronic Illness (PSCI) measure. The most frequently reported conditions were asthma, food allergies, and multiple conditions. We used fuzzy cluster analysis to identify two clusters, high stress and low stress, based on ratings of CHC-related stressors. Relationships between coping strategies and the PedsQL and PSCI, and between the PSCI and PedsQL, were assessed using Pearson partial correlations. Relationships between the PSCI, PedsQL, and coping strategies for the two clusters were assessed using adjusted mean differences. We adjusted for multiple comparisons by controlling the false discovery rate. Significance was set at p < 0.05. Results: Teens were most likely to use secondary control engagement coping and involuntary engagement to respond to CHC-related stressors. Teens in the two clusters differed on health-related quality of life but not coping strategies or perceived condition severity. CHC diagnosis category was associated with cluster membership. Conclusions: This exploratory study highlighted relationships among quality of life, coping strategies, and CHC diagnosis category that should be explored in future studies. Improved understanding of CHC-related stress and coping strategies in teens with CHCs could have an impact on their quality of life and well-being. Full article

(This article belongs to the Section Pediatric Mental Health)

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15 pages, 266 KiB

Open AccessReview

Current Treatment Options for Children with Functional Constipation—What Is in the Pipeline?

by Charlotte A. L. Jonker, Tirza M. van Os, Ramon R. Gorter, Marc A. Levitt and Marc A. Benninga

Children 2025, 12(7), 857; https://doi.org/10.3390/children12070857 (registering DOI) - 28 Jun 2025

Abstract

In this review, we summarize current insights into the treatment of functional constipation (FC) in children. Constipation is a global issue in the pediatric population, with a prevalence of approximately 9.5%. Initial management involves a combination of non-pharmacological and pharmacological interventions. However, a [...] Read more.

In this review, we summarize current insights into the treatment of functional constipation (FC) in children. Constipation is a global issue in the pediatric population, with a prevalence of approximately 9.5%. Initial management involves a combination of non-pharmacological and pharmacological interventions. However, a significant number of children continue to experience therapy-resistant FC despite optimal non-pharmacological and pharmacological treatments. While studies on novel pharmacological options in children are limited, adult trials have shown promising results. New agents such as lubiprostone, prucalopride, linaclotide, and plecanatide have demonstrated improved outcomes compared to placebo or conventional therapies, particularly in increasing spontaneous bowel movements. Neurostimulation presents an additional treatment modality. Posterior tibial nerve stimulation appears to be a promising new option, offering high treatment satisfaction and a favorable safety profile with a low rate of severe adverse events. For children who do not respond to optimal conservative therapy, the impact on quality of life can be substantial. In such cases, surgical interventions may be considered, including intrasphincteric botulinum toxin injections, antegrade continence enema surgery, and, in severe cases, colonic resection or a diverting ostomy. The choice of surgical treatment remains a subject of ongoing debate. Therapy-resistant FC in children is a complex and impactful condition. An individualized, stepwise approach is essential, with surgical options such as colonic resection reserved as a last resort. Full article

(This article belongs to the Special Issue Bowel Management in Paediatric Colorectal Disease)

12 pages, 490 KiB

Open AccessArticle

Socio-Economic Disparities in Pediatric Viral Gastroenteritis: A Comparative Study of Clinical Outcomes and Management in Hospitalized Children with Rotavirus, Adenovirus, and Norovirus Infections

by Ioana Arbanas, Gabriela Coja, Alice Bilotta, Raluca-Ileana Lixandru, Oana Patran, Laura Bleotu and Oana Falup-Pecurariu

Children 2025, 12(7), 856; https://doi.org/10.3390/children12070856 (registering DOI) - 27 Jun 2025

Abstract

Background: Acute viral gastroenteritis (AVG) still has an impact on children under 5 years old in developing countries. In Romania, vaccination against Rotavirus is not included in the National Immunization Program. Children from poor social backgrounds represent 48% of the patients hospitalized in [...] Read more.

Background: Acute viral gastroenteritis (AVG) still has an impact on children under 5 years old in developing countries. In Romania, vaccination against Rotavirus is not included in the National Immunization Program. Children from poor social backgrounds represent 48% of the patients hospitalized in Children’s Clinical Hospital of Brasov. The use of antibiotics in Romania is high. Methods: The retrospective study enrolled 1054 children, 0–48 months of age, hospitalized in the Emergency Clinical Hospital for Children Brasov between January 2022–December 2023, for Rotavirus, Adenovirus or Norovirus acute gastroenteritis. Children presenting nosocomial infections were excluded. All children that have met the previously mentioned criteria, presenting positive stool samples (immunochromatography method) for Rotavirus, Adenovirus or Norovirus were included in the study. Results: Out of 1054 cases of AVG 782 (74.2%) were due to Rotavirus, 196 (18.5%) to Adenovirus and 76 (7.3%) to Norovirus. A total of 477 (45.3%) patients came from poor social backgrounds and 577 (54.7%) children from good social backgrounds. Rotavirus infection was equally prevalent in both groups (p < 0.35). Children from poor social backgrounds presented an average age of 11 months (SD ± 9; range 14 days–48 months) and a hospitalization average of 5.86 days (SD ± 3.67; range 1–22 days) compared to the others, who presented an average of 21 months (SD ± 15; range 26 days–48 months) and hospitalization average of 5.20 days (SD ± 2.51; range 1–18 days) (p < 0.01; p < 0.01). Severe dehydration presented 267 children from poor settings (56%) and 186 (17.6%) received antibiotics, compared to the other group—224 children (38.8%) with severe dehydration and 216 (20.4%) receiving antibiotics. The most used antibiotic for both groups was Ceftriaxone (53.9% and 57.6% of all AVG). Conclusions: Rotavirus is the leading AVG cause. Children from poor backgrounds were younger, more dehydrated, hospitalized longer. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

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17 pages, 549 KiB

Open AccessReview

Idiopathic Short Stature in the Genomic Era: Integrating Auxology, Endocrinology, and Emerging Genetic Insights

by Roberto Paparella, Arianna Bei, Irene Bernabei, Francesca Tarani, Marcello Niceta, Ida Pucarelli and Luigi Tarani

Children 2025, 12(7), 855; https://doi.org/10.3390/children12070855 (registering DOI) - 27 Jun 2025

Abstract

Idiopathic short stature (ISS) represents one of the most frequent yet enigmatic conditions in pediatric endocrinology. Traditionally defined by auxological parameters in the absence of identifiable causes, ISS has long served as a diagnosis of exclusion. However, with the advent of next-generation sequencing, [...] Read more.

Idiopathic short stature (ISS) represents one of the most frequent yet enigmatic conditions in pediatric endocrinology. Traditionally defined by auxological parameters in the absence of identifiable causes, ISS has long served as a diagnosis of exclusion. However, with the advent of next-generation sequencing, our understanding of the etiological landscape has significantly evolved. Recent studies have revealed that many children previously labeled as idiopathic actually harbor monogenic variants in genes related to the growth hormone–insulin-like growth factor axis, extracellular matrix components, or growth plate signaling pathways. This review integrates auxological assessment with current knowledge on molecular diagnostics to propose a more accurate and individualized approach to short stature. We examine emerging genotype–phenotype correlations, criteria for selecting candidates for genetic testing, and implications for recombinant human growth hormone therapy. Additionally, we advocate for a shift in clinical mindset: from a descriptive to a biologically grounded framework. ISS should be regarded as a transitional label pending further endocrine and genetic clarification. Recognizing this paradigm shift will improve diagnostic accuracy, personalize treatment strategies, and ultimately enhance care for children with growth failure in the genomic era. Full article

(This article belongs to the Special Issue Pediatric Growth and Skeletal Disorders)

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16 pages, 956 KiB

Open AccessArticle

Gender Differences in Child Poverty and Social Exclusion Across Europe: A Comparative Focus on Serbia

by Svetlana Vukosavljevic, Snezana Radovanovic, Olgica Mihaljevic, Nebojsa Zdravkovic, Vladislava Stojic, Stefan Milojevic, Jovana Radovanovic, Milos Stepovic, Katarina Janicijevic, Nevena Folic, Marija Radovanovic and Branka Markovic

Children 2025, 12(7), 854; https://doi.org/10.3390/children12070854 (registering DOI) - 27 Jun 2025

Abstract

Background: Child poverty is a critical issue that affects millions of children worldwide and represents a global issue. This article focuses on exploring the risk of child poverty and social exclusion across Europe, with Serbia being in a comparable position with respect [...] Read more.

Background: Child poverty is a critical issue that affects millions of children worldwide and represents a global issue. This article focuses on exploring the risk of child poverty and social exclusion across Europe, with Serbia being in a comparable position with respect to other countries with different levels of development. Methods: This is an epidemiological, retrospective, and descriptive study based on data on the national populations of the European countries within our research interest. The data analyzed in this study was taken from publicly available datasets from Eurostat. The indicators of interest were the ones considering the social inclusion of children in the time period between 2014 and 2023 for all European countries available in the datasets. Results: The indicator of the risk of poverty and social exclusion showed a decreasing trend in the majority of countries; but still, seven countries showed an increase during the observation period of one decade. The highest percentage was in Romania and the lowest in Slovenia. The indicator of the risk of poverty exhibited a significant difference in terms of gender (being mostly higher among females) in Bulgaria, Lithuania, Portugal, Sweden, Switzerland, Montenegro, Albania, and Turkey. The indicator of children living in households with very low work intensity exhibited a significant difference in terms of gender (being mostly higher among males) in Bulgaria, Lithuania, Malta, the Netherlands, Finland, Sweden, Switzerland, and Albania. The indicator of severe social and material deprivation exhibited a significant difference in terms of gender (being mostly higher among females) in Bulgaria, Denmark, Estonia, Lithuania, Montenegro, Albania, and Turkey. Serbia did not show a significant gender difference, but the male gender had higher values than the female for all indicators. Conclusions: Child poverty is a multifaceted issue that affects various aspects of children’s lives, including health, education, and social inclusion. Addressing this issue requires a comprehensive approach that includes social protection, access to quality services, and efforts to combat discrimination. Full article

(This article belongs to the Section Global Pediatric Health)

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36 pages, 1004 KiB

Open AccessSystematic Review

Influence of Physical Activity in Children and Adolescents with Cerebral Palsy: A Systematic Review

by Faustino Andrés-Pérez, Lluna Maria Bru-Luna, Sergio Hidalgo-Fuentes, Fátima Llamas-Salguero and Manuel Martí-Vilar

Children 2025, 12(7), 853; https://doi.org/10.3390/children12070853 (registering DOI) - 27 Jun 2025

Abstract

Cerebral palsy (CP) is one of the most common disorders in childhood that significantly impacts quality of life. Background/Objectives: This study conducted a literature review of physical activity (PA)-based interventions for children and adolescents with CP, highlighting the physical, cognitive, and social benefits, [...] Read more.

Cerebral palsy (CP) is one of the most common disorders in childhood that significantly impacts quality of life. Background/Objectives: This study conducted a literature review of physical activity (PA)-based interventions for children and adolescents with CP, highlighting the physical, cognitive, and social benefits, as well as the factors and barriers that influence practice. Methods: The PRISMA methodology was used to identify and analyze the most relevant studies up to December 2024 through specific search equations and the databases Science Direct, Scopus, and Dialnet. Of the 707 articles identified, a total of 62 publications were selected for further analysis. These were subjected to a quality assessment through a checklist based on seven items. Results: The practice of PA guaranteed improvements in balance, postural control, strength, socialization, and self-confidence. On the other hand, some programs, such as Makey Makey, Ballet, aquatic PA, and Matrogymnasia, among others, were highlighted because they promoted an increase in physical practice among the population. However, there are still some barriers, such as sedentary lifestyles (90%), limited accessibility, and a lack of qualified professionals that hinder the intervention and ensure motivation and interest in its practice for those individuals who have not yet begun to practice it. Conclusions: PA is an effective tool to favor quality of life in children and adolescents, as it contributes to their integral development and social inclusion. The need for interdisciplinary strategies to reduce barriers and increase the benefits of PA is emphasized. A joint effort to promote integration in leisure time could promote optimal long-term results. Full article

(This article belongs to the Section Pediatric Mental Health)

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