Editor’s Choice Articles

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

Order results
Result details
Results per page
Select all
Export citation of selected articles as:
10 pages, 236 KB  
Perspective
Equity or Two-Tier Care? Guardrails for Silver Diamine Fluoride and Delegated Early Childhood Caries Pathways
by Ziad D. Baghdadi
Children 2026, 13(3), 386; https://doi.org/10.3390/children13030386 - 10 Mar 2026
Cited by 1 | Viewed by 1204
Abstract
Early childhood caries (ECC) is a complex, multifactorial disease shaped by biofilm ecology, host susceptibility, diet and behaviors, and structural determinants of health. Silver diamine fluoride (SDF) is an effective non-restorative option for arresting cavitated lesions in many settings and can support access [...] Read more.
Early childhood caries (ECC) is a complex, multifactorial disease shaped by biofilm ecology, host susceptibility, diet and behaviors, and structural determinants of health. Silver diamine fluoride (SDF) is an effective non-restorative option for arresting cavitated lesions in many settings and can support access when definitive care is delayed. However, translating short-horizon “arrest” outcomes into broad policy claims—that SDF-first, delegated pathways can substitute for dentist-led diagnosis and comprehensive rehabilitation—risks institutionalizing a two-tier standard of care for children facing the greatest access barriers. This perspective critically appraises evidence-to-implementation pathways for SDF and delegated ECC management, using risk-of-bias and reporting guidance as interpretive tools and drawing on pragmatic regimen trials, microbiome substudies, oral health-related quality of life (OHRQoL) analyses, and implementation work including the Canadian Caries Risk Assessment Tool (CCRAT) in primary care. We explicitly distinguish what studies demonstrate (e.g., feasibility and short-term arrest differences by reapplication interval) from what they do not establish (e.g., long-term tooth survival, pulpal outcomes, definitive treatment completion, and equity impacts). We propose practical guardrails that position SDF as interim management within a continuum of care: dentist-led diagnosis and escalation when pulpal risk is suspected; time-bound referral pathways with completion tracking; protocolized follow-up aligned with lesion/risk status; outcome sets that extend beyond “arrest” to include pain, function, OHRQoL, tooth survival, and equity stratification; and lesion-site sampling plus preregistered analyses when mechanistic claims are advanced. Full article
(This article belongs to the Collection Advance in Pediatric Dentistry)
17 pages, 562 KB  
Article
Enhancing Parent–Child Interaction and Self-Efficacy in Motor Skills Development for Young Children with Developmental Delays
by Yu-Lin Lai, Szu-Yin Chu, I-Huei Lee and Hsiu-Wen Yang
Children 2026, 13(2), 309; https://doi.org/10.3390/children13020309 - 23 Feb 2026
Cited by 1 | Viewed by 1706
Abstract
Background/Objectives: The present study investigated the effects of parental participation in home program intervention on parent–child interactions, parental self-efficacy, and the goal attainment of children with developmental delays in motor skills. Methods: While the interviews consisted of qualitative data, quantitative analyses [...] Read more.
Background/Objectives: The present study investigated the effects of parental participation in home program intervention on parent–child interactions, parental self-efficacy, and the goal attainment of children with developmental delays in motor skills. Methods: While the interviews consisted of qualitative data, quantitative analyses were applied to the results, making this a mixed-methods study. Participants were 2–6-year-old young children and their families. Twenty-three parent–child dyads were randomly assigned to an intervention group (n = 13) or a comparison group (n = 10). Outcomes were evaluated using the Parent–Child Interaction Questionnaire and Parental Self-Efficacy Questionnaire. Results: Improvements in parental self-efficacy and in the Goal Attainment Scale scores of the children were evident in the posttest, whereas no evidence of differences in improvement was found in parent–child interactions between the intervention and comparison groups on the pretest and posttest. Conclusions: Parent collaboration with therapists has a significant impact on achieving functional goals for young children, and parental involvement in intervention programs effectively enhances parental self-efficacy. Full article
(This article belongs to the Special Issue Health Care in Children with Disabilities)
Show Figures

Figure 1

9 pages, 203 KB  
Perspective
When “Advances” Become Substitutes for Access: A Systems Critique of Children’s Dentistry in NHS England and the Normalisation of Extraction, Containment, and Planned Tooth Loss
by Ziad D. Baghdadi
Children 2026, 13(2), 263; https://doi.org/10.3390/children13020263 - 13 Feb 2026
Cited by 2 | Viewed by 1414
Abstract
Background: England is a high-income country with a predominantly publicly funded health system organised around the National Health Service (NHS). Yet children’s oral health outcomes continue to reflect a persistent access and prevention gap, with late presentation and hospital-based extractions remaining common. [...] Read more.
Background: England is a high-income country with a predominantly publicly funded health system organised around the National Health Service (NHS). Yet children’s oral health outcomes continue to reflect a persistent access and prevention gap, with late presentation and hospital-based extractions remaining common. Objective: To present a policy-facing, evidence-informed critique of how structural constraints in NHS dentistry shape paediatric clinical pathways—often converting “advances” (biological caries management, silver diamine fluoride, and planned extraction pathways for compromised permanent molars) into compensations for service failure rather than patient-centred progress. Methods: Narrative commentary drawing on UK official statistics and major policy reports, alongside key clinical trials and evidence syntheses relevant to contemporary paediatric dentistry. Results: The dominant failure mode is not a lack of clinical tools but impaired delivery: restricted access to routine NHS dentistry, contract and workforce pressures, and unequal prevention coverage. These pressures correlate with crisis-led care (including extractions under general anaesthesia) and can distort how minimally invasive/biological interventions are used—functioning as endpoints rather than bridges to definitive care. In parallel, guidance for compromised first permanent molars (including those affected by MIH) risks being operationalised as an “efficiency pathway” when restorative capacity is constrained. Conclusions: In NHS England, paediatric dental “advances” cannot be judged solely by trial efficacy; they must be evaluated within a delivery system that currently selects for late-stage, irreversible outcomes. A credible “advances” agenda requires contract reform, workforce retention, prevention at scale, and explicit safeguards against the normalisation of extraction-only trajectories. Full article
(This article belongs to the Collection Advance in Pediatric Dentistry)
25 pages, 677 KB  
Review
Transitioning Adolescents and Young Adults with Type 1 Diabetes Mellitus in Italy: A Scoping Review
by Valentina Vanzi, Ilaria Campagna, Fabiola Spina, Adele Passaro, Federica Cancani, Annalisa Deodati, Orsola Gawronski, Emanuela Tiozzo and Immacolata Dall’Oglio
Children 2026, 13(2), 248; https://doi.org/10.3390/children13020248 - 10 Feb 2026
Cited by 1 | Viewed by 793
Abstract
Background/Objectives: Worldwide, Type 1 diabetes mellitus (T1DM) in youth represents a growing public health concern, and Italy is among the countries with the highest incidence in the pediatric population. The transition from pediatric to adult care is a vulnerable period associated with increased [...] Read more.
Background/Objectives: Worldwide, Type 1 diabetes mellitus (T1DM) in youth represents a growing public health concern, and Italy is among the countries with the highest incidence in the pediatric population. The transition from pediatric to adult care is a vulnerable period associated with increased risks of acute complications and long-term morbidity. This scoping review aimed to map the available Italian evidence on healthcare transition in adolescents and young adults (AYAs) with T1DM, addressing five key areas: characteristics of the transition process and involved populations, emotional and psychological experiences, the role of technology, existing transitional care models and related outcomes, and assessment criteria and tools for transition readiness. Methods: This review followed the JBI methodology and included studies focused on Italian AYAs (aged 10–24 years) with T1DM. Study selection was documented using the PRISMA flow chart. Results: Twenty studies were included. The evidence revealed a heterogeneous and inconsistently implemented transition landscape. Several structured transition projects were identified, differing in multidisciplinary team composition, organization, and outcome evaluation. Emotional distress, fear of separation from pediatric providers, and variable satisfaction with transition experiences were commonly reported. Adoption of technologies increased over time and was associated with improved clinical outcomes, although overall uptake remained suboptimal. Importantly, no Italian-validated tools for assessing transition readiness were identified. Conclusions: Transitional care for Italian AYAs with T1DM is increasingly recognized but remains insufficiently standardized and evaluated. Future research should prioritize multicenter studies, stratified analyses, and the development of culturally validated readiness assessment tools to support effective and individualized transitions. Full article
(This article belongs to the Special Issue The Latest Challenges and Explorations in Pediatric Nursing)
Show Figures

Figure 1

15 pages, 552 KB  
Review
Sleep, Emotion, and Sex-Specific Developmental Trajectories in Childhood and Adolescence
by Giuseppe Marano and Marianna Mazza
Children 2026, 13(2), 171; https://doi.org/10.3390/children13020171 - 26 Jan 2026
Cited by 1 | Viewed by 1215
Abstract
Sleep plays a central role in shaping emotional development during childhood and adolescence, yet increasing evidence indicates that these processes unfold differently in boys and girls. This narrative review synthesizes current findings on sex-specific associations between sleep patterns, neurodevelopmental trajectories, and emotional regulation [...] Read more.
Sleep plays a central role in shaping emotional development during childhood and adolescence, yet increasing evidence indicates that these processes unfold differently in boys and girls. This narrative review synthesizes current findings on sex-specific associations between sleep patterns, neurodevelopmental trajectories, and emotional regulation across pediatric populations. It examines how biological factors, including pubertal timing, sex hormones, circadian physiology, and maturation of fronto-limbic circuits, interact with environmental influences to generate distinct vulnerabilities to anxiety, depression, and behavioral dysregulation. Growing data suggest that girls exhibit greater sensitivity to sleep disturbances, particularly during the pubertal transition, with stronger links to internalizing symptoms such as anxiety and mood disorders. In contrast, boys appear more prone to externalizing behaviors and show differential responses to circadian misalignment and short sleep duration. Emerging evidence on sex-specific sleep architecture, REM-related emotional processing, and the bidirectional pathways through which sleep quality affects affective functioning are explored. Finally, clinical implications for early detection, personalized prevention, and targeted interventions tailored by sex and developmental stage are discussed. Understanding sex-based differences in sleep–emotion interactions offers a critical opportunity to refine pediatric mental health strategies and improve outcomes across developmental trajectories. Full article
(This article belongs to the Special Issue Advances in Mental Health and Well-Being in Children (Third Edition))
Show Figures

Figure 1

11 pages, 430 KB  
Article
Association Between Point-of-Care Viral Testing for Influenza and Adenovirus and Antibiotic Management in a Pediatric Emergency Department in Italy
by Tommaso Bellini, Andrea Lacovara, Daniele Franzone, Marcello Mariani, Giorgia Iovinella, Martina Virgilio, Julia Lasagna, Simona Matarese, Carlotta Pepino, Francesca Canzoneri, Milena Guazzi, Emanuela Piccotti and Andrea Moscatelli
Children 2026, 13(1), 151; https://doi.org/10.3390/children13010151 - 21 Jan 2026
Cited by 1 | Viewed by 662
Abstract
Background: Respiratory tract infections (RTIs) represent one of the most prevalent reasons for visits to Pediatric Emergency Departments (PEDs). Because viral and bacterial presentations frequently overlap, a substantial proportion of antibiotic prescriptions in pediatric acute care are potentially unnecessary, contributing to antimicrobial resistance. [...] Read more.
Background: Respiratory tract infections (RTIs) represent one of the most prevalent reasons for visits to Pediatric Emergency Departments (PEDs). Because viral and bacterial presentations frequently overlap, a substantial proportion of antibiotic prescriptions in pediatric acute care are potentially unnecessary, contributing to antimicrobial resistance. Rapid Diagnostic Tests (RDTs) for respiratory viruses have been suggested as tools to enhance diagnostic precision and support antimicrobial stewardship. However, evidence regarding their real-world impact in pediatric emergency settings is limited. Objectives: This study aimed to assess the association between point-of-care RDT results and antibiotic management in a tertiary PED, focusing on both the discontinuation of antibiotics in children already receiving treatment and the avoidance of new antibiotic prescriptions in untreated children. The secondary objective was to evaluate the short-term safety through 72-h return visits. Methods: A retrospective cohort study was conducted at a tertiary PED during two epidemic seasons (December–February 2023–2024 and 2024–2025). Children aged <18 years who underwent RDTs for febrile respiratory illnesses were included. Patients were stratified based on whether they were already receiving antibiotic therapy at presentation. The primary outcomes were antibiotic discontinuation among treated patients and initiation among untreated patients. Unplanned return visits to the PED within 72-h post-discharge were used as a pragmatic short-term safety outcome to capture early clinical deterioration. RDTs (SD Biosensor Standard F Antigen) were performed at the bedside with a turnaround time of 10–15 min. Results: A total of 1238 children were included, of whom 330 (26.6%) tested positive for influenza and/or adenovirus. Among the 234 children already receiving antibiotics, discontinuation was significantly more frequent in the RDT-positive group (p < 0.001; OR 0.044). Among the 1004 untreated children, antibiotic prescription was significantly lower in the positive group than in the negative group (p < 0.001; OR 0.097). Return visits within 72-h did not differ between the groups in either cohort. No invalid tests occurred. Conclusions: Influenza/adenovirus RDT positivity was associated with lower antibiotic initiation among untreated children and higher discontinuation among those already receiving antibiotics, with no differences in 72-h return visits. These findings suggest a potential role for bedside viral testing as a decision-support tool for antibiotic management in the PED. Full article
Show Figures

Figure 1

18 pages, 1235 KB  
Article
Parental Attitudes and Hesitancy Towards Childhood Influenza Vaccination in Slovakia: A Cross-Sectional Survey of 301 Parents
by Peter Kunč, Jaroslav Fábry, Martina Neuschlová, Matúš Dohál, Renata Péčová, Jana Mazuchová and Miloš Jeseňák
Children 2026, 13(1), 144; https://doi.org/10.3390/children13010144 - 20 Jan 2026
Cited by 1 | Viewed by 775
Abstract
Background/Objectives: Seasonal influenza imposes a significant burden on pediatric public health. Despite official recommendations and full insurance coverage, vaccination rates among children in Slovakia remain critically low. This study aims to analyze the attitudes, beliefs, and determinants of parental hesitancy regarding childhood [...] Read more.
Background/Objectives: Seasonal influenza imposes a significant burden on pediatric public health. Despite official recommendations and full insurance coverage, vaccination rates among children in Slovakia remain critically low. This study aims to analyze the attitudes, beliefs, and determinants of parental hesitancy regarding childhood influenza vaccination in the post-pandemic context. Methods: A single-center cross-sectional survey was conducted between February and March 2025 using convenience sampling among parents of children attending a pediatric immunoallergology center. An anonymous questionnaire collected data on demographics, risk perception, and attitudes. Data from 301 parents were analyzed using descriptive statistics, chi-squared tests, and odds ratios (OR) to identify key predictors of hesitancy. Results: Only 27.6% of parents expressed willingness to vaccinate their children, while 42.5% were opposed and 29.9% hesitant. Statistical analysis revealed no significant association between parental university education and vaccination intent (p > 0.05), indicating that vaccine hesitancy in this specific setting was present across all educational backgrounds. However, the source of information proved to be a critical determinant: consulting a pediatrician significantly increased the odds of acceptance (OR = 6.32; 95% CI: 3.54–11.28), whereas reliance on the internet and social media was a significant predictor of refusal (OR = 0.29; 95% CI: 0.17–0.50). The primary reported barrier was fear of adverse effects (70.4%), which significantly outweighed doubts about efficacy (30.2%). Conclusions: Parental hesitancy in Slovakia is a widespread phenomenon pervasive across all educational backgrounds, driven primarily by safety concerns and digital misinformation. The contrast between the protective influence of pediatricians and the negative impact of digital media underscores that clinical encounters are currently the most effective firewall against hesitancy. Public health strategies must therefore pivot from general education to empowering pediatricians with active, presumptive communication strategies. Full article
(This article belongs to the Special Issue Pediatric Infectious Disease Epidemiology)
Show Figures

Figure 1

21 pages, 717 KB  
Article
Perceived Financial Strain and Adolescent Mental Health: Evidence from a Population-Based Study in South Tyrol, Italy
by Christian J. Wiedermann, Verena Barbieri, Hendrik Reismann, Giuliano Piccoliori, Adolf Engl and Doris Hager von Strobele-Prainsack
Children 2026, 13(1), 121; https://doi.org/10.3390/children13010121 - 13 Jan 2026
Cited by 2 | Viewed by 1007
Abstract
Background/Objectives: Socioeconomic stressors, such as financial strain, rising living costs, and perceived price burden, have gained relevance in the post-pandemic period and may adversely affect adolescent mental health. This study examined the association between subjective financial stress and symptoms of depression, anxiety, and [...] Read more.
Background/Objectives: Socioeconomic stressors, such as financial strain, rising living costs, and perceived price burden, have gained relevance in the post-pandemic period and may adversely affect adolescent mental health. This study examined the association between subjective financial stress and symptoms of depression, anxiety, and emotional/behavioral difficulties among adolescents in Northern Italy. Methods: Data were obtained from the 2025 Corona and Psyche South Tyrol (COP-S) population survey. A total of 2554 adolescents aged 11–19 years and their parents participated; 1598 adolescents provided complete data for analyses of socioeconomic stressors (parent-reported Family Affluence Scale III, adolescent self-reported and parent proxy and self-reported burden due to price increases). Mental health outcomes included depressive symptoms (PHQ-2), generalized anxiety (SCARED-GAD), and emotional/behavioral difficulties (SDQ). Associations were assessed using chi-square tests, Kendall’s tau correlations, and two-factor ANOVA models. Results: Elevated depressive symptoms were present in 10.7% of adolescents, emotional/behavioral difficulties in 13.9%, and anxiety symptoms in 27.9% of adolescents. Female adolescents consistently showed higher symptom levels in all domains. Self-reported financial burden was the strongest and most consistent correlate of mental health problems, demonstrating small-to-moderate positive correlations with depressive symptoms (τ = 0.20, p < 0.001), emotional/behavioral difficulties (τ = 0.14, p < 0.001), and anxiety (τ = 0.25, p < 0.001). Parent-reported burden showed weaker and less consistent associations, and the Family Affluence Scale III was not significantly related to any of the mental health outcomes. ANOVA models indicated that adolescents’ own perception of financial burden significantly predicted anxiety levels in both age groups (11–14 and 15–19 years), whereas discrepancies between adolescent and parent burden perceptions were particularly relevant among younger adolescents. Conclusions: In this affluent European region, subjective financial strain, especially adolescents’ perception of burden due to rising prices, is a stronger determinant of depressive symptoms, anxiety, and psychosocial difficulties than parental burden reports or structural affluence indicators. Adolescents, especially females, appear to be particularly vulnerable. These findings underscore the importance of addressing subjective financial stress in adolescent mental health and public health strategies. Full article
Show Figures

Figure 1

10 pages, 252 KB  
Review
Review Regarding the Impact of Breastfeeding on Early Childhood Caries
by Mihaela Tănase, Ana-Maria Pistol, Diana Daniela Daciana Zmărăndache, Ioana-Andreea Stanciu and Aneta Munteanu
Children 2026, 13(1), 102; https://doi.org/10.3390/children13010102 - 10 Jan 2026
Cited by 3 | Viewed by 1174
Abstract
Background: Early childhood caries (ECC) compromise the nutrition, growth, and quality of life in young children, and their relationship with breastfeeding practices remains disputed. Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children aged under 71 months. Material [...] Read more.
Background: Early childhood caries (ECC) compromise the nutrition, growth, and quality of life in young children, and their relationship with breastfeeding practices remains disputed. Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children aged under 71 months. Material and Methods: A systematic review of PubMed, Multidisciplinary Digital Publishing Institute, and Evidence-Based Dentistry, was conducted through August 2025, including observational studies, randomized trials, narrative reviews, and meta-analyses on breastfeeding and ECC. Results: Thirty-one studies involving 28,000 children were included. Exclusive breastfeeding for under six months halves ECC probability (OR 0.53–0.58), whereas breastfeeding beyond 12 months and nocturnal feeds increase probability by 60–86% (OR 2.35–7.14). Parental factors—high plaque levels, feeding-to-sleep, and skipped post-feed cleaning—strongly predict ECC (OR 8.51–75.6). Interventions combining feeding counseling with home visits or visual aids reduce ECC incidence by 22–32% (RR 0.68–0.78). Conclusions: Exclusive breastfeeding through six months is protective against ECC, but prolonged or nocturnal feeding heightens risk. Integrating structured oral health education into breastfeeding promotion is recommended. Full article
(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)
31 pages, 1451 KB  
Article
Social–Cognitive Factors in Antisocial Behavior and School Violence: A Cross-Sectional Analysis of Greek Vocational Students
by Anastasia Petropoulou, Hera Antonopoulou, Agathi Alexandra Vlachou, Evgenia Gkintoni and Constantinos Halkiopoulos
Children 2025, 12(12), 1647; https://doi.org/10.3390/children12121647 - 4 Dec 2025
Cited by 8 | Viewed by 1242
Abstract
Background/Objectives: School violence represents a significant concern for educational communities worldwide, affecting student well-being and academic development. While prior research has documented prevalence rates and risk factors, limited studies have examined social–cognitive factors associated with antisocial behavior specifically within vocational education contexts using [...] Read more.
Background/Objectives: School violence represents a significant concern for educational communities worldwide, affecting student well-being and academic development. While prior research has documented prevalence rates and risk factors, limited studies have examined social–cognitive factors associated with antisocial behavior specifically within vocational education contexts using integrated analytical approaches. This exploratory cross-sectional study examined social–cognitive factors—specifically self-reported attitudes about aggression norms, prosocial attitudes, and school climate perceptions—associated with violence-supportive attitudes among Greek vocational students. Methods: A cross-sectional design employed validated self-report instruments and traditional statistical methods. The sample comprised 76 vocational high school students (38.2% male; ages 14–18; response rate 75.2%) from one school in Patras, Greece. Validated instruments assessed attitudes toward interpersonal peer violence (α = 0.87), peer aggression norms across four subscales (α = 0.83–0.90), and school climate dimensions (α = 0.70–0.75). Analyses included descriptive statistics, Pearson correlations with bootstrapped confidence intervals, MANOVA for multivariate group comparisons, independent samples t-tests, propensity score matching for urban–rural comparisons, polynomial regression for developmental patterns, and path analysis for theoretical model testing. Results: Strong associations emerged between perceived school-level and individual-level aggression norms (r = 0.80, p < 0.001, 95% CI [0.71, 0.87]), representing one of the strongest relationships documented in school violence research. Violence-supportive attitudes demonstrated inverse associations with prosocial alternative norms (r = −0.37, p < 0.001, 95% CI [−0.55, −0.16]). Significant gender differences emerged for teacher–student relationships (d = −0.78, p = 0.002), with females reporting substantially more positive perceptions. Propensity-matched urban students demonstrated higher aggression norm endorsement compared to rural students across multiple indicators (d = 0.61–0.78, all p < 0.020). Polynomial regression revealed curvilinear developmental patterns with optimal teacher relationship quality during mid-adolescence (ages 15–16). Path analysis supported a sequential association model wherein school-level norms related to individual attitudes through prosocial alternative beliefs (indirect effect β = −0.22, p = 0.002, 95% CI [−0.34, −0.11]). Conclusions: This preliminary investigation identified social–cognitive factors—particularly normative beliefs about aggression at both individual and environmental levels—as strongly associated with violence-supportive attitudes in Greek vocational education. The exceptionally strong alignment between school-level and individual-level aggression norms (r = 0.80) suggests that environmental normative contexts may play a more substantial role in attitude formation than previously recognized in this educational setting. Gender and urban–rural differences indicate meaningful heterogeneity requiring differentiated approaches. Future research should employ longitudinal designs with multi-informant assessment and larger multi-site samples to establish temporal precedence, reduce method variance, and test causal hypotheses regarding relationships between normative beliefs and behavioral outcomes. Full article
(This article belongs to the Section Global Pediatric Health)
Show Figures

Figure 1

26 pages, 992 KB  
Review
Emotion and Feeling in Parent–Child Dyads: Neurocognitive and Psychophysiological Pathways of Development
by Antonios I. Christou and Flora Bacopoulou
Children 2025, 12(11), 1478; https://doi.org/10.3390/children12111478 - 2 Nov 2025
Cited by 9 | Viewed by 4403
Abstract
Although widely used across disciplines, the terms emotion and feeling remain conceptually ambiguous, particularly within developmental science. Emotion is defined as an evolutionarily conserved, biologically embedded system of action readiness and intersubjective communication, shaped by attentional, neural, and physiological reactivity to environmental salience. [...] Read more.
Although widely used across disciplines, the terms emotion and feeling remain conceptually ambiguous, particularly within developmental science. Emotion is defined as an evolutionarily conserved, biologically embedded system of action readiness and intersubjective communication, shaped by attentional, neural, and physiological reactivity to environmental salience. In contrast, feeling is conceptualized as the consciously experienced, representational outcome of emotional activation, emerging through cognitive appraisal and symbolic processing. Building upon this distinction, the review explores how emotion develops within parent–child dyads through coregulated neurocognitive and psychophysiological mechanisms. Drawing on empirical evidence from eye-tracking studies of visual attention to emotional faces, functional near-infrared spectroscopy (fNIRS) research on social-emotional activation in prefrontal brain regions, and cortisol-based assessments of hormonal synchrony, the paper highlights how emotional attunement and transmission are embedded in early caregiving interactions. The review also emphasizes the moderating role of environmental sensitivity—both in children and parents—in shaping these developmental pathways. By positioning emotion as a dynamic, intersubjective process and feeling as its emergent experiential correlate, this review offers a novel developmental framework for understanding affect and proposes directions for future research on resilience, dysregulation, and intervention. Full article
(This article belongs to the Special Issue Parental Mental Health and Child Development)
Show Figures

Figure 1

21 pages, 756 KB  
Review
Fundamental Movement/Motor Skills as an Important Component of Physical Literacy and Bridge to Physical Activity: A Scoping Review
by Tomasz Piotrowski, Hubert Makaruk, Edyta Tekień, Wojciech Feleszko, Maciej Kołodziej, Katarzyna Albrecht, Krystyna Grela, Robert Makuch, Bożena Werner and Jakub S. Gąsior
Children 2025, 12(10), 1406; https://doi.org/10.3390/children12101406 - 17 Oct 2025
Cited by 15 | Viewed by 7643
Abstract
Background: Movement is crucial for human development, particularly during childhood. Fundamental movement skills (FMSs) are essential movement patterns that support physical, cognitive, and social development. Recent studies indicate an alarming worldwide decline in FMS acquisition, potentially impacting children’s long-term physical fitness and health. [...] Read more.
Background: Movement is crucial for human development, particularly during childhood. Fundamental movement skills (FMSs) are essential movement patterns that support physical, cognitive, and social development. Recent studies indicate an alarming worldwide decline in FMS acquisition, potentially impacting children’s long-term physical fitness and health. This scoping review explored FMSs, their relationship to motor competence and physical literacy, associations with physical activity and fitness, assessment methods, and effective interventions. Methods: A comprehensive literature review was conducted using the PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases. The search utilized key phrases related to FMSs, motor competence, and physical literacy. Initially, 2251 publications were identified. Results: After rigorous screening, 95 English-language literature reviews and meta-analyses focusing on FMSs in healthy children were selected for detailed analysis. The accepted publications were categorized into five thematic areas: FMSs and motor development (11 publications), conceptual terms in FMS context (8 publications), relationships between FMSs and other parameters (15 publications), FMS assessment tools (14 publications), and intervention effects on FMSs (47 publications). Conclusions: Effective FMS acquisition requires collaborative interventions involving teachers, parents, sports professionals, and healthcare providers. Future research should focus on developing standardized assessment tools, interpreting FMSs as part of physical literacy to understand their association with PA level and design efficient intervention strategies. Full article
Show Figures

Figure 1

19 pages, 1061 KB  
Review
Salivary Biomarkers in Pediatric Acute Appendicitis: Current Evidence and Future Directions
by Zenon Pogorelić, Miro Jukić, Tomislav Žuvela, Klaudio Pjer Milunović, Ivan Maleš, Ivan Lovrinčević and Jasenka Kraljević
Children 2025, 12(10), 1342; https://doi.org/10.3390/children12101342 - 6 Oct 2025
Cited by 6 | Viewed by 1691
Abstract
Background: Acute appendicitis is the most common surgical emergency in children, yet timely and accurate diagnosis remains challenging due to nonspecific clinical presentations and limitations of imaging and blood tests. Saliva has emerged as a promising diagnostic medium because it is non-invasive, painless, [...] Read more.
Background: Acute appendicitis is the most common surgical emergency in children, yet timely and accurate diagnosis remains challenging due to nonspecific clinical presentations and limitations of imaging and blood tests. Saliva has emerged as a promising diagnostic medium because it is non-invasive, painless, inexpensive, and highly acceptable for pediatric patients. Salivary biomarkers may provide rapid and child-friendly adjuncts to existing diagnostic pathways. Methods: A systematic literature search was performed in Ovid/MEDLINE, Scopus, Web of Science, and the Cochrane Library to identify studies assessing salivary biomarkers in pediatric appendicitis. Eligible studies included children with suspected or confirmed appendicitis and evaluated the diagnostic accuracy of salivary markers compared to clinical, laboratory, or imaging standards. Results: To date, only three salivary biomarkers have been investigated. Leucine-rich α-2-glycoprotein 1 (LRG1) demonstrated high specificity of 100% but low sensitivity of 35–36%, with diagnostic accuracy ranging from AUC 0.77 to 0.85. C-reactive protein (CRP) showed excellent diagnostic performance with sensitivity of 91.3% and specificity of 95.4% (AUC 0.97), and strong correlation with serum CRP (ρ = 0.96). Irisin showed sensitivity of 90% and specificity of 60% with estimated AUC around 0.75, suggesting potential as an adjunct marker but limited as a standalone test. Conclusions: Salivary biomarkers in pediatric appendicitis are promising but remain underexplored, with evidence limited to small, single-center studies totalling fewer than 300 patients. Their advantages include feasibility, tolerability, and suitability for integration into point-of-care testing. Future research should focus on multicenter validation, development of multi-marker salivary panels, and application of biosensor technologies. With further evidence, salivary diagnostics could complement existing strategies and improve the accuracy and child-friendliness of appendicitis care. Full article
Show Figures

Figure 1

21 pages, 3560 KB  
Review
A Comprehensive Review of Pediatric Necrotizing Pneumonia
by Manette Ness-Cochinwala and Balagangadhar R. Totapally
Children 2025, 12(9), 1248; https://doi.org/10.3390/children12091248 - 17 Sep 2025
Cited by 7 | Viewed by 8655
Abstract
Necrotizing pneumonia is a serious complication of pediatric pneumonia, characterized by liquefaction and cavitation of the lung parenchyma. Streptococcus pneumoniae and Staphylococcus aureus are the most implicated organisms. Mycoplasma pneumoniae has been an increasingly recognized pathogen, especially is Asian and Pseudomonas aeruginosa is [...] Read more.
Necrotizing pneumonia is a serious complication of pediatric pneumonia, characterized by liquefaction and cavitation of the lung parenchyma. Streptococcus pneumoniae and Staphylococcus aureus are the most implicated organisms. Mycoplasma pneumoniae has been an increasingly recognized pathogen, especially is Asian and Pseudomonas aeruginosa is mainly noted in a higher percentage of patients with complex chronic conditions. Clinical presentation typically includes fever, respiratory distress, and failure to respond to standard antibiotic therapy. These patients are more likely to have pleural involvement in the form of effusion or empyema and a higher need for respiratory support. Diagnosis is typically through a combination of chest radiographs, lung ultrasound, and chest computed tomography. Management is primarily via prolonged intravenous antibiotics that cover the above organisms, though pleural drainage with fibrinolytics is often required. Surgical intervention is often reserved for refractory cases that fail initial fibrinolytic therapy. Prognosis is usually favorable in the short and long term, though early recognition and appropriate management are imperative to reduce the duration of illness and morbidity. Full article
(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)
Show Figures

Figure 1

23 pages, 1171 KB  
Review
Non-Invasive Wearables in Pediatric Healthcare: A Comprehensive Review of Uses and Implications
by Kyra-Angela Magsayo and Seyedeh Fatemeh Khatami Firoozabadi
Children 2025, 12(9), 1233; https://doi.org/10.3390/children12091233 - 15 Sep 2025
Cited by 4 | Viewed by 3226
Abstract
Wearable technology is rapidly evolving, with increasing efforts to integrate a wide range of sensors capable of capturing real-time physiological and behavioral health data from users. These devices have shown significant promise in supporting health monitoring and promoting well-being by providing continuous, objective [...] Read more.
Wearable technology is rapidly evolving, with increasing efforts to integrate a wide range of sensors capable of capturing real-time physiological and behavioral health data from users. These devices have shown significant promise in supporting health monitoring and promoting well-being by providing continuous, objective feedback based on data analytics. Importantly, they enable early detection of potential health issues, allowing for timely intervention and more personalized healthcare. While a wide variety of commercially available wearable devices are designed for adults—tracking metrics such as physical activity, heart rate, body temperature, electrocardiograms (ECG), and oxygen saturation—there remains a notable gap in the availability and development of wearable technologies specifically tailored to the pediatric population. This narrative review paper focuses on non-invasive wearable technologies developed for individuals under the age of 18, with an emphasis on health-related applications. We examine the current landscape of pediatric wearable research, including devices aimed at monitoring developmental progress and chronic health conditions. Particular attention is given to the limited research on wearables for younger children, where physiological and developmental differences pose additional challenges. Furthermore, we explore emerging applications, identify key barriers to adoption, and discuss opportunities for future development, including improvements in design, data privacy, and age-appropriate functionality. Full article
Show Figures

Figure 1

9 pages, 1344 KB  
Article
Bleomycin Electrosclerotherapy for Peripheral Low-Flow Venous and Lymphatic Malformations in Children: A Monocentric Case Series
by Edoardo Guida, Alessandro Boscarelli, Zeljko Zovko, Matea Peric-Anicic, Marianna Iaquinto, Maria-Grazia Scarpa, Sonia Maita, Damiana Olenik, Daniela Codrich and Jürgen Schleef
Children 2025, 12(9), 1167; https://doi.org/10.3390/children12091167 - 1 Sep 2025
Cited by 4 | Viewed by 1830
Abstract
Background: Vascular malformations are relatively common in children. Current therapeutic strategies include observation, medical therapy, sclerotherapy or embolization, laser therapy, cryoablation, and surgery, depending on the type and anatomical location of the malformation. Surgery is commonly limited to small and/or circumscribed lesions, to [...] Read more.
Background: Vascular malformations are relatively common in children. Current therapeutic strategies include observation, medical therapy, sclerotherapy or embolization, laser therapy, cryoablation, and surgery, depending on the type and anatomical location of the malformation. Surgery is commonly limited to small and/or circumscribed lesions, to debulking in case of large volumes, or in drug-resistant cases. Sclerotherapy is a minimally invasive treatment generally used to treat dysplastic vasculature and to significantly improve patients’ symptoms. Herein, we describe our preliminary experience with bleomycin electrosclerotherapy (BEST) in the treatment of peripheral low-flow venous and lymphatic malformations in the pediatric population. Methods: We prospectively collected and analyzed data from patients who underwent BEST for peripheral low-flow vascular malformations (venous and lymphatic) and were treated at our institution from May 2022 onward. Results: Twelve patients (4 boys and 8 girls) with peripheral low-flow vascular malformations who underwent BEST were enrolled in this preliminary study. The median patient age at the first procedure was 81 months (IQR = 46–128). The most frequent anomaly was peripheral low-flow venous malformation. No relevant postoperative complications were encountered in any of the patients. All patients underwent a clinical evaluation of the malformation 1 month after the procedure. A clinical and ultrasonographic evaluation of the malformation was performed 2 months after the procedure to determine whether to repeat BEST. In cases of clinical resolution, a second ultrasonographic evaluation was performed 6 months after the procedure. Conclusions: BEST appears to be a promising and safe option for treating peripheral low-flow vascular malformations in children. Further studies with a greater number of patients and longer follow-up periods are needed to confirm our preliminary experience. Full article
Show Figures

Figure 1

13 pages, 700 KB  
Article
Between Screens and Self-Perception: The Role of Gender and Digital Media Use in Shaping Body Esteem and Self-Esteem Among Adolescents
by Mateusz Grajek, Tomasz Jurys and Mateusz Rozmiarek
Children 2025, 12(9), 1143; https://doi.org/10.3390/children12091143 - 28 Aug 2025
Cited by 4 | Viewed by 5332
Abstract
Background/Objectives: Adolescence is a critical period for identity development and self-perception, increasingly shaped by digital media. This study aimed to examine how gender, body mass index (BMI), and Internet use influence body esteem and global self-esteem among adolescents aged 15–18 years old, with [...] Read more.
Background/Objectives: Adolescence is a critical period for identity development and self-perception, increasingly shaped by digital media. This study aimed to examine how gender, body mass index (BMI), and Internet use influence body esteem and global self-esteem among adolescents aged 15–18 years old, with particular focus on the psychological impact of digital exposure. Methods: A three-wave online study was conducted using the Computer-Assisted Web Interview (CAWI) technique. The final sample consisted of 500 Polish adolescents (251 girls, 249 boys). Participants completed the Body Esteem Scale (BES) and Rosenberg Self-Esteem Scale (SES) at three time points. The study explored gender differences, the role of BMI, and the impact of time spent online. Results: Girls reported significantly lower BES and SES scores than boys (p < 0.001), despite no significant gender differences in BMI. Time spent online was negatively associated with both body esteem and self-esteem (p < 0.01), with the most pronounced effects among girls using the Internet for more than 4 h daily. Regression analyses identified gender and Internet use as significant predictors of self-perception, while BMI did not. Conclusions: Digital media use, particularly prolonged exposure, appears to be a stronger predictor of adolescent self-perception than objective body measures such as BMI. Girls are especially vulnerable to its adverse effects on both body esteem and global self-esteem. These findings underscore the need for gender-sensitive interventions focused on media literacy, emotional resilience, and healthy digital habits among adolescents. Full article
(This article belongs to the Section Global Pediatric Health)
Show Figures

Figure 1

18 pages, 494 KB  
Article
Competitive Anxiety, Sports Injury, and Playing Category in Youth Soccer Players
by Rafael Sánchez-Ruiz, Laura Gil-Caselles, Alejo García-Naveira, Félix Arbinaga, Roberto Ruiz-Barquín and Aurelio Olmedilla-Zafra
Children 2025, 12(8), 1094; https://doi.org/10.3390/children12081094 - 20 Aug 2025
Cited by 7 | Viewed by 4087
Abstract
Background: Adolescence is a critical period of physical, psychological, and social development, during which athletes are particularly vulnerable to stress and injuries. Competitive anxiety has been identified as a psychological factor that may increase injury risk; however, its role among young soccer players [...] Read more.
Background: Adolescence is a critical period of physical, psychological, and social development, during which athletes are particularly vulnerable to stress and injuries. Competitive anxiety has been identified as a psychological factor that may increase injury risk; however, its role among young soccer players remains underexplored. Objectives: This study aimed to analyse the association between competitive anxiety and injury vulnerability in young male soccer players aged 10 to 15 years. Methods: A total of 322 male soccer players from youth categories (Alevin, Infantil, and Cadete) participated. Competitive anxiety was assessed using the Sport Anxiety Scale-2 (SAS-2), and injury data were collected via a self-reported questionnaire covering the 2024–2025 season. Descriptive, comparative, and correlational analyses were conducted using non-parametric tests. Results: A high incidence of injuries was observed, increasing progressively with age category. In the overall sample, injuries were associated with higher levels of Somatic Anxiety, as well as with age and sporting experience, variables also linked to increased Worry and reduced Distraction. When analysed by category, no significant associations between anxiety and injury were found in Alevin players. In the Infantil group, injury incidence showed a slight increase with age and experience, but no association with anxiety was detected. Among Cadete players, injuries were positively related to Somatic Anxiety and Distraction, highlighting the influence of psychological factors at this developmental stage. Conclusions: These findings underscore the relevance of competitive anxiety, particularly Worry and Distraction, as risk factors for injury in youth soccer. The implementation of preventive psychological interventions and ongoing monitoring is recommended to reduce anxiety levels and injury vulnerability, thereby promoting safer and healthier athletic development among young soccer players. Full article
(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)
Show Figures

Figure 1

47 pages, 1390 KB  
Review
Biological, Psychosocial, and Microbial Determinants of Childhood-Onset Obsessive–Compulsive Disorder: A Narrative Review
by Alejandro Borrego-Ruiz and Juan J. Borrego
Children 2025, 12(8), 1063; https://doi.org/10.3390/children12081063 - 13 Aug 2025
Cited by 5 | Viewed by 9703
Abstract
The etiology of obsessive–compulsive disorder (OCD) remains incompletely understood, but it is widely recognized as the result of a complex interplay among multiple contributing mechanisms, often emerging during childhood. This narrative review synthesizes current evidence on the etiology of childhood-onset OCD, with particular [...] Read more.
The etiology of obsessive–compulsive disorder (OCD) remains incompletely understood, but it is widely recognized as the result of a complex interplay among multiple contributing mechanisms, often emerging during childhood. This narrative review synthesizes current evidence on the etiology of childhood-onset OCD, with particular focus on whether GM alterations are involved in the pathophysiological mechanisms underlying the disorder. Specifically, the review first examines both biological and psychosocial determinants of OCD, and then explores the role of the gut microbiome (GM), including the potential of psychobiotics as a novel therapeutic approach. OCD has a strong hereditary component, involving both common polygenic variants and rare mutations. Epigenetic mechanisms such as DNA methylation and microRNA play a role in mediating gene–environment interactions and influencing OCD risk. Dysfunction and hyperactivity within cortico-striato-thalamo-cortical circuits underlie one of the neurobiological bases of OCD. Infections and autoimmune reactions can trigger or exacerbate OCD, particularly in pediatric populations. A range of psychosocial factors have been implicated in the onset of OCD, often in interaction with underlying neurobiological vulnerabilities. Current evidence indicates that GM alterations may also contribute to OCD pathophysiology through immune-mediated neuroinflammation, disrupted gut–brain signaling, and neurotransmitter imbalance. Individuals with OCD present reduced microbial diversity and lower abundance of butyrate-producing taxa, as well as altered IgA levels and increased infection susceptibility. These shifts may affect dopaminergic, glutamatergic, and serotonergic pathways, particularly via tryptophan metabolism and compromised gut integrity. Thus, the GM plays a pivotal role in OCD, constituting a promising approach for understanding its etiology and highlighting the significant clinical potential of microbial-based treatments such as psychobiotics. Nevertheless, despite progress, gaps remain in understanding childhood-onset OCD determinants, including limited longitudinal studies, incomplete characterization of the GM, scarce psychobiotic trials, and a need for integrated multidisciplinary approaches. Moreover, epidemiological evidence is compromised by reliance on lay diagnoses, questionable assessment validity, and insufficient distinction from related disorders. Full article
(This article belongs to the Section Pediatric Mental Health)
Show Figures

Figure 1

27 pages, 1164 KB  
Review
Physical Literacy as a Pedagogical Model in Physical Education
by Víctor Manuel Valle-Muñoz, María Mendoza-Muñoz and Emilio Villa-González
Children 2025, 12(8), 1008; https://doi.org/10.3390/children12081008 - 31 Jul 2025
Cited by 9 | Viewed by 7904
Abstract
Background/Objectives: Legislative changes in educational systems have influenced how student learning is understood and promoted. In physical education (PE), there has been a shift from behaviorist models to more holistic approaches. In this context, physical literacy (PL) is presented as an emerging [...] Read more.
Background/Objectives: Legislative changes in educational systems have influenced how student learning is understood and promoted. In physical education (PE), there has been a shift from behaviorist models to more holistic approaches. In this context, physical literacy (PL) is presented as an emerging pedagogical model in school PE, aimed at fostering students’ motor competence in a safe, efficient, and meaningful way. The aim of this study is to analyze the origins, foundations, methodological elements, and educational value of PL, highlighting its potential to promote holistic and inclusive learning as the basis for an emerging PL model. Methods: A narrative review was conducted through a literature search in the Web of Science, PubMed, Scopus, and SportDiscus databases up to June 2025, focusing on scientific literature related to PL and PE. The analysis included its historical background, philosophical and theoretical foundations, and the key methodological elements and interventions that support its use as a pedagogical model. Results/Discussion: The findings indicate that the PL model can be grounded in key principles, such as student autonomy, teacher training, connection with the environment, inclusion, and collaboration. Additionally, motivation, enjoyment, creativity, and continuous assessment are identified as essential components for effective implementation. Moreover, this model not only guides and supports teachers in the field of PL but also promotes comprehensive benefits for students at the physical, cognitive, affective, and social levels, while encouraging increased levels of physical activity (PA). Conclusions: PL is understood as a dynamic and lifelong process that should be cultivated from early childhood to encourage sustained and active participation in PA. As a pedagogical model, PL represents an effective tool to enhance student learning and well-being in PE classes. Full article
(This article belongs to the Section Global Pediatric Health)
Show Figures

Figure 1

13 pages, 583 KB  
Review
Chronic Disease in Pediatric Population—A Narrative Review of Psychosocial Dimensions and Strategies for Management
by Francesca Mastorci, Maria Francesca Lodovica Lazzeri, Lamia Ait-Ali, Pierluigi Festa and Alessandro Pingitore
Children 2025, 12(8), 967; https://doi.org/10.3390/children12080967 - 23 Jul 2025
Cited by 7 | Viewed by 7400
Abstract
Children living with chronic diseases represent a great challenge for the health care system, their families, and communities. These young patients face continuous medical needs that affect not only their health but also their daily routines, emotional well-being, and family dynamics. In response, [...] Read more.
Children living with chronic diseases represent a great challenge for the health care system, their families, and communities. These young patients face continuous medical needs that affect not only their health but also their daily routines, emotional well-being, and family dynamics. In response, clinical practice is increasingly integrating psychosocial indicators alongside traditional medical parameters. Consequently, there is a growing consensus that the evaluation of pediatric chronic diseases should address not only clinical dimensions but also the disease’s impact on socialization, emotional health, and daily functioning. This narrative review explores the role of psychosocial variables in the management of pediatric chronic illnesses, including the experiences of parents and siblings, with a focus on effective strategies to improve everyday life. The integration of quality of life and well-being within a multidimensional care model could be instrumental in both symptom management and psychosocial support. Recognizing that children with chronic conditions are at increased risk for long-term adverse outcomes, it is critical to develop interventions that go beyond clinical care, encompassing education, coping reinforcement, and family-centered approaches. Full article
(This article belongs to the Section Pediatric Mental Health)
Show Figures

Figure 1

18 pages, 882 KB  
Review
The Association Between Skipping Breakfast and Anxiety and Depression in Adolescents—A Scoping Review
by Tatiana Naumoska, Kristina Zafirovski and Fahad Hanna
Children 2025, 12(7), 953; https://doi.org/10.3390/children12070953 - 19 Jul 2025
Cited by 5 | Viewed by 6532
Abstract
Background: Anxiety and depression are among the most common mental health disorders affecting adolescents worldwide. Skipping breakfast is a prevalent dietary behaviour linked to inadequate nutrient intake, which may contribute to the development or exacerbation of mental health issues in this age group. [...] Read more.
Background: Anxiety and depression are among the most common mental health disorders affecting adolescents worldwide. Skipping breakfast is a prevalent dietary behaviour linked to inadequate nutrient intake, which may contribute to the development or exacerbation of mental health issues in this age group. Despite growing interest, a comprehensive synthesis of evidence on the association between breakfast omission and adolescent anxiety or depression remains limited. Objectives: This scoping review aimed to synthesise existing research on the association between skipping breakfast and the risk of anxiety and/or depression in adolescents. Methods: A systematic scoping review was conducted using the Joanna Briggs Institute (JBI) methodological framework. A comprehensive search of PubMed, ProQuest, and EBSCOhost databases was performed, focusing on studies published in English between 2014 and 2024. Keywords included “skipping breakfast,” “risk,” “anxiety,” “depression,” and “adolescen*.” Studies were screened and selected based on predefined inclusion and exclusion criteria. Results: Out of 1671 initially identified studies, 12 met the inclusion criteria. The majority were cross-sectional (n = 9), with one prospective cohort study, one secondary data analysis, and one systematic review with meta-analysis. Most studies reported a significant association between breakfast skipping and increased risk of anxiety and depression in adolescents. Only one study reported no significant relationship between the two variables. Conclusions: This review underscores a consistent association between skipping breakfast and elevated risk of anxiety and depression among adolescents. While causality remains to be established, breakfast omission emerges as a modifiable lifestyle factor with potential public health implications. These findings highlight the need for prospective research, as well as the importance of community- and school-based health promotion strategies that advocate for regular and nutritious breakfast consumption as part of broader mental health support efforts. Full article
(This article belongs to the Section Pediatric Mental Health)
Show Figures

Figure 1

16 pages, 539 KB  
Article
Virtual Reality as a Non-Pharmacological Aid for Reducing Anxiety in Pediatric Dental Procedures
by Laria-Maria Trusculescu, Dana Emanuela Pitic, Andreea Sălcudean, Ramona Amina Popovici, Norina Forna, Silviu Constantin Badoiu, Alexandra Enache, Sorina Enasoni, Andreea Kiș, Raluca Mioara Cosoroabă, Cristina Ioana Talpos-Niculescu, Corneliu Constantin Zeicu, Maria-Melania Cozma and Liana Todor
Children 2025, 12(7), 930; https://doi.org/10.3390/children12070930 - 14 Jul 2025
Cited by 6 | Viewed by 2135
Abstract
Background/Objectives: Dental anxiety in children is a common issue that can hinder the delivery of effective dental care. Traditional approaches to managing this are often insufficient or involve pharmacological interventions. This study shows the potential of virtual reality (VR) to aid in reducing [...] Read more.
Background/Objectives: Dental anxiety in children is a common issue that can hinder the delivery of effective dental care. Traditional approaches to managing this are often insufficient or involve pharmacological interventions. This study shows the potential of virtual reality (VR) to aid in reducing anxiety in children undergoing simple dental procedures. By immersing children in relaxing VR environments (such as beaches, forests, mountains, or underwater scenes with calm music), the objective is to assess VR’s effectiveness in calming pediatrics patients during these procedures. Methods: Children scheduled for minor dental treatments wore a wearable device that monitored pulse, perspiration, and stress levels. Each child’s baseline data was collected without the VR headset, followed by data collection during VR exposure before and during dental procedures. VR scenarios ranged from soothing nature scenes to animated cartoons, designed to foster relaxation. Results: The data collected showed a reduction in physiological indicators of stress, such as lower heart rate and reduced perspiration, when the VR headset was used. Children appeared more relaxed, with a calmer response during the procedure itself, compared to baseline levels without VR. Conclusions: This study provides preliminary evidence supporting VR as an effective tool for reducing anxiety and stress in pediatric dental patients. By offering an engaging, immersive experience, VR can serve as an alternative or complementary approach to traditional anxiety management strategies in pediatric dentistry, potentially improving patient comfort and cooperation during dental procedures. Further research could determine if VR may serve as an alternative to local anesthesia for non-intrusive pediatric dental procedures. Full article
(This article belongs to the Special Issue Children’s Behaviour and Social-Emotional Competence)
Show Figures

Figure 1

21 pages, 1759 KB  
Review
Three Decades of Managing Pediatric Obstructive Sleep Apnea Syndrome: What’s Old, What’s New
by Beatrice Panetti, Claudia Federico, Giuseppe Francesco Sferrazza Papa, Paola Di Filippo, Armando Di Ludovico, Sabrina Di Pillo, Francesco Chiarelli, Alessandra Scaparrotta and Marina Attanasi
Children 2025, 12(7), 919; https://doi.org/10.3390/children12070919 - 11 Jul 2025
Cited by 6 | Viewed by 5486
Abstract
Obstructive sleep apnea syndrome (OSAS) in children and adolescents is a prevalent and multifactorial disorder associated with significant short- and long-term health consequences. While adenotonsillectomy (AT) remains the first-line treatment, a substantial proportion of patients—especially those with obesity, craniofacial anomalies, or comorbid conditions—exhibit [...] Read more.
Obstructive sleep apnea syndrome (OSAS) in children and adolescents is a prevalent and multifactorial disorder associated with significant short- and long-term health consequences. While adenotonsillectomy (AT) remains the first-line treatment, a substantial proportion of patients—especially those with obesity, craniofacial anomalies, or comorbid conditions—exhibit persistent or recurrent symptoms, underscoring the need for individualized and multimodal approaches. This review provides an updated and comprehensive overview of current and emerging treatments for pediatric OSAS, with a focus on both surgical and non-surgical options, including pharmacological, orthodontic, and myofunctional therapies. A narrative synthesis of recent literature was conducted, including systematic reviews, randomized controlled trials, and large cohort studies published in the last 10 years. The review emphasizes evidence-based indications, mechanisms of action, efficacy outcomes, safety profiles, and limitations of each therapeutic modality. Adjunctive and alternative treatments such as rapid maxillary expansion, mandibular advancement devices, myofunctional therapy, intranasal corticosteroids, leukotriene receptor antagonists, and hypoglossal nerve stimulation show promising results in selected patient populations. Personalized treatment plans based on anatomical, functional, and developmental characteristics are essential to optimize outcomes. Combination therapies appear particularly effective in children with residual disease after AT or with specific phenotypes such as Down syndrome or maxillary constriction. Pediatric OSAS requires a tailored, multidisciplinary approach that evolves with the child’s growth and clinical profile. Understanding the full spectrum of available therapies allows clinicians to move beyond a one-size-fits-all model, offering more precise and durable treatment pathways. Emerging strategies may further redefine the therapeutic landscape in the coming years. Full article
Show Figures

Figure 1

15 pages, 1027 KB  
Article
Parent–Child Eye Gaze Congruency to Emotional Expressions Mediated by Child Aesthetic Sensitivity
by Antonios I. Christou, Kostas Fanti, Ioannis Mavrommatis and Georgia Soursou
Children 2025, 12(7), 839; https://doi.org/10.3390/children12070839 - 25 Jun 2025
Cited by 4 | Viewed by 1610
Abstract
Background/Objectives: Sensory Processing Sensitivity (SPS), particularly its aesthetic subcomponent (Aesthetic Sensitivity; AES), has been linked to individual differences in emotional processing. This study examined whether parental visual attention to emotional facial expressions predicts corresponding attentional patterns in their children, and whether this intergenerational [...] Read more.
Background/Objectives: Sensory Processing Sensitivity (SPS), particularly its aesthetic subcomponent (Aesthetic Sensitivity; AES), has been linked to individual differences in emotional processing. This study examined whether parental visual attention to emotional facial expressions predicts corresponding attentional patterns in their children, and whether this intergenerational concordance is mediated by child AES and moderated by child empathy. Methods: A sample of 124 Greek Cypriot parent–child dyads (children aged 7–12 years) participated in an eye-tracking experiment. Both parents and children viewed static emotional facial expressions (angry, sad, fearful, happy). Parents also completed questionnaires assessing their child’s SPS, empathy (cognitive and affective), and emotional functioning. Regression analyses and moderated mediation models were employed to explore associations between parental and child gaze patterns. Results: Children’s fixation on angry eyes was significantly predicted by parental fixation duration on the same region, as well as by child AES and empathy levels. Moderated mediation analyses revealed that the association between parent and child gaze to angry eyes was significantly mediated by child AES. However, neither cognitive nor affective empathy significantly moderated this mediation effect. Conclusions: Findings suggest that child AES plays a key mediating role in the intergenerational transmission of attentional biases to emotional stimuli. While empathy was independently associated with children’s gaze behavior, it did not moderate the AES-mediated pathway. These results highlight the importance of trait-level child sensitivity in shaping shared emotional attention patterns within families. Full article
(This article belongs to the Section Global Pediatric Health)
Show Figures

Figure 1

18 pages, 541 KB  
Review
Developmental-Centered Care in Preterm Newborns: Scoping Review
by Jina M. Velasco Arias, Aida M. Peres, Francisco M. Escandell Rico, M. Carmen Solano-Ruiz, Vicente F. Gil-Guillen and Ana Noreña-Peña
Children 2025, 12(6), 783; https://doi.org/10.3390/children12060783 - 16 Jun 2025
Cited by 6 | Viewed by 7286
Abstract
Background/Objectives: Preterm newborns often require specialized care and management. However, exposure to multiple stimuli during hospitalization can adversely affect their neurological development. Developmental-centered care integrates evidence-based practices and neuroprotective strategies to create an optimal care environment that minimizes harmful stimuli in the neonatal [...] Read more.
Background/Objectives: Preterm newborns often require specialized care and management. However, exposure to multiple stimuli during hospitalization can adversely affect their neurological development. Developmental-centered care integrates evidence-based practices and neuroprotective strategies to create an optimal care environment that minimizes harmful stimuli in the neonatal intensive care unit (NICU) and supports the neurological development of preterm infants. To identify interventions related to developmental-centered care that support preterm newborns in the NICU. Methods: A scoping review was conducted following the guidelines of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A comprehensive search was performed in MEDLINE, CINAHL, and Web of Science databases. The results were categorized based on the general characteristics of the studies and the main interventions related to developmental-centered care. Results: Out of 163 potentially relevant sources identified, 19 studies met the inclusion criteria. A total of 52 interventions were identified and classified into three thematic categories related to the benefits of the kangaroo care method, the family-centered care model, and the neonatal individualized developmental care and assessment program. Conclusions: The findings underscore the importance of integrating developmental-centered care practices, such as skin-to-skin contact, specialized feeding, and active parental involvement, into clinical practice to support neurodevelopment and improve health outcomes in preterm infants. Full article
(This article belongs to the Section Pediatric Neonatology)
Show Figures

Figure 1

19 pages, 692 KB  
Review
Music Therapy and Music-Based Interventions in Pediatric Neurorehabilitation
by Elisa Milcent Fernandez and Christopher J. Newman
Children 2025, 12(6), 773; https://doi.org/10.3390/children12060773 - 14 Jun 2025
Cited by 7 | Viewed by 6220
Abstract
Background: Music therapy and music-based interventions are increasingly recognized as valuable adjuncts in pediatric neurorehabilitation, leveraging rhythm, singing, instrument playing, and improvisation to support children with neurological disabilities. Objective/Method: This narrative review synthesizes evidence from studies published between 2000 and 2025, focusing on [...] Read more.
Background: Music therapy and music-based interventions are increasingly recognized as valuable adjuncts in pediatric neurorehabilitation, leveraging rhythm, singing, instrument playing, and improvisation to support children with neurological disabilities. Objective/Method: This narrative review synthesizes evidence from studies published between 2000 and 2025, focusing on children aged 3 to 18 years receiving neurorehabilitation. Results: The literature demonstrates that music therapy and music-based interventions can improve motor function—particularly gait and upper limb coordination—as well as speech production, while also reducing anxiety and enhancing participation. Techniques such as rhythmic auditory stimulation and melodic intonation therapy have shown promise in targeting movement and communication deficits. Music therapy is further associated with positive effects on vital signs and emotional well-being, supporting its role in holistic care. Neurobiological findings suggest that music-based interventions may promote neuroplasticity and strengthen brain connectivity, though high-quality mechanistic studies remain limited. Conclusions: Despite methodological heterogeneity and small sample sizes in the current literature, the overall evidence supports music therapy and music-based interventions as accessible, cost-effective, and child-centered complements to standard neurorehabilitation. Future research should prioritize rigorous clinical trials and neurobiological investigations to clarify mechanisms and optimize therapeutic protocols. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
Show Figures

Figure 1

15 pages, 590 KB  
Article
Sex/Gender Differences in the Effects of Childhood Abuse on Future Risk of Depression: Longitudinal Evidence from the Global Flourishing Study
by Shervin Assari, Babak Najand and Alexandra Donovan
Children 2025, 12(6), 754; https://doi.org/10.3390/children12060754 - 11 Jun 2025
Cited by 6 | Viewed by 2534
Abstract
Background: Adverse childhood experiences (ACEs) such as abuse (defined as emotional, physical, or sexual abuse without distinguishing type or severity) have long been linked to mental health challenges in adulthood. However, less is known about how these effects differ by sex/gender in global [...] Read more.
Background: Adverse childhood experiences (ACEs) such as abuse (defined as emotional, physical, or sexual abuse without distinguishing type or severity) have long been linked to mental health challenges in adulthood. However, less is known about how these effects differ by sex/gender in global samples, particularly using large-scale, multi-country panel data. Objectives: To examine whether the long-term association between childhood abuse and changes in depressive symptoms during adulthood differ between men and women, after adjusting for demographic and socioeconomic factors. Methods: We conducted a secondary analysis of Waves 1 and 2 of the Global Flourishing Study (GFS), a longitudinal panel study covering 22 diverse countries. The sample included adult participants with complete data on childhood abuse (yes/no); depression at baseline and follow-up; sex/gender; and relevant covariates (age; education; marital status; immigration status; smoking status; and employment). Depression was measured using a two-item scale. Multi-group structural equation models were used to test the effect of ACE on changes in depression over time where groups were defined based on sex/gender. Results: Overall, childhood abuse was associated with a statistically significant increase in depression scores between Wave 1 and Wave 2. This association was significant among women but not among men. Conclusions: Our findings suggest that the mental health consequences of childhood abuse extend into adulthood and disproportionately affect women. These sex/gender differences may reflect variations in stress processing; coping; and social roles. Interventions addressing early adversity may need to be tailored to recognize and respond to such sex/gender-specific vulnerabilities. Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Assessment and Long-Term Outcomes)
Show Figures

Figure 1

14 pages, 559 KB  
Review
Significance of Oral Care for Children with Autism Spectrum Disorder—A Narrative Literature Review
by Sirma Angelova, Desislava Konstantinova, Anna Nenova-Nogalcheva and Rouzha Pancheva
Children 2025, 12(6), 750; https://doi.org/10.3390/children12060750 - 9 Jun 2025
Cited by 5 | Viewed by 3770
Abstract
Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition in children that typically involves challenges in cognition, behavior, and communication. While many children with ASD exhibit significant impairments in both verbal and non-verbal communication, the severity and nature of these difficulties can vary [...] Read more.
Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition in children that typically involves challenges in cognition, behavior, and communication. While many children with ASD exhibit significant impairments in both verbal and non-verbal communication, the severity and nature of these difficulties can vary widely. In addition to its impact on overall health, ASD also affects oral health, leading to increased vulnerability to dental disease. Aim: This narrative review aims to summarize key oral health challenges and care strategies for children with ASD, focusing on clinical risks, behavioral barriers, caregiver roles, and effective interventions. Materials and Methods: A comprehensive literature search was conducted using four databases—PubMed, Scopus, Web of Science, and Google Scholar—as well as relevant study registries where applicable. Peer-reviewed articles published in English between 2010 and 2024 were identified using keywords and their synonyms, such as autism spectrum disorder, children, oral care, dental practitioners, and parents. Studies were included based on relevance to oral health challenges and interventions in children diagnosed with ASD. Results: Children with ASD experience a range of sensory sensitivities, attention deficits, hyperactivity, and behavioral resistance, which significantly hinder the performance of adequate oral hygiene practices. These challenges contribute to a lack of effective dental prophylaxis and limited access to regular preventive care, ultimately resulting in poorer oral health outcomes and reduced oral health-related quality of life. Conclusion: Due to the multifaceted characteristics of ASD, children with this condition face significant barriers in accessing appropriate and individualized oral care. This increases their risks of developing oral health disorders, underscoring the need for coordinated efforts between caregivers and dental professionals to improve oral health outcomes in this vulnerable population. Full article
(This article belongs to the Section Pediatric Dentistry & Oral Medicine)
Show Figures

Figure 1

19 pages, 792 KB  
Review
Parental Perspectives and Infant Motor Development: An Integrated Ecological Model
by Ran An and Klaus Libertus
Children 2025, 12(6), 724; https://doi.org/10.3390/children12060724 - 31 May 2025
Cited by 4 | Viewed by 8699
Abstract
Infant motor development has traditionally been studied through child-centered frameworks that often overlook the vital role parents play in shaping early outcomes. This paper provides a renewed ecological approach, foregrounding parental perspectives—knowledge, beliefs, attitudes, theories, and expectations—and examining how they directly and indirectly [...] Read more.
Infant motor development has traditionally been studied through child-centered frameworks that often overlook the vital role parents play in shaping early outcomes. This paper provides a renewed ecological approach, foregrounding parental perspectives—knowledge, beliefs, attitudes, theories, and expectations—and examining how they directly and indirectly guide infants’ motor trajectories. Drawing on cross-cultural evidence, we illustrate how differences in parental priorities and caregiving behaviors can either accelerate or delay the emergence of crucial motor skills. We also highlight the reciprocal relationship between parent and child: while parental views shape caregiving practices, children’s developing abilities and behaviors can, in turn, alter their parents’ perspectives. Building on existing theories, including Bronfenbrenner’s ecological systems theory and dynamic systems theory, our integrated model situates the parent–child dyad within broader socioeconomic, cultural, and environmental contexts. This model shows the dynamic, ever-evolving interplay between parents and children and demonstrates the importance of aligning parental cognition with targeted interventions to optimize motor development. By examining how cultural norms, individual experiences, and contextual factors converge, this paper offers both a theoretical framework and practical implications for supporting infants’ growth. This paper will inform future research by encouraging parent-focused developmental studies and guiding practitioners to design culturally informed interventions in the field of motor development. Full article
Show Figures

Figure 1

13 pages, 233 KB  
Article
Prevalence of Early Childhood Caries in 3- to 6-Year-Old Children in Serbia: A National Pathfinder Study
by Tamara Peric, Evgenija Markovic, Jovan Markovic, Bojan Petrovic, Biljana Kilibarda, Ana Vukovic and Dejan Markovic
Children 2025, 12(6), 692; https://doi.org/10.3390/children12060692 - 28 May 2025
Cited by 5 | Viewed by 5353
Abstract
This study aimed to assess dental caries status of 3- to 6-year-old preschool children in the Republic of Serbia. Stratified cluster sampling was implemented. Children were examined in four administrative regions of Serbia. Dental caries indices (decayed, missing, and filled) for deciduous teeth [...] Read more.
This study aimed to assess dental caries status of 3- to 6-year-old preschool children in the Republic of Serbia. Stratified cluster sampling was implemented. Children were examined in four administrative regions of Serbia. Dental caries indices (decayed, missing, and filled) for deciduous teeth and the first permanent molar were recorded at the tooth level (dmft, DMFT) and surface level (dfs, DFS). In addition to cavitated caries lesions (ICDAS 3-6), visual changes in enamel (ICDAS 1-2) were recorded. This study included 1060 3-year-old and 1820 6-year-old children in Serbia. Fifty-six percent of 3-year-olds and 21% of 6-year-olds were caries-free. The mean dmft was 2.11 ± 3.45 for 3-year-olds and 4.46 ± 3.69 for 6-year-olds. The mean dfs was 2.62 ± 5.56 for 3-year-olds and 6.06 ± 6.33 for 6-year-olds. The decayed component was dominant in dmft/dfs. The prevalence of surfaces with initial lesion was 8% for 3-year-olds and 13% for 6-year-olds. Among children diagnosed with early childhood caries, 54% of 3-year-olds and 37% of 6-year-olds had a severe form. The mean DMFT was 0.15 ± 0.55, with only the first permanent molars being affected. Dental caries remains a significant public dental health issue among preschool children in Serbia. There is a noticeable trend of increasing numbers of decayed teeth as children progress through their preschool years. It is imperative to take corrective action enhance the existing oral health prevention program in Serbia with the aim of achieving better dental health among preschool children. Full article
(This article belongs to the Special Issue Oral Disease Prevention and Treatment for Children and Adolescents)
11 pages, 215 KB  
Review
The Perioperative Use of Dexmedetomidine in Paediatric Patients
by Esaias Janse van Rensburg, Laura Indiveri and Palesa Mogane
Children 2025, 12(6), 690; https://doi.org/10.3390/children12060690 - 28 May 2025
Cited by 6 | Viewed by 5015
Abstract
Background/Objectives: Dexmedetomidine, an alpha-2 adrenergic agonist, has gained significant attention for its sedative, analgesic, and anxiolytic properties in paediatric anaesthesia. This review explores its pharmacokinetics and pharmacodynamics, perioperative applications and efficacy, and safety profile in paediatric patients. Findings: Dexmedetomidine has emerged [...] Read more.
Background/Objectives: Dexmedetomidine, an alpha-2 adrenergic agonist, has gained significant attention for its sedative, analgesic, and anxiolytic properties in paediatric anaesthesia. This review explores its pharmacokinetics and pharmacodynamics, perioperative applications and efficacy, and safety profile in paediatric patients. Findings: Dexmedetomidine has emerged as a highly effective adjunct in paediatric anaesthesia, offering significant advantages across various perioperative settings. It reduces the need for other anaesthetics and opioids, leading to smoother recoveries with lower postoperative pain and agitation. Studies highlight its role in enhancing procedural sedation, improving patient cooperation, and providing superior analgesia in neuraxial and general anaesthesia. Its neuroprotective properties and stable haemodynamic profile make it particularly valuable in the perioperative and critical care settings. Conclusions: Dexmedetomidine has shown a favourable safety and efficacy profile in paediatric anaesthesia when doses are carefully titrated within the ranges recommended in the literature. While its use remains off-label in paediatric populations, increasing clinical experience and evidence support its integration into perioperative protocols. Full article
(This article belongs to the Section Pediatric Anesthesiology, Pain Medicine and Palliative Care)
16 pages, 550 KB  
Article
Age and Gender Differences in Emotional and Behavioral Functioning Among Youth Referred to a Psychiatric Outpatient Clinic at a Public Hospital
by Inbar Levkovich, Uri Yatzkar and Vered Shenaar-Golan
Children 2025, 12(6), 683; https://doi.org/10.3390/children12060683 - 26 May 2025
Cited by 11 | Viewed by 5429
Abstract
Background: Emotional and behavioral difficulties are prevalent among children and adolescents referred for psychiatric care. This study examined how these challenges vary across age and gender, including regulatory functioning. It also explored whether emotion regulation mediates the relationship between depressive symptoms and internalizing [...] Read more.
Background: Emotional and behavioral difficulties are prevalent among children and adolescents referred for psychiatric care. This study examined how these challenges vary across age and gender, including regulatory functioning. It also explored whether emotion regulation mediates the relationship between depressive symptoms and internalizing problems and whether this mediating effect is moderated by gender and age. Methods: A cross-sectional study was conducted among 661 children and adolescents (aged 9–17 years) referred to a psychiatric outpatient clinic. Participants completed self-report questionnaires assessing depressive symptoms (MFQ-C), anxiety (SCARED-C), emotion regulation (DERS), and emotional/behavioral problems (SDQ). Statistical analyses included group comparisons and moderated mediation modeling using SPSS 27. Results: Adolescents aged 15–17 years reported significantly higher levels of depressive symptoms, emotion regulation difficulties, and anxiety-related symptoms compared to younger participants. Girls exhibited higher levels of internalizing symptoms and greater emotion regulation difficulties than boys, whereas boys showed more conduct problems. A significant gender × age interaction was found for depressive symptoms. Depressive symptoms indirectly affected internalizing problems through emotion regulation, with the strongest effect among adolescent girls. Conclusions: The findings emphasize the need for developmentally tailored assessment and intervention strategies in youth psychiatric care. Emotion regulation emerged as a central mechanism linking depressive symptoms to internalizing difficulties, particularly in older adolescent girls, supporting the design of targeted interventions to reduce emotional distress. Full article
(This article belongs to the Special Issue Parenting a Child with Disabilities)
Show Figures

Figure 1

13 pages, 674 KB  
Review
The Interplay Between Body Weight and the Onset of Puberty
by Alexandros K. Kythreotis, Marina Nicolaou, Eirini Mitsinga, Habib Daher and Nicos Skordis
Children 2025, 12(6), 679; https://doi.org/10.3390/children12060679 - 25 May 2025
Cited by 4 | Viewed by 5543
Abstract
This overview explores the complex relationship between environmental factors, particularly obesity, and the timing of puberty, with a focus on how hormonal and genetic interactions are influenced by external conditions. Puberty (gonadarche) is characterised by the activation of the hypothalamic–pituitary–gonadal (HPG) axis. The [...] Read more.
This overview explores the complex relationship between environmental factors, particularly obesity, and the timing of puberty, with a focus on how hormonal and genetic interactions are influenced by external conditions. Puberty (gonadarche) is characterised by the activation of the hypothalamic–pituitary–gonadal (HPG) axis. The onset and progression of puberty vary significantly among individuals, primarily due to genetic factors, with key genes like kisspeptin 1 (KISS1) and makorin ring finger protein 3 (MKRN3) playing a crucial role. Cohesively, this paper emphasises that environmental factors, particularly obesity and exposure to endocrine-disrupting chemicals (EDCs), have become significant influences on the timing of puberty. Childhood obesity has risen significantly in recent decades and the age of pubertal onset has declined over the same period. Obesity greatly disrupts hormone regulation in pre-pubertal children. Leptin accelerates the onset of puberty in girls but not in boys. The underlying mechanism is proposed to be the increase in Kiss1/GnRH signalling. On the contrary, excess leptin in boys suppresses testosterone production by increasing oestrogen conversion. Low adiponectin in obese girls may contribute to earlier puberty due to a reduced inhibition of Kiss1/GnRH signalling. Low adiponectin in boys is linked to delayed puberty due to its role in maintaining insulin sensitivity and testosterone production. Hyperinsulinemia influences pubertal timing through central and peripheral mechanisms. Insulin acting synergistically with leptin promotes the earlier onset of puberty in girls but not in boys. The effects of exposure to certain EDCs—mostly obesogenic chemicals that mimic the action of natural hormones—on the timing of puberty remain unclear; hence, further research on this topic is needed. Addressing and preventing obesity in children could potentially mitigate these alterations in pubertal timing. Full article
(This article belongs to the Section Pediatric Endocrinology & Diabetes)
Show Figures

Figure 1

12 pages, 767 KB  
Article
Effect of Relative Age on Gross Motor Coordination Development, Considering Biological Maturity and Sex
by Xiaoyu Zhang, Gaël Ennequin, Anthony J. Blazevich and Sébastien Ratel
Children 2025, 12(5), 619; https://doi.org/10.3390/children12050619 - 10 May 2025
Cited by 4 | Viewed by 1284
Abstract
Objective: This study aimed to investigate the effect of relative age on gross motor coordination (GMC) development, taking into account biological maturity and sex. Methods: 729 participants aged 10 to 16 years completed three GMC tests newly designed to minimize the potentially confounding [...] Read more.
Objective: This study aimed to investigate the effect of relative age on gross motor coordination (GMC) development, taking into account biological maturity and sex. Methods: 729 participants aged 10 to 16 years completed three GMC tests newly designed to minimize the potentially confounding effects of physical fitness. The tests included a Hand-Foot coordination test, Dribbling-Targeting test (DT test), and a T balance and agility test (T test). Relative age was determined using birth quartiles: BQ1 (January–March); BQ2 (April–June); BQ3 (July–September); and BQ4 (October–December). Regarding biological maturity, the participants were categorized according to their estimated peak height velocity (pre- and post-PHV). Results: Relative age did not significantly impact the overall GMC score. In contrast, biological maturity emerged as a significant determinant of GMC, with post-PHV participants outperforming their pre-PHV counterparts in the three tests (p < 0.001). The results also showed a significant main effect of sex in the DT and T tests, i.e., in tasks involving dynamic coordination and agility, with boys consistently outperforming girls (p < 0.001). Significant biological maturity × sex interactions in the DT and T tests also indicated an advantage of boys over girls with advancing biological maturity (p < 0.05). Conclusions: these findings highlight the importance of considering biological maturity and sex rather than relative age in GMC development from childhood through adolescence. Full article
(This article belongs to the Special Issue Effects of Exercise Interventions on Children)
Show Figures

Figure 1

20 pages, 907 KB  
Review
Growth Failure in Children with Congenital Heart Disease
by Jihye Lee, Teresa Marshall, Harleah Buck, Mulder Pamela and Sandra Daack-Hirsch
Children 2025, 12(5), 616; https://doi.org/10.3390/children12050616 - 9 May 2025
Cited by 5 | Viewed by 7048
Abstract
Background/Objectives: Growth failure is a common complication in children with congenital heart disease (CHD), yet its underlying mechanisms and consequences remain incompletely understood. This review aims to provide a comprehensive overview of growth failure in children with CHD and outline a framework [...] Read more.
Background/Objectives: Growth failure is a common complication in children with congenital heart disease (CHD), yet its underlying mechanisms and consequences remain incompletely understood. This review aims to provide a comprehensive overview of growth failure in children with CHD and outline a framework of factors contributing to this condition. Methods: To lay the foundation for this narrative review, several databases were searched using broad search terms related to CHD and growth failure. Results: Growth failure is most pronounced during the first year of life, but often improves after achieving hemodynamic stability through surgical or medical interventions. However, children with complex conditions, such as single-ventricle physiology or multiple heart defects, may experience persistent growth impairment due to chronic disease effects. Specific features of CHD—cyanosis, pulmonary hypertension, and low cardiac output—can further hinder growth by disrupting endocrine function and impairing musculoskeletal development. Long-term use of medications and exposure to repeated diagnostic procedures also contribute to growth failure. Beyond physical effects, growth failure profoundly influences neurodevelopment, psychosocial well-being, and survival outcomes. Based on our review, we have developed a knowledge map to better understand the complexities of growth failure in children with CHD. Conclusions: A thorough understanding of the multifaceted contributors to growth failure in CHD is essential for identifying high-risk children and devising strategies to support optimal growth. Integrating this knowledge into clinical practice can improve long-term outcomes for children with CHD. Full article
(This article belongs to the Section Pediatric Cardiology)
Show Figures

Figure 1

34 pages, 1830 KB  
Review
The Role of miRNA Expression in Congenital Heart Disease: Insights into the Mechanisms and Biomarker Potential
by Savina Mannarino, Valeria Calcaterra, Filippo Puricelli, Giulia Cecconi, Claudia Chillemi, Irene Raso, Erika Cordaro and Gianvincenzo Zuccotti
Children 2025, 12(5), 611; https://doi.org/10.3390/children12050611 - 7 May 2025
Cited by 7 | Viewed by 2565
Abstract
Congenital heart diseases (CHDs) are among the most common congenital malformations. Despite significant advancements in understanding the embryonic development of the heart, the etiology of CHDs remains largely unknown. The complexity of the processes involved in heart formation limits our ability to identify [...] Read more.
Congenital heart diseases (CHDs) are among the most common congenital malformations. Despite significant advancements in understanding the embryonic development of the heart, the etiology of CHDs remains largely unknown. The complexity of the processes involved in heart formation limits our ability to identify all molecular mechanisms underlying CHDs. Recently, microRNAs (miRNAs) have provided new insights into the molecular mechanisms of CHDs. This narrative review evaluates the evidence linking expression to CHDs and discusses the potential of RNA expression regulation as a promising avenue for therapeutic biomarker development. A search of the literature, focusing on the role of miRNAs in CHDs, was carried out to identify pertinent studies published over the last decade. The literature search was performed utilizing the PubMed and Scopus databases. The selection criteria included peer-reviewed original studies, clinical research, meta-analyses, and review articles written in English. Multiple investigations have highlighted the essential role of miRNAs in cardiac development and function, showing that their distinct expression patterns can broadly and specifically influence cellular signaling pathways involved in heart abnormalities. The regulation of mRNA expression emerges as a key factor in the pathogenesis of CHD, paving the way for the identification of novel molecular biomarkers. Alterations in transcriptional profiles could offer innovative and highly specific tools for risk stratification and the clinical monitoring of patients. In conclusion, although further studies are needed to validate the efficacy and clinical applicability of these biomarkers, the mRNA-based approach stands out as a promising perspective for precision medicine in the CHD context. Full article
(This article belongs to the Section Pediatric Cardiology)
Show Figures

Figure 1

14 pages, 1369 KB  
Article
Motor Skill Development at Preschool Age in Girls and Boys: The Role of Outdoor Free Play
by Valentina Biino, Caterina Pesce and Clarice Martins
Children 2025, 12(5), 594; https://doi.org/10.3390/children12050594 - 2 May 2025
Cited by 6 | Viewed by 7298
Abstract
Background/Objectives: Trajectories of fundamental movement skill (FMS) development start diverging in females and males in early childhood, with determinants of this divergence spanning from individual to social and environmental factors. The present cross-sectional study focuses on the role of free outdoor play and [...] Read more.
Background/Objectives: Trajectories of fundamental movement skill (FMS) development start diverging in females and males in early childhood, with determinants of this divergence spanning from individual to social and environmental factors. The present cross-sectional study focuses on the role of free outdoor play and aims to investigate whether sex differences in FMS typically observed in early childhood are associated with participation in free outdoor play. Methods: One hundred and forty-two children aged 4.3 ± 0.8 yrs were evaluated for locomotor and object control skills (TGMD-3), weight status (BMI), and free outdoor play (parent-reported). Motor skill competence scores were submitted to moderated regression analyses to evaluate the individual and joint effects of sex, outdoor play, age, and BMI; interrelations among these variables were also estimated with network analysis. Results: Results of the moderated regression showed, beyond the expected prediction of motor skill competence (overall and object control skills) by sex and age, also a significant sex x outdoor play interaction, with higher motor skills being predicted by more frequent outdoor play in males only. The network analysis confirmed a positive association between outdoor play and motor skill competence in males but not in females. Conclusions: Males might capitalize on free outdoor play opportunities as early as preschool age to engage in activities that promote their motor and especially object control skill development. Longitudinal studies are needed to test causality and derive practical indications for enabling both males and females to fully exploit the opportunities provided by free outdoor play to exercise both locomotor and object control skills. Full article
Show Figures

Figure 1

12 pages, 537 KB  
Article
Intraoperative Methadone Versus Non-Methadone Analgesia in Pediatric Cardiac Surgery: A Retrospective Cohort Study
by Brian Blasiole, Danielle R. Lavage, Hsing-Hua Sylvia Lin, Scott E. Licata, Sahana Sivam, Inesh Sivam, Laura M. Le and Senthilkumar Sadhasivam
Children 2025, 12(5), 567; https://doi.org/10.3390/children12050567 - 28 Apr 2025
Cited by 5 | Viewed by 1351
Abstract
Introduction: Methadone is an opioid-sparing opioid and it is increasingly used in children undergoing surgery due to its beneficial effects on postoperative pain scores, decreased opioid requirements, and fewer adverse effects compared to other opioids. Intraoperative methadone is not well studied in pediatric [...] Read more.
Introduction: Methadone is an opioid-sparing opioid and it is increasingly used in children undergoing surgery due to its beneficial effects on postoperative pain scores, decreased opioid requirements, and fewer adverse effects compared to other opioids. Intraoperative methadone is not well studied in pediatric cardiac surgery. We hypothesized that intraoperative methadone-based analgesia would provide comparable effectiveness in pain management to non-methadone-based analgesia, including caudal morphine, following pediatric cardiac surgery. Methods: We conducted a retrospective cohort study of 287 children undergoing cardiac surgery using single institutional electronic health records with Society of Thoracic Surgeons database outcomes. Patients were administered intravenous opioids plus caudal morphine (≤6 years) or intravenous opioids in the non-methadone group versus intravenous methadone (two 0.1 mg/kg doses given intraoperatively) with or without additional intraoperative opioids. The primary outcome was postoperative opioid use in morphine milligram equivalents (MME)/kg. Results: This study included 287 pediatric cardiac surgical patients with a mean age of 3.8 years, 59% male, and 72% White. Among 287 patients, 67 (23%) received intraoperative methadone. Unadjusted analysis showed the methadone group had lower postoperative opioid use on the day of surgery (median = 0.3 vs. 0.5 MME/kg, p = 0.005). Adjusted analyses showed there were no significant differences in postoperative opioid use, average pain, maximum pain, antiemetic use, reintubation, and use of naloxone between methadone and non-methadone groups. Hospital length of stay was 2.62 times longer (95% CI: [1.55, 4.41] p < 0.001) in the methadone group vs non-methadone group, but this was only shown in the younger children (≤6 years), who also had higher max pain scores in the methadone group. All outcomes were similar between analgesia groups in older children (>6 years). Conclusions: Intraoperative methadone-based analgesia had comparable effectiveness in postoperative opioid use, pain, and antiemetic use compared to non-methadone-based intraoperative pain management for pediatric cardiac surgery. Large prospective studies of perioperative methadone are needed to examine methadone’s analgesic benefits in children undergoing cardiac surgery. Full article
Show Figures

Figure 1

14 pages, 1598 KB  
Review
Modern Treatment of Supracondylar Humeral Fractures in Children
by Adrian Surd, Rodica Muresan, Carmen Iulia Ciongradi, Lucia Maria Sur, Lucia Raluca Ardelean, Lia Oxana Usatiuc, Kriszta Snakovszki, Camelia Munteanu and Ioan Sârbu
Children 2025, 12(5), 556; https://doi.org/10.3390/children12050556 - 25 Apr 2025
Cited by 5 | Viewed by 6856
Abstract
Supracondylar humeral fractures are the most common type of elbow fractures in children. The treatment methods vary depending on the type of fracture (Gartland classification), which can be conservative or surgical. There is no clear consensus or guidelines to dictate the treatment of [...] Read more.
Supracondylar humeral fractures are the most common type of elbow fractures in children. The treatment methods vary depending on the type of fracture (Gartland classification), which can be conservative or surgical. There is no clear consensus or guidelines to dictate the treatment of complicated supracondylar humeral fractures (Gartland types II and III). Gartland type II and III fractures are most frequently treated with closed reduction and percutaneous Kirchner-wire pinning or open reduction with K-wire pinning, depending on the degree of displacement and the orthopedic surgeon’s preference. Most studies recommend avoiding open reduction because of prolonged hospitalization and higher rates of complications. Orthopedic surgeons have different opinions regarding the Kirschner pin placement technique. Studies suggest that only lateral pinning is safe and effective, but medial and lateral pinning is proven to give more stability; there is always a risk of iatrogenic ulnar nerve damage during surgery. Modern treatment of supracondylar humeral fracture in children should focus on minimally invasive techniques and avoid open reduction, when possible, to ensure the best outcome for the patients. This scoping review’s purpose is to gather the available information on the topic in one place and to underline the lack of clear protocols. Full article
(This article belongs to the Special Issue Pediatric Orthopedic Injuries: Diagnosis and Treatment)
Show Figures

Graphical abstract

19 pages, 243 KB  
Review
From Motor Skills to Digital Solutions: Developmental Dysgraphia Interventions over Two Decades
by Weifeng Han and Tianchong Wang
Children 2025, 12(5), 542; https://doi.org/10.3390/children12050542 - 24 Apr 2025
Cited by 7 | Viewed by 7211
Abstract
Background/Objectives: Developmental dysgraphia, a graphomotor difficulty affecting handwriting, significantly impacts children’s academic performance, emotional well-being, and overall development. Over the past two decades, intervention strategies have transitioned from traditional task-oriented motor training to more innovative, technology-driven, and holistic approaches. This paper aims to [...] Read more.
Background/Objectives: Developmental dysgraphia, a graphomotor difficulty affecting handwriting, significantly impacts children’s academic performance, emotional well-being, and overall development. Over the past two decades, intervention strategies have transitioned from traditional task-oriented motor training to more innovative, technology-driven, and holistic approaches. This paper aims to synthesise key developments in dysgraphia interventions, categorising them into distinct thematic areas and evaluating their effectiveness in improving handwriting outcomes. Methods: A review of 12 key studies was conducted, classifying interventions into four primary categories: (1) task-oriented and sensorimotor-based interventions; (2) technology-assisted solutions; (3) self-regulated and individualised approaches; and (4) integrated methodologies. Each study was analysed based on its methodology, intervention design, target population, and reported outcomes to assess the effectiveness and feasibility of different approaches. Results: The findings indicate significant advancements in handwriting interventions, with technology-assisted and integrated approaches demonstrating promising results in engagement, accessibility, and skill development. However, challenges remain in terms of scalability, cultural adaptability, and long-term sustainability. While self-regulated and individualised approaches offer tailored support, their effectiveness depends on factors such as learner motivation and instructional design. Conclusions: Despite progress in intervention strategies for developmental dysgraphia, further research is needed to optimise hybrid models that combine the strengths of multiple approaches. A more inclusive and adaptable framework is required to ensure equitable access to effective handwriting interventions. This study highlights the need for continued collaboration among researchers, educators, and policymakers to advance evidence-based interventions, fostering equitable learning opportunities for all children with dysgraphia. Full article
(This article belongs to the Special Issue Physical Therapy in Pediatric Developmental Disorders)
Show Figures

Graphical abstract

18 pages, 9804 KB  
Review
Transcatheter Pulmonary Valve Implantation in Congenital Heart Diseases: Current Advances and Future Prospectives
by Mario Giordano, Raffaella Marzullo, Gianpiero Gaio, Maurizio Cappelli Bigazzi, Giovanni Domenico Ciriello, Maria Teresa Palladino, Berardo Sarubbi and Maria Giovanna Russo
Children 2025, 12(5), 547; https://doi.org/10.3390/children12050547 - 24 Apr 2025
Cited by 5 | Viewed by 4165
Abstract
Pulmonary disfunction is frequent in repaired congenital heart diseases. Both pulmonary regurgitation and pulmonary stenosis are possible complications over time. In the past, the surgical approach was the only feasible management but exposed the patient to a redo-surgery with its consequent risks. Nowadays, [...] Read more.
Pulmonary disfunction is frequent in repaired congenital heart diseases. Both pulmonary regurgitation and pulmonary stenosis are possible complications over time. In the past, the surgical approach was the only feasible management but exposed the patient to a redo-surgery with its consequent risks. Nowadays, the development of novel devices and techniques has made possible a transcatheter pulmonary valve implantation. The Melody Transcatheter Pulmonary Valve (TPV) (Medtronic Inc., Minneapolis, MN, USA) and the Edwards Sapien XT and S3 Transcatheter Heart Valve (Edwards Lifesciences LLC, Irvine, CA, USA) are balloon-expandable valvular bioprostheses approved for pulmonary position. Venus P-Valve (Venus Medtech, Shanghai, China) and Harmony TPV (Medtronic Inc., Minneapolis, MN, USA) are self-expandable pulmonary valves. Alterra Adaptive Prestent (Edwards Lifesciences LLC, Irvine, CA, USA) is an hourglass self-expandable stent that reduces the size of large right ventricular outflow tracts, creating a suitable landing zone to implant an Edwards Sapien S3 THV 29 mm. Novel stents and percutaneous valves are being planned and experimented with to widen the field of transcatheter approach. The aim of this review is to describe both the current approaches, strategies, and techniques as well as the future perspective to deal with the patients with significant pulmonary stenosis and/or regurgitation. Full article
Show Figures

Figure 1

29 pages, 4317 KB  
Article
Are the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents as Effective for OCD as for Anxiety and Depression?
by Lauren Milgram, Madison E. Bigler, Elizabeth R. Halliday, Kiara R. Timpano and Jill Ehrenreich-May
Children 2025, 12(4), 529; https://doi.org/10.3390/children12040529 - 21 Apr 2025
Cited by 4 | Viewed by 2829
Abstract
Background: Obsessive–compulsive disorder (OCD) in youth commonly co-occurs with other affective disorders (e.g., anxiety, depression). Exposure and response prevention (ERP) is the front-line treatment for OCD but may require significant adaptation to treat co-occurring symptoms or complex comorbidity patterns. Preliminary evidence suggests [...] Read more.
Background: Obsessive–compulsive disorder (OCD) in youth commonly co-occurs with other affective disorders (e.g., anxiety, depression). Exposure and response prevention (ERP) is the front-line treatment for OCD but may require significant adaptation to treat co-occurring symptoms or complex comorbidity patterns. Preliminary evidence suggests that the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A) are effective in reducing OCD symptoms. Still, it is not yet known if the UP-C/A are comparably effective to treat OCD as they are for anxiety and depression, the disorders for which there is the most robust empirical support. Methods: This study compared trajectories of OCD, anxiety, and depression symptom change among 388 youth who received UP-C/A treatment (M = 15 sessions) at a university-based research clinic. We also examined whether youth with (n = 60) and without (n = 328) an OCD diagnosis demonstrated comparable improvements in anxiety, depression, and transdiagnostic treatment targets (i.e., anxiety sensitivity, cognitive flexibility, and distress tolerance). Results: OCD symptoms improved at a slower rate than anxiety and depression symptoms during the first half of UP-C/A treatment but at a comparable rate to anxiety and depression symptoms during the second half of treatment. Youth with and without OCD exhibited comparable improvements in anxiety, depression, anxiety sensitivity, cognitive flexibility, and distress tolerance across the treatment course. Conclusions: Findings support the efficacy of UP-C/A treatment for co-occurring OCD and affective disorders but suggest that initiating exposure earlier in the treatment course may confer additional benefits. Full article
Show Figures

Figure 1

13 pages, 1063 KB  
Article
Social Affiliation and Attention to Angry Faces in Children: Evidence for the Contributing Role of Parental Sensory Processing Sensitivity
by Antonios I. Christou, Kostas Fanti, Ioannis Mavrommatis, Georgia Soursou, Pantelis Pergantis and Athanasios Drigas
Children 2025, 12(4), 524; https://doi.org/10.3390/children12040524 - 18 Apr 2025
Cited by 11 | Viewed by 2613
Abstract
Low social affiliation has been described as a phenotypic marker of antisocial behaviors by disrupting children’s initiation and enjoyment of positive physical and emotional connections with others. Laboratory studies have shown that, in early childhood, low social affiliation rates are preceded by lower [...] Read more.
Low social affiliation has been described as a phenotypic marker of antisocial behaviors by disrupting children’s initiation and enjoyment of positive physical and emotional connections with others. Laboratory studies have shown that, in early childhood, low social affiliation rates are preceded by lower attention to faces. In addition, while low social affiliation has also been associated with behavioral outcomes when accounting for parenting influences, the effect that parental environmental sensitivity may have on contributing to the link between emotional processing early in life and later behavioral manifestations associated with antisocial behavior is currently unknown. Objectives: The present eye-tracking study aims to delineate the potential contribution of parental Sensory Processing Sensitivity (SPS) to the link between children’s rates of social affiliation and their attentional patterns in response to emotional faces. Methods: For the needs of this study, children performed a lab-based, computerized facial processing task (N = 153; Mage = 9.97; SDage = 1.28; 48.8% females). In addition, one of the children’s parents completed questionnaires for their children’s and their own behavior (N = 153; Mage = 40.9; SDage = 4.85; 87.7% females). Results: The results underline the contributing role of parental SPS on the associations between social affiliation and visual scanning when viewing angry emotional faces. In particular, children with low rates of social affiliation spent significantly more time fixating on the mouth regions of angry faces only when their parents had higher SPS. Conclusions: This study unveils the possibility for the contextual influence of parental environmental sensitivity on the early emotional processing mechanisms in children with low rates of social affiliation. These findings suggest that interventions aimed at improving emotional processing in children at risk for antisocial behavior should consider parental SPS as a contributing factor. Tailoring parent-based interventions to address how highly sensitive parents interpret and respond to emotional challenges may reduce children’s attentional biases to threats and support healthier socioemotional development. Full article
Show Figures

Figure 1

19 pages, 1456 KB  
Review
Advancing Pediatric Surgery with Indocyanine Green (ICG) Fluorescence Imaging: A Comprehensive Review
by Marco Di Mitri, Annalisa Di Carmine, Benedetta Zen, Edoardo Collautti, Cristian Bisanti, Simone D’Antonio, Michele Libri, Tommaso Gargano and Mario Lima
Children 2025, 12(4), 515; https://doi.org/10.3390/children12040515 - 16 Apr 2025
Cited by 6 | Viewed by 3423
Abstract
Background: Indocyanine green (ICG) fluorescence imaging has revolutionized pediatric surgery by enhancing precision, safety, and outcomes across various specialties. In recent years, its use has spread through the framework of pediatric surgery, where its ability to illuminate anatomical structures and pathological conditions has [...] Read more.
Background: Indocyanine green (ICG) fluorescence imaging has revolutionized pediatric surgery by enhancing precision, safety, and outcomes across various specialties. In recent years, its use has spread through the framework of pediatric surgery, where its ability to illuminate anatomical structures and pathological conditions has improved surgical outcomes. Methods: We conducted a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search was performed using the term “Indocyanine green” in all fields, including papers about pediatric patients (aged 0–18 years) published between January 2014 and July 2024. Results: This review systematically explores ICG applications, dosing regimens, timing of administration, and integration into modern surgical technologies, including robotics and minimally invasive platforms. ICG resulted in an excellent safety profile and enables the real-time visualization of anatomical structures and pathological conditions, proving invaluable in pediatric cases characterized by smaller anatomical dimensions and congenital anomalies. Conclusions: This review highlights ICG fluorescence imaging as an indispensable tool in pediatric surgery, offering transformative potential for improving surgical outcomes and patient safety. Despite its advantages, it is necessary to standardize dosing and timing protocols to maximize its utility. The aim of this review is to explore the various applications of ICG in pediatric surgery, report the dosage and administration times across different surgical fields, and establish best practices to guide its future use. Full article
Show Figures

Figure 1

15 pages, 253 KB  
Article
Problematic Internet Use and Its Relationship with Cyberbullying, Anxiety, and Executive Functions in Adolescence
by Marta Real-Fernández, Ignasi Navarro-Soria, Megan Rosales-Gómez and Beatriz Delgado
Children 2025, 12(4), 503; https://doi.org/10.3390/children12040503 - 14 Apr 2025
Cited by 6 | Viewed by 3070
Abstract
Introduction/objectives: Brain development changes during adolescence are directly linked to various cognitive and behavioral challenges characteristic of this stage. The main objective of this study is to investigate the risks associated with Internet use and its relationship with Executive Functions (EFs) and anxiety [...] Read more.
Introduction/objectives: Brain development changes during adolescence are directly linked to various cognitive and behavioral challenges characteristic of this stage. The main objective of this study is to investigate the risks associated with Internet use and its relationship with Executive Functions (EFs) and anxiety in a representative sample of Spanish secondary school students. Methods: The sample consisted of 1164 participants (48% males) aged 12 to 17 years (M age = 14.86; SD = 1.41) from five selected academic centers. Executive Functions were assessed using the Adolescent and Adult Executive Functioning Questionnaire (ADEXI), anxiety was measured with the Depression, Anxiety and Stress Scale (DASS-21), and Problematic Internet Use (PIU) was evaluated with the Internet Addiction Test (IAT). Results: Significant positive correlations were found between the PIU, EF, anxiety, and cyberbullying variables. Predictive models were developed to explain the different variables. Conclusions: The results emphasize the need to increase awareness of these issues and to develop effective intervention strategies. Programs that promote responsible Internet use, along with classroom activities addressing anxiety and Executive Functions, could provide clear benefits. Full article
Show Figures

Graphical abstract

19 pages, 3043 KB  
Review
Salivary Markers as Potential Stress Descriptors for Pediatric Dental Patients: A Literature Review
by Shelby Main, Marcela R. Carrilho, Anna Alessandri-Bonetti, Caroline Sawicki, Jahnavi Rao, Sheila Hall and Linda Sangalli
Children 2025, 12(4), 500; https://doi.org/10.3390/children12040500 - 14 Apr 2025
Cited by 6 | Viewed by 2652
Abstract
Dental fear and anxiety are frequently identified as major contributing factors to non-compliance, uncooperativeness, and difficulties during dental procedures in pediatric patients. These issues can lead to avoidance of dental treatment, resulting in long-term negative consequences for oral health and overall well-being. The [...] Read more.
Dental fear and anxiety are frequently identified as major contributing factors to non-compliance, uncooperativeness, and difficulties during dental procedures in pediatric patients. These issues can lead to avoidance of dental treatment, resulting in long-term negative consequences for oral health and overall well-being. The assessment and quantification of psychological functioning (i.e., dental fear, anxiety, and self-perceived stress) has traditionally relied on self-reported questionnaires validated for the pediatric population. While this approach is cost-effective and non-invasive, it relies on subjective self-reported data, oftentimes influenced by parental or guardian interaction, especially in young children. Salivary diagnostics has recently emerged as an objective method for the procurement of biological molecules that serve as biomarkers for a variety of oral and systemic conditions. This literature review aims to comprehensively summarize the available literature on the correlation between psychological and salivary physiological measurements assessing dental fear, dental anxiety, and self-perceived stress in pediatric dental patients, highlighting the advantages and disadvantages of each method of assessment. Four databases (PubMed®, PsycInfo, Dentistry & Oral Sciences Source, and Web of Science) were searched for published articles, in the English language, assessing the correlation between psychological and physiological distress in children undergoing dental procedures. Studies on pediatric patients reveal positive correlations between salivary cortisol and dental fear, stress, and anxiety, especially in returning patients. Conversely, findings on salivary alpha-amylase and secretory immunoglobulin A were inconsistent, with some studies suggesting correlations with dental fear and prior dental experiences. Full article
Show Figures

Figure 1

12 pages, 204 KB  
Review
Advances in Artificial Intelligence and Machine Learning for Precision Medicine in Necrotizing Enterocolitis and Neonatal Sepsis: A State-of-the-Art Review
by Miriam Duci, Giovanna Verlato, Laura Moschino, Francesca Uccheddu and Francesco Fascetti-Leon
Children 2025, 12(4), 498; https://doi.org/10.3390/children12040498 - 13 Apr 2025
Cited by 6 | Viewed by 3222
Abstract
Necrotizing enterocolitis remains one of the most severe gastrointestinal diseases in neonates, particularly affecting preterm infants. It is characterized by intestinal inflammation and necrosis, with significant morbidity and mortality despite advancements in neonatal care. Recent advancements in artificial intelligence (AI) and machine learning [...] Read more.
Necrotizing enterocolitis remains one of the most severe gastrointestinal diseases in neonates, particularly affecting preterm infants. It is characterized by intestinal inflammation and necrosis, with significant morbidity and mortality despite advancements in neonatal care. Recent advancements in artificial intelligence (AI) and machine learning (ML) have shown potential in improving NEC prediction, early diagnosis, and management. A systematic search was conducted across multiple databases to explore the application of AI and ML in predicting NEC risk, diagnosing the condition at early stages, and optimizing treatment strategies.AI-based models demonstrated enhanced accuracy in NEC risk stratification compared to traditional clinical approaches. Machine learning algorithms identified novel biomarkers associated with disease onset and severity. Additionally, deep learning applied to medical imaging improved NEC diagnosis by detecting abnormalities earlier than conventional methods. The integration of AI and ML in NEC research provides promising insights into patient-specific risk assessment. However, challenges such as data heterogeneity, model interpretability, and the need for large-scale validation studies remain. Future research should focus on translating AI-driven findings into clinical practice, ensuring ethical considerations and regulatory compliance. Full article
Show Figures

Graphical abstract

21 pages, 2535 KB  
Article
Examining Preschoolers’ Emotion Regulation Strategies: Psychometric Properties of the Translated Dutch Early Emotion Regulation Behavior Questionnaire (EERBQ-Dutch)
by Iris Heselmans, Marie Van Gaever, Hana Hoogers and Kurt Eggers
Children 2025, 12(4), 494; https://doi.org/10.3390/children12040494 - 11 Apr 2025
Cited by 3 | Viewed by 2587
Abstract
Objectives: Early difficulties in emotion regulation are associated with psychopathological, broader social, and developmental outcomes, underscoring the need for robust assessment tools at a young age. However, most of the existing instruments for preschoolers measure emotion regulation in general, without focusing on specific [...] Read more.
Objectives: Early difficulties in emotion regulation are associated with psychopathological, broader social, and developmental outcomes, underscoring the need for robust assessment tools at a young age. However, most of the existing instruments for preschoolers measure emotion regulation in general, without focusing on specific emotion regulation strategies. This study addresses a critical gap by validating a Dutch version of the Early Emotion Regulation Behavior Questionnaire (EERBQ), enabling researchers and practitioners to assess preschoolers’ emotion regulation strategies in both positive- as well as negative-emotion-eliciting situations outside of laboratory settings. Methods: Through a rigorous back-translation process, the parental questionnaire was adapted into Dutch (EERBQ-Dutch) and subsequently validated with a sample of 299 Dutch-speaking caregivers of typically developing 2–7-year-old children. The test underwent psychometric analysis including inter-item correlations, item–total correlations, test–retest reliability, and confirmatory factor analysis. Finally, potential sociodemographic predictors (i.e., age, sex, and socioeconomic status (SES)) of specific emotion regulation strategies were investigated. Results: Psychometric analyses demonstrated strong reliability and validity, and a factor structure consistent with the original English questionnaire. Age and sex were found to be significant predictors of certain emotion regulation strategies, with more proficient use of adaptive emotion regulation strategies over time and girls employing more Verbal Help-Seeking and less Physical Venting and Reactivity compared to boys. SES only contributed to Emotional Reactivity with a higher SES predicting more Reactivity. Conclusions: Our findings support the EERBQ-Dutch as a reliable and culturally appropriate instrument for assessing early emotion regulation and provide insight into key predictors of emotion regulation strategies. Full article
(This article belongs to the Section Pediatric Mental Health)
Show Figures

Figure 1

21 pages, 1619 KB  
Review
A Theoretical Link Between the GH/IGF-1 Axis and Cytokine Family in Children: Current Knowledge and Future Perspectives
by Ignazio Cammisa, Donato Rigante and Clelia Cipolla
Children 2025, 12(4), 495; https://doi.org/10.3390/children12040495 - 11 Apr 2025
Cited by 11 | Viewed by 5614
Abstract
Background/Objectives: Growth in childhood and adolescence is influenced by a complex interaction of genetic, environmental, and hormonal factors, with growth hormone (GH) and insulin-like growth factor 1 (IGF-1) playing crucial roles in linear growth and development. However, chronic inflammation, often detected in situations [...] Read more.
Background/Objectives: Growth in childhood and adolescence is influenced by a complex interaction of genetic, environmental, and hormonal factors, with growth hormone (GH) and insulin-like growth factor 1 (IGF-1) playing crucial roles in linear growth and development. However, chronic inflammation, often detected in situations like inflammatory bowel disease and juvenile idiopathic arthritis, can significantly disrupt the GH/IGF-1 axis, causing a relevant growth impairment. Methods: We conducted a retrospective review focusing on the role of cytokines in the GH-IGF-1 axis and growth. Results: Inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 have been shown to contribute to GH resistance through an array of mechanisms that involve the downregulation of GH receptors and alterations in IGF-1 metabolism. This disruption negatively impacts the growth plate, particularly by impairing chondrocyte proliferation and differentiation, which are essential for proper bone elongation. This review delves into the intricate relationship among growth, chronic inflammation, and GH-IGF-1 axis, emphasizing the contribution of inflammatory cytokines in modulating GH signaling. It also highlights how cytokines can interfere with the molecular pathways that regulate skeletal growth, ultimately leading to growth disturbances in children suffering from chronic inflammatory diseases. Conclusions: The findings underscore the importance of controlling inflammation in affected individuals to mitigate its detrimental effects on growth and ensure that children may reach their growth full potential. Full article
(This article belongs to the Section Pediatric Endocrinology & Diabetes)
Show Figures

Figure 1

Back to TopTop