Search Results (156)

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

Deaf and hard-of-hearing (DHH) children are often reported to show deficits on working memory (WM) tasks. These deficits are often characterized as contributing to their struggles to acquire spoken language. Here we report a longitudinal study of a large (N = 103) sample of DHH children who acquired American Sign Language (ASL) as their first language. Using an n-back working memory task, we show significant growth in WM performance across the 7–13-year-old age range. Furthermore, we show that children with early access to ASL from their DHH parents demonstrate faster WM growth and that this group difference is mediated by ASL receptive skills. The data suggest the important role of early access to perceivable natural language in promoting typical WM growth during the middle school years. We conclude that the acquisition of a natural visual–gestural language is sufficient to support the development of WM in DHH children. Further research is required to determine how the timing and quality of ASL exposure may play a role, or whether the effects are driven by acquisition-related corollaries, such as parent–child interactions and maternal stress. Full article

Math learning is a key educational goal, and one marked by substantial individual differences even in the earliest grades. Although considerable research has examined the extent to which domain-general processes, such as executive functions and fluid intelligence, contribute to this variability, there is a notable gap in understanding how they may interact to predict early math learning. In particular, prior work had not examined potential moderating effects whereby the relation between executive functions and math outcomes depends on a child’s fluid intelligence, and vice versa. The current study addressed this gap by examining the math skills in Russian first-graders (N = 160) as a function of fluid intelligence (measured with Raven’s matrices) and various components of executive functions. Consistent with prior research, the results revealed the main effects of Raven’s scores, verbal working memory, and the control component of executive function (a composite of inhibition and cognitive flexibility scores) on math growth. Importantly, extending previous research, the study found that both memory and control components of executive function interacted with fluid intelligence. Specifically, executive function had a stronger positive effect on math learning for children with lower levels of fluid intelligence. The implications for intervention research and educational practice are discussed. Full article

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

Ankyloglossia causes impairment of normal tongue motility and disrupts the average balance of the muscle forces that form the orofacial complex. Inadequate swallowing from birth can cause long-term anatomical and functional consequences in adult life. Using the video presented herein, we describe the current knowledge about the long-term implications of ankyloglossia. After a literature review of the Medline, Google Scholar, and Embase databases on the relations between ankyloglossia and sleep-disordered breathing, we designed and created a three-dimensional (3D) video using Adobe After Effects based on the anatomical and functional changes produced by repeated deglutition, with and without ankyloglossia, from childhood to adulthood. The animated video (Blender 3D, Amsterdam, The Netherlands, 2024) presented herein was based on the most recent literature review of dentition, breathing, posture, and abnormal swallowing, emphasizing the importance of the potential consequences of sleep-disordered breathing. The resulting animated 3D video includes dynamic sequences of a growing child, demonstrating the anatomy and physiology of deglutition with and without ankyloglossia, and its potential consequences for the surrounding structures during growth due to untreated ankyloglossia. This visual instructional video regarding the impacts of ankyloglossia on deglutition/swallowing may help motivate early childhood diagnosis and treatment of ankyloglossia. This instrument addresses the main myofunctional aspects of normal deglutition based on the importance of free tongue motion and can be used by students or professionals training in myofunctional disorders. Full article

The study investigates the universal design for learning (UDL) framework, utilizing neuroscience-based principles to support all children, particularly those with autism spectrum disorder (ASD), within inclusive preschool environments. Highlighting the critical nature of early childhood for cognitive and social development, it examines practical UDL strategies implemented through a case study of five preschoolers, aged between 4 and 8 years, conducted from September 2023 to May 2024. The research employs observation aligned with UDL guidelines version 3.0., focusing on skill development in communication and social interaction. In the study, children’s skill development has been assessed using Vygotsky’s Zone of Proximal Development as the measurement framework. This concept underscores the importance of providing appropriate support and scaffolding to facilitate learning within a child’s optimal development zone. By integrating Vygotsky’s principles, the research highlights how tailored, supportive strategies—aligned with UDL’s emphasis on flexible, individualized support—can effectively bridge the gap between current abilities and potential, fostering meaningful skill acquisition and social growth. Findings affirm the effectiveness of UDL principles in facilitating inclusion and growth, emphasizing the importance of teacher competence in successful implementation. Full article

Background/Objectives: Glycogen storage disease type IX (GSD IX) is a group of inherited metabolic disorders caused by phosphorylase kinase deficiency affecting the liver or muscle. Despite being relatively common among GSDs, GSD IX remains underexplored. Methods: A systematic review of GSD IX was conducted per PRISMA guidelines using SCOPUS and PubMed, registered with PROSPERO. Inclusion focused on human clinical studies published up to 31 December 2024. Results: A total of 400 patients with GSD IX were analyzed: 274 IXa (mean age at diagnosis 5.1 years), 72 IXc (mean age at diagnosis 4.9 years), 39 IXb (mean age at diagnosis 4.2 years), and 15 IXd (mean age at diagnosis 44.9 years). Hepatomegaly was commonly reported in types IXa, IXb, and especially IXc (91.7%), but was rare in IXd. Elevated transaminases were frequently observed in types IXa, IXb, and particularly IXc, while uncommon in IXd. Fasting hypoglycemia was occasionally observed in types IXa and IXb, more frequently in IXc (52.7%), and was not reported in IXd. Growth delay or short stature was observed in a substantial proportion of patients with types IXa (43.8%), IXb, and IXc, but was rare in IXd. Muscle involvement was prominent in IXd, with all patients showing elevated CPK (mean 1011 U/L). Neurological involvement was infrequently reported in types IXa and IXc. Conclusions: This systematic review includes the most extensive clinical case history of GSD IX described in the literature. The clinical spectrum of GSD IX varies widely among subtypes, with IXc being the most aggressive. While liver forms are generally present in early childhood, muscle-type IXd shows delayed onset and milder symptoms, often leading to diagnostic delays. For diagnosis, it is essential not to underestimate key clinical features such as hepatic involvement and hypoglycemia in a child under 5 years of age. Other manifestations, including the as-yet unexplored systemic involvement of bone and kidney, remain insufficiently understood and require further investigation. Next-generation sequencing has improved diagnostic precision over traditional biopsy. Dietary management, including uncooked cornstarch, Glycosade^®, and high-protein intake, remains the cornerstone of treatment. However, there is a paucity of well-designed, evidence-based studies to determine the most effective therapeutic approach. Despite its historically perceived benign course, the broad phenotypic variability of GSD IX, including progressive liver involvement and potential neurological complications, highlights its substantial clinical relevance and underscores the need for accurate diagnostic classification and long-term multidisciplinary follow-up. Full article

Precisely estimating a child’s body measurements and weight from a single image is useful in pediatrics for monitoring growth and detecting early signs of malnutrition. The development of estimation models for this task is hampered by the unavailability of a labeled image dataset to support supervised learning. This paper introduces the “Age-Restricted Anonymized” (ARAN) dataset, the first labeled image dataset of children with body measurements approved by an ethics committee under the European General Data Protection Regulation guidelines. The ARAN dataset consists of images of 512 children aged 16 to 98 months, each captured from four different viewpoints, i.e., 2048 images in total. The dataset is anonymized manually on the spot through a face mask and includes each child’s height, weight, age, waist circumference, and head circumference measurements. The dataset is a solid foundation for developing prediction models for various tasks related to these measurements; it addresses the gap in computer vision tasks related to body measurements as it is significantly larger than any other comparable dataset of children, along with diverse viewpoints. To create a suitable reference, we trained state-of-the-art deep learning algorithms on the ARAN dataset to predict body measurements from the images. The best results are obtained by a DenseNet121 model achieving competitive estimates for the body measurements, outperforming state-of-the-art results on similar tasks. The ARAN dataset is developed as part of a collaboration to create a mobile app to measure children’s growth and detect early signs of malnutrition, contributing to the United Nations Sustainable Development Goals. Full article

Gestational diabetes mellitus (GDM) leads to increased lifelong cardiometabolic risk in both mothers and their offspring. The identification of effective strategies to contain the future risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) is of utmost importance to reduce the burden of the disease. Breastfeeding (BF) is effective in reducing short- and long-term child morbidity. In recent years, BF has emerged as a candidate low-cost intervention to prevent future cardiometabolic complications both in mothers and infants exposed to GDM. The aim of this review is to provide an overview of the evidence about the possible metabolic benefits of BF for both mothers with a history of GDM and their offspring. Increasing evidence supports the positive effects of exclusive BF over formula feeding (FF) or mixed feeding on glucose homeostasis and the lipid profile in women with previous GDM in the early postpartum period. Studies with a longer observation suggest clear benefits of intensive and longer BF on the risk of diabetes and prediabetes in mothers after adjustment for confounders. In regards to infants, in most studies, the intensity and duration of BF are positively associated with slower infant growth curves compared with FF, indicating that the positive effect of BF on growth trends might contrast the increased risk of obesity and metabolic diseases observed in infants exposed to GDM. Considering these findings, a global effort should be made to support BF practice to possibly reduce cardiometabolic morbidity after GDM. Full article

Primary osteoporosis in children and young adults often suggests a monogenic disease affecting bone microarchitecture and bone mineral density. While Osteogenesis Imperfecta (OI) is the most recognized genetic cause of recurrent fractures, many other genes involved in bone metabolism may contribute to osteoporosis. Among them, FGFR2 plays a critical role in bone growth and development by regulating osteoblast differentiation and proliferation, as well as chondrogenesis. Germline pathogenic FGFR2 variants are typically associated with syndromic craniosynostosis, conditions not characterized by bone fragility or osteoporosis. A report recently identified FGFR2 as a potential cause of dominant early-onset osteoporosis and bone fractures in a family. We report the case of a child affected by severe osteoporosis with multiple fractures. We performed clinical exome sequencing in trio to investigate potential genetic causes of the observed phenotype and identified a likely mosaic pathogenic FGFR2 variant, absent in both parental samples. Our findings provide further evidence that FGFR2 pathogenic variants can lead to a novel non-syndromic bone mineralization disorder, reinforcing the role of FGFR2 in the pathogenesis of early-onset osteoporosis. Full article

Much attention has been given to the predictive role of callous–unemotional (CU) traits in children’s social and peer functioning. As an important dimension of social adaptation, early social withdrawal in preschool left-behind children (LBC) might be the outcome of psychological factors and growth environments. This study explored the predictive effect of CU traits on social withdrawal among preschool LBC, including the indirect effect of emotion regulation and teacher–child relationship quality. Data from 513 Chinese preschool LBC (257 boys and 256 girls) were reported by their teachers in rural areas, including assessments of CU traits, emotion regulation, social withdrawal, and teacher–child relationship quality. Path analyses showed that the CU traits of young LBC could significantly positively predict the prevalence of social withdrawal, and emotion regulation played a key mediating role in this effect path. Notably, teacher–child relationship quality moderated the indirect effect of emotion regulation on CU traits and withdrawal behaviors. Therefore, the moderated mediation model was supported. The findings expanded the recognition of LBC with CU traits and further suggested that the association of some personality traits and growing environments in the early left-behind childhood can significantly make a difference in peer functioning and social adjustment. Full article

The present study aims to investigate whether there are different second language trajectories among immigrant children and what influences these trajectories. This longitudinal study included 443 children all learning German as a second language (49.9% girls). On average, at T1, the children were 3;6; at T2, 4;9; at T3, 6;2; and at T4, 7;3 years old. Discontinuous piecewise latent class growth analysis revealed four classes: improvement to low-level proficiency, improvement to medium-level proficiency, improvement to high-level proficiency, and permanent high-level proficiency. Class membership was predicted by early childcare attendance, the duration of the parents’ residence in Switzerland, contact with German speakers, the child’s cognitive abilities, and the parental socioeconomic status. Full article

Background: Childhood nutrition plays an important role in the promotion of long-term health. Introducing solid foods in alignment with the Mediterranean Diet during weaning fosters a preference for healthy foods early in life. However, access to nutritious diets remains a challenge in underserved communities. Scampia, a socioeconomically disadvantaged district in Naples, Italy, exemplifies a community where barriers to healthy eating persist. This research reports a trial protocol that plans for a study to evaluate the impact of the Mediterranean Diet on child health and to establish preventive strategies for chronic diseases. Methods: The PEMED (PrEventive effect of MEditerranean Diet in Children) trial is a Bayesian Sequential Pragmatic Cluster Randomized Clinical Trial. Family Pediatricians (FPs) are randomized to deliver either Mediterranean Diet-based dietary guidance starting at weaning or standard dietary practices using typical baby foods. Children will be followed up for six years, with regular assessments of growth, microbiome composition, and adherence to the Mediterranean Diet, using validated tools. Interim analyses will be conducted at three-year intervals to evaluate the efficacy and monitor adverse events. Saliva and stool samples will be collected for genetic and microbiome analyses, and adherence will be monitored through quarterly dietary recalls and biomarkers. Results: This trial will consider Italy’s established FP network for implementing innovative dietary intervention in a real-world setting. Conclusions: This study will address nutritional disparities in the underserved Scampia community and provide a scalable model for early dietary interventions. The results will shed light on the role of the Mediterranean Diet in improving childhood health and informing public health strategies globally. Full article

Background: Inappropriate complementary feeding during the first two years of life significantly impacts children’s health, increasing risks of malnutrition and illness. Methods: This study investigates factors influencing early feeding patterns among 600 mothers of children aged 9–23 months in selected hospitals in Punjab, Pakistan. Using a structured questionnaire, data were collected and analyzed, with associations measured by odds ratios (ORs) and 95% confidence intervals (CIs). Results: The results showed the key indicators of inappropriate complementary feeding among young children, including timely complementary feeding, minimum meal frequency, dietary diversity, and acceptable diet. The rates for these factors were found to be 60.3%, 32.7%, 24.6%, and 48.5%, respectively. The study identified several significant factors influencing these practices. Key predictors of inappropriate feeding included the order of birth, the mother’s employment status, parental education, the number of children, household income, maternal knowledge, and maternal health. Conclusion: The findings underscore that maternal education, employment, and health significantly influence complementary feeding. Targeted interventions and education programs are essential to support healthy feeding behaviors, especially for mothers facing challenges related to education, work, or health conditions. Addressing these practices can improve child health outcomes, contributing to economic growth and a healthier future for Pakistan’s youngest population. Full article

Background: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women. Methods: From 1985–2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White participants; 98% using Medicaid in pregnancy). Study visits, including questionnaires, dietary assessments, and biospecimen collection, occurred in early and late pregnancy as well as at delivery. Medical records were abstracted, and a subset of mothers and infants participated in a six-week postpartum visit. Results: Findings from the Camden Study have added to the understanding of adolescent and young adult maternal health and perinatal outcomes. These include associations of adolescent linear growth while pregnant with smaller neonatal birth size, low dietary zinc intake in early pregnancy with increased risk of delivery <33 gestational weeks, and higher circulating fatty acid levels with greater insulin resistance. More recent analyses have begun to unpack the biochemical pathways in pregnancy that may be shaped by race as an indicator of systemic racism. Conclusions: The Camden Study data and biorepositories are well-positioned to support future research aimed at better understanding perinatal health in under-represented women and infants. Linkages to subsequent health and administrative records and the potential for recontacting participants over 18–39 years after initial participation may provide key insights into the trajectories of maternal and child health across the life course. Full article