Category: Paediatrics

Categories : PaediatricsTags :

Antibodies in Breastmilk Protect Infants Against Rotavirus

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Photo by Wendy Wei: https://www.pexels.com/photo/mother-breastfeeding-her-child-3074935/

A study led by researchers at the found that breast milk provides protection against rotavirus, a common gastrointestinal disease in infants. Babies whose mothers had high levels of specific antibodies in their breast milk were able to fend off the infection for a longer period than infants whose mothers had lower levels. The researchers also uncovered an unexpected relationship between BMI and antibody levels.

Published in the Journal of Clinical Investigation, the University of Rochester Medical Center-led study also found significant differences in antibody profiles in breast milk between mothers in high-income countries (HICs) and low- and middle-income countries (LMICs). Researchers analysed human milk samples from 695 women in Finland, the US, Pakistan, Peru, and Bangladesh, and measured specific IgA and IgG antibodies, which are common antibodies produced in breast milk, against 1607 proteins from 30 pathogens.

The research, led by Dr Kirsi Jarvinen-Seppo, MD, PhD, professor at UR Medicine Golisano Children’s Hospital (GCH), tracked antibody levels and kinetics over time to analyse antibody responses to a wide range of respiratory, diarrhoeal and sepsis pathogens in human milk. The primary aim of the study, funded by the Bill and Melinda Gates Foundation, was to understand the protective properties of these antibodies and how they vary across different geographic and economic regions.

“We would expect to find differences in antibody levels in different countries, due to different diseases circulating among areas of the world, but this is one of the first times that there’s been a head-to-head comparison for dozens of pathogens across several continents,” said Jarvinen-Seppo. “It was encouraging to see such a clear link between higher antibody levels and a delay to rotavirus infection, and this was consistently observed among an independent validation cohort.”  

Other notable findings from the study:

  • Milk from women in LMICs had higher levels of IgA and IgG antibodies against various intestinal and respiratory pathogens compared to milk from HICs. This difference was particularly notable for pathogens such as Shigella and pneumococcus, which are major contributors to morbidity and mortality in young children.
  • Higher body mass index (BMI) was associated with lower antibody levels, which went against expectations.

“The variation in antibody profiles between regions highlights the impact of economic and environmental factors on maternal immunity,” said Jarvinen-Seppo.

In addition to Rotavirus findings, the discovery that a higher BMI was associated with lower antibody counts in breast milk was also unexpected.

“We had anticipated that underweight mothers might have lower antibody levels due to poorer nutritional status,” said Jarvinen-Seppo. “Due to rising obesity rates worldwide, this could be a significant finding, but this is preliminary and additional research is needed since this is the first time this has been measured.”

“While the data on rotavirus protection is compelling, the geographical and BMI-related variations highlight areas where further research is essential. The study sets the stage for additional investigations that could lead to better understanding and interventions for improving infant health globally,” said Jarvinen-Seppo.

Source: University of Rochester Medical Center

Categories : Paediatrics Pain ManagementTags :

When a Child Hurts, Validating their Pain may be the Best First Aid

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Whether it’s a sore arm or a fear of injections, how a child is treated when they present with pain could significantly affect how they respond to and manage pain later in life.

In a new study published in the journal Pain, researchers say that parents and doctors should be mindful of how they talk to and treat children experiencing pain – no matter how big or small the injury – knowing that these foundational experiences can be carried forward into adulthood.

Drawing from diverse research across developmental psychology, child mental health, and pain sciences, the University of South Australia researchers say that it may be important to validate children’s pain by demonstrating that their pain-related experiences, emotions, or behaviours are acceptable, understood, and legitimate.

By validating a child’s pain, the child feels heard and believed, which reinforces their trust and connection with their parent, or with a treating doctor.

UniSA researcher Dr Sarah Wallwork says social relationships play a critical role in shaping how health is experienced throughout the lifespan.

“When a parent or doctor validates a child’s experiences in a way that matches their expressed vulnerability, it helps the child to feel accepted, builds connection and trust, and may help the child to develop critical skills in regulating their emotions,” Dr Wallwork says.

“For example, when a doctor is attentive, and responds to a child’s emotional and behavioural cues, particularly about seeking help, the clinician is telling the child their pain is real and concurrently reinforcing helpful pain management behaviours, such as attending the clinic.

“However, if these cues are missed, or the doctor questions the validity of their pain, this can have negative consequences for the child. Not only can it affect the clinician-patient relationship and trust but it can also impact future attendance at appointments and adherence to a pain management plan.

“Pain and emotion are inextricably linked, with emotion dysregulation commonly co-occurring with chronic pain.

“By validating children’s experiences of pain, they are likely to hold fewer negatively biased memories of pain and be in better position to seek help in the future, when then need it.”

In Australia, as many as one in four children experience chronic pain.

Dr Wallwork says that setting children up for success should cover all aspects of life, including pain management.

“Our research highlights an underemphasised element of child and youth pain treatment, especially for children in minoritised groups, who are systematically undertreated for pain,” Dr Wallwork says.

“People with chronic pain often report that their pain-related experiences are met with disbelief or dismissal. This can have significant consequences, including poor mental health and reduced quality of life.

“Given the significant burden of chronic pain, and the clear intersection with the rising child mental health crisis, it’s important that we better manage pain earlier on, rather than waiting until it is too late.”

Dr Wallwork says this review provides a building block for future empirical research.

Source: University of South Australia

Categories : Paediatrics Respiratory DiseasesTags :

Signs of Developing Asthma are Evident in the First Year of Life

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Respiratory tract. Credit: Scientific Animations CC4.0

What factors lead to chronic respiratory disease? Researchers investigated this question using health data from about 780 infants. Their analysis, published in The Lancet Digital Health, shows that children’s risk of developing asthma later in life can be more reliably predicted by observing the dynamic development of symptoms during the first year of life.

Genetic predisposition, passive smoking, high levels of air pollution and infections are only a few of the risk factors for asthma. Each factor has only a small influence on its own. It is their interplay that makes asthma more likely, according to the hypothesis of an international research committee, of which Professor Urs Frey of the University of Basel and the University Children’s Hospital Basel is a member.

Together with Dr Uri Nahum from his team and international colleagues, Frey investigated how the interaction of these factors during the course of the first year of life affected children’s developing respiratory systems. The analysis was based on health data from two cohorts, amounting to around 780 healthy infants born in various European countries.

A new way of looking at chronic illness

For both cohorts the researchers calculated the network of interactions between a range of known risk factors for every week of each child’s life, and then compared these with the appearance of symptoms such as coughing or wheezing. “Observing this interaction of risk factors in the context of dynamic development over time is a new way of looking at chronic illnesses,” underlines Frey. It is a case of watching the developing lungs adapting to their environment.

And it was exactly this, the adaptation of the lungs, that differentiated the group of children who developed asthma at between two and six years of age from those who had not developed it by the time they started school (generally at six years old in Switzerland). “It’s a nice, practical example of the value of digital health data, which were first quantified mathematically using these kinds of dynamic network analyses,” says Frey.

The findings cannot yet be used for early diagnosis in individual children. However, according to Frey: “With greater amounts of data and machine learning, it would certainly be conceivable to calculate a risk profile for individual children in the future.” Nowadays, digital health data is relatively easy to collect with the help of smartphone apps.

Source: University of Basel

Categories : Mental Health PaediatricsTags :

Do Videogames Made to Improve Children’s Mental Health Work?

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In a review of 27 different studies, a Johns Hopkins Children’s Center team concludes that some video games created as mental health interventions can be helpful – if modest – tools in improving the mental well-being of children and teens with depression and attention-deficit/hyperactivity disorder (ADHD). They did not significantly help with anxiety, however.

A report on the review of studies from peer-reviewed journals between 2011 and March 20, 2024, was published in JAMA Pediatrics.

An estimated 20% of children and teenagers ages three to 17 in the US have a mental, emotional, developmental or behavioural disorder.

“We found literature that suggests that even doubling the number of paediatric mental health providers still wouldn’t meet the need,” says Barry Bryant, MD, a resident in the Department of Psychiatry and Behavioral Sciences in the Johns Hopkins University School of Medicine and first author of the new study.

In a bid to determine if so-called “gamified digital mental health interventions,” or video games designed to treat mental health conditions, benefited those with anxiety, depression and ADHD, the research team analysed their use in randomised clinical trials for children and adolescents.

Bryant and child and adolescent psychologist Joseph McGuire, PhD, identified 27 such trials from the US and around the world. The studies overall included 2911 participants with about half being boys and half being girls, ages six to 17 years old.

The digital mental health interventions varied in content, but were all created with the intent of treating ADHD, depression and anxiety. For example, for ADHD, some of the games involved racing or splitting attention, which required the user to pay attention to more than one activity to be successful in gameplay. For depression and anxiety, some of the interventions taught psychotherapy-oriented concepts in a game format. All games were conducted on technology platforms, such as computers, tablets, video game consoles and smartphones. The video games are available to users in a variety of ways. Some are available online, while others required access through specific research teams involved in the studies.

The research team’s analysis found that video games designed for patients with ADHD and depression provided a modest reduction (both with an effect size of .28) in symptoms related to ADHD and depression, such as improved ability to sustain attention and decreased sadness, based on participant and family feedback from the studies. (An effect size of .28 is consistent with a smaller effect size, where as in-person interventions often produce moderate [.50] to large [.80] effects.)  By contrast, video games designed for anxiety did not show meaningful benefits (effect size of .07) for reducing anxiety symptoms for participants, based on participant and family feedback.

Researchers also examined factors that led to improved benefit from digital mental health interventions. Specific factors related to video game delivery (i.e., interventions on computers and those with preset time limits) and participants (i.e., studies that involved more boys) were found to positively influence therapeutic effects. Researchers say these findings suggest potential ways to improve upon the current modest symptom benefit.

“While the benefits are still modest, our research shows that we have some novel tools to help improve children’s mental health – particularly for ADHD and depression – that can be relatively accessible to families,” says Joseph McGuire, Ph.D., an author of the study and an associate professor of psychiatry and behavioural sciences in the school of medicine. “So if you are a paediatrician and you’re having trouble getting your paediatric patient into individual mental health care, there could be some gamified mental health interventions that could be nice first steps for children while waiting to start individual therapy.”

The team cautioned that their review did not indicate why certain video game interventions performed better than others. They also note that some of the trials included in the study used reported outcome measures, and the studies did not uniformly examine the same factors which could have influenced the effects of the treatment. Some of the video games included in the studies are not easily accessible to play.

The researchers also noted that while video game addiction and the amount of screen time can be concerns, those children who played the games studied in a structured, time-limited format tended to do best.

Source: Johns Hopkins Medicine

Categories : Gastrointestinal PaediatricsTags :

Breastfeeding Shapes the Gut Microbiome and Protects against Asthma

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Photo by Wendy Wei

Human breast milk regulates a baby’s mix of microbes, known as the microbiome, during the infant’s first year of life, in turn lowers the child’s risk of developing asthma, according to a new study published in Cell.

Led by researchers at NYU Langone Health and the University of Manitoba, the study results showed that breastfeeding beyond three months supports the gradual maturation of the microbiome in the infant’s digestive system and nasal cavity, the upper part of the respiratory tract. Conversely, stopping breastfeeding earlier than three months disrupts the paced development of the microbiome and was linked to a higher risk of preschool asthma.

Some components in breast milk, such as complex sugars called human milk oligosaccharides, can only be broken down with the help of certain microbes. This provides a competitive advantage to microbes capable of digesting these sugars. By contrast, infants who are weaned earlier than three months from breast milk and who then rely solely on formula feeding, become home to a different set of microbes –ones that will help the infant to digest the components in formula. While many of these microbes that thrive on formula do eventually end up in all babies, the researchers showed that their early arrival is linked to an increased risk of asthma.

“Just as a pacemaker regulates the rhythm of the heart, breastfeeding and human milk set the pace and sequence for microbial colonisation in the infant’s gut and nasal cavity, ensuring that this process occurs in an orderly and timely manner,” said study co-senior investigator and computational biologist Liat Shenhav, PhD. “Healthy microbiome development is not only about having the right microbes. They also need to arrive in the right order at the right time,” said Dr Shenhav, an assistant professor at NYU Grossman School of Medicine, its Institute for Systems Genetics, and the school’s Department of Microbiology.

For the study, Dr Shenhav, who is also an assistant professor at NYU’s Courant Institute of Mathematical Sciences, worked in collaboration with study co-senior investigator Meghan Azad, PhD, director of the Manitoba Interdisciplinary Lactation Center, and a professor of paediatrics and child health, at the University of Manitoba.

Another key study finding was that the bacterium Ruminococcus gnavus appeared much sooner in the guts of children who were weaned early from breast milk than in those of children who were exclusively breastfed. The bacterium is known to be involved in the production of molecules called short-chain fatty acids, and the formation and breakdown of the amino acid tryptophan. Both tryptophan and its metabolites have been linked to immune system regulation and disruption in previous research, including an increased risk of asthma. The study authors noted that beyond aiding in digestion, an infant’s microbiome plays a crucial role in the immune system’s development.

The study tracked the ebb and flow of microbes in the guts and noses of infants during the first year of life, as well as details on breastfeeding and the composition of their mothers’ milk. All the children and their mothers were participating in the CHILD Cohort Study, a long-term research project that has been studying the same 3500 Canadian children at different stages of life from the womb well into adolescence.

The data provided by the CHILD Cohort Study enabled researchers to detangle the impact of breastfeeding on an infant’s microbiome from a range of other environmental factors, including prenatal smoke exposure, antibiotics, and the mother’s asthma history.

Even when these factors were accounted for, they found that breastfeeding duration remained a powerful determinant for the child’s microbial makeup over time. They also used these microbial dynamics and data on milk components to train a machine learning model that accurately predicted asthma years in advance. Finally, they created a statistical model to learn causal relationships, which showed that the primary way breastfeeding reduces asthma risk is through shaping the infant’s microbiome.

“The algorithms we developed provide valuable insights into microbial dynamics during an infant’s first year of life and how these microbes interacted with the infant,” said Dr Shenhav. “These insights allowed us to move beyond identifying associations, enhancing our ability to make predictions and explore causal relationships.

“Our research highlights the profound impact of breastfeeding on the infant microbiome and breastfeeding’s essential role in supporting respiratory health. By uncovering the mechanisms behind the protective effects of breast milk, as demonstrated in this study, we aim to inform national guidelines on breastfeeding and weaning from breast milk in a data-driven manner.

“With further research, our findings could also contribute to developing strategies to prevent asthma in children who cannot be breastfed for at least three months,” she added.

Source: NYU Langone Health / NYU Grossman School of Medicine

Categories : Environmental Effects PaediatricsTags :

Girls may Start Puberty Early Due to Chemical Exposure

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Girls exposed to certain endocrine-disrupting chemicals (EDCs) may be more likely to start puberty early, according to new research published in Endocrinology, the flagship basic science journal of the Endocrine Society. EDCs mimic, block or interfere with hormones in the body’s endocrine system.

There has been an alarming trend toward early puberty in girls, suggesting the influence of chemicals in our environment. Early puberty is associated with an increased risk of psychosocial problems, obesity, diabetes, cardiovascular disease, and breast cancer.

“We conducted a comprehensive screen of 10 000 environmental compounds with extensive follow-up studies using human brain cells that control the reproductive axis, and our team identified several substances that may contribute to early puberty in girls,” said study author Natalie Shaw, MD, MMSc, of the National Institute of Environmental Health Sciences (NIEHS).

Those substances include musk ambrette, which is a fragrance used in some detergents, perfumes, and personal care products, and a group of medications called cholinergic agonists.

“More research is needed to confirm our findings,” noted Shaw. “But the ability of these compounds to stimulate key receptors in the hypothalamus – the gonadotropin-releasing hormone receptor [GnRHR] and the kisspeptin receptor [KISS1R] – raises the possibility that exposure may prematurely activate the reproductive axis in children.”

According to the research team, musk ambrette is potentially concerning because it can be found in personal care products, and some rat studies have suggested it can cross the blood-brain barrier. Children are less likely to encounter cholinergic agonists in their daily lives.

Canadian and European regulations restrict musk ambrette use because of its potential toxicity, and the U.S. Food and Drug Administration removed the fragrance from its “generally recognized as safe” list. Yet it is still available on the market in some personal care products.

“This study suggests that, out of an abundance of caution, it is important for parents to only use personal care products for their children that are federally regulated,” Shaw said.

As part of the study, the research team screened a Tox21 10 000-compound library of licensed pharmaceuticals, environmental chemicals and dietary supplements against a human cell line overexpressing GnRHR or KISS1R. They conducted follow-up analysis using human hypothalamic neurons and zebrafish, finding that musk ambrette increased the number of GnRH neurons and GnRH expression.

“Using human hypothalamic neurons and zebrafish provides an effective model for identifying environmental substances that stimulate the KISS1R and GnRHR,” said co-author Menghang Xia, PhD, from the National Center for Advancing Translational Sciences (NCATS) “This study was a multidisciplinary team effort, and it showed that we can efficiently reduce the time and cost of assessing environmental chemicals for their potential effects on human health.”

Source: Endocrine Society

Categories : Paediatrics Respiratory DiseasesTags :

Saline Nasal Drops Shorten the Common Cold in Children by Two Days

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Using hypertonic saline nasal drops can reduce the length of the common cold in children by two days, according to a study presented at the European Respiratory Society (ERS) Congress in Vienna, Austria [1]. They can also reduce the onward transmission of colds to family members.

The results of the ELVIS-Kids randomised controlled trial were presented by Professor Steve Cunningham from Child Life and Health, University of Edinburgh, UK.

He said: “Children have up to 10 to 12 upper respiratory tract infections, what we refer to as colds, per year, which have a big impact on them and their families. There are medicines to improve symptoms, such as paracetamol and ibuprofen, but no treatments that can make a cold get better quicker.”

ELVIS-Kids Chief Investigator Dr Sandeep Ramalingam, consultant virologist, NHS Lothian, Edinburgh, UK, had noted that salt-water solutions are often used by people in South Asia, as nasal irrigation and gargling, to treat a cold and wanted to explore if this clinical benefit could be replicated in a large study.

The research team recruited 407 children aged up to six years to a study where they were given either hypertonic saline ~2.6% (salt-water) nasal drops or usual care when they developed a cold. Overall, 301 children developed a cold; for 150 of these, their parents were given sea salt and taught to make and apply salt-water nose drops to the children’s noses (three drops per nostril, a minimum of four times per day, until well) and 151 children had usual cold care.

Professor Cunningham explains: “We found that children using salt-water nose drops had cold symptoms for an average of six days where those with usual care had symptoms for eight days. The children receiving salt water nose drops also needed fewer medicines during their illness.

“Salt is made up of sodium and chloride. Chloride is used by the cells lining the nose and windpipes to produce hypochlorous acid within cells, which they use to defend against virus infection. By giving extra chloride to the lining cells this helps the cells produce more hypochlorous acid, which helps suppress viral replication, reducing the length of the virus infection, and therefore the duration of symptoms.”

When children got salt-water nose drops, fewer households reported family members catching a cold (46% vs 61% for usual care). Eighty-two per cent of parents said the nose drops helped the child get better quickly and 81% said they would use nose drops in the future.

Professor Cunningham added: “Reducing the duration of colds in children means that fewer people in their house also get a cold, with clear implications for how quickly a household feels better and can return to their usual activities like school and work etc.

“Our study also showed that parents can safely make and administer nose drops to their children and therefore have some control over the common cold affecting their children.”

Professor Alexander Möeller is Head of the ERS Paediatric Assembly and Head of the Department for Respiratory Medicine at the University Children’s Hospital Zurich, Switzerland, and was not involved in the research. He said: “This is an important study that is the first of its kind to investigate the impact of salty nose drops in children with colds. Although most colds usually don’t turn into anything serious, we all know how miserable they can be, especially for young children and their families.

“This extremely cheap and simple intervention has the potential to be applied globally; providing parents with a safe and effective way to limit the impact of colds in their children and family would represent a significant reduction in health and economic burden of this most common condition.”

The team hope to further investigate the effect of saltwater nose drops on wheeze during colds, after initial results from this study showed that children who received the drops had significantly fewer episodes of wheeze (5% vs 19%).

Reference

[1] Abstract no: OA1985 “A randomised controlled trial of hypertonic saline nose drops as a treatment in children with the common cold (ELVIS-Kids trial)”, by Dr Sandeep Ramalingam et al; Presented in session “Advancements in paediatric infectious respiratory health” at 15:45–17:00 CEST on Sunday 8 September 2024.

https://live.ersnet.org/programme/session/92864

Source: European Respiratory Society

Categories : Neurology PaediatricsTags :

Study Confirms the Utility of Screening for Autism in Toddlers Born Preterm

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New research published in Developmental Medicine & Child Neurology reveals that children born preterm are more likely to screen positive for autism than full-term children.

For the study, 9725 toddlers were screened at 15-, 18-, or 24-month well child visits using a test called the Modified Checklist for Autism in Toddlers, Revised.

Screening results that were positive for autism were most common among children born extremely preterm (51.35%) and least common among those born full-term (6.95%). Subsequent evaluations after positive screening revealed the following rates of autism diagnoses: 16.05% of extremely preterm, 2.00% of very preterm, 2.89% of moderately preterm, and 1.49% of full-term births.

Utilising the screening test at ages unadjusted for early birth was effective for identifying autism, as only a small number of preterm children (1.90%) who screened positive with the test did not receive a diagnosis of autism or other developmental delay following evaluation.

“With this research, we are hoping to help dissipate doubts that clinicians might have about the utility of screening for autism in toddlers born preterm,” said corresponding author Georgina Perez Liz, MD, of the AJ Drexel Autism Institute. “Low-cost, universal public health strategies such as screening can lead to less disparity in autism detection and help children on the spectrum start specific intervention and supports earlier in life.”

Source: Wiley

Categories : Neurology PaediatricsTags :

Early Sensorimotor Skill Differences can Guide Autism Diagnosis

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New research published in the journal iSCIENCE has revealed new insights into early sensorimotor features and cognitive abilities of toddlers who are later diagnosed with Autism Spectrum Disorder (ASD). The research, led by Kristina Denisova, a professor of Psychology and Neuroscience at the CUNY Graduate Center and Queens College, takes an important step toward better understanding ASD so that more precise, individually tailored interventions can be developed.

ASD, typically diagnosed around the ages of 4 to 5 years, is a neurodevelopmental disorder with complex and varied presentations, including atypical communication and restrictive and repetitive patterns of behaviour. Moreover, cognitive abilities are often lower in individuals with ASD. Despite the established link between lower intelligence quotient (IQ) in infancy and a future diagnosis of ASD, not all children with ASD exhibit lower cognitive abilities during infancy. The study addresses the critical gap in knowledge regarding the early features that differentiate children with varying cognitive abilities who later develop ASD.

The research team investigated the relationship between movement and cognitive abilities in toddlers before their ASD diagnosis, both during sleep and wakefulness. The study posed two key questions: Do ASD children with lower IQ exhibit altered movement during sleep compared to children with higher IQ? Additionally, are lower motor skills during wakefulness characteristic of lower-IQ children with ASD compared to those of higher-IQ ASD toddlers?

The research was conducted in two stages. In the first sample, the team examined sensorimotor features obtained from sleep functional magnetic resonance imaging (fMRI) in 111 toddlers with ASD. In the second, independent sample, they analysed sensorimotor functioning during wakefulness in over 1000 toddlers with ASD, categorised by lower vs higher cognitive abilities.

The findings revealed that toddlers with ASD and lower IQs have significantly altered sensorimotor features compared to toddlers with ASD and higher IQs. Interestingly, the sensorimotor features of higher-IQ ASD toddlers were nearly indistinguishable from typically developing (TD) toddlers. This suggests that a higher IQ may confer resilience to atypical sensorimotor functioning, and conversely, that poor sensorimotor functioning may be a key marker for lower IQ in childhood autism.

Moreover, the study found that lower-IQ ASD toddlers consistently exhibited lower gross motor skills across various age milestones (6, 12, 18, 24, and 30 months). This disruption in early sensorimotor learning during critical developmental periods indicates a potential vulnerability in the brain’s motor control circuitry, associated with lower cognitive abilities in toddlers who later receive an ASD diagnosis.

“The implications of these findings are far-reaching,” said Denisova. “They underscore the need for more precise, tailored interventions for children with ASD, particularly those with lower cognitive abilities. Interventions for lower-IQ autistic children may need to focus on enhancing both sensorimotor and cognitive skills, while interventions for higher-IQ autistic children might prioritise leveraging their strengths to mitigate potential mental health consequences.”

Denisova emphasised the importance of future research in this area, particularly involving underserved families who face barriers in accessing early intervention services.

Source: The Graduate Center, CUNY

Categories : Paediatrics Substance UseTags :

Less Sleep and Later Bedtime in Childhood Linked to Future Substance Use

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A good night’s sleep is essential for children’s health and development, but childhood sleep patterns may also be linked to future substance use. A new study, led by a team of Penn State researchers, found that adolescents were more likely to have consumed alcohol or tried marijuana by age 15 if they went to bed later and slept fewer hours during childhood and adolescence. The team published their findings in Annals of Epidemiology.

“The study suggests that there might be some critical ages when sleep can be a target for intervention,” said Anne-Marie Chang, associate professor of biobehavioural health at Penn State and senior author of the paper. “If we improve sleep in the school-age population, not only could that show improvements in sleep health but in other aspects like the decision to engage in risky behaviours like alcohol and other substance use.”

The research team explored childhood sleep at different developmental stages within the same sample of children to see if there’s an impact on later substance use, which few studies have investigated. They focused on two different facets of sleep health – total duration of sleep and time of sleep or bedtime. The researchers explained that if children, especially school-aged children, go to bed later, it could affect their ability to sleep well.

“Sleep is multifaceted. It’s important for children because it helps with growth and development. The brain is more plastic during younger ages and you want healthy sleep to support neural development,” said David Reichenberger, co-lead author and who earned his doctoral degree in biobehavioural health at Penn State during the time of the research. “Poor sleep health could have downstream effects on their physical health as well as decision making, which could in turn be related to their decision to engage in substance use.”

The study drew on data from 1514 children in the Future of Families and Child Wellbeing Study, a diverse longitudinal birth cohort of children from 20 cities across the United States. Parents reported their child’s regular weekday bedtime at ages three, five and nine. They also reported their child’s sleep duration at ages five and nine.

When the research team evaluated the relationship between childhood bedtime and sleep duration with future alcohol and marijuana use as teens, they found a longitudinal association. Teens were 45% more likely to try alcohol by age 15 if they had a later bedtime at age nine when compared to other children with earlier bedtimes at age nine. However, bedtime at age five wasn’t associated with future alcohol use, nor was sleep duration at ages five or nine. When it came to marijuana use, later bedtime at age five was associated with 26% increased odds of trying marijuana by age 15, while sleeping an hour less at age nine was associated with 19% increased odds of trying marijuana by age 15.

The research team also examined data from adolescents at age 15, who self-reported their bedtime, sleep duration and alcohol and marijuana use. They found that teens with a later bedtime had a 39% greater chance of drinking alcohol and a 34% greater chance of trying marijuana. Sleeping one hour less was associated with 28% increased odds of ever trying alcohol but wasn’t associated with marijuana use.

“Sleep at ages closer to adolescence is the most crucial in terms of future substance use risk. It’s that stage of development when children are rapidly changing and their brain is maturing,” Reichenberger said, noting that previous research by other groups suggests that shorter sleep duration and later bedtimes may increase impulsivity and impair decision making, which could influence substance use choices.

The findings highlight the critical role of sleep across multiple aspects of long-term health and wellbeing, researchers said. For school-age children, creating an environment that’s conducive for sleep and establishing an age-appropriate bedtime are key elements for cultivating good sleep.

“Exploring the connection between sleep and substance use is a critical area of research because we continue to struggle with an epidemic of opioid addiction and substance use,” Chang said. “It’s an important area to continue to research and to disseminate our research findings to the broader population, families and health care professionals.”

Source: University of Pennsylvania