Frequency of mouthing behavior in young children.
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Young children may be more likely than adults to be exposed to pesticides following a residential application as a result of hand- and object-to-mouth contacts in contaminated areas. However, relatively few studies have specifically evaluated mouthing behavior in children less than 5 years of age. Previously unpublished data collected by the Fred Hutchinson Cancer Research Center (FHCRC) were analyzed to assess the mouthing behavior of 72 children (37 males/35 females). Total mouthing behavior data included the daily frequency of both mouth and tongue contacts with hands, other body parts, surfaces, natural objects, and toys. Eating events were excluded. Children ranged in age from 11 to 60 months. Observations for more than 1 day were available for 78% of the children. The total data set was disaggregated by gender into five age groups (10-20, 20-30, 30-40, 40-50, 50-60 months). Statistical analyses of the data were then undertaken to determine if significant differences existed among the age/gender subgroups in the sample. A mixed effects linear model was used to test the associations among age, gender, and mouthing frequencies. Subjects were treated as random and independent, and intrasubject variability was accounted for with an autocorrelation function. Results indicated that there was no association between mouthing frequency and gender. However, a clear relationship was observed between mouthing frequency and age. Using a tree analysis, two distinct groups could be identified: children < or = 24 and children >24 months of age. Children < or = 24 months exhibited the highest frequency of mouthing behavior with 81+/-7 events/h (mean+/-SE) (n=28 subjects, 69 observations). Children >24 months exhibited the lowest frequency of mouthing behavior with 42+/-4 events/h (n=44 subjects, 117 observations). These results suggest that children are less likely to place objects into their mouths as they age. These changes in mouthing behavior as a child ages should be accounted for when assessing aggregate exposure to pesticides in the residential environment. (+info)
Childhood overweight: a contextual model and recommendations for future research.
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The prevalence of overweight among children has doubled within the past two decades. Increases in the rate of childhood overweight are of particular concern due to the negative health and psychological effects noted among overweight children. As shown by previous research, the development of childhood overweight involves a complex set of factors from multiple contexts that interact with each other to place a child at risk of overweight. This multifaceted system can be conceptualized using Ecological Systems Theory (EST). EST highlights the importance of considering the context(s), or ecological niche, in which a person is located in order to understand the emergence of a particular characteristic. In the case of a child, the ecological niche includes the family and the school, which are in turn embedded in larger social contexts including the community and society at large. In this review, EST is used as a framework with which to summarize research assessing predictors of childhood overweight. Specifically, child characteristics that place children at risk of the development of overweight (including dietary intake, physical activity, and sedentary behaviour) will be reviewed while taking into consideration the influence of the familial environment, the school environment, and the community and larger social environments. It is concluded that future research needs to adopt a broader contextual approach in order to understand and intervene against the processes leading to the development of overweight among children and that the use of theories or paradigms such as EST will facilitate developing and testing models of causal processes. (+info)
Socioeconomic differences in injury risks in childhood and adolescence: a nation-wide study of intentional and unintentional injuries in Sweden.
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STUDY OBJECTIVE: To measure socioeconomic differences in injuries among different age groups of children and adolescents. SUBJECTS: Children under 20 living in Sweden between 1990 and 1994 (about 2.6 million). METHOD: A cross sectional study based on record linkage between 15 Swedish national registers. Children were divided into four age groups and allocated to four household socioeconomic status groups. Absolute and relative risks were compiled using children of high/intermediate level salaried employees as the comparison group. Four diagnostic groups were considered: fall, traffic, interpersonal violence, and self inflicted injuries. RESULTS: Injury incidences were relatively low and socioeconomic differences negligible in the 0-4 year olds. Thereafter, significant socioeconomic differences were observed in all diagnostic groups except falls. The highest absolute differences were in traffic injuries, especially among 15-19 year olds, and in self inflicted injuries among 15-19 year old girls. Relative differences were highest in both categories of intentional injuries for the age group 10-14. Social circumstances in the household other than family socioeconomic status affected the social pattern of intentional but not that of unintentional injuries. CONCLUSIONS: Socioeconomic differences in injury risks are not necessarily constant over age. Inequalities are particularly high in absolute terms among adolescents 15-19 years old for traffic injuries and in relative terms among 10-14 year olds for intentional injuries. (+info)
Children who witness violence, and parent report of children's behavior.
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OBJECTIVES: To examine how much distress children report in response to violence that they have witnessed and how this is associated with parental reports of children's behavior. METHODS: As part of a study of in utero exposure to cocaine, children completed the Levonn interview for assessing children's symptoms of distress in response to witnessing violence. The children's caregivers completed the Exposure to Violence Interview (EVI), a caretaker-report measure of the child's exposure to violent events during the last 12 months. The EVI was analyzed as a 3-level variable: no exposure, low exposure, and high exposure. The caregivers also completed the Children's Behavior Checklist (CBCL). RESULTS: Of 94 six-year-old children, 58% had no exposure to violence, 36% had low exposure to violence, and 6% had high exposure to violence, according to caretaker reports. The children's median+/-SD Levonn score was 64 (SD +/- 19.3). The mean SD +/- CBCL total T-score was 53 (SD +/- 10.2). In multiple regression analyses with gender, low and high exposure on EVI, Levonn, and prenatal cocaine exposure status as predictors, the Levonn score explained 4.8% of total variance in children's CBCL internalizing scores, 9.1% of the total variance in CBCL externalizing score, and 12.2% of the total variance in CBCL total score (P =.04, P =.004, and P<.001, respectively). CONCLUSIONS: After accounting for the caretaker's report of the level of the child's exposure to violence, the child's own report significantly increased the amount of variance in predicting child behavior problems with the CBCL. These findings indicate that clinicians and researchers should elicit children's own accounts of exposure to violence in addition to the caretakers' when attempting to understand children's behavior. (+info)
Risperidone in children with autism and serious behavioral problems.
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BACKGROUND: Atypical antipsychotic agents, which block postsynaptic dopamine and serotonin receptors, have advantages over traditional antipsychotic medications in the treatment of adults with schizophrenia and may be beneficial in children with autistic disorder who have serious behavioral disturbances. However, data on the safety and efficacy of atypical antipsychotic agents in children are limited. METHODS: We conducted a multisite, randomized, double-blind trial of risperidone as compared with placebo for the treatment of autistic disorder accompanied by severe tantrums, aggression, or self-injurious behavior in children 5 to 17 years old. The primary outcome measures were the score on the Irritability subscale of the Aberrant Behavior Checklist and the rating on the Clinical Global Impressions - Improvement (CGI-I) scale at eight weeks. RESULTS: A total of 101 children (82 boys and 19 girls; mean [+/-SD] age, 8.8+/-2.7 years) were randomly assigned to receive risperidone (49 children) or placebo (52). Treatment with risperidone for eight weeks (dose range, 0.5 to 3.5 mg per day) resulted in a 56.9 percent reduction in the Irritability score, as compared with a 14.1 percent decrease in the placebo group (P<0.001). The rate of a positive response, defined as at least a 25 percent decrease in the Irritability score and a rating of much improved or very much improved on the CGI-I scale, was 69 percent in the risperidone group (34 of 49 children had a positive response) and 12 percent in the placebo group (6 of 52, P<0.001). Risperidone therapy was associated with an average weight gain of 2.7+/-2.9 kg, as compared with 0.8+/-2.2 kg with placebo (P<0.001). Increased appetite, fatigue, drowsiness, dizziness, and drooling were more common in the risperidone group than in the placebo group (P<0.05 for each comparison). In two thirds of the children with a positive response to risperidone at eight weeks (23 of 34), the benefit was maintained at six months. CONCLUSIONS: Risperidone was effective and well tolerated for the treatment of tantrums, aggression, or self-injurious behavior in children with autistic disorder. The short period of this trial limits inferences about adverse effects such as tardive dyskinesia. (+info)
Children's intellectual and emotional-behavioral adjustment at 4 years as a function of cocaine exposure, maternal characteristics, and environmental risk.
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The authors examined 223 children at age 4 years for the effects of prenatal cocaine exposure, exposure to other substances, maternal and environmental risk factors, and neonatal medical problems on IQ, externalizing problems, and internalizing problems. Regression analyses showed that maternal verbal IQ and low environmental risk predicted child IQ. Cocaine exposure negatively predicted children's overall IQ and verbal reasoning scores, but only for boys. Cocaine exposure also predicted poorer short-term memory. Maternal harsh discipline, maternal depressive symptoms, and increased environmental risk predicted externalizing problems. In contrast, only maternal depressive symptoms predicted internalizing problems. These findings indicate that early exposure to substances is largely unrelated to subsequent IQ or adjustment, particularly for girls. (+info)
The influence of appraisals in understanding children's experiences with medical procedures.
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OBJECTIVE: To examine the influence of cognitive appraisals on anticipatory anxiety, procedural distress, and postprocedural evaluations in 100 children (ages 8-17) undergoing esophagogastroduodenoscopy (EGD). METHOD: Children's knowledge about the procedure, appraisals of the procedure's aversiveness, coping ability, and state anxiety prior to the procedure were assessed by self-report. Distress during the EGD was assessed by observer ratings. Postprocedural evaluations were assessed by self-report 1 hour after the procedure. RESULTS: Structural equation modeling indicated that children who knew more about the EGD appraised it as less threatening, and, in turn, children who appraised the procedure as less threatening experienced less anxiety. Decreased anxiety was associated with decreased distress, which, in turn, was associated with decreased pain, evaluations of less aversiveness, and less negative attitudes toward future procedures. CONCLUSIONS: This study has implications for how children are prepared for EGDs and supports the utility of an appraisal-based model in understanding children's experiences with medical procedures. (+info)
Psychological differences between children with and without chronic encopresis.
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OBJECTIVE: To validate a theoretical model of encopresis in terms of psychological factors that differentiates children with and without chronic encopresis and to identify scales that demonstrate these differences. METHODS: Eighty-six children with encopresis were compared to 62 nonsymptomatic children on five psychometric instruments. Differences in the mean scores and the percentages of children falling beyond preselected clinical thresholds were compared across the patient-control groups. RESULTS: Children with encopresis were found to have more anxiety/depression symptoms, family environments with less expressiveness and poorer organization, more attention difficulties, greater social problems, more disruptive behavior, and poorer school performance (ps =.01 < or =.001 on 15/20 subscales). There were no differences in self-esteem. On those subscales where proportionately more encopretic children exceeded clinical thresholds, approximately 20% more of the encopretic children exceeded thresholds than control children. CONCLUSIONS: As a group, children with encopresis differ from children without encopresis on a variety of psychological parameters. However, only a minority of children with encopresis demonstrated clinically significant elevations in these parameters. Identification and treatment of such clinical issues may enhance treatment efficacy. (+info)