Families provide the essential context for human development, forming the foundation of safety, belonging, and meaning across the lifespan. This chapter integrates relational, developmental, and ecological perspectives to illuminate how family systems nurture resilience from infancy through older adulthood. Drawing upon attachment theory, ecological systems models, Maslow&s;s hierarchy of needs, reflective function theory, Erikson&s;s life stages, and the Developmental, Individual-Differences, Relationship-Based (DIR)/Floortime framework, the chapter explores how trust, attunement, and agency are cultivated through everyday family life. Particular attention is given to families raising children with autism spectrum disorder, emphasizing how diagnosis and intervention intersect with emotional health. Case vignettes illustrate the lived realities of families navigating early childhood, adolescence, and adult transitions. Finally, the chapter addresses contemporary challenges—digital disruption, systemic inequity, caregiver stress, and others—while offering practical implications for professionals supporting families.
Background Peanut oral immunotherapy (pOIT) can achieve desensitization, yet patients with high peanut-sIgE may experience more adverse reactions and treatment failure. We evaluated a conservative pOIT protocol in children with high Ara h 2-sIgE (≥40 kU/L) and examined longitudinal basophil activation test (BAT) and sIgE/sIgG4 trajectories as candidate biomarkers. Methods Thirty-two peanut-allergic children underwent pOIT, including 16 with high and 16 with lower Ara h 2-sIgE. All received low-dose initiation and slow up-dosing. Clinical outcomes, safety, and immunologic markers were evaluated longitudinally for up to 36 months. Results Effective desensitization (≥300 mg peanut protein) was achieved in 68.8% of high-sIgE and 62.5% of lower-sIgE participants. One severe adverse event occurred in each subgroup, with no treatment-related discontinuations. Peanut and Ara h 2/6-sIgE levels rose transiently before gradually declining, whereas sIgG4 increased early, leading to a reduced sIgE/sIgG4 ratio. A ratio <50 was associated with effective desensitization. BAT responses initially increased and subsequently declined, with progressive increase in the activation threshold. Baseline BAT and sIgE were not associated with desensitization. However, BAT area under the curve (AUC) <100 was significantly associated with effective desensitization with ROC AUC of 0.784 (bootstrap 95% CI 0.536–0.983). Exploratory time-lagged analyses did not establish prospective predictive utility. Conclusions Low-dose initiation, slow-escalation pOIT achieved effective desensitization in patients with high Ara h 2-sIgE, without treatment-related discontinuations. Longitudinal reductions in BAT and sIgE/sIgG4 ratio were associated with increased ingested dose. These exploratory biomarkers may provide adjunctive information during pOIT, but prospective validation is required.
Optimal early childhood development (ECD) is critical for long-term health and economic well-being. Over a quarter of young children across low- and middle-income countries face developmental delays. Domestic violence (DV) is harmful to children's healthy development. Using a difference-in-differences design across 38,955 African children aged 36–59 months, this study examines the impact of laws prohibiting DV on ECD status. We find that DV laws significantly increase the probability of being developmentally on track for children born after enactment by 27.7 percentage points. Children with partial exposure also showed a 24.1 percentage point increase. These gains are primarily driven by advancements in the socio-emotional domain.
Reward-related Positivity (RewP) indexes neural sensitivity to reward feedback and has been widely studied in adolescents and adults. However, little is known about how individual differences in RewP are associated with emotional functioning during early childhood, a critical period for affective development. Interpretation of feedback-related ERPs in children is further complicated by temporally overlapping components. This study examined whether a principal component analysis (PCA)-derived RewP is associated with affective functioning in children aged 4-7 years. Electroencephalography was recorded from 140 children during an age-appropriate reward task. Temporospatial PCA was performed on the full EEG sample ( n = 140), and primary regression analyses were conducted in the subset with complete covariate data ( n = 48). Temporospatial PCA was applied to isolate a RewP component differentiating gain from loss feedback. Positive and negative affect were assessed using the child version of the Positive and Negative Affect Schedule. Regression analyses examined whether PCA-derived RewP- and gain-related P200 amplitudes were associated with affective functioning while controlling for age, sex, ethnicity, income-to-need ratio, child depressive symptoms, and parental depressive symptoms. At the group level, boys showed greater PCA-derived gain-related P200 amplitudes than girls. At the individual level, higher child positive affect was associated with larger PCA-derived RewP amplitudes in the primary covariate-adjusted regression model. In sensitivity analyses conducted in the larger sample without the income-to-needs covariate, negative affect, rather than positive affect, was significantly associated with PCA-derived RewP amplitude. These findings provide novel evidence that RewP may serve as an early neural marker of affective functioning. By extending RewP research to an understudied developmental period and emphasizing normative emotional functioning, this study advances understanding of early reward processing and highlights the utility of PCA for isolating meaningful ERP components in children.
Yu Sun Chung, Armen Bagdasarov, Michael Santo Gaffrey
This article analyzes storytelling as a pedagogical resource in Early Childhood Education, focusing on oral language, comprehension, imagination, social participation, and reader development. A qualitative narrative literature review was conducted using Brazilian curricular documents and national and international studies on shared reading, literary mediation, and narrative development. The synthesis shows that exposure to books alone does not ensure learning. Outcomes depend on the aesthetic quality of the works, regularity of experiences, responsive teacher listening, and opportunities for children to predict, ask, interpret, retell, and create. Literature preserves its artistic character when planning does not reduce it to exercises, but combines enjoyment, conversation, and meaning-making. Storytelling can therefore be integrated into daily school life as an intentional and playful practice aligned with children's learning rights. Assessment should rely on records of participation and progression, respect multiple forms of expression, and avoid the formal anticipation of literacy instruction.
Eliane Magni Soares, Evani Pereira Espindola, Evelise Dourado Felix
Abstract Objective This observational study aimed to investigate the potential association between reported childhood diseases and medications during early infancy and the later appearance of molar incisor hypomineralization (MIH). Materials and methods As part of a prospectively designed epidemiological study, 5,418 Bavarian children aged 8 to 10 were examined for the presence of caries (WHO standard) and MIH (EAPD criteria). In addition, each child received a questionnaire to be completed by their parents. A total of 1,315 questionnaires were returned, containing complete information on childhood diseases, medication and socioeconomic status. Marginalized zero-inflated negative binomial regression models were constructed. Results A total of 263 children (20.0%) were diagnosed with MIH, with a mean of 3.3 (± 2.0) MIH-affected teeth. In cases of bronchitis (IRR 1.25 with 95% CI 1.07–1.46), otitis media (aOR 1.91 with 95% CI 1.30–2.80), eye diseases, allergies, speech disorders, worm infections and cardiac diseases, significant associations were found for the presence of MIH. In addition, a significant association between antibiotic use and MIH was confirmed (first year of life: IRR 1.45 with 95% CI 1.15–1.83; aOR 1.86 with 95% CI 1.13–3.05/second year of life: IRR 1.35 with 95% CI 1.05–1.77; aOR 1.36 with 95% CI 1.05–1.77). Conclusions The associations were mostly associated with low case numbers and accordingly cannot explain the documented MIH prevalence of 20.0%. Therefore, childhood diseases and antibiotic use probably do not solely contribute to MIH development. Clinical relevance MIH aetiology remains unclear, indicating a need for further research.
Elena Pernegger, Nour Ammar, Karl-Ferdinand Fresen et al.
Objective To identify factors associated with early non-response to first-line treatment in children with primary immune thrombocytopenia (ITP), and to develop and externally validate a prediction model. Methods This multicenter retrospective cohort study included 335 children with newly diagnosed primary ITP as the derivation cohort, including 255 responders and 80 non-responders. Clinical data obtained after admission were collected. Candidate variables were screened using correlation analysis and least absolute shrinkage and selection operator (LASSO) regression, followed by multivariable logistic regression to identify factors associated with early treatment non-response. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). An independent external validation cohort of 78 children was additionally included to assess model discrimination. Results Among the 335 children, 255 (76.1%) achieved a treatment response within 14 days after first-line therapy, whereas 80 (23.9%) did not. Multivariable analysis showed that older age (OR = 1.769, 95% CI: 1.629–1.920, P < 0.001), higher platelet-to-lymphocyte ratio (PLR) (OR = 1.622, 95% CI: 1.112–2.367, P = 0.012), and antinuclear antibody (ANA) positivity (OR = 3.142, 95% CI: 1.626–6.071, P < 0.001) were independently associated with early treatment non-response. The combined model incorporating age, PLR, and ANA achieved an AUC of 0.831 (95% CI: 0.778–0.885) in the derivation cohort and 0.718 (95% CI: 0.591–0.845) in the independent external validation cohort. Calibration was acceptable in both cohorts, with Hosmer–Lemeshow P values of 0.609 and 0.220 and Brier scores of 0.129 and 0.137, respectively. Conclusion Older age, higher PLR, and ANA positivity were independently associated with early non-response to first-line treatment within 14 days in children with newly diagnosed primary ITP. These findings may help identify children at high risk of treatment non-response and support individualized monitoring and treatment strategies.
For all humans, neurodiverse and neurotypical, optimal development is based upon reciprocal interactions and interpersonal synchrony with an attuned and responsive caregiver followed by independent action beginning in infancy (Mayo & Gordon, 2020 ). Such good-enough early experience leads to a sense of safety and basic trust and to a secure attachment guiding the regulation of the allostatic process through inner perceptions of a responsive and helpful world. Positive outcomes represent open-system functioning that involves using available love akin to Lord&s;s (Clarke & Lord, 2024 ) conceptualization of social competence. When an infant or child experiences difficulty participating in reciprocal interactions with caregivers, whether caused by neurobiological factors as in autistic individuals or actual maltreatment, he experiences chronic stress that sculpts a maladaptive trajectory (Singletary, 2015 ; McEwen, 2016 ). From our perspective, adverse childhood experiences impel development toward basic mistrust and insecure attachment and lead to difficulty forming caring social connections and to a maintenance of a sense of being alone in a dangerous world. Loneliness heightens stress and promotes allostatic overload, which interferes with emotional and physical health (Cacioppo & Cacioppo, 2018 ; Hawkley , 2022; Holt-Lunstad et al., 2015 ; Murthy , 2020). Treatment that aims at developing the capacity to build caring social connections offers new hope in the prevention and treatment of the autism profile.
Objective: Childhood cerebrovascular diseases (CVDs) comprise a heterogeneous group of disorders associated with significant neurological morbidity and long-term functional impairment. Despite increasing awareness, epidemiological and outcome data in pediatric populations remain limited. This study aimed to evaluate the demographic characteristics, etiological distribution, clinical presentation, neuroimaging findings, treatment approaches, and long-term outcomes of pediatric patients diagnosed with CVD in a tertiary pediatric neurology center. Methods: This retrospective single-center study included 25 pediatric patients diagnosed with CVD and followed up between 2010 and 2026. Demographic data, clinical findings, etiological factors, neuroimaging characteristics, treatment strategies, and follow-up outcomes were retrospectively reviewed. Functional outcomes were assessed using the Modified Rankin Scale (mRS). Results: The mean age at diagnosis was 8.4 years, and 60% of patients were male. Ischemic stroke was identified in 68% of patients, whereas 32% had hemorrhagic stroke. Hematologic/thrombophilic disorders and vasculopathies represented the most common etiological subgroups. Acute-onset hemiparesis, headache, and seizures were the leading presenting symptoms. Neuroimaging abnormalities were detected in all patients, with multiple lesions observed in 68% and bilateral involvement in 44% of cases. Pediatric intensive care unit admission was significantly more frequent among patients with hemorrhagic stroke (P < .001), and was significantly associated with long-term neurological sequelae development (P = .004). Long-term neurological sequelae were identified in 60% of patients, and post-stroke epilepsy developed in 52%. Mortality was 4%, while the median mRS score at the last follow-up visit was 2. Conclusion: Pediatric CVDs are associated with substantial long-term neurological burden despite relatively low mortality rates. Hemorrhagic events were linked to more severe clinical outcomes and higher intensive care requirements. Early recognition, comprehensive neurovascular imaging, and multidisciplinary long-term follow-up are essential for improving neurological outcomes in affected children. Cite this article as: Sengenc E, Tunc A, Guler S, et al. From acute events to chronic burden: a 16-year single-center experience in pediatric cerebrovascular diseases. Cerrahpaşa Med J 2026, 50, 0098, doi: 10.5152/cjm.2026.26098.
The young child depends on talking with adults to gain an understanding of the world around him and Focus on Meaning (originally published in 1973) helps the teacher, the parent, and all concerned with growing children to gain insight into the part that language plays during the early years of childhood. The fact that the author is a mother as well as a teacher of international reputation in the language field is apparent in the sympathetic, straight-forward treatment of crucial areas of language and learning development, built on a sound and logical theoretical basis. First there is a brief account of the early stages of language development and a discussion of the importance of the attitudes of parents towards their children and of the way in which these influence the development of the child’s skill in using language. Through the discussion of recorded conversations, the reader is given a view of the wide range of uses of language which the young child can develop if he meets experiences which encourage him to think and express his ideas. The importance of the part the teacher can play in stimulating the development of these skills in children in the nursery and infant school is discussed and is illustrated by examples. The discussion is always on a practical level, but the samples of recorded talk illustrate the factors which influence the child’s use of language and the part played by language in much of his early learning.
