Infant social withdrawal is an early indicator of infant distress linked to adverse socio-emotional development. We hypothesized that parental sensitivity moderates an association between parental depression (PPD) and infant social withdrawal. We examined these associations cross-sectionally in 471 families in which mothers screened positive for PPD, assessing infant social withdrawal (mean infant age 3.6 months) during interactions with mothers, fathers/co-parents and a stranger. No significant association was found between parental PPD symptom severity and infant social withdrawal in interaction with either the parents or the stranger. Instead, parental sensitivity was negatively associated with infant social withdrawal in mother-infant interactions and less consistently in father/co-parent-infant interactions, though not in interactions with the stranger. Thus, in families at risk for PPD, infant withdrawal may be more closely related to parental sensitivity than parental depressive symptoms. Moreover, the influence of parental sensitivity on infant social withdrawal may not extend beyond parent-infant interactions.
Maja Rudling, Anne Christine Stuart, Johanne Smith-Nielsen et al.
Children's eating behaviours are important determinants of childhood obesity; however, few studies have examined whether early childhood obesity prevention interventions influence these behaviours. This study investigated the impact of a home-based obesity prevention intervention on children's eating behaviours. The Guelph Family Health Study is a randomised controlled trial of a 6-month obesity prevention intervention focused on establishing healthful household routines among 285 families with preschool-aged children. A total of 384 children (3.5 ± 1.3 years old, 50.3% girls, 20.2% at risk for overweight/obesity, 8.2% with overweight/obesity) were included in the analyses. Children's eating behaviours were assessed using the parent-reported Child Eating Behaviour Questionnaire at baseline, immediately after the intervention, and one year after the end of intervention (18 months from baseline). No significant group by time interactions were observed, indicating that the intervention had no significant impact on children's eating behaviours compared to controls. Significant time effects were observed for many eating behaviours. Irrespective of study groups, emotional overeating and food fussiness increased over time, while desire to drink, emotional undereating, and slowness in eating decreased over time. This study showed that, compared to controls, a home-based lifestyle obesity prevention intervention did not influence preschool-aged children's eating behaviours. Future studies should assess whether focusing on eating behaviours in addition to lifestyle behaviours improves the efficacy of childhood obesity prevention interventions and could help prevent the development of obesity-associated eating behaviours in preschool-aged children.
Raphaëlle Jacob, Kathryn Walton, Andrea C Buchholz et al.
Survival
Peer-reviewed article·PubMed (US National Library of Medicine)·
Music cognition research has explored whether and how music training improves word reading. However, extant theories and empirical studies have only focused on alphabetical languages, limiting the current theoretical understanding to alphabetical languages alone. This cross-sectional study evaluated (1) whether musically trained children outperformed untrained children in Chinese word reading and (2) the relative mediating roles of segmental phonological and tone awareness in the relation between music perception and Chinese word reading in musically trained children. We recruited 86 musically trained children and untrained children with similar family income. They were tested on Chinese word reading, segmental phonological awareness, tone awareness, and music perception. Musically trained children outperformed musically untrained children on Chinese word reading, segmental phonological awareness, and tone awareness. Segmental phonological awareness mediated the relation between music perception and word reading in musically trained children, whereas tone awareness did not. This study provides initial evidence supporting the potential of music training to improve Chinese word reading, laying an empirical foundation for future music training studies. Moreover, the findings reflect a possible intervention mechanism in which music training improves Chinese word reading by enhancing segmental phonological awareness. From a theoretical perspective, the findings support the segmental phonological awareness account but not the tone awareness account.
William Choi, Veronica Ka Wai Lai, Siu-Hang Kong et al.
DevelopmentPractitioner
Peer-reviewed article·PubMed (US National Library of Medicine)·
BACKGROUND: Outdoor play may offer developmental opportunities that support good mental health. Cross-sectional data indicate that more outdoor play is associated with better mental health, particularly internalising problems (e.g. anxiety and depression), but longitudinal research is lacking. We used a longitudinal cohort dataset to evaluate whether outdoor play at 2-4 years predicted children's mental health trajectories into middle childhood. METHODS: Data were from the Growing up in Scotland dataset. Parents/caregivers were asked how many days their child had played outside over the previous week when children were aged ~2, 3 and 4 years. When the children were aged ~4, 5, 6 and 8 years, parents/caregivers completed the Strengths and Difficulties Questionnaire measure of child mental health. We used growth mixture modelling (GMM) to identify trajectories over time for internalising and externalising symptoms separately. Next, we used multilevel multinomial regression to evaluate whether early outdoor play predicted trajectory classification. RESULTS: The analysis sample included 4,151 children. A three-class solution was optimal for internalising and externalising symptoms. The three trajectory groups differed on both symptom level at age 4 and slope as follows: normative (low with stable trajectory); increasing (moderate with increasing trajectory); decreasing (high with decreasing trajectory). After controlling for covariates, outdoor play significantly predicted trajectory class; children who played outdoors more often as preschoolers had significantly decreased odds (p < .001) of belonging to the increasing or decreasing trajectory groups, relative to the normative group, for internalising (increasing: OR = 0.92, decreasing: OR = 0.88) and externalising (increasing: OR = 0.94, decreasing: OR = 0.94) symptoms. CONCLUSIONS: This study uses nationally representative longitudinal data and provides the first evidence that early outdoor play predicts mental health trajectories across childhood. A key limitation is reliance on parent-report measures. The findings indicate that increasing outdoor play may be a useful public health approach to reduce child mental health problems.
Peer-reviewed article·PubMed (US National Library of Medicine)·
PURPOSE: Early feeding practices such as feeding to soothe distress can shape children's self-regulation and eating behaviors. Maternal childhood maltreatment history and emotion regulation difficulties may contribute to greater reliance on feeding to soothe, though further evidence is needed. Furthermore, cultural differences in feeding may influence the association between emotion regulation and feeding to soothe. This study examined whether maternal trauma and emotion regulation difficulties predicted feeding to soothe and differences by racial marginalization group. METHODS: Women (N = 181) were drawn from the Michigan Prenatal Stress Study. When children were 2.5 years, mothers reported on their history of childhood maltreatment, current feeding practices, emotion regulation difficulties, and demographics. RESULTS: Racially marginalized women reported greater use of feeding to soothe than racially non-marginalized women. Emotion regulation difficulties and racial marginalization group predicted greater feeding to soothe use, whereas maltreatment was unrelated. Results of the interaction between emotion regulation difficulties and racial marginalization group revealed that among racially marginalized women, feeding to soothe did not significantly change based on emotion regulation difficulties. In contrast, racially non-marginalized women's use of feeding to soothe increased with increasing emotion regulation difficulties. CONCLUSIONS: Findings highlight that the mechanisms driving feeding to soothe may not be uniform across racial marginalization groups and underscore the importance of considering social, structural, and cultural context when examining child feeding practices. Culturally responsive interventions should account for these contextual factors rather than treating all mothers as a homogeneous group, and support emotion regulation particularly among racially non-marginalized women.
Sara F Stein, Alison L Miller, Maria M Galano et al.
Development
Peer-reviewed article·PubMed (US National Library of Medicine)·
ImportancePulmonary alveolar proteinosis (PAP) is a rare pulmonary disorder characterized by alveolar surfactant accumulation leading to respiratory impairment. MARS1 mutations lead to an early onset PAP associated in a setting of multi-organ involvement and respond to high-dose methionine supplementation. While pulmonary manifestations of MARS1-related PAP and their response to methionine are well documented, its potential impact on cognitive and adaptive functioning in pediatric patients remains poorly understood. Understanding the neurodevelopmental profile of children with MARS1-related PAP is essential for optimizing comprehensive care and long-term outcomes. ObjectiveTo characterize the neurodevelopmental profile of children with MARS1-related PAP by assessing intellectual functioning and adaptive behavior using standardized neuropsychological measures and parent-reported questionnaires. DesignObservational cohort study including 16 pediatric patients with MARS1-related PAP aged 14 months to 7.3 years, followed at the Necker-Enfants Malades Hospital (Paris, France) and treated with methionine. Intellectual functioning was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) when age-appropriate, and adaptive behavior was evaluated via the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) through parent interviews. ResultsSixteen children with MARS1-related PAP underwent the full evaluation. Methionine was started at a median age of 6 months (IQR [5, 15]). Eight of them were able to undergo the WPPSI-IV assessment. The mean Full-Scale IQ was 72.25 (SD = 16.85), indicating borderline to mild intellectual disability relative to normative data. Adaptive behavior composite scores on the VABS-II averaged 69.75 (SD = 23.58), reflecting significant deficits across communication, daily living skills, socialization, and motor domains. The neurodevelopmental impairments were relatively homogeneous across the cohort. ConclusionsChildren with MARS1-related pulmonary alveolar proteinosis exhibit marked impairments in intellectual and adaptive functioning, suggesting a consistent neurodevelopmental profile associated with the disease, and despite methionine supplementation. These findings highlight the need for routine cognitive and developmental monitoring in pediatric PAP patients and support the development of multidisciplinary interventions addressing both respiratory and neurodevelopmental outcomes.
Peer-reviewed article·PubMed (US National Library of Medicine)·
BACKGROUND: While previous literature has established a link between psychopathology symptom trajectories and psychosocial risk, most studies have not extended into adulthood or incorporated comprehensive risk measures. We aimed to identify symptom trajectories for externalizing and internalizing symptoms over a 25-year span and predict them using machine learning. METHODS: We used data from a longitudinal birth cohort study (N = 317, 171 females). Psychopathology symptoms were measured between age 8 and 33. Symptom trajectories were identified using growth mixture models. An extensive battery of risk and protective measures over the lifespan (e.g., polygenic scores, psychosocial risk factors, temperament) was used to train machine learning-based classification models. RESULTS: We identified three trajectories for both externalizing and internalizing symptoms (entropy > 0.8, likelihood ratio test p < .05): Low, increasing (late-adolescent emergence), and decreasing (childhood-limited) symptoms classes. Both genetic (e.g., polygenic scores for cognition and mental disorders) and environmental factors (e.g., adverse family characteristics, poor social functioning) predicted symptom trajectories. For externalizing symptoms trajectories, random forest achieved fair discriminatory power with a multiclass macro-average AUC of 0.77 and a multiclass micro-average of 0.88. For internalizing symptoms trajectories, logistic regression achieved modest discriminatory power with a multiclass macro-average AUC of 0.75 and a multiclass micro-average of 0.83. CONCLUSIONS: Psychopathology risk trajectories vary across development and are influenced by diverse risk factors. Understanding these risk factors can support early identification of at-risk individuals and inform targeted prevention and intervention efforts.
BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition characterized by early-onset inattention, hyperactivity, and impulsiveness. Affecting 5% to 10% of youth and persisting into adulthood in ∼6%, ADHD is frequently discussed in genetic terms by patients and their families, making it essential for clinicians to understand current genetic evidence.ObjectiveTo summarize contemporary genetic findings relevant to ADHD across the lifespan and provide practical guidance for clinicians on assessment, treatment, and psychoeducation.Scope and methodsThis focused narrative review integrates evidence from family and twin studies, genome-wide association studies (GWAS), copy number variants (CNVs), polygenic risk scores (PRS), and Mendelian randomization (MR), as well as pharmacogenetics and studies of gene-environment interplay.FindingsADHD is highly heritable (∼70%), comparable to other major neuropsychiatric conditions. GWAS reveals that thousands of common variants collectively contribute to risk (i.e., polygenic), though each has a small effect. Rare CNVs are more frequent in ADHD than controls and overlap with CNVs in autism. Genetic findings implicate neurodevelopmental pathways expressed in early brain and frontal cortical circuits. ADHD genetic risk correlates with cognitive traits, risk-taking behaviours, and multiple psychiatric and physical health outcomes. Gene-environment correlations and interactions influence risk and course. Pharmacogenetic evidence supports CYP2D6 genotyping for atomoxetine dosing; routine genetic testing for stimulant selection is not justified.Clinical implicationsThere are no diagnostic genetic tests for ADHD. Assessment should prioritize functional impairment, developmental and family history, and comorbidity. Psychoeducation should emphasize modifiable risks and the interplay of genes and the environment. While genetic insights may eventually refine diagnosis and personalized care, current best practice relies on comprehensive clinical evaluation and multimodal management.ConclusionGenetic research confirms ADHD's neurodevelopmental basis, continuity across the lifespan, and overlap with other neurodevelopmental conditions of childhood. Clinicians can use these insights for counselling and risk monitoring while avoiding over-reliance on genetic testing outside targeted pharmacogenetic use.
Peer-reviewed article·PubMed (US National Library of Medicine)·
BACKGROUND: Some young people with eating disorders (EDs) require transfer from paediatric to adult services, which can be difficult and distressing. While most research on this topic is qualitative, no qualitative focused synthesis yet exists. METHODS: Systematic review identified 21 qualitative studies, which were analysed using meta-aggregation. RESULTS: Findings included: (1) Age-related transfers deserve specific attention; (2) The distress of the young person, families, and clinicians must be considered; (3) Clear communication between all parties is essential; (4) Paediatric supports should include early conversations and build health management skills; (5) Timing should align with developmental readiness; (6) Plans should be personalised and account for concurrent life transitions; (7) Referrals should be straightforward; GPs need more training to support young people during referral gaps; [Correction added on 06 July 2026, after first online publication: The word "support" has been added to the preceding sentence.] (8) Joint supports include overlapping care, transition coordinators, transition passports, and peer support; (9) Paediatric and adult services should develop a shared philosophy/culture for emerging adults; (10) Parent/carer involvement should be balanced with building the young person's independence; (11) ED-specific guidelines or interventions may be beneficial; (12) Adult supports include emerging adult programming, increased resources, and ED training for generalist services. DISCUSSION: While consistent with existing expertise based guidance, this synthesis provides a qualitative evidence base to inform intervention development and co-production.
Amelia Austin, Manya Singh, Sela Scott et al.
DevelopmentProtection
Peer-reviewed article·PubMed (US National Library of Medicine)·
BACKGROUND: Motor milestone attainment is used in developmental surveillance of preterm infants, yet it has limited sensitivity for detecting subtle motor difficulties. This study examined the longitudinal relationship between movement quality and motor milestone attainment in preterm infants and compared early motor behaviors between moderate-to-late preterm and extremely-to-very preterm infants. METHODS: In this prospective cohort study, 90 preterm infants were assessed at corrected ages of 8, 12, and 18 months. Movement quality was evaluated using the Infant Motor Profile (IMP), and motor milestone attainment was assessed using the Alberta Infant Motor Scale (AIMS). Associations between IMP scores and AIMS scores were examined using Spearman's correlation coefficients. Group differences were analyzed using the linear regression model. RESULTS: At corrected ages of 8 and 18 months, IMP scores (except symmetry) were significantly positively correlated with AIMS scores (ρ = 0.23-0.90, all p < 0.05). In contrast, at 12 months, adaptability and total IMP scores were significantly negatively correlated with AIMS scores (ρ = -0.57 and - 0.26; both p < 0.05). Extremely-to-very preterm infants (n = 23) demonstrated significantly lower total IMP and adaptability scores at 8 months, lower AIMS score at 12 months, and lower total IMP, adaptability, fluency, and AIMS scores at 18 months compared with moderate-to-late preterm infants (n = 67) (all p < 0.05). CONCLUSIONS: Movement quality assessment captures motor characteristics not fully reflected by milestone attainment and differentiates preterm subgroups earlier. Incorporating movement quality measures may improve early identification of subtle motor difficulties and guide timely intervention.
Chia-Hsuan Hsieh, Yen-Ling Lin, Pei-Fen Liao et al.
