Diabetes technology has transformed the management of type 1 diabetes (T1D) and improved glycemic outcomes, yet preschool-aged children with T1D remain a uniquely vulnerable population. Complete dependence on caregivers and practical considerations such as limited body surface area and skin sensitivity create distinct barriers to effective technology use. These challenges are often compounded by the transition to daycare or school setting, where disruption in diabetes care coordination between home and classroom can compromise glycemic outcomes. This review synthesizes the evidence for diabetes technology use, summarizes the current guidelines, provides practical considerations, and reviews guidance for training protocols and competency requirements in the educational setting. School-based legal protections are discussed, including Section 504 plans and Individualized Education Programs, which should outline the diabetes-related accommodations required in the school setting in alignment with the Diabetes Medical Management Plan. Targeted interventions to improve training of school/daycare staff, facilitate communication across home and school settings, and address disparities in technology access are essential to optimize care and improve long-term health outcomes.
Background Wireless electroencephalography (EEG) systems offer practical advantages over conventional wired devices in the assessment of children with developmental disabilities (DDs), including enhanced portability, reduced participant burden, and ease of use. However, how these systems have been applied across diverse DD populations, research purposes, and clinical contexts remains unclear. Objective This scoping review aimed to map available evidence on wireless EEG applications in children with DDs, characterize device specifications by application purpose, identify neurobehavioral challenges and corresponding methodological solutions, and assess data quality-related reporting practices. Methods This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews), PRISMA-S (PRISMA Statement for Reporting Literature Searches in Systematic Reviews), and the population, concept, and context framework: population, children aged<19 years with DDs; concept, studies using wireless EEG devices for data collection; and context, all research and clinical settings. A systematic search was conducted across 7 databases (PubMed, Embase, IEEE Xplore, Web of Science, CINAHL, PsycINFO, and Scopus) from their inception through December 2025. Screening was performed independently by 4 reviewers. Data on study characteristics, device specifications, neurobehavioral recording challenges, and data quality reporting were extracted and synthesized descriptively, including cross-tabulation of devices by application purpose. Results Of 594 identified records, 64 studies enrolling 3103 participants met the inclusion criteria. Studies were published between 2005 and 2025, with an increasing trend in both publications and sample sizes. Attention-deficit/hyperactivity disorder (38/64, 59.4%) and autism spectrum disorder (20/64, 31.3%) were the most frequently studied conditions. Primary application domains were biomarker-driven assessment and diagnosis (33/64, 51.6%), brain-computer interface (BCI) technology (18/64, 28.1%), intervention evaluation (8/64, 12.5%), and task or state monitoring (5/64, 7.8%). Across 65 study-device pairs, consumer-grade devices predominated (31/65, 47.7%), followed by research-use-only (19/65, 29.2%) and medical devices (15/65, 23.1%). Purpose-driven patterns emerged: BCI studies favored low-channel, dry-electrode, consumer-grade devices, whereas biomarker-driven and intervention studies used higher channel counts and greater signal fidelity. Recurring neurobehavioral challenges (eg, inattention, sensory hypersensitivity, and motor impairment) were addressed through rapid, low-preparation electrode setups, child-friendly device designs, and adapted recording protocols such as home-based or caregiver-mediated sessions. Data quality-related reporting was substantially incomplete: 85.9% (55/64) did not report validation against a wired EEG system, 79.7% (51/64) did not specify impedance thresholds, and 12.5% (8/64) described no artifact handling. Conclusions This scoping review is the first to comprehensively map wireless EEG research in children across a broad spectrum of DDs-integrating diagnosis, study context, and device characteristics-rather than focusing on a single condition or purpose. This review highlights critical gaps in data quality-related reporting that limit the interpretability and comparability of current findings. Future studies should prioritize rigorous validation within DD cohorts and the development of population-specific guidelines for device selection, signal quality assurance, and reporting transparency.
Scoliosis in children and adolescents, particularly adolescent idiopathic scoliosis (AIS), is a complex three-dimensional spinal deformity with a well-defined global prevalence and a considerable disease burden. This narrative review synthesizes the latest advances in the field, encompassing epidemiology, screening strategies, conservative treatment (bracing and physiotherapeutic scoliosis-specific exercises), biomechanical research, and artificial intelligence applications. A recent global meta-analysis indicates that the overall prevalence of scoliosis in children and adolescents is approximately 1.65%, with a consistent female predominance observed across most studies (global pooled OR = 2.16, 95% CI: 2.01-2.33), although the magnitude of this sex disparity varies by region, and prevalence increasing with age. However, the included studies are geographically unbalanced, with limited data from low-latitude regions, which may bias the global prevalence estimate. School-based screening remains the cornerstone of early detection, but screening policies vary significantly across countries. The development of novel home-based screening tools offers a new approach to overcome the limitations of school screening, yet their widespread adoption is constrained by economic factors and parental awareness. Multiple randomized controlled trials and meta-analyses have confirmed the efficacy of bracing and physiotherapeutic scoliosis-specific exercises, but no unified clinical guidelines exist for selecting the optimal treatment strategy. Furthermore, long-term longitudinal evidence on the intrinsic link between treatment approaches and patients' mental health is still lacking. In addition, biomechanical techniques such as finite element analysis provide new perspectives for elucidating the mechanical properties of scoliosis and optimizing treatment strategies, but most models are constructed under idealized conditions, differing from the physiological state, and their clinical translational value awaits further validation. This review integrates core evidence from the field, aiming to provide a reference for clinical practice and future research directions.
Background Gamification, defined as the application of game design principles in nongame contexts, has garnered increasing attention for its potential to enhance motivation and engagement across various fields, including medical education and training. However, there is a lack of virtual reality (VR)-based simulations on pneumatic reduction of intussusception (PRI) in children in Brunei, thereby limiting practical training opportunities for medical students and surgical trainees. Objective This study aims to obtain experts' reviews of proposed gamification guidelines by conceptualizing a gamified training prototype for pneumatic reduction of intussusception. Methods The design science research methodology (DSRM) was adopted using an iterative development approach. Guidelines for designing gamified training interventions were first identified through a prior systematic literature review. These guidelines were then implemented in the development of a low-fidelity VR prototype as a proof of concept. A qualitative formative evaluation was conducted through a semistructured focus group discussion with 6 healthcare professional participants involved in the pediatric intussusception process. Results Participants' formative evaluation indicated that the embedded guidelines could assist in providing effective VR simulation for PRI. The low-fidelity prototype was clear, consistent, and well-aligned with PRI procedures and processes by the participants. The prototype showed promise as an intervention to ensure and enhance trainee motivation and engagement. The overall layout was seen as appealing. Results are presented and discussed with detailed feedback and recommendations for further improvement. Conclusions This study can be viewed as a contribution to the developing literature on the gamification of medical training by exploring the possibility of applying the guidelines to the conceptual design of a gamified training prototype. The findings indicate that the prototype and its design approach are initially accepted by experts. Subsequent research will consist of creating a high-fidelity prototype and testing it with a larger, more varied sample of participants, including surgeons and medical students, to verify its effectiveness and generalizability.
Peer interaction plays a central role in social, emotional, and cognitive development across childhood and adolescence. For autistic individuals, difficulties in peer interaction are a defining feature and are associated with reduced participation, limited social learning, and adverse outcomes such as loneliness, rejection, and isolation. Despite its importance, the literature on peer interactions in autism remains fragmented, employing diverse measures, age groups, and study designs, with inconsistent attention to individual and environmental factors. The aim of this systematic review was to examine the quantity and quality of peer interactions among autistic children and adolescents, and to explore how peer interactions are associated with individual and contextual characteristics, including age, sex, autism severity, social skills, cognitive abilities, partner type, and emotional and behavioral factors. Electronic searches (2014-2024), supplemented by manual journal searches, identified 29 quantitative and mixed-methods studies focusing on peer interactions (excluding interventions) among school-age autistic participants. Through inductive thematic analysis, four central themes emerged: peer participation and social network centrality, interaction quality, partner type, and individual differences. Overall, autistic children and adolescents demonstrated lower peer engagement, more peripheral or isolated social positions, and lower peer acceptance compared to non-autistic peers. Importantly, findings showed substantial heterogeneity, influenced by age, autism severity, social skills, cognitive abilities, emotional factors, and partner type. These findings highlight the need for developmentally sustained, peer-based interventions that promote complex interactions, reduce isolation, and value mixed and unmixed peer interactions. Future research should employ consistent, naturalistic measures and diverse samples to capture variability in peer experiences.
Introduction Excessive screen time during early childhood can affect developmental outcomes. However, evidence on the differential effects of screen time types in Thailand remains limited. In this study, we examined associations between different types of screen time and developmental outcomes among children aged 0-6 years in Thailand. Methods This cross-sectional study was conducted in community kindergartens and primary healthcare centres in Thailand. A multistage area-selection procedure was used to select the study settings, followed by convenience sampling of caregiver-child pairs. Data on screen time and related characteristics were collected through structured caregiver interviews. Children's developmental outcomes were assessed using the Developmental Surveillance and Promotion Manual by trained public health practitioners. Adjusted multivariable logistic regression models were used to examine associations between different types of screen time and suspected developmental delays. Results In total, 465 caregiver-child pairs were included. The mean age of children was 41.97 (SD 19.76) months. The median daily screen time was 2.25 h (IQR 1.83-3.00), with 78.9% exceeding recommended limits. Each additional hour of total screen time was associated with increased odds of suspected developmental delays across developmental domains, particularly receptive language delay (aOR 1.52, 95% CI 1.30-1.79) and gross motor delay (aOR 1.49, 95% CI 1.21-1.84). Recreational screen time showed the strongest associations, particularly for receptive language delay (aOR 2.39, 95% CI 1.73-3.30) and personal-social delay (aOR 2.27, 95% CI 1.68-3.08). In contrast, educational screen time was associated with lower odds of receptive language delay (aOR 0.45, 95% CI 0.23-0.88) and expressive language delay (aOR 0.40, 95% CI 0.16-0.99), whereas communication-based screen time was associated with lower odds of personal-social delay (aOR 0.14, 95% CI 0.02-0.95). Conclusions Higher total and recreational screen time were associated with increased odds of suspected developmental delays, whereas educational and communication-based screen time were associated with lower odds in specific domains. Limiting recreational screen time and promoting age-appropriate, high-quality, interactive screen use may support child development.
Abstract Background Induction of labour occurs in approximately 1 in 3 pregnancies in high income countries. Induction of labour is recommended from 41 weeks to reduce the risks of stillbirth, neonatal death and neonatal intensive care admission by the World Health Organisation and the National Institute for Health and Care Excellence (NICE) in the UK, however in recent years the gestational age at delivery has decreased. In this study we aimed to determine the childhood outcomes of Induction of labour at term compared to those expectantly managed. Methods and Findings: We conducted a population cohort study of all children born after 37 weeks between 1988–2015 using routinely collected Scottish maternity data linked to school census data. The exposure was induction of labour with no recognised medical indication at each week of term (37–41 weeks gestation). For each week we identified a comparison group of women who had been expectantly managed and delivered after the gestation at which the comparator induction of labour had been performed. The primary outcome was special educational need (a learning or physical difficulty) at school. Analyses were performed using multiple logistic regression. Of 721 177 women with singleton pregnancy, 158 217 underwent elective induction of labour (21.9%). At each week of gestation between 37 and 40 completed weeks, elective induction of labour was associated with an increased risk of special educational need compared with expectant management (adjusted odds ratio for induction of labour at 39 weeks compared to expectant management 1.18 [95% CI 1.12–1.24]; p < 0.001). However at 41 weeks gestation there was no difference in the risk of special educational need between the groups (adjusted OR 1.01, 95% CI [0.95–1.07]; p = 0.762). Conclusion Compared to expectant management, elective induction of labour at each week from 37–40 weeks’ gestation is associated with an increased risk of special educational need in children. This information should be used when counselling women especially regarding induction of labour before 41 weeks’ gestation.
Purpose To evaluate the impact of psychosocial interventions on health outcomes among children and adolescents (0-19 years) living with cancer across the care continuum, specifically on (1) neurocognitive, (2) psychological, and (3) health-related quality of life (HRQOL) outcomes. Methods Five electronic databases (APA PsycINFO, CINAHL, MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials [CENTRAL]) were searched with no date restrictions, supplemented by backward citation chaining of the reference lists of included studies and relevant systematic reviews. All identified citations were imported into Covidence systematic review software for the removal of duplicate records and the study selection process by two reviewers. Methodological quality and meta-analyses were performed. Results Two thousand nine hundred sixty-one articles were identified, and 34 studies were included. The studies were conducted in 17 countries and representative of 1988 participants. Studies investigating the effects of cognitive interventions demonstrated a significant positive effect on neurocognitive outcomes (SMD: 0.51 [95% CI: 0.32, 0.69]; I2 = 0%, p < 0.01). Play and creative therapies, animal assistance therapy, self-management education, and physical activity were associated with a significant overall improvement in psychological outcomes (SMD: 0.42 [95% CI: 0.17, 0.68]; I2 = 70.1%, p < 0.01). Animal assistance therapy, play and creative therapies, and physical activity interventions led to a significant improvement in quality-of-life outcomes (SMD: 0.80 [95% CI: 0.48, 1.11]; I2 = 87.1%, p < 0.01). Conclusions Psychosocial interventions improved neurocognitive, psychological, and HRQOL outcomes in children and adolescents with cancer, with the most consistent benefits for neurocognition (working memory), anxiety, and pain; effects on depression, coping, self-worth, fatigue and global HRQOL were not significant. Future trials should identify optimal intervention timing, dosage and delivery format, and stratify outcomes by age, diagnosis, and treatment intensity. Implications for cancer survivors These findings suggest the promise of interventions for improving neurocognitive, psychological, and HRQOL outcomes in children and adolescents affected by cancer, while also highlighting substantial evidence gaps, particularly for early targeted approaches in the cancer care continuum.
Sleep health in adolescence is a global public health concern. However, limited studies on adolescent sleep health in Africa exist, and the extent of the available literature on the African continent has not been previously mapped. This review aimed to map the studies on adolescent sleep health in Africa with a focus on the geographical distribution, publication trends, pattern of sleep health measures, prevalence of sleep disorders, the barriers and facilitators to good sleep health, rural-urban disparities, as well as the associations of sleep health with mental health, school schedule and cardio-metabolic risk among the adolescents. All published articles on adolescent sleep health in Africa in English, French, Spanish, Portuguese, and Italian languages were to be included. We conducted a scoping review by searching five databases: MEDLINE (via PubMed), CINAHL (via EBSCOHost), PsycINFO (via EBSCOHost), Scopus, and the African Journal Online (AJOL), from the inception of the databases to January 2025. As previously highlighted in our published protocol, we used the JBI methodology for the scoping review. After screening 921 titles and abstracts and 78 full-text articles, we included 43 articles. There has been an increasing number of studies on adolescent sleep in Africa in the past 25 years. Cross-sectional studies were the most frequent design (67.4%). Most studies focused on sleep quantity and quality, with small sample sizes and scanty evidence on other aspects of sleep health. Inadequate weekday sleep duration was common among adolescents, often compensated by longer weekend sleep durations. Screen use at bedtime, sleeping environment, school schedules, and chronic medical conditions were the major risk factors for sleep disturbances. Poor sleep was associated with poor academic performance, depression, anxiety, and adverse cardiometabolic risk. This review shows a lack of studies on the multidimensional aspects of sleep health and the need for more objective sleep measures to better characterise the sleep health of adolescents in Africa. Larger studies with longitudinal and mixed-method designs are needed to drive the planning and execution of interventions to improve sleep health among African adolescents.
Pediatric chronic kidney disease (CKD) is traditionally viewed as a disorder of impaired renal function, yet its effects extend far beyond the kidneys. Growing evidence indicates that CKD may disrupt brain development through interconnected biological, vascular, inflammatory, and psychosocial mechanisms, with lasting consequences for cognition, mental health, and educational attainment. In this perspective, we propose the kidney-brain axis as a neuro-renal framework for understanding these neurological consequences of pediatric CKD. We discuss current evidence linking CKD with neurocognitive impairment, structural brain abnormalities, psychosocial burden, and adverse educational outcomes, while examining the biological mechanisms that may underlie these associations. We also consider the role of kidney transplantation, emphasizing that restoration of renal function does not necessarily restore normal neurodevelopmental trajectories. Finally, we outline the clinical implications of integrating routine neurodevelopmental assessment into pediatric nephrology care and highlight priorities for future research. Recognizing neurodevelopment as a core component of pediatric CKD may help redefine disease burden and support more comprehensive, lifelong care for affected children.
