JAMA PediatricsPub Date : 2024-11-11DOI: 10.1001/jamapediatrics.2024.4489
Ophélie A. Collet, Pascale M. Domond, Cédric Galéra, Thuy Mai Luu, Tianna Loose, Alejandro Vásquez-Echeverría, Massimiliano Orri, Sylvana M. Côté
{"title":"School Readiness and Early Childhood Education and Care Services Among Dual Language Learners","authors":"Ophélie A. Collet, Pascale M. Domond, Cédric Galéra, Thuy Mai Luu, Tianna Loose, Alejandro Vásquez-Echeverría, Massimiliano Orri, Sylvana M. Côté","doi":"10.1001/jamapediatrics.2024.4489","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.4489","url":null,"abstract":"ImportanceDual language learners (DLL) (ie, children learning 2 or more languages) present lower school readiness than non-DLL children, putting DLL children at risk of later school difficulties and adverse outcomes. However, it is unclear whether participation in early childhood education and care (ECEC) services may reduce this gap.ObjectiveTo assess whether ECEC exposure may reduce the school readiness gap between DLL and non-DLL children in a population-based sample.Design, Setting, and ParticipantsThis census survey study was performed from February to May 2022 in the Canadian province of Quebec using data from the Quebec Survey of Child Development in Kindergarten, which includes all children who attended kindergarten in the 2021 to 2022 school year in public and private schools in Quebec (n = 80 587), except for Cree and Inuit territories.ExposureChildren’s ECEC arrangement before kindergarten was retrieved from register-based data and teachers and arrangements were categorized as exclusive parental care, childcare, pre-kindergarten only, or childcare and pre-kindergarten. Based on their mother tongue and language of instruction, children were classified as French speaking, English speaking, bilingual French-English speaking, or neither French nor English speaking (allophone) children, the last 2 groups of which represented the DLL category.Main Outcomes and MeasuresVulnerability in school readiness was defined as a score below the 10th percentile in any of the 5 domains of the validated Early Development Instrument (EDI): (1) physical health and well-being; (2) social competence; (3) emotional maturity; (4) language and cognitive development; and (5) communication skills and general knowledge.ResultsIn total, 80 587 children were surveyed, and 71 585 children were included in analyses. Mean (SD) child age was 6.0 (0.3) years, 34 911 children (48.8%) were female, and 18 341 children (25.6%) were DLL. English-speaking, bilingual French-English–speaking, and allophone children were more likely to be vulnerable in the EDI (769 of 2355 children [32.7%], 4814 of 13 981 children [34.4%], and 1622 of 4360 children [37.2%], respectively) than French-speaking children (13 664 of 50 890 children [26.9%]). In logistic regression analyses adjusted for social selection bias in ECEC arrangement, attending ECEC services was associated with a lower risk of being vulnerable among all language groups compared to parental care, with odds ratios ranging from 0.26 (95% CI, 0.25-0.27) to 0.96 (95% CI, 0.80-1.14), except in the emotional maturity domain. ECEC exposure was associated with reduction in vulnerabilities disparities between DLL and non-DLL children after adjusting for confounding factors, including socioeconomic status.Conclusions and RelevanceECEC services may foster school readiness for all children, especially DLL, and should be considered to reduce school inequalities.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"215 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PediatricsPub Date : 2024-11-04DOI: 10.1001/jamapediatrics.2024.4710
Thomas W Frazier, Lacey Chetcuti, Mirko Uljarevic
{"title":"Evidence That Intervention Dosage Is Associated With Better Outcomes in Autism.","authors":"Thomas W Frazier, Lacey Chetcuti, Mirko Uljarevic","doi":"10.1001/jamapediatrics.2024.4710","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.4710","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PediatricsPub Date : 2024-11-04DOI: 10.1001/jamapediatrics.2024.4432
Ping-I Lin, Weng Tong Wu, Yue-Liang Leon Guo
{"title":"Screen Time Before 2 Years of Age and Risk of Autism at 12 Years of Age.","authors":"Ping-I Lin, Weng Tong Wu, Yue-Liang Leon Guo","doi":"10.1001/jamapediatrics.2024.4432","DOIUrl":"10.1001/jamapediatrics.2024.4432","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PediatricsPub Date : 2024-11-04DOI: 10.1001/jamapediatrics.2024.4392
Yi-Sheng He, Fan Cao, Xiao Hu, Yu-Chen Liu, Sha-Sha Tao, Peng Wang, Shengping Hou, Hai-Feng Pan
{"title":"Time Trends in the Burden of Environmental Heat and Cold Exposure Among Children and Adolescents.","authors":"Yi-Sheng He, Fan Cao, Xiao Hu, Yu-Chen Liu, Sha-Sha Tao, Peng Wang, Shengping Hou, Hai-Feng Pan","doi":"10.1001/jamapediatrics.2024.4392","DOIUrl":"10.1001/jamapediatrics.2024.4392","url":null,"abstract":"<p><strong>Importance: </strong>Environmental heat and cold exposure (EHCE) remains the principal preventable cause of morbidity and mortality in children and adolescents globally.</p><p><strong>Objective: </strong>To report EHCE-related burden and analyze its temporal trends among children and adolescents from 1990 to 2019.</p><p><strong>Design, setting, and participants: </strong>This repeated cross-sectional study used data from the Global Burden of Disease Study 2019, which encompassed 204 countries and territories from 1990 to 2019. Children and adolescents aged 0 to 19 years were included in the study. Data analysis occurred from December 2023 to March 2024.</p><p><strong>Exposure: </strong>EHCE in children and adolescents from January 1990 to December 2019.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were cases and rates of EHCE incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and average annual percentage changes (AAPCs). Global trends in these metrics were also analyzed by sex, age, and sociodemographic index (SDI), which is a comprehensive indicator of the socioeconomic status of a country or region. A linear regression model was used to calculate AAPCs and a joinpoint regression model was used to identify the years in which trends changed significantly.</p><p><strong>Results: </strong>From 1990 to 2019, EHCE-related incidence, prevalence, mortality, and DALYs showed a downward trend globally. However, an upward trend in EHCE incidence and prevalence was detected between 2010 and 2019 (incidence AAPC, 1.46; 95% CI, 1.05-1.87; prevalence AAPC, 1.25; 95% CI, 1.01-1.50). Regionally, although EHCE-related incidence showed a decreasing trend in most regions from 1990 to 2019, there were still some regions with an increasing trend (Southern sub-Saharan Africa AAPC, 0.23; 95% CI, 0.01-0.44). In 2019, the mortality and DALYs of EHCE were higher among children and adolescents in countries with low SDI levels. Additionally, the burden of EHCE among children and adolescents varied according to sex and age.</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional study, a global increase was observed in EHCE incidence and prevalence since 2010. Furthermore, children and adolescents in low-SDI regions, which bear the brunt of the climate crisis, were disproportionately impacted. This suggests that future responses to climate change crises should emphasize health equity, which implies that vulnerable populations, such as children and adolescents, should be given priority in the allocation of resources to address climate change.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PediatricsPub Date : 2024-11-04DOI: 10.1001/jamapediatrics.2024.4707
Micheal Sandbank, James E Pustejovsky
{"title":"Evidence That Intervention Dosage Is Associated With Better Outcomes in Autism-Reply.","authors":"Micheal Sandbank, James E Pustejovsky","doi":"10.1001/jamapediatrics.2024.4707","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.4707","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PediatricsPub Date : 2024-11-04DOI: 10.1001/jamapediatrics.2024.4438
Gabriel Tse, Aydin Zahedivash, Arash Anoshiravani, Jennifer Carlson, William Haberkorn, Keith E Morse
{"title":"Large Language Model Responses to Adolescent Patient and Proxy Messages.","authors":"Gabriel Tse, Aydin Zahedivash, Arash Anoshiravani, Jennifer Carlson, William Haberkorn, Keith E Morse","doi":"10.1001/jamapediatrics.2024.4438","DOIUrl":"10.1001/jamapediatrics.2024.4438","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PediatricsPub Date : 2024-11-04DOI: 10.1001/jamapediatrics.2024.4361
Susanna Tall, Suvi M Virtanen, Mikael Knip
{"title":"Day Care Attendance and Risk of Type 1 Diabetes: A Meta-Analysis and Systematic Review.","authors":"Susanna Tall, Suvi M Virtanen, Mikael Knip","doi":"10.1001/jamapediatrics.2024.4361","DOIUrl":"10.1001/jamapediatrics.2024.4361","url":null,"abstract":"<p><strong>Importance: </strong>A meta-analysis published in 2001 suggested that exposure to infections measured by day care attendance may be important in the pathogenesis of type 1 diabetes. Several new studies on the topic have since been published.</p><p><strong>Objective: </strong>To investigate the association between day care attendance and risk of type 1 diabetes and to include all available literature up to March 10, 2024.</p><p><strong>Data sources: </strong>Data from PubMed and Web of Science were used and supplemented by bibliographies of the retrieved articles and searched for studies assessing the association between day care attendance and risk of type 1 diabetes.</p><p><strong>Study selection: </strong>Studies that reported a measure of association between day care attendance and risk of type 1 diabetes were included.</p><p><strong>Data extraction and synthesis: </strong>Details, including exposure and outcome assessment and adjustment for confounders, were extracted from the included studies. The multivariable association with the highest number of covariates, lowest number of covariates, and unadjusted estimates and corresponding 95% CIs were extracted. DerSimonian and Laird random-effects meta-analyses were performed and yielded conservative confidence intervals around relative risks.</p><p><strong>Main outcomes and measures: </strong>The principal association measure was day care attendance vs no day care attendance and risk of type 1 diabetes.</p><p><strong>Results: </strong>Seventeen articles including 22 observational studies of 100 575 participants were included in the meta-analysis. Among the participants, 3693 had type 1 diabetes and 96 882 were controls. An inverse association between day care attendance and risk of type 1 diabetes was found (combined odds ratio, 0.68; 95% CI, 0.58-0.79; P < .001; adjusted for all available confounders). When the 3 cohort studies included were analyzed separately, the risk of type 1 diabetes was 15% lower in the group attending day care; however, the difference was not statistically significant (odds ratio, 0.85; 95% CI, 0.59-1.12; P = .37).</p><p><strong>Conclusions and relevance: </strong>These results demonstrated that day care attendance appears to be associated with a reduced risk of type 1 diabetes. Increased contacts with microbes in children attending day care compared with children who do not attend day care may explain these findings. However, further prospective cohort studies are needed to confirm the proposed association.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PediatricsPub Date : 2024-11-04DOI: 10.1001/jamapediatrics.2024.4368
Yaxing Meng, James E Sharman, Fiia Iiskala, Feitong Wu, Markus Juonala, Katja Pahkala, Suvi P Rovio, Brooklyn J Fraser, Rebecca K Kelly, Nina Hutri, Mika Kähönen, Tomi Laitinen, Antti Jula, Jorma S A Viikari, Olli T Raitakari, Costan G Magnussen
{"title":"Tracking and Transition Probability of Blood Pressure From Childhood to Midadulthood.","authors":"Yaxing Meng, James E Sharman, Fiia Iiskala, Feitong Wu, Markus Juonala, Katja Pahkala, Suvi P Rovio, Brooklyn J Fraser, Rebecca K Kelly, Nina Hutri, Mika Kähönen, Tomi Laitinen, Antti Jula, Jorma S A Viikari, Olli T Raitakari, Costan G Magnussen","doi":"10.1001/jamapediatrics.2024.4368","DOIUrl":"10.1001/jamapediatrics.2024.4368","url":null,"abstract":"<p><strong>Importance: </strong>Despite its relevance for pediatric blood pressure (BP) screening, the long-term predictive utility and natural progression of pediatric BP classification remain understudied.</p><p><strong>Objective: </strong>To evaluate BP tracking from childhood to midadulthood using the American Academy of Pediatrics (AAP) thresholds and estimate transition probabilities among BP classifications over time considering multiple time points.</p><p><strong>Design, setting, and participants: </strong>The analyses were performed in 2023 using data gathered from September 1980 to August 2018 within the longitudinal Cardiovascular Risk in Young Finns Study. Participants had BP examined 9 times over 38 years, from childhood (aged 6-12 years) or adolescence (15-18 years) to young adulthood (21-27 years), late young adulthood (30-37 years), and midadulthood (39-56 years).</p><p><strong>Exposures: </strong>BP classifications (normal, elevated, hypertension) were based on AAP guidelines for children and adolescents and the 2017 American College of Cardiology/American Heart Association guidelines for adults.</p><p><strong>Main outcomes and measures: </strong>Outcomes were BP classifications at follow-up visits. Tracking coefficients were calculated using generalized estimated equations. Transition probabilities among BP classifications were estimated using multistate Markov models.</p><p><strong>Results: </strong>This study included 2918 participants (mean [SD] baseline age, 10.7 [5.0] years; 1553 female [53.2%]). Over 38 years, the tracking coefficient (odds ratio [OR]) for maintaining elevated BP/hypertension was 2.16 (95% CI, 1.95-2.39). Males had a higher probability than females of progressing to and maintaining hypertension and a lower probability of reverting to normal BP from childhood to midadulthood (transition probability: from normal BP to stage 2 hypertension, 0.20; 95% CI, 0.17-0.22 vs 0.08; 95% CI, 0.07-0.10; maintaining stage 2 BP, 0.32; 95% CI, 0.27-0.39 vs 0.14; 95% CI, 0.09-0.21; from stage 2 hypertension to normal BP, 0.23; 95% CI, 0.19-0.26 vs 0.58; 95% CI, 0.52-0.62. For both sexes, the probability of transitioning from adolescent hypertension to normal BP in midadulthood was lower (transition probability, ranging from 0.16; 95% CI, 0.14-0.19 to 0.44; 95% CI, 0.39-0.48) compared with childhood hypertension (transition probability, ranging from 0.23; 95% CI, 0.19-0.26 to 0.63; 95% CI, 0.61-0.66). The probability of maintaining normal BP sharply decreased in the first 5 to 10 years, stabilizing thereafter. Children with normal BP generally maintained this status into adolescence (male: transition probability, 0.64; 95% CI, 0.60-0.67; female: transition probability, 0.81; 95% CI, 0.79-0.84) but decreased by young adulthood (male: transition probability, 0.41; 95% CI, 0.39-0.44; female: transition probability, 0.69; 95% CI, 0.67-0.71).</p><p><strong>Conclusion and relevance: </strong>Results of this cohort study reveal an e","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PediatricsPub Date : 2024-11-01DOI: 10.1001/jamapediatrics.2024.3297
Pin-Yen Chen, Chung-Ming Chen
{"title":"Low-Dose Iron and Early Development in Breastfed Infants.","authors":"Pin-Yen Chen, Chung-Ming Chen","doi":"10.1001/jamapediatrics.2024.3297","DOIUrl":"10.1001/jamapediatrics.2024.3297","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"1227"},"PeriodicalIF":24.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}