Children in foster care are at elevated risk for adverse outcomes. Placement instability and failure to achieve timely permanence exacerbate that risk. A handful of studies have found that parent-management training is effective in promoting placement stability and timely permanence.

Unlike parent-management training, youth focused interventions have not been systematically evaluated for their impact on placement and permanency outcomes. A mentoring and skills group intervention for preadolescents in foster care demonstrated better placement and permanency outcomes, especially for high-risk subgroups. (Read the full article)

Preterm children born between 29 and 36 gestational weeks are at higher risk of developmental delay. The Ages and Stages Questionnaires (ASQ) have been recommended as a developmental screening tool.

At 12 months’ corrected age (CA), the ASQ was insufficient in identifying delays on both mental and psychomotor scales of the Bayley Scales of Infant Development but was accurate in detecting mental delay at CA of 24 months. (Read the full article)

Known rates of nonsuicidal self-injury, hurting oneself without the intent to die, are between ~7% and 24% in samples of early adolescents and older adolescents, yet research has not reported rates for youth younger than 11 years old.

Children as young as 7 years old report engaging in nonsuicidal self-injury. There is a grade by gender interaction for nonsuicidal self-injury, such that ninth-grade girls report the greatest rates of engagement and do so by cutting themselves. (Read the full article)

Neonatal hearing screening occasionally fails because of several perinatal and neonatal factors. However, the effect of mode of delivery on hearing screening has not yet been established.

We show significantly more failures on hearing screening in cesarean delivery infants. Hence, the timing of screening after cesarean delivery should preferably be postponed beyond 48 hours to improve success rate, minimize maternal anxiety, and decrease costs. (Read the full article)

Providers who speak Spanish, regardless of their proficiency level, may use Spanish for clinical care without seeking professional interpretation. Failure to use professional interpretation increases the risk for miscommunication and can lead to patient harm.

Providing residents with objective feedback on Spanish language proficiency decreased willingness to use Spanish in straightforward clinical scenarios. Language proficiency testing, coupled with institutional policies requiring professional interpretation, may improve care for patients with limited English proficiency. (Read the full article)

Previous studies show beneficial effects of cycled lighting in neonatal care on infant day–night activity, sleep behavior, and postnatal growth. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend neonatal care under cycled lighting conditions.

This study found that cycled lighting during neonatal care reduces infant’s fussing and crying behavior at 5 and 11 weeks’ corrected age and improves growth during neonatal period. These findings support the introduction of cycled lighting in neonatal care practice. (Read the full article)

Early speech and language delays are risk factors for later developmental and social difficulties. It is easier to identify them retrospectively than prospectively. Population characteristics and prevalence rates make screening problematic.

Using data from a birth cohort, this study identifies predictors of language performance at 5 years and 4 patterns of change between 3 and 5 years, comparing those who change with those whose profile remains low across time points. (Read the full article)

Death or neurodevelopmental impairment in extremely premature neonates can be predicted at birth by considering gender, antenatal steroids, multiple birth, birth weight, and gestational age.

Prediction of death or neurodevelopmental impairment in extremely premature infants is improved by using information available later during the clinical course. The importance of birth weight declines, whereas that of respiratory illness severity increases with advancing postnatal age. (Read the full article)

Parents are increasingly following alternative immunization schedules. Current studies suggest up to 21% of parents in the United States are intentionally delaying or refusing some or all of the recommended early-childhood vaccines.

This is the first study to use Immunization Information System data to quantify the proportion of children consistently delaying receipt of vaccines. Consistent-limiting children were found to have lower levels of recommended vaccines. (Read the full article)

Male circumcision reduces risk of HIV acquisition in men by 60% and is associated with other health benefits. Compared with adult circumcision, infant male circumcision is safer, less expensive, and represents a cost-saving intervention for HIV prevention in many settings.

IMC is little known in East Africa and is not routinely practiced. This is the first study to assess acceptability and uptake of IMC in East Africa among parents who were actually offered the procedure. (Read the full article)

Chronic fatigue syndrome (CFS) is a disabling illness. Some children with chronic disabling fatigue are housebound. Some primary care physicians find making the diagnosis of CFS difficult.

Chronic disabling fatigue is more common in 13-year-olds than previously realized with a population prevalence of ~2.0%. Chronic disabling fatigue in teenagers is more common in those with higher levels of early family adversity. (Read the full article)

Literature about polymorphic expression of an apparent life-threatening event (ALTE), particularly that concerning discrimination between ALTE with evident cause and idiopathic ALTE, is scarce. Relationships between SIDS and ALTEs have been supposed but data are still controversial and no genetic data are available.

Genetic analysis (5HTT and MAOA) on ALTEs and idiopathic ALTEs discriminated the 2 syndromes and found a link between the idiopathic form and SIDS. Consequently, we hypothesized that the 2 latter syndromes could be different phenotype expressions of a common genetic base. (Read the full article)

Children with a single kidney are often counseled to avoid contact/collision sports based on the concern of injury to the kidney; however, the incidence of kidney injury during sport is not well understood.

Based on this multiyear, prospective injury surveillance system of varsity-level high school athletes, sport-related kidney injury is rare. Reevaluation of American Academy of Pediatrics recommendations regarding sport participation by children with a single kidney is indicated. (Read the full article)

Prevalence estimates for neurologic and neurodevelopmental disorders in children vary widely, and there is uncertainty as to what extent the individual disorders overlap. Most previous prevalence studies have been based on survey data and not on specialist-confirmed diagnoses.

This study used nationwide register data to determine the proportions of Norwegian children diagnosed with autism spectrum disorder, attention-deficit/hyperactivity disorder, epilepsy, and cerebral palsy and to study how the disorders overlap. All diagnoses were specialist-confirmed. (Read the full article)

Emphasis on preventing central line-associated bloodstream infections (CLABSIs) in US health care facilities and prophylactic antifungal medication use in neonates may impact incidence of Candida spp. CLABSIs. However, data on trends in incidence of neonatal Candida spp. CLABSIs are lacking.

Data from a large sample of US NICUs was analyzed to assess trends in incidence over time. This analysis provides a description of the epidemiology of Candida spp. CLABSIs in a national health care-associated infections surveillance system. (Read the full article)

Febrile infants in the first 90 days may have life-threatening serious bacterial infection. Well-appearing febrile infants with serious bacterial infections cannot be distinguished from those without by examination alone. Variation in care resulting in both undertreatment and overtreatment is common.

The systemwide implementation of an evidence-based care process model for the care of febrile infants in Intermountain Healthcare was associated with increased delivery of evidence-based care, improved infant outcomes, and lower costs. This model adopted nationally can improve value. (Read the full article)

Infant malnutrition is known to be associated with behavioral and cognitive impairment throughout childhood, adolescence, and young adulthood. However, controlled studies addressing adult outcomes in middle life, including earning potential, educational attainment, and standard of living, are limited.

A discrete episode of moderate to severe malnutrition in infancy, with good rehabilitation thereafter, is associated with lower adult social status and a widening income gap relative to healthy controls, partially attributable to cognitive impairment in the previously malnourished. (Read the full article)

There is no literature on the concentrations of vitamin B₆ vitamers in cerebrospinal fluid of preterm and term newborn infants. This knowledge, however, is highly important, because vitamin B₆ plays a pivotal role in brain development and functioning.

In cerebrospinal fluid of newborn infants, B₆ vitamer concentrations are strongly dependent on postmenstrual age, indicating that vitamin B₆ homeostasis in brain differs between preterm and term newborns. This has implications for the evaluation of epilepsy and vitamin B₆ deficiency. (Read the full article)

Neonatal hyperbilirubinemia may progress to bilirubin encephalopathy. Findings from previous studies on long-term development of neonatal hyperbilirubinemia are conflicting.

Using Ages and Stages Questionnaire, we observed no association between bilirubin exposure and overall development in 1- to 5-year-old children who in the neonatal period had total serum bilirubin level ≥25 mg/dL and no or only minor neurologic symptoms. (Read the full article)

Preterm infants from 33 gestational weeks can detect specific shape features (prism and cylinder) by touch (without visual control), and remember them; however, nothing is known about such abilities earlier in development.

The preterm infant, even when very immature (from 28 gestational weeks), is endowed with tactile sensory abilities: the exploration and memorization of an object by touch, the discrimination of a novel object, and the recognition of a familiar object after interference. (Read the full article)

Overall antibiotic prescribing rates for children declined throughout the 1990s and early 2000s. These declines were concurrent with changes in practice related to acute otitis media, the most common reason for antibiotic treatment in young children.

The downward trend in antibiotic-dispensing rates to young children in 16 Massachusetts communities ended by 2004–2005 and remained stable thereafter. This trend was driven by a declining otitis media diagnosis rate. Antibiotic treatment of diagnosed otitis media remained constant. (Read the full article)

Late preterm infants are at risk for a variety of developmental impairments; however, little is known about developmental differences among children born within the term range of 37 to 41 weeks’ gestation.

This study links comprehensive birth record data from 128 050 term births to children’s school records 8 years later. Analyses establish that, even among the "normal term" range, gestational age is an important independent predictor of academic achievement. (Read the full article)

Childhood abuse has been associated with obesity risk in adulthood. Little is known regarding the impact of abuse severity on risk, potential mechanisms are poorly understood, and few studies have been conducted among minority populations.

Severity of child/teenager physical and sexual abuse is associated with increased risk for adult obesity and/or central adiposity in adulthood. These are the first such findings in a large cohort of US black women. (Read the full article)

Sudden cardiac death in young athletes is an uncommon but devastating event. Addition of routine electrocardiogram (ECG) screening to standard preparticipation care may reduce the number of sudden deaths. Lack of data regarding effectiveness and costs has prevented widespread implementation.

Adding ECG screening to current preparticipation evaluation is not cost-effective. Cost is driven primarily by the evaluation of the large number of false-positive findings. An ECG-only screening strategy is more cost-effective. (Read the full article)

Physical punishment is associated with aggression, delinquency, and internalizing conditions in childhood, as well as a range of Axis I mental disorders in adulthood. More research is needed on the possible long-term relationship between physical punishment and mental health.

To our knowledge, this is the first nationally representative examination of physical punishment and a range of Axis I and II disorders, gender interactions, and proportion of mental disorders in the general population that may be attributable to physical punishment. (Read the full article)

Moderately preterm-born children (32–35^6/7 weeks’ gestation) are at risk for both neonatal morbidities after birth and developmental delays in early childhood. It is unknown whether neonatal morbidities contribute to the developmental delays of this particular group.

Of all neonatal morbidities commonly seen in moderately preterm-born children, only hypoglycemia increased the risk of developmental delay after moderately preterm birth. A concerted effort to prevent hypoglycemia after birth might enhance developmental outcome in this group. (Read the full article)

This research presents the first 2 experimental studies on the short-term effects of smoking portrayal in movies on children’s beliefs about smoking.

Exposure to movie smoking from cartoon and family-oriented movies had no effect on implicit associations toward smoking. For smoking beliefs, effects were again small and only statistically significant for social norms regarding smoking. (Read the full article)

Family-centered rounds (FCR) show promise for higher patient care satisfaction. Many previous studies are limited by small sample size and observational or pre-post designs, and health care service outcomes have not been previously examined.

Our study uses an FCR assessment tool and a comparison group of non-FCR patients. We found that FCR are associated with improved family experiences, with no additional burden to health care service use. (Read the full article)

Clinical trials have demonstrated that prophylactic human papillomavirus (HPV) vaccines are highly effective in preventing HPV infection, but the impact of vaccination on HPV prevalence rates in real-world, community settings is uncertain.

This study provides evidence of a substantial decrease in the prevalence of vaccine-type HPV among young women and evidence of herd protection in a community only 4 years after the quadrivalent HPV vaccine was licensed. (Read the full article)

Data suggest that delivery at high-volume, high-technology hospitals reduces neonatal mortality. No study has examined other complications or compared the effects in multiple states by using a study design to control for unmeasured differences in case mix.

The survival benefit to delivering at a high-level NICU between 1995 and 2005 is larger than previously reported and varies between states. The survival benefits affect both extremely and moderately preterm infants. Complication rates were similar between hospital types. (Read the full article)

In humans, evidence for an association between maternal caffeine intake during pregnancy and alterations in fetal brain development with persistent alterations in the offspring’s brain and behavior in later life is inconclusive.

Prenatal caffeine intake is not associated with a higher risk for behavior problems in young children. Results do not provide evidence to advise pregnant women to reduce their caffeine intake to prevent problem behavior in their children. (Read the full article)

Adolescent dating violence has been studied from the perpetrators' and survivors' perspectives. The risk and protective factors have been explored, and the strength of the association of these factors with adolescent dating violence has been adequately described.

This study assessed the perceptions and practices of school counselors on adolescent dating violence. Knowing school personnel’s practices and perceptions may help researchers and practitioners gain insights into possible ways to alleviate the problem of dating violence in adolescents. (Read the full article)

The US Surgeon General has determined that the relationship between movie smoking exposure (MSE) and youth smoking is causal; however, it is not known whether movie rating influences how adolescents respond.

The response to PG-13–rated MSE was indistinguishable from R-rated MSE. An R rating for smoking could reduce smoking onset in the United States by 18% (by eliminating PG-13 MSE), an effect similar to making all parents maximally authoritative in their parenting. (Read the full article)

A dose-response relationship exists between light irradiance and decrease of total serum bilirubin concentration (TsB) at relatively low irradiances. It has been questioned whether by increasing irradiance a "saturation point" exists, above which no further decrease of TsB is seen.

We found a linear relation between light irradiance in the range of 20 to 55 μW/cm²/nm and decrease in TsB after 24 hours of therapy, with no evidence of a saturation point. (Read the full article)

Although the impact of changes in the economy on child physical abuse rates is not well understood, there is concern that increased numbers of children may have been victims of physical abuse as a result of the recent economic recession.

Results of this study demonstrate that the rate of admissions for physical abuse to pediatric hospitals has increased during the past 10 years and suggest an association between that increase and the housing mortgage crisis. (Read the full article)

Among adolescents, weight status has been inversely associated with sports participation but not active commuting or physical education. Studies of each form of physical activity have not included adequate adjustments for other physical activities, previous body weight, or diet quality.

Estimates indicate overweight/obesity and obesity prevalence would decrease by 11% and 26%, respectively, if adolescents played on at least 2 sports teams per year; obesity prevalence would decrease by 22% if adolescents walked/biked to school 4–5 days per week. (Read the full article)

Dental composites composed of bisphenol A (BPA) derivatives are common alternatives to amalgam, but may release BPA. Gestational BPA exposure has been associated with poorer behavior in children. A safety trial of amalgam found worse psychosocial outcomes for children randomized to composites.

In the trial, greater exposure to bisphenol-A-glycidyl-methacrylate-based dental composite in children aged 6 to 10 years was associated with worse self-reported psychosocial functioning at 5-year follow-up. There were no such associations with exposure to dental amalgam or urethane-dimethacrylate-based polyacid-modified composite (compomer). (Read the full article)

Persistent facial nerve palsy is a well-described neurologic deficit after Lyme neuroborreliosis and occurs in 13% to 20% of children. Other neurologic deficits are less closely described. Nonspecific subjective symptoms are reported as often among patients as controls in previous short-term follow-up studies.

Persistent neurologic deficits, other than facial nerve palsy, were found in 14% of patients, causing impaired fine motor skills, poor balance, or persistent pain. Nonspecific subjective symptoms were reported as often among patients as controls in this long-term follow-up study and should not be considered as sequelae after Lyme neuroborreliosis. (Read the full article)

Eating disorder not otherwise specified (EDNOS) is the most common eating disorder diagnosis. Binge eating disorder, 1 type of EDNOS, is associated with obesity among adults. Little is known about the health outcomes associated with other types of EDNOS.

This is the first study to evaluate the prospective association of full and subthreshold bulimia nervosa, binge eating disorder, purging disorder, and other EDNOSs with specific mental and physical health outcomes. (Read the full article)

Macromastia is associated with severe physical and emotional symptoms and negatively impacts health-related quality of life in adult women. Reduction mammaplasty is the most effective treatment for adults. Little is known regarding the impact of macromastia during adolescence.

Adolescents with macromastia have impaired health-related quality of life, lower self-esteem, more breast-related symptoms, and are at higher risk for disordered eating in comparison with their peers. These negative health outcomes have implications for early intervention in this patient population. (Read the full article)

Trisomy 13 and 18 are conditions with 1-year survival rates of less than 10% and have traditionally been treated with palliative care. There are increasing reports of ethical dilemmas caused by parental requests for clinical interventions.

Parents who belong to social networks report an enriching family experience and describe surviving children as happy. Many of these parents describe challenging encounters with health care providers. (Read the full article)

Children’s mastery of fundamental movement skills is correlated with a number of health benefits, including higher levels of physical activity, cardiorespiratory fitness, perceived scholastic and athletic competence, and lower levels of overweight.

This is the first study to examine the associations between low skill competence (a new and novel way to report motor skills) and a range of health-related and sociodemographic factors in a large representative sample of children and youth. (Read the full article)

Infantile hemangiomas have a period of rapid growth in early infancy. Most hemangioma growth is completed by 5 months of age, but the majority of patients are not seen by a specialist until after the growth phase is complete.

The most rapid hemangioma growth is between 1 and 2 months of life, much earlier than previously believed. Patients with high-risk hemangiomas should be followed closely, and treatment initiation should be considered before or during the most rapid growth phase. (Read the full article)

Because most childhood tuberculosis cases are sputum smear-negative, diagnosis relies largely upon clinical presentation, tuberculin skin testing, and chest radiograph. Diagnostic limitations contribute to treatment delays and high mortality. However, childhood tuberculosis (TB) mortality risk factors are not well documented.

This study demonstrates that false-negative TST is common in children with active TB and is associated with increased risk of death. A negative TST should not delay anti-TB therapy. Improved diagnostic modalities are urgently needed in resource-limited settings. (Read the full article)

Percentile charts for birth weight are used to assess the somatic development of neonates (small, appropriate, or large for gestational age).

A systematic error was identified in the majority of birth weight percentile charts. As a consequence, small for gestational age rates are overestimated and large for gestational age rates are underestimated; ~5% of neonates are misclassified. (Read the full article)

The American Academy of Pediatrics prioritized detection of mental illness in children presenting to emergency departments (ED) by using standardized clinical tools. Only a minority of ED physicians indicate that they use evidence-based screening methods to assess mental health concerns.

This study presents the psychometrics of the HEADS ED (home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources), a brief, standardized screening tool for pediatric EDs. This tool ensures key information is obtained for decision-making, determining acuity level, and areas of need. (Read the full article)

Food insecurity has been linked to childhood obesity in a number of studies. Few studies have explored potential pathways through which food insecurity is related to child weight, especially in low-income families with young infants.

We found that food insecurity was related to maternal controlling feeding styles and concerns about the infants’ future weight. Early obesity prevention should aim to decrease food insecurity and to reduce controlling feeding styles in families who remain food insecure. (Read the full article)

Children with obstructive sleep apnea (OSA) are usually treated by surgical removal of their upper airway lymphadenoid tissue. Recently, medications were offered to patients with nonsevere OSA. Montelukast, for this indication, had never been studied in a randomized controlled manner.

Montelukast effectively reduced polysomnographic findings, symptoms, and the size of the adenoidal tissue in children with nonsevere OSA. The findings support the potential of a leukotriene modifier as a novel, safe, noninvasive alternative for children with mild to moderate OSA. (Read the full article)

To date, 4 small to moderate sized studies have revealed conflicting results on the clinically important question whether thrombocytopenia contributes to persistent patent ductus arteriosus (PDA) in very immature, preterm infants.

Thrombocytopenia in the first 24 hours after birth was not associated with the incidence of PDA at postnatal day of life 4 to 5 in a large cohort of preterm infants with <1500 g birth weight. Platelet dysfunction, rather than platelet number, might play a role in ductus arteriosus patency. (Read the full article)

Since the introduction of effective vaccines in the United States, the incidence of invasive Haemophilus influenzae type b (Hib) disease in children aged <5 years has decreased by 99%. In 2007, in response to limited vaccine supply, Hib booster doses were deferred for 18 months.

This review found no significant change in the incidence of invasive Hib disease in the United States during the booster dose deferral period, suggesting that booster dose deferral is a reasonable approach to Hib vaccine shortages in the short-term. (Read the full article)