Two-Year-Olds From Poor Neighborhoods More Likely to Have Language Difficulties

Two-year-olds from disadvantaged backgrounds are three times more likely to develop difficulties with language than those from more affluent areas, according to a new Scottish study published in the journal JAMA Network Open.

Researchers say the findings highlight the need for policy makers to address the social factors that can hinder speech, language and communication (SLC) development.

Failing to do so means children might not fully develop the language skills necessary for emotional development, wellbeing and educational and employment opportunities.

“Growing up in a disadvantaged neighbourhood where there is poverty and reduced access to services is closely associated with problems with preschool language development,” said Professor James Boardman of Neonatal Medicine at the University of Edinburgh’s MRC Centre for Reproductive Health.

“These results suggest that policies designed to lessen deprivation could reduce language and communication difficulties among pre-school children.”

For the study, a research team from the University of Edinburgh and NHS Lothian in Scotland looked at more than 26,000 records of children who had received a routine health review between 27 and 30 months between April 2013 and April 2016.

The findings show that two-year-olds living in the most economically deprived neighborhoods were three times more likely to have SLC concerns compared to those brought up in better-off areas.

It is believed that growing up in neighborhoods with low income and unemployment — which is related to problems with education, health, access to services, crime and housing — can increase the risk of setbacks.

The researchers also discovered that being born prematurely had an impact on language issues. The findings show that each week a child spent in the womb from 23 to 36 weeks was associated with an 8.8% reduction in the likelihood of the children having an SLC concern reported at 27 months.

A pregnancy is considered full term between 39 weeks and 40 weeks, 6 days, while preterm birth is defined as delivery before 37 weeks of gestation. Socioeconomic disadvantage has also been associated with a greater risk for preterm birth.

Although the research team looked at birth data from children born in the Lothians, experts say similar results might be expected across the United Kingdom.

Source: University of Edinburgh

Eczema in Children Linked to Anxiety, Depression in Parents

A new study has found that a majority of family members and caregivers of children with atopic dermatitis, the most common form of eczema, suffer from anxiety and depression.

For the study, researchers from the PHI University Clinic of Dermatology assessed the impact of an atopic dermatitis diagnosis on the families of 35 children between the ages of 1 and 6. The researchers, who evaluated 83 family members and caregivers,  found that all of them reported at least mild severity anxiety, with some showing moderate severity anxiety. Almost three in four — 74 percent — were also found to have depression.

According to the study’s findings, depression and anxiety scores were associated with the persistence and longevity of atopic dermatitis.

The researchers noted they did not find an association between scores and the severity of the disease, meaning that depression or anxiety was not observed to increase where atopic dermatitis was more severe.

Atopic dermatitis, the most common form of eczema, affects between 10 and 20 percent of the pediatric population of Europe. It causes the skin to become itchy, red, dry, and cracked. It is a chronic condition that most often occurs in people who have allergies and can develop alongside asthma and hay fever.

Patients with the condition are also known to suffer insomnia, anxiety, and psychosocial stress, linked to the physical manifestation of their eczema, according to the researchers.

For the study, researchers used the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating scale (HAM-A).

The researchers also asked participants what their greatest concerns were. The most frequent worry was the information families and caregivers receive about the nature of the disease, since atopic dermatitis is a long-term condition that requires complex and costly medical treatments.

“The chronicity and complexity of chronic dermatitis often leads to overlooked anxiety and depression in family members and caregivers, but our results show the extent of this cannot be overstated,” said lead researcher Dr. Vesna Grivcheva-Panovska.

“In the future, we must take a widened approach to the management of atopic dermatitis, not only of the patients but of their families as well.”

The research was presented at the 2019 European Academy of Dermatology and Venereology (EADV) Congress.

Source: Spink Health

Severe Morning Sickness May Be Risk Factor for Autism

A new study discovers children whose mothers had a severe form of a morning sickness during pregnancy were 53 percent more likely to be diagnosed with autism spectrum disorder. Kaiser Permanente researchers said the condition, known as hyperemesis gravidarum, is rare and occurs in less that 5 percent of all pregnancies.

Nevertheless, researchers believe the findings are important because the research suggests that children born to women with hyperemesis may be at an increased risk of autism. “Awareness of this association may create the opportunity for earlier diagnosis and intervention in children at risk of autism,” explains lead study author Darios Getahun, M.D., Ph.D., of Kaiser Permanente Southern California Department of Research and Evaluation.

The study appears in the American Journal of Perinatology.

Experts explain that women with the severe form of morning sickness experience intense nausea and are unable to keep down food and fluids. This can lead to dangerous dehydration and inadequate nutrition during pregnancy.

To determine the extent of the association between hyperemesis gravidarum and autism spectrum disorder, researchers reviewed electronic health records of nearly 500,000 pregnant women and their children born between 1991 and 2014 at Kaiser Permanente in Southern California. They compared children whose mothers had a diagnosis of hyperemesis gravidarum during pregnancy to those whose mothers did not.

Other findings from the research included:

• Exposure to hyperemesis gravidarum was associated with increased risk of autism when hyperemesis gravidarum was diagnosed during the first and second trimesters of pregnancy, but not when it was diagnosed only in the third trimester;
• Exposure to hyperemesis gravidarum was associated with risk of autism regardless of the severity of the mother’s hyperemesis gravidarum;
• The association between hyperemesis gravidarum and autism spectrum disorder was stronger in girls than boys and among whites and Hispanics than among blacks and Pacific Islanders;
• The medications used to treat hyperemesis gravidarum did not appear to be related to autism risk.

Investigators explain that the results are consistent with the hypothesis that women experiencing hyperemesis gravidarum have poor nutritional intake. This may, in turn lead to potential long-term neurodevelopment impairment in their children.

The study cannot, however, rule out other possible explanations, such as perinatal exposures to some medications and maternal smoking.

Source: Kaiser Permanente/EurekAlert

Early Prenatal Anemia May Increase Risk of Autism, ADHD

A new Swedish study suggests anemia early in pregnancy may increase the risk of autism, ADHD and intellectual disability in children. Anemia is a common condition in late pregnancy and researchers discovered anemia toward the end of pregnancy did not have the same correlation.

The findings, published in JAMA Psychiatry, underscore the importance of early screening for iron status and nutrition counseling.

An estimated 15-20% of pregnant women worldwide suffer from iron deficiency anemia — lower blood oxygen levels due to a lack of iron. By the third trimester, pregnant women have nearly 50% more blood than they did pre-pregnancy in order to provide enough oxygen for both the woman and the fetus, and their iron requirements are nearly double that of nonpregnant women. Thus, the vast majority of anemia diagnoses are made toward the end of pregnancy, when blood levels are at their highest.

In the current study, the researchers examined what impact the timing of an anemia diagnosis had on the fetus’ neurodevelopment. Investigators specifically assessed if there was an association between an earlier diagnosis in the mother and the risk of intellectual disability (ID), autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in the child.

Overall, very few women are diagnosed with anemia early in pregnancy. In this study of nearly 300,000 mothers and more than half a million children born in Sweden between 1987-2010, less than 1% of all mothers were diagnosed with anemia before the 31st week of pregnancy. Among the 5.8% of mothers who were diagnosed with anemia, only 5% received their diagnosis early on.

The researchers found that children born to mothers with anemia diagnosed before the 31st week of pregnancy had a somewhat higher risk of developing autism and ADHD and a significantly higher risk of intellectual disability compared to healthy mothers and mothers diagnosed with anemia later in pregnancy.

Among the early anemic mothers, 4.9% of the children were diagnosed with autism compared to 3.5% of children born to non-anemic mothers, 9.3% were diagnosed with ADHD compared to 7.1%, and 3.1% were diagnosed with intellectual disability compared to 1.3%.

After considering other factors such as income level and maternal age, the researchers concluded that the risk of autism in children born to mothers with early anemia was 44% higher compared to children with non-anemic mothers. The risk of ADHD was 37% higher and the risk of intellectual disability was 120% higher.

Even when compared to their siblings, children exposed to early maternal anemia were at higher risk of autism and intellectual disability. Importantly, anemia diagnosed after the 30th week of pregnancy was not associated with a higher risk for any of these conditions.

“A diagnosis of anemia earlier in pregnancy might represent a more severe and long-lasting nutrition deficiency for the fetus,” says Renee Gardner, project coordinator at the Department of Public Health Sciences at Karolinska Institutet and the study’s lead researcher.

“Different parts of the brain and nervous system develop at different times during pregnancy, so an earlier exposure to anemia might affect the brain differently compared to a later exposure.”

The researchers also noted that early anemia diagnoses were associated with infants being born small for gestational age while later anemia diagnoses were associated with infants being born large for gestational age.

Babies born to mothers with late-stage anemia are typically born with a good iron supply, unlike babies born to mothers with early anemia.

Although researchers could not specify whether iron deficiency anemia is more detrimental than anemia caused by other factors, iron deficiency is by far the most common cause of anemia. Investigators say the findings may thus support regular iron supplementation in maternity care.

Scientists emphasize the importance of early screening for iron status and nutrition counseling but note that more research is needed to find out if early maternal iron supplementation could help reduce the risk of neurodevelopmental disorders in children.

Adult women 19 to 50 years old typically need 18 mg of iron per day, though needs increase during pregnancy. Since excessive iron intake can be toxic, pregnant women should discuss their iron intake with their midwife or doctor.

Source: JAMA

European Study: Changing Roles & Family-Friendly Policies Make For Happier Parents

New research from the University of Zurich (UZH) finds that mothers and fathers today are happier with their lives than parents were 20 or 30 years ago, thanks mainly to evolving roles.

Greater freedom of choice and the increased equality of mothers and fathers have been supported as well by government and employer policies for families.

According to researchers, motherhood is no longer seen as an obligatory part of female identity and fulfillment. It is no longer automatically expected that mothers will give up paid work, and it is becoming increasingly normal for fathers to have a more active role in raising and caring for children.

Researchers from the UZH along with sociologists from Germany investigated how these new societal expectations altered the life satisfaction of mothers and fathers. For their empirical work, investigators evaluated information garnered from a long-term study of individuals living in Germany.

The database provides information on more than 18,000 women and almost 12,000 men who were surveyed between 1984 and 2015. “While in the last few years the prevailing message in the media is that modern parents are under great stress or even regret having become parents, our analysis shows the opposite,” said first author Dr. Klaus Preisner from the UZH Institute of Sociology.

In surveys in the 1980s, most mothers were less satisfied with their lives than women without children. The idea of having a “little bundle of joy” that would bring great happiness — which stemmed in part from the taboo against speaking negatively of motherhood in any way — did not translate to reality for many women.

“With the increasing freedom to choose whether or not to have a child and to shape parenthood more individually, the ‘maternal happiness gap’ has closed. Today we no longer find a difference in the life satisfaction of mothers and of women without children,” Preisner said.

Researchers discovered the picture is different for men: In the past, in contrast to women, men were not expected to take an active role in childcare, to take parental leave or to reduce their working hours after having children.

Although that situation is different today, the life satisfaction of men has barely changed as a result. What’s more, there is no difference in life satisfaction between fathers and men without children.

“Fathers who step up to meet the new expectations placed on them are increasingly rewarded with public praise for their commitment,” said Preisner.

Alongside changed normative expectations in Germany, new political measures have been introduced, such as support for parental leave after the birth of a child and childcare for small children outside the family.

On the one hand, such changes mean mothers and fathers can choose more freely how they want to arrange their family lives with regard to childcare. On the other, the roles and responsibilities are more equally distributed between mothers and fathers nowadays. Both these aspects have a positive effect on parents’ life satisfaction.

Researchers report that the greater freedom of choice and the increased equality of mothers’ and fathers’ roles has been encouraged — and in some cases even made possible at all — by modern policies for families.

Parental leave enables mothers and fathers to share childcare responsibilities and to be involved in their children’s upbringing. In addition, subsidized childcare outside the home, such as that in Germany, also makes it easier for families to combine parenthood and employment.

Preisner also sees another advantage: “These family-friendly political measures are not only significant for equality between the sexes. They are just as important for their role in improving life satisfaction of parents, and thus ultimately of children.”

Source: University of Zurich

Common Household Drugs Often Used By Youth in Suicide Attempts

A new study finds that adolescent suicide attempts by self-poisoning often involve common household medications, such as ibuprofen or antidepressants.

The findings, published online in the journal Clinical Toxicology, also reveal that self-poisoning suicide attempts are more common in rural communities, particularly during the academic school year.

The study expands on previous research that looked at the incidence and outcomes from intentional suspected-suicide self-poisoning in children and young adults ages 10 to 24 years old from 2000-2018.

In that 19-year time frame, there were more than 1.6 million intentional suspected-suicide self-poisoning cases in youth and young adults reported to U.S. poison centers. The majority of cases were female (71%), and involved a pharmaceutical (92%).

“While most of these cases involved medications, with adolescents, any available medication can be a potential hazard,” said Henry Spiller, M.S., D.ABAT, director of the Central Ohio Poison Center at Nationwide Children’s Hospital, and co-author of the study.

“It’s not so much a matter of substance type, but rather a matter of access to the substance. Any type of medication can be misused and abused in ways that can unfortunately lead to very severe outcomes, including death.”

The two most common substance groups in all age groups were over-the-counter (OTC) painkillers such as acetaminophen, ibuprofen and aspirin, followed by antidepressants. In youth (ages 10-12) and adolescents (ages 13-15), ADHD medications were common, and had the highest risk of serious medical outcomes. Opiates only accounted for 7% of cases with serious medical outcomes.

“Because medications are so readily available in homes, many families do not take precautions to store them safely. Our findings suggest this is a big problem,” said John Ackerman, Ph.D., clinical psychologist and suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children’s, and co-author of the study.

“Medications can be part of effective treatment, but they require an extra layer of care. The answer is not to stop prescribing medications to those who stand to benefit, but rather to emphasize the practice of safe storage and vigilance when administering any kind of medicine, especially when children and teens live in the home.”

The findings also show that states with a lower population per square mile (rural areas) had a greater number of reported cases with all outcomes and serious medical outcomes.

Results also revealed there was a significant decrease in the number of cases in school-aged individuals during non-school months of June through August (27.5% decrease in 10-12-year-olds; 27.3% decrease in 13-15-year-olds; and 18.3% decrease in 16-18-year-olds), compared with school months September through May.

Nationwide Children’s Big Lots Behavioral Health experts recommend that parents check in with their children regularly, and ask them directly how they are doing and if they have ever had thoughts about ending their life. These direct questions are even more critical if warning signs of suicide are observed.

Medications should be stored up, away and out of sight, preferably in a locked cabinet. Administration of medicine should always be supervised.

“It should concern us that youth in rural areas are about twice as likely as those living in urban areas to die by suicide. Although we are in dire need of more research to help us understand what places some people at more risk than others, available evidence indicates that include increased social isolation, stigma, access to lethal means and lack of appropriate mental health resources may play a role in this disparity,” said Ackerman.

His suicide prevention team provides comprehensive training to more than 140 central and southeast Ohio schools with the SOS Signs of Suicide program.

“It is vital that parents, teachers and other trusted adults start conversations about mental health early, and pay even closer attention during the school year, as rates of anxiety and depression are shown to increase during that time. Warning signs can often be detected and support is available for young people in crisis.”

Source: Nationwide Children’s Hospital