Category: Paediatrics

Categories : Neurology PaediatricsTags :

New Brain Stimulation Technique Improves Short Term Social Skills in Children with Autism

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Accelerated continuous theta burst stimulation (a-cTBS) may be a “viable and scalable therapeutic option” say researchers 

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A new non-invasive brain stimulation technique known as accelerated continuous theta burst stimulation (a-cTBS) improves social communication at one month follow up and has a favourable safety profile in children with autism, finds a trial from China published by The BMJ today.

The researchers say the findings suggest that a-cTBS may be “a viable and scalable therapeutic option for children with autism spectrum disorder.”

Preliminary results from a recent pilot study suggest that a-cTBS is safe and effective for enhancing social communication in children with autism. A key advantage of a-cTBS is its shorter sessions compared with conventional brain stimulation, making it more suitable for children.

To build on this work, the researchers investigated the effectiveness and safety of a five day a-cTBS protocol in improving social communication among children with autism, including younger children and those with intellectual disability.

The trial involved 200 children (167 boys and 33 girls) aged 4-10 years with autism recruited from three academic hospitals in China from July 2023 to October 2024, half of whom also had intellectual disability.

The children were randomised to receive either active a-cTBS (intervention) or sham (control) treatment for five consecutive days (10 sessions each day). The stimulation targeted the brain’s left primary motor cortex, which is linked to movement, language, and social cognition.

The researchers used the Social Responsiveness Scale (SRS-2) to measure changes in social communication impairment from baseline to post-intervention and from baseline to one month follow-up. Language improvements were also assessed using three recognised measures.

A total of 193 participants completed the full five day intervention course. Compared with the sham group, the a-cTBS group showed significantly greater improvements in social communication from baseline to post-intervention and from baseline to one month follow-up, with mean difference impairment score reductions of -6.25 and -6.17, respectively.

The a-cTBS group also showed greater improvements in language abilities. This finding was supported by a small effect size (Cohen’s d) ranging from 0.12 to 0.47, representing the difference between the two group means.

Adverse events were more frequent in the a-cTBS group than in the sham group (54.5% v 29.3%), with restlessness and scalp discomfort being the most common. All adverse events were mild to moderate and resolved spontaneously.

The researchers acknowledge some limitations with the SRS-2 measure and potential bias from greater treatment expectancy in the intervention group. The trial also had a short one-month follow-up and more than 80% of participants were boys.

However, they point out that the inclusion of young children and those with intellectual disability supports the protocol’s broad applicability, and consistent effects across sensitivity analyses provides greater confidence in their conclusions.

As such, they say their results suggest that a-cTBS may be “a feasible, effective, and scalable therapeutic option for children with autism spectrum disorder, including those with intellectual disability” and their protocol “represents a major advancement towards equitable autism care worldwide.”

In a linked editorial, researchers in Hong Kong agree that the findings show promise, but advocate for cautious optimism.

They note that while “a-cTBS should not replace psychosocial support or educational adaptation,” it “may become an important component of a multimodal pathway for children with autism with significant social communication difficulties,” provided it is “further replicated and integrated thoughtfully with behavioural care.”

Source: The BMJ Group

Categories : PaediatricsTags :

WHO Prequalifies First-ever Malaria Treatment for Infants

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Ahead of World Malaria Day on 25 April, the World Health Organization (WHO) has announced a significant step forward in the fight against malaria with the prequalification of the first treatment developed specifically for newborns and young infants weighing between two and five kilograms. The prequalification designation indicates that the medicine meets international standards of quality, safety and efficacy, and will help to expand access to quality-assured treatment for one of the most underserved patient groups.

The newly prequalified treatment, artemether-lumefantrine, is the first antimalarial formulation designed specifically for the youngest malaria patients. Until now, infants with malaria have been treated with formulations intended for older children, which increase the risk of dosing errors, side effects and toxicity. WHO prequalification will enable public sector procurement, contributing to closing a long-standing treatment gap for some 30 million babies born each year in malaria-endemic areas of Africa.

“For centuries, malaria has stolen children from their parents, and health, wealth and hope from communities,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “But today, the story is changing. New vaccines, diagnostic tests, next-generation mosquito nets and effective medicines, including those adapted for the youngest, are helping to turn the tide. Ending malaria in our lifetime is no longer a dream – it is a real possibility, but only with sustained political and financial commitment. Now we can. Now we must.”

New prequalified tests

On 14 April 2026, WHO also prequalified three new rapid diagnostic tests (RDTs) designed to address emerging diagnostic challenges for malaria. The most common malaria RDTs for P. falciparum parasite work by detecting the protein, known as HRP2. But based on reported studies and surveys in 46 countries, some strains of the malaria parasite have lost the gene that makes this protein – so they become “invisible” to HRP2-based RDTs, leading to false-negative results. In countries in the Horn of Africa, up to 80% of cases were missed, leading to delayed treatment, severe illness, and even death.

The new tests address this issue by targeting a different parasite protein (pf-LDH) that the malaria parasite cannot easily shed. They provide a reliable, quality-assured alternative where HRP2-based tests are failing. WHO now recommends that countries switch to these alternative RDTs when more than 5% of cases are missed due to pf-hrp2 deletions. This ensures accurate diagnosis, appropriate treatment, and protects hard-won malaria control gains – especially for the most vulnerable communities.

Source: World Health Organization

Categories : PaediatricsTags :

Family Environment Shapes Life Outcomes Across Generations

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Source: CC0

Adopted children who have grown up in more favourable family environments than their siblings are at lower risk of mental health issues, criminality and social problems – benefits that, in some cases, extend to the next generation. These are the findings of a new study of Swedish siblings published in The BMJ.

Children who grow up in difficult family circumstances are at greater risk of experiencing problems later in life. These may include mental health issues, difficulties at school or criminal behaviour. 

To determine the extent to which these factors can be influenced, researchers at Karolinska Institutet studied pairs of siblings in Sweden where one sibling was adopted away from a high-risk family while the other remained with and grew up with their biological parents. This allowed them to compare the long-term effects of different family environments while taking genetic factors into account.

“Our study shows that a more favourable home environment can make a big difference, particularly for children who start life with clear risk factors,” says Erik Pettersson, associate professor at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet.

Followed over 12 000 siblings

The study is based on Swedish population registers and covers just over 12 000 full and half-siblings born between 1950 and 1980. All come from families where at least one parent had experienced some form of psychiatric or social issue, such as mental illness, criminality or attempted suicide, and where at least one child had been given up for adoption before the age of ten. Families who took in adopted children often had greater resources and higher socio-economic status.

The results show that the adopted children had a lower risk of mental illness, criminality and dependence on social security benefits as adults, compared to their siblings who grew up with their biological parents. They also performed better at school and, on average, attained a higher level of education. Furthermore, men who had been adopted performed better during military conscription, both on intelligence tests and in interviews measuring stress resilience and social adaptability.

May affect the next generation

The researchers also investigated whether these differences were passed on to the next generation. In total, nearly 22,000 children of the sibling pairs were studied. 

On average, the children of adopted siblings displayed higher functioning than their cousins, for example a lower risk of criminality and financial problems. The effects were weaker than in the previous generation, but pointed in the same direction.

“This suggests that improved living conditions benefit not only the individual, but also the next generation,” says Erik Pettersson.

Value of support measures

He emphasises that the results should not be seen as an argument for adoption, which is currently uncommon in Sweden. However, he believes the study highlights the value of interventions for children in vulnerable environments.

“Research into the effects of various support measures aimed at giving children a better upbringing is both limited and fragmented,” he says. “Some studies show significant long-term benefits; others show little or none at all. Our study suggests that the potential is considerable, even though we cannot say which measures are most important.” 

Source: Karolinska Institutet

Categories : PaediatricsTags :

Common Fluid Treatments for Paediatric Sepsis Found to Have Similar Efficacy and Safety

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Trial found that balanced fluids and saline solution are equally effective for treating patients and reducing the risk of major adverse kidney events

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A major study, led by researchers at Children’s Hospital of Philadelphia, Nemours Children’s Health, and Children’s National Hospital, found that different types of crystalloid fluid resuscitation were equally effective for staving off the most serious adverse kidney events after the treatment of paediatric patients with suspected septic shock. The findings of this large clinical trial are detailed in a study published by The New England Journal of Medicine and are being presented at the Pediatric Academic Societies (PAS) Meeting in Boston.

Sepsis is a life-threatening response to infection that causes organ failure. The combination of the body’s immune system and the infection together cause an abnormal response, which can prevent different organ systems from working normally. While many decades of research and improvements in clinical care have significantly improved outcomes for paediatric sepsis patients, about 1 in 10 children in the US with sepsis or septic shock are still at risk of dying.

In some previous multi-centre studies, researchers found that critically ill adults who received balanced crystalloid fluid – an intravenous (IV) treatment meant to exhibit similar properties to human plasma – resulted in lower risk of complications and death compared with a standard 0.9% saline IV solution. This prompted researchers to explore whether a similar study could determine whether one fluid treatment was superior for pediatric sepsis patients.

“We knew we were going to need thousands of patients to answer this question, which we knew would be a challenge,” said co-lead author Fran Balamuth, MD, PhD, an attending physician and Division Chief of Emergency Medicine at CHOP. “Yet we were excited to proceed because these fluids are inexpensive and universally available around the world, meaning that we wouldn’t have decades of waiting to take action once the study was complete; we could be pragmatic and take immediate action based on the results that we found.”

Because suspected cases of sepsis are uncommon among the general population, Balamuth, co-lead author Scott L. Weiss, MD, attending physician and Division Chief of Critical Care at Nemours Children’s Hospital, Delaware, and their colleagues required the collaboration of many hospitals to achieve the data standards needed for meaningful conclusions. For this, they collaborated with Nathan Kuppermann, MD, Executive Vice President and Chief Academic Officer of Children’s National Hospital and Director of the Children’s National Research Institute, who has a history of running successful clinical trials in acutely ill children, and served as the senior author.

“This trial demonstrates the power of large collaborative research networks to answer important clinical questions for children,” Kuppermann said. “By enrolling thousands of patients across multiple countries, we were able to provide the kind of evidence clinicians need to guide care for children with suspected septic shock.”

In the end, a total of 47 emergency departments across five countries were represented in the study, with more than 9000 patients enrolled who received either balanced fluid or 0.9% saline.

The primary outcome of the study was Major Adverse Kidney Events by 30 days (MAKE30), an important outcome for kidney injury that accounts for death, new renal replacement therapy or persistent renal dysfunction. The researchers found that MAKE30 occurred in 3.4% of patients enrolled in the balanced fluid group and 3.0% in the 0.9% saline ground. The study found biochemical differences in children treated with the two fluids, including a higher frequency of elevated blood chloride levels in the 0.9% saline group, and higher lactate levels in the balanced fluid group. Both groups had 23 median hospital-free days of 28, and there were no differences in mortality or other safety outcomes or adverse events. 

“This trial confirms that either balanced fluid or 0.9% saline are effective and safe for the initial resuscitation of children with suspected septic shock, and that a fluid strategy that reduces hyperchloraemia does not necessarily translate to improved patient outcomes,” said Weiss, an attending physician and Division Chief of Critical Care at Nemours Children’s Hospital, Delaware. “We also did not identify differences across subgroups. However, despite the large number of participants, it is important to note that we cannot exclude the possibility of benefit of one fluid or the other in a subset of children with the most severe illness.”

“A large trial like this definitively answers a question we’ve had in our field for many, many years,” Balamuth said. “In an emergency department with a child with suspected sepsis, you can treat the child with whichever fluid is readily available. And we think that’s great news for children around the world.”

Source: EurekAlert!

Categories : Cardiovascular Disease PaediatricsTags :

Benefits of Physical Activity May Outweigh Risks for Kids with Cardiomyopathy, ICDs

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With proper assessment and monitoring, the risk of serious heart events during physical activity may be lower than previously believed for children and adolescents with certain heart conditions, according to a new American Heart Association scientific statement

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Physical activity in children and teenagers with cardiomyopathy (conditions that affect the heart muscle’s structure and function, impairing its ability to pump or fill effectively), as well as children with implantable cardioverter-defibrillators (ICDs) may be safer than previous research suggested, according to a new scientific statement from the American Heart Association, published today in the Association’s flagship peer-reviewed journal Circulation.

While physical activity and exercise are essential for childhood development and long-term health, they have been traditionally discouraged among children and adolescents with cardiomyopathies and ICDs (implantable devices that detect life-threatening abnormal heart rhythms and deliver electrical shocks) due to concerns that they could worsen heart function or lead to sudden cardiac death.

“While safety is always paramount, halting all physical activity among children with cardiomyopathy or ICDs has at times led to unintended consequences. The latest research indicates that restricting children’s movement can negatively affect their heart health, physical fitness levels, mental well-being and social development, and quality of life,” said Jonathan B. Edelson, MD, MSCE, chair of the scientific statement writing group, an associate professor of paediatrics and medical director of the sports cardiology program and heart transplant and ventricular assist device programs in the division of cardiology at Children’s Hospital of Philadelphia.

What do parents and caregivers need to know?

Ensuring safe participation in physical activity requires thoughtful, individualized planning and ongoing collaboration among clinicians, families and patients.

  • Personalised approach: Tailored risk assessments based on diagnosis, risk profile, genetic profile and clinical evaluations are critical to better guide decisions about prescribing physical activity for children with different types of cardiomyopathies. Various diagnostic screening tools, such as echocardiograms, cardiac imaging and exercise stress tests, can be used to assess symptoms at rest and with activity. Genetic testing and family screening can also be helpful to assess individual risk.
  • Shared decision-making: Clinicians, families and (when developmentally appropriate) children or adolescents with cardiomyopathy and/or ICDs can work together to balance a patient’s risk, patient- and family-tailored goals and values. It is important for clinicians to disclose when risk evidence is based on adult data.
  • Close follow-up and reassessment: Ongoing monitoring is important to track potential shifts in risk, assess if symptoms progress and evaluate if heart function improves or deteriorates. The recommendations for safe physical activity must evolve as the child grows, activities change and the disease progresses.


Close follow-up and reassessment: Ongoing monitoring is important to track potential shifts in risk, assess if symptoms progress and evaluate if heart function improves or deteriorates. The recommendations for safe physical activity must evolve as the child grows, activities change and the disease progresses.

What types of activities can be considered?

The new scientific statement aims to shift from adopting a one-size-fits-all approach to physical activity limitations to considering ways for youth with heart conditions or an ICD to safely participate in physical activities – from low-intensity daily activities to high-intensity training and sports in select cases – after a detailed individualised risk assessment.

Light-to-moderate intensity exercise (such as walking, light cycling or swimming) may be appropriate to maintain physical fitness, social development and quality of life, with regular monitoring of their condition. Structured physical activity, such as fitness classes, strength training, running, biking, hiking or organised sports programs, may be reasonable for some children and adolescents with heart conditions. For some carefully selected paediatric patients with certain cardiomyopathies, participation in physical activity including competitive sports may be reasonable after expert assessment and shared decision-making discussion about the risks and benefits. Emergency action plans, including AED (automated external defibrillator) access and bystanders trained in CPR, are essential during organised sports. Additional guidance for specific types of cardiomyopathies are detailed in the manuscript.

“Children with cardiomyopathy should not automatically be sidelined from participating in physical activity, including recreational or competitive sports,” Edelson said. “Most children should be physically active – with individualised evaluation, monitoring and planning. Physical activity is important for their long-term health, physical and social development.”

The statement notes more research is needed about childhood cardiomyopathies because most of the findings in the statement are based on observational studies in adults; therefore, findings should be applied cautiously to a paediatric population. In addition, outstanding questions remain, such as how moderate or vigorous exercise may affect the long-term progression and how risk varies across different types of cardiomyopathies.

Source: American Heart Association

Categories : Neurology PaediatricsTags :

Early Warning Signs of Brain Infection in Children Identified in New Study

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Despite new diagnostic methods and expanded vaccination programmes, many children in Uganda continue to suffer from severe brain infections. This is shown in a new study from Karolinska Institutet, published in The Lancet Regional Health – Africa. The researchers’ analysis highlights simple clinical signs that can help healthcare providers more quickly identify children at high risk of death.

The study followed 212 children aged 0 to 12 who were treated for suspected central nervous system infections at two hospitals in southwestern Uganda. Fifteen per cent of the children died during hospitalisation, and 18 per cent were discharged with neurological disabilities such as seizures or muscle weakness. Malaria and the bacterium Streptococcus pneumoniae were the most commonly identified causes.

Simple observations can provide crucial information

“Our results show that even in settings where advanced diagnostics are not always available, simple clinical observations can provide crucial information about which children are in greatest need of rapid care,” says Phuthumani Mlotshwa, doctoral student at the Department of Global Public Health and the study’s first author.

The infections were caused by several different microorganisms. Malaria was detected in 20 per cent of the children, and bacteria in the cerebrospinal fluid in 11 per cent. For nearly half of the cases, no specific pathogen could be identified, which the researchers say underscores the need for improved diagnostic tools.

“The combination of high mortality and significant disabilities among survivors shows that we need to strengthen prevention, diagnostics, and follow-up,” says Giulia Gaudenzi, researcher at the same department and the study’s senior author.

Source: Karolinska Institutet

Categories : PaediatricsTags :

Trial Shows Bone Healing ‘Superpower’ in Children

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Most children with a severely broken wrist can be treated without surgery, according to a major NIHR-funded UK trial led by researchers at the University of Oxford. The findings suggest that a non-surgical, cast-first approach delivers similar long-term recovery while reducing the risks associated with surgery and costs.

Broken wrists are among the most common injuries in children accounting for about half of children’s fractures. Severely displaced distal radial fractures, where the bones move out of place, are often routinely treated with surgery. However – unlike adults – children have a remarkable ability to straighten broken bones, in a process called remodelling.

Researchers questioned whether a plaster cast would achieve the same long-term result without exposing children to the risks of an operation.

Professor Matt Costa, senior author and Professor, Orthopaedics Trauma Surgery at the Kadoorie Institute, University of Oxford said: ‘These fractures can look very severe on an X-ray, which has traditionally led to surgery to straighten the bone. But because children’s bones are still growing, they have a remarkable capacity to heal. Until now, there has been limited high-quality evidence on whether surgery was always necessary.’

The CRAFFT trial (Children’s Radius Acute Fracture Fixation Trial) was funded by the National Institute for Health and Care Research (NIHR) and supported by the NIHR Biomedical Research Centre: Oxford. It recruited 750 children aged 4–10 from 49 hospitals across the UK. Participants were randomly assigned to receive either surgical fixation or treatment with a plaster cast.

Patients were measured at regular intervals against a set of criteria. At three months, children who had surgery reported slightly better arm function, but the difference between groups was very small. By six and 12 months, there was no difference in recovery, suggesting that early advantages with surgery do not persist.

There were complications following surgery, including infections, scarring and nerve irritation. Non-surgical treatment, which avoids anaesthesia and operative intervention, was shown to reduce NHS costs by around £1,600 per patient on average.

The trial was designed with input from families, who helped define what level of improvement would be meaningful enough to warrant surgery. The observed difference between treatments fell below this threshold.

Professor Dan Perry, NIHR Research Professor and Children’s Orthopaedic Surgeon at Alder Hey Children’s Hospital and the University of Liverpool, and lead author, said: ‘It is astonishing that children have the ability to grow bent, broken bones straight again. It really is a superpower that is unique to children. From both a clinical and health system perspective, these findings are important. Adoption of these results could reduce the number of children exposed to the risks of anaesthesia and surgery, and ease pressure on healthcare services without compromising recovery.’

The results, published in The Lancet, support wider adoption of a cast-first approach for most children with these injuries.

Source: NDORMS, University of Oxford

Categories : Mental Health PaediatricsTags :

Study Identifies Why Nightmares Persist in Children and How to Break the Cycle

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Recently published research from the University of Oklahoma and the University of Tulsa proposes a new model to explain why nightmares can persist over time in children and how therapy can be designed to break that cycle.

The study, published in Frontiers in Sleep, introduces the DARC-NESS model, a mnemonic for the factors that can keep a child stuck in chronic nightmares. At the centre of the model is “nightmare efficacy,” or the idea that children can learn skills to rid themselves of nightmares and restore good sleep.

“The DARC-NESS model looks at the mechanisms of what is maintaining nightmares, as well as the mechanisms that can break the cycle of nightmares,” said Lisa Cromer, PhD., a professor of psychology at the University of Tulsa and a volunteer child psychiatry faculty member at the OU School of Community Medicine in Tulsa. “It’s a child’s response to a nightmare that causes the chronic nightmares to happen, which means if we can learn to respond to nightmares differently, then we can interrupt that cycle. It’s empowering to understand that we can take steps to master our dreams.”

Rather than focusing only on the content of a nightmare, the model encourages clinicians to consider a broader set of factors, including how a child interprets the dream, worries about going to sleep, experiences anxiety at bedtime and copes after waking.

That information can help guide a personalized treatment plan instead of a one-size-fits-all approach. For some children, treatment may focus on reducing bedtime anxiety. Others may benefit from improving sleep habits or participating in exposure-based therapy, such as describing, writing about or drawing the nightmare and then working with a clinician to “rewrite” it.

“We believe we have created a way to conceptualize why nightmares persist and how we can better treat them in kids,” said OU Health child and adolescent psychiatrist Tara Buck, MD, an associate professor at the OU School of Community Medicine in Tulsa. “What’s unique about the model is that it’s customisable to what the patient needs, and it focuses on what the patient can control. We look for the potential intervention points and target those in a collaborative way with patients and their families.”

Unlike insomnia, in which people fear they won’t sleep, children with chronic nightmares are afraid they will sleep. According to Buck, helping children build confidence in their ability to address nightmares can have benefits far beyond sleep.

“Self-efficacy is at the heart of the model,” she said. “When children feel empowered to do something about the nightmares, they begin to see how things are interconnected – because they’re sleeping better, they have more energy, they go to school more consistently and their parents report improved behaviour.”

The model is designed for use by a range of clinicians, including therapists and pediatricians. For many years, health care providers either assumed that nightmares couldn’t be treated or that they would go away if an underlying trauma or mental health condition were addressed. However, that’s not always the case.

“We’ve worked with children who have been in mental health treatment for a long time and their nightmares are still persistent,” Buck said. “There is a need for a nightmare treatment model to help children when their nightmares are recurrent and distressing.”

“A nightmare is a bad dream that you wake up from,” Cromer said. “If you don’t wake up, then the brain is doing its job of resolving the fear of the dream. But if a child does wake up, they’re trying to escape the nightmare. And when a child wakes up, they’re not able to resolve the nightmare, which actually exacerbates the problem. That’s why nightmares are so important to treat.”

By April Wilkerson

Source: Oklahoma University

Categories : PaediatricsTags :

How Unsupervised Screen Time Harms Vulnerable Preschoolers

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Strong evidence ties early language difficulties to later adjustment challenges. Can environmental factors make these problems worse? In a new study, FAU researchers, in collaboration with Aarhus University in Denmark, find that unsupervised or “solo” screen time worsens the behavioural and emotional challenges confronting young children with limited language skills. A total of 546 4- to 5-year-old children from 24 childcare centres in Denmark were followed for six months. Investigators assessed their language abilities, behavioural adjustment and the amount of time the children spent watching screens alone.

The study findings, published in the journal Research on Child and Adolescent Psychopathology, found that solitary screen time acts as an amplifier, exacerbating conduct problems in children with poor communication skills and low productive vocabulary. The results highlight the critical role of the home learning environment in early childhood development. For children who struggle with language skills, time spent alone with a screen is time not spent mitigating risks through healthy social engagement with parents or friends.

Early problems with language can have a lasting negative impact on social and emotional development. Building on this foundation, a new groundbreaking study from Florida Atlantic University and Aarhus University in Denmark tests the hypothesis that unsupervised, solitary screen time during early childhood increases the likelihood that language difficulties will lead to socioemotional difficulties.

The study, published in Research on Child and Adolescent Psychopathology , found that pathways from poor communication skills and low productive vocabulary to later adjustment problems were particularly strong among preschool- and kindergarten-aged children who averaged at least 10 to 30 minutes of solitary screen time per day across the course of a week.

Study participants were 546 4- and 5-year-olds (264 girls, 282 boys) attending 24 population-based childcare centers across 13 municipalities in Denmark. Teachers completed assessments twice of child adjustment difficulties, such as conduct and emotional problems, over the course of about six months during a single school year. At the outset, teachers administered standardized tests of child language abilities, including communication skills and productive vocabulary. Parents reported on solitary screen time, which was defined as the average number of hours per week that children spent alone viewing handheld devices or television, excluding screen time supervised by or consumed with an adult.

Consistent with several previous studies, there were longitudinal associations from oral language problems to later adjustment difficulties. Across the six-month period, poor communication skills and high levels of solitary screen time separately predicted escalating emotional difficulties.

Unique to this study was the finding that solo screen time magnified problems arising from language difficulties. Associations from low productive vocabulary and poor communication skills to increases in conduct problems were strongest among children whose parents reported that their children were well above average in solitary screen time exposure.

“Unsupervised screen time forecloses opportunities for social engagement that might mitigate the behavioral risks that follow from language problems,” said Brett Laursen, Ph.D., senior author and a professor of psychology in FAU’s Charles E. Schmidt College of Science.

Laursen uses an economics model to explain the results. Economists define opportunity costs as losses attached to a choice. If an adult stays up late with a book, the opportunity cost of reading is a good night’s sleep.

“The opportunity costs of solitary screen time can be particularly steep for vulnerable youth. Children have a finite number of free time hours in a day,” said Laursen. “Every hour a child spends alone with a device is an hour they aren’t engaged in social interactions that boost language skills. It is an hour not spent practicing the social and emotional skills required to build friendships. Screens don’t demand compromise, sharing or dialogue – the exact skills that children with communication difficulties need to practice.”

Young children learn language from in-person interactions – very little is acquired from video screens. Further, electronic media cannot replace the rich social experiences children gain from play and engagement with peers.

“Young children with limited language skills are already at risk for social and emotional challenges,” said Molly Selover, lead author and an FAU doctoral student in psychology. “There is little reason to expect that screens help children overcome the adaptive challenges posed by oral language problems and many reasons to suspect that they make matters worse.”

Excessive screen use by young children is widespread: the World Health Organization recommends no more than one hour per day for children ages 2 to 5, yet a global review found that two-thirds of households exceed this limit. In the United States, about half of young children spend more than two hours a day on screens during the week, with even higher use on weekends. Of course, both content and supervision matter.

For children ages 2 to 5, the American Psychological Association encourages parents to limit screen time to no more than one hour per day and to co-view and interact with their children during this time rather than using the screen as a babysitter. They also note that the quality of the content on screens is extremely important, perhaps more important than the total amount of time spent viewing.

The authors say that high caliber content has documented benefits for children, especially as children get older. Unfortunately, when left to their own devices, many young children prefer fast-paced, brief and highly stimulating content, some of which may be age-inappropriate.

“Electronic media is as an integral component of the home learning environment; many children spend more time with tablets and phones than with toys, books and friends,” said Selover. “Like other home environment risks, solitary screen time poses a unique peril to young children with heightened vulnerabilities. Adults tend to think of screens as pleasant distractions and may use them as convenient babysitters. But for preschool children with language vulnerabilities, unsupervised screen time is not benign – it can be an active barrier to well-being.”

The authors acknowledge that their findings may not be popular. Screens are a ubiquitous part of everyday life. Nevertheless, they encourage parents to carefully scrutinize how young children engage screens.

“The findings matter because they show that an all-too-common environmental risk – elevated solitary screen time – can worsen behavioural and conduct challenges for children who face an already difficult developmental path,” Selover said.

By gisele galoustian | 4/6/2026

Source: Florida Atlantic University

Categories : Healthcare Politics and Regulations PaediatricsTags :

World is Falling Behind on UN’s Child Mortality Sustainable Development Goal

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Despite a 63% drop in under-five deaths since 1990, more than a quarter of countries won’t reach the UN’s 2030 child mortality target on time, with sub-Saharan Africa lagging the most

Years in which the U5MR reduction target is expected to be achieved. U5MR: under-5 mortality rate. 
Image credit: Cao et al., 2026, PLOS One, CC-BY 4.0

A new study tracking global progress on child mortality finds that the world will miss a key United Nations (UN) health target by at least five years at current rates, with the burden falling heavily on Sub-Saharan Africa. The findings are published on April 1, 2026, in the open-access journal PLOS One by Min Liu of Peking University, Beijing, China, and colleagues.

The UN’s Sustainable Development Goal 3.2 calls for all countries to reduce the mortality rate for children under five to fewer than 25 deaths per 1000 live births by 2030. As that deadline approaches, there has been no comprehensive assessment of where countries stand.

In the new study, researchers used data from the UN to analyse annual under-five death counts and mortality rates from 1990 to 2023 across 200 countries and territories. They calculated the rate of change in mortality over time and used those trends to project when those countries still above the target threshold would be expected to reach it.

The researchers found that globally, under-five deaths fell by 63% over the study period – from nearly 13 million in 1990 to 4.78 million in 2023 – and the mortality rate dropped by an average of 3.18% per year. However, the global rate still stands at 36.72 deaths per 1000 live births, well above the SDG target, and is not projected to reach the target until 2035. 133 countries have already met the target and nine more are on track to do so by 2030. However, 58 countries will miss the deadline, including 25 that are not projected to reach the target until after 2050, and Dominica, where under-five deaths have risen. More than four-fifths of all under-five deaths worldwide are concentrated in just two regions: Sub-Saharan Africa, where the mortality rate remains at 68.82 deaths per 1000 live births and is not projected to meet the SDG target until 2055, and Central and Southern Asia.

The study is limited by the assumption that trends over the last two decades will continue unchanged. Data quality was also poor in some conflict-affected regions and low-income countries, the very places where child mortality is highest. 

The authors conclude that to meet UN targets, policymakers must focus on scaling up proven interventions – including skilled birth attendance, postnatal care, vaccination, improved nutrition, and treatment for common childhood illnesses – in every community, and especially in Sub-Saharan Africa.

Provided by PLOS