Table of Content

10 May 2025, Volume 33 Issue 5

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Professional Forum

Early identification and comorbidity of developmental coordination disorders in children

HUA Jing

2025, 33(5):  465-471.  DOI: 10.11852/zgetbjzz2025-0374

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Developmental coordination disorder (DCD) in children is a common neurodevelopmental disorder with a steadily increasing prevalence.It seriously impairs children's social adaptability and the development of their physical and mental health.Studies have shown that if DCD is not identified and intervened early, motor difficulties may persist and have long-term negative impacts on academic performance, social functioning, and mental health.Early identification and timely intervention are crucial for slowing disease progression, improving functional outcomes, and promoting social participation.Compared to adults, children with neurodevelopmental disorders have a higher rate of comorbidity.In clinical practice, in addition to accurately distinguishing DCD from other neurodevelopmental disorders, close attention should also be paid to its comorbid characteristics to facilitate the development of more precise and individualized diagnosis and treatment strategies.

Original Articles

Comorbid sleep and behavioral problems in preschool children with developmental coordination disorder

LIN Senran, LI Huizhen, HUANG Songsong, HUA Jing

2025, 33(5):  472-477.  DOI: 10.11852/zgetbjzz2025-0239

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Objectives To investigate the comorbid sleep and behavioral problems in preschool children with developmental coordination disorder (DCD), in order to provide evidence for early screening and intervention. Methods A cross-sectional study was conducted among 24 230 children aged 3 - 6 years in Shanghai Pudong New Area from June 24 to July 12, 2021.DCD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria combined with the Developmental Coordination Disorder Questionnaire (DCDQ)(DCDQ'07 andLittle DCDQ versions).The Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep problems, while the Conners Parent Symptom Questionnaire (PSQ) was utilized to evaluate hyperactivity symptoms. Results A total of 2 129 children (8.8%) were identified as suspected DCD.Compared to non-DCD children, those with suspected DCD exhibited significantly higher rates of overall sleep problems (84.2% vs. 70.0%, χ²=191.484, P<0.001) and hyperactivity symptoms (7.1% vs. 2.8%, χ²=113.54, P<0.001).Additionally, suspected DCD children scored higher across all CSHQ and PSQ subscales (P<0.001).Multivariate analysis confirmed that the association between DCD and these scores remained statistically significant (P<0.001) after adjusting for birth and family-related covariates. Conclusions Preschool children with DCD demonstrate more pronounced sleep and behavioral difficulties than their typically developed peers.However, the bidirectional mechanisms warrant further investigation.An early screening system incorporating multidimensional assessments should be established, along with individualized intervention strategies integrating motor rehabilitation and behavioral management.

Risk factors and nomogram prediction model of developmental coordination disorder in preschool children

WANG Fei, JIN Hua, WU Ting, SHEN Mengqing, WANG Yun

2025, 33(5):  478-483.  DOI: 10.11852/zgetbjzz2024-0855

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Objective To investigate the current status of developmental coordination disorder (DCD) among preschool children in Wujiang District, Suzhou City, to analyze its influencing factors, and to establish and validate a nomogram prediction model. Methods From September 2023 to January 2024, 341 preschool children in Wujiang District, Suzhou City, were randomly selected as the modeling set. From February to April 2024, 145 preschool children were randomly selected as the validation set. The Movement Assessment Battery for Children-2 (MABC-2) was used for screening, and the Developmental Coordination Disorder Questionnaire (DCDQ) was administered for surveys. The scores of MABC-2 dimensions and DCDQ were compared across different genders and age groups. Univariate and multivariate Logistic regression analyses were conducted to identify factors influencing DCD in preschool children. A nomogram prediction model was constructed, and receiver operating characteristic (ROC) curves and calibration curves were plotted to evaluate the discrimination and consistency of the model in internal (modeling set) and external (validation set) validation. Results Girls scored higher in manual dexterity but lower in aiming and catching compared to boys (t=2.811, 5.384, P<0.05). Girls and 6-year-old children scored higher in motor control, fine motor/writing abilities, and general coordination compared to boys (t=2.860, 5.775, 3.801) and 5-year-old children (t=4.372, 3.099, 2.679, P<0.05). Among the 341 preschool children in the modeling set, 31 cases of DCD were detected, yielding a detection rate of 9.09%. Independent risk factors for DCD included male gender (OR=2.072), father's education level of high school or below (OR=2.176), mother's education level of high school or below (OR=2.088), family annual income of <50 000 yuan (OR=2.551), and housing area of <75 m² (OR=5.138, P<0.05). In the nomogram model, housing area was the most influential factor (99.8 points), followed by family income (59.2 points), father's education level (48.8 points), mother's education level (45.5 points), and gender (44.0 points). The area under the ROC curve (AUC) for internal validation (modeling set) was 0.789 (95%CI: 0.691 - 0.878), indicating good discrimination. The Hosmer-Lemeshow goodness-of-fit test yielded a value of 4.202 (P=0.838), indicating good consistency. For external validation (validation set), the AUC was 0.737 (95%CI: 0.676 - 0.853), with good discrimination, and the Hosmer-Lemeshow goodness-of-fit test yielded a value of 6.782 (P=0.624), indicating good consistency. Conclusions The detection rate of DCD among preschool children in Wujiang District, Suzhou City, is relatively high. Factors such as gender, parental education level, family annual income, and housing area significantly influence the occurrence of DCD. The constructed nomogram model demonstrates good discrimination and consistency, providing an intuitive tool for predicting the risk of developmental coordination disorder in children.

Core symptoms of preschool children with developmental coordination disorders and their association with emotional and behavioral problems

XU Zhanbin, QIN Hongchao, XU Xiaojing, WANG Feiying

2025, 33(5):  484-488.  DOI: 10.11852/zgetbjzz2025-0290

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Objectives To investigate the core symptoms of children aged 3 - 6 years with developmental coordination disorder (DCD), and to analyze their association with emotional and behavioral problems, in order to provide evidence for comprehensive intervention strategies. Methods From October 2023 to December 2024, 126 children aged 3 - 6 years diagnosed with DCD were recruited from the Child Health Department of Nantong Maternal and Child Health Hospital, along with 126 age-matched healthy controls.Motor coordination was assessed using the Movement Assessment Battery for Children-Second Edition (MABC-2), and emotional/behavioral problems were evaluated using the Strengths and Difficulties Questionnaire (SDQ).The relationship between core DCD symptoms and emotional/behavioral outcomes was analyzed. Results The DCD group exhibited significantly lower MABC-2 scores in manual dexterity (15.83±2.75 vs.25.68±4.24), aiming/catching (10.13±2.11 vs.20.10±3.08), static/dynamic balance (21.62±3.27 vs. 28.37±4.60), and total motor coordination (46.92±4.56 vs. 74.38±6.72) compared to controls (t=5.813, 6.698, 4.621, 9.463, P<0.01).Abnormal SDQ rates in the DCD group were higher for emotional symptoms (15.08% vs. 6.35%), hyperactivity/inattention (33.33% vs. 8.73%), and total difficulties (11.90% vs. 4.76%) (χ² =5.019, 22.961, 4.208, P<0.05).Negative correlations were observed between DCD core symptoms (age, manual dexterity, aiming/catching, balance, total motor coordination) and SDQ emotional/behavioral problems (r:-0.52 to -0.10,P<0.05), while positive correlations existed with prosocial behavior (r＝0.18-0.33,P<0.05).Multivariate regression confirmed that static/dynamic balance (β =-0.47) and total motor coordination (β =-0.59) independently predicted reduced emotional/behavioral difficulties (P<0.01). Conclusions DCD children demonstrate significant deficits in fine/gross motor and balance skills, alongside elevated emotional/behavioral problems—particularly hyperactivity/inattention.Core DCD symptoms correlate with worse psychosocial outcomes, suggesting that symptom severity exacerbates functional impairments.Increased awareness, early screening, and targeted interventions are urgently needed to mitigate long-term developmental risks.

Effect of serum uric acid levels on metabolic syndrome and its components in children and adolescents

ZHU Bowen, WANG Tongshuai, WANG Xingyun, GUO Xirong

2025, 33(5):  489-496.  DOI: 10.11852/zgetbjzz2024-0565

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Objective To elucidate the impact of serum uric acid (SUA) on metabolic syndrome (MetS) and its components in children and adolescents, in order to provide a basis for the prevention of MetS in this population. Methods Demographic data, anthropometric measurements, and biochemical indicators were obtained from the China Health and Nutrition Survey (CHNS) database. Logistic regression models were used to assess the association between SUA and MetS. Additive and multiplicative models were employed to evaluate the interaction effects of age, sex, and body mass index (BMI) with SUA on MetS. Results A total of 591 children and adolescents aged 10 - 17 years were included, of whom 8.8% had central obesity, 6.9% had elevated fasting blood glucose, 12.4% had elevated blood pressure, 25.0% had hypertriglyceridemia (high TG), and 9.1% had low high-density lipoprotein (HDL). Hyperuricemia (HUA) was identified as a risk factor for MetS based on both Chinese criteria (OR=18.79,95%CI: 3.08 - 114.66) and Cook criteria (OR=7.53, 95%CI: 1.97 - 28.77). HUA was also significantly positively associated with MetS components, including central obesity, high TG, and low HDL. Subgroup analysis revealed that the associations between HUA and MetS, as well as its components (central obesity and hypertriglyceridemia), were more pronounced in males, the 10 - 12 age group, and the normal-weight group. Conclusion HUA is closely associated with the risk of MetS in children and adolescents, particularly in phenotypes characterized by central obesity, hypertriglyceridemia, and low HDL. These findings suggest that regular monitoring of SUA levels in children and adolescents, along with efforts to prevent HUA, is crucial for reducing the incidence and progression of MetS and related cardiovascular diseases.

Case-control study of the association between sleep and precocious puberty in children

FAN Yiwei, CHEN Xue, ZHANG Peng, XIAO Xianhe, LIU Hongxiu, LI Ruizhen

2025, 33(5):  497-502.  DOI: 10.11852/zgetbjzz2024-1092

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Objective To investigate the association between sleep and precocious puberty in children, in order to provide a scientific basis for the prevention and early intervention of precocious puberty. Methods This case-control study recruited children diagnosed with precocious puberty for the first time at Wuhan Children's Hospital between October 2022 and February 2024, along with healthy children from the health examination center as controls, matched 1∶1 with the precocious puberty group. A family health questionnaire was used to collect general demographic data and lifestyle habits, and the Sleep Disturbance Scale for Children (SDSC) was employed to assess the degree of sleep disturbances. A binary Logistic regression model was used to analyze the relationship between sleep disturbances and precocious puberty. Results A total of 274 participants were included in the study, with a mean age of (8.75±1.12) years. There were no statistically significant differences between the precocious puberty group and the control group in terms of sleep environment (χ²= 2.279) or the habit of sleeping with a night light (χ²=0.769) (P>0.05). However, significant differences were observed between the two groups in terms of mode of delivery (χ²=5.500), maternal age at menarche (χ²=4.202), parental history of precocious puberty (χ²=9.460), sex education exposure (χ²= 7.831), disorders of initiating and maintaining sleep (Z=2.968), excessive daytime sleepiness (Z=2.384), and total SDSC score (Z=1.968) (P<0.05). After adjusting for baseline characteristics, binary Logistic regression analysis indicated that more severe disorders of initiating and maintaining sleep were associated with a higher risk of precocious puberty(OR=2.30,95%CI: 1.06 - 5.00, P=0.036) and central precocious puberty (OR=3.20,95%CI: 1.23 - 8.35, P=0.017),and severity of excessive daytime sleepiness positively correlated with precocious puberty risk (OR=2.13, 95%CI: 1.09 - 4.14, P=0.026). Conclusions Both initiation and maintenance of sleep disorders and excessive daytime sleepiness are associated with an increased risk of precocious puberty in children, with higher scores correlating with greater risk.It warrants clinical attention and requires evidence-based interventions.

Associations between daily physical activity and family supportive factors for school-aged children

LI Yijia, ZHAO Hanhua, GAO Ying

2025, 33(5):  503-507.  DOI: 10.11852/zgetbjzz2024-0818

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Objective To assess the level of daily physical activity, and associations between daily physical activity and family supportive factors for school-aged children, in order to provide a reference for promoting children's physical activity. Methods From April to June 2024, a total of 88 school-aged children aged 8 - 12 years were recruited from an elementary school in Hangzhou, with the average age of (10.72±0.96) years old. Among them, 57(64.8%) were boys. All the participants wore triaxial accelerometers for 7 consecutive days to collect data on sleep, sedentary behavior , low-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). The Physical Activity Parenting Questionnaire for Children (PAP-C) was used to assess children's self-perceived family supportive factors, including parental autonomy support, parental involvement, and parental physical activity structure. Multiple linear regression analysis was conducted to examine the associations between physical activity and family supportive factors. Results The average daily sleep duration of school-aged children was (9.28±0.71) hours, sedentary time was (10.12±1.19) hours, LPA was (2.99±0.86) hours, and MVPA was (1.61±0.57) hours. Overall, family supportive factors were significantly associated with MVPA time in school-aged children (P<0.05), but not with sleep duration or SB time (P>0.05). Gender-specific analysis revealed that parental autonomy support scores were positively correlated with MVPA time in boys (β＝0.281, P<0.05), while parental physical activity structure scores were negatively correlated with LPA time in girls (β＝-0.760, P<0.05). Conclusions School-aged children generally exhibit prolonged sedentary time and relatively high levels of physical activity. Family supportive factors are closely related to MVPA in school-aged children. Future efforts should emphasize the influence of family supportive environments on the physical activity of school-aged children.

Evaluation of vitamin D level in children with common developmental behavior disorders based on propensity score matching method

LIU Shu, LIAO Xiaoxian, HUANG Xiuqing, LI Qing, YANG Qin, TONG Xiubin, XU Xiu, LI Huiping

2025, 33(5):  508-513.  DOI: 10.11852/zgetbjzz2024-0479

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Objective To compare the vitamin D levels among children with different developmental and behavioral disorders, and to analyze the correlation between vitamin D levels and core symptoms. Methods The 25(OH)D test data, general demographic information, and clinical diagnosis information of 19 119 children from September 2018 to November 2022 at Xiamen Children's Hospital were collected. After excluding physical diseases and drug interference factors, 1 311 children with developmental and behavioral disorders were included as the developmental and behavioral disorder group, and 2 969 typically developing children were included as the typical development group. A retrospective case-control study design was adopted, and propensity scores were used to perform a 1∶1 match for the two confounding variables of age and gender. The differences in 25(OH)D levels were analyzed between the developmental and behavioral disorder group and the typical development group, as well as between the typical development group and the groups with language development disorder(LD), tic disorder(TD), global developmental delay(GDD), attention-deficit/hyperactivity disorder(ADHD), and autism spectrum disorder(ASD). Results In both age groups of 36 to 72 months and 72 months to 12 years, the 25(OH)D levels in the developmental and behavioral disorder group were significantly lower than those in the typical development group(t=2.252, 5.343, P<0.05). Within the developmental and behavioral disorder group, age was moderately negatively correlated with 25(OH)D(r=-0.525, P<0.001). The 25(OH)D levels in the ASD and ADHD groups were significantly lower than those in the typical development group, and the risks of ASD(OR=0.970) and ADHD(OR=0.960) were negatively correlated with 25(OH)D. Conclusions Children with developmental and behavioral disorders, similar to typically developing children, exhibit a decreasing trend in 25(OH)D levels as they age. Children with developmental and behavioral disorders have lower vitamin D levels compared to typically developed children, with the most significant decreases observed in those with ASD and ADHD.

Association of sleeping time and sedentary behavior with overweight and obesity in children and adolescents

WANG Yun, ZENG Xia

2025, 33(5):  514-519.  DOI: 10.11852/zgetbjzz2024-1164

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Objective To investigate the combined associations of sleeping time and sedentary behaviour with overweight and obesity, in order to provide a scientific basis for the prevention and control of overweight and obesity in children and adolescents. Methods A multi-stage stratified cluster random sampling method was used to select primary and secondary school students in Guangzhou City from September 2023 to January 2024, finally 799 students were enrolled. Data collection was carried out through physical examination data and questionnaires, with the data classified according to the "Screening for overweight and obesity among school-age children and adolescents" (WS/T 586-2018), categorizing individuals into either overweight/obese or non-overweight/obese groups. χ² test was used to compare the differences between different groups, while the binary Logistic regression was used to analyze the association of sedentary behaviour and sleeping time with overweight and obesity in children and adolescents. Results The rate of overweight and obesity among children and adolescents aged 7 to 19 years in Guangzhou City was 16.5%(132/799). After controlling for confounding factors, compared with the reference group adequate sleep & sedentary time ≤ 8h/d group, the risk of overweight and obesity was higher in the inadequate sleep & sedentary time ≤8h/d group (OR=1.799, 95%CI: 1.077 - 3.004) and the inadequate sleep & sedentary time > 8h/d group (OR=1.931, 95%CI: 1.077 - 3.459). Conclusions There is a combined correlation of sleep duration and sedentary behavior with overweight-obesity among children and adolescents. As children and adolescents are in a critical period of growth and development, it is important to ensure sufficient sleep time and reduce sedentary time to prevent the occurrence and development of overweight-obesity in this population.

Review

Research progress of milk ladder treatment for milk protein allergy in children

SHUAI Jiaji, YANG Sufei

2025, 33(5):  520-523.  DOI: 10.11852/zgetbjzz2024-0832

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Cow's milk protein allergy(CMPA) is a common allergic reaction among children. The milk ladder approach involves gradually introducing cow's milk protein through steps of varying degrees of denaturation and increasing doses, which can induce earlier long-term tolerance to cow's milk protein in children. Existing research has proven the milk ladder to be a safe and effective method. However, as an emerging treatment, the milk ladder necessitates diverse improvement strategies based on individual and cultural differences, and requires further research to verify its long-term safety.

Advances in clinical diagnosis and treatment of functional constipation in children

ZHANG Nini, WANG Baoxi, JIANG Xun

2025, 33(5):  524-528.  DOI: 10.11852/zgetbjzz2024-0952

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Functional constipation(FC) is a common disorder affecting children worldwide, significantly impacting the social, physical, and emotional functioning of both the affected children and their caregivers. Currently, the diagnosis of FC is clinically based on the Rome Ⅳ criteria. Non-pharmacological treatments include health education, lifestyle advice, and toilet training. Pharmacological interventions include disimpaction, maintenance therapy, and eventual withdrawal of medication if possible. Polyethylene glycol(PEG) is considered the first-choice laxative for disimpaction and maintenance therapy. Additionally, various osmotic laxatives, stimulant laxatives, lubricants, and enemas can serve as alternative therapeutic options. For probiotics and newly emerging drugs, there is a lack of evidence supporting their widespread use in childhood FC, necessitating more high-quality research. This review summarizes the currently available scientific evidence and clinical experience to facilitate better clinical management of FC in children by pediatricians.

Application of artificial intelligence in the diagnosis and management of bronchial asthma in children

TAN Hong, ZHOU Xuehua, WU Huajie, WANG Min, ZHOU Han, SU Hui, SUN Xin

2025, 33(5):  529-532.  DOI: 10.11852/zgetbjzz2024-1284

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Artificial intelligence (AI), as an emerging technology capable of augmenting or even replacing certain human functions, has significant potential in enhancing the accuracy of disease diagnosis, enabling personalized treatment, and improving disease management. Bronchial asthma, one of the most prevalent chronic inflammatory airway diseases, has long been a focus in terms of its diagnosis, treatment, and management. AI can utilize techniques such as representation learning, machine learning, deep learning, and natural language processing to collect and analyze vast amounts of textual, visual, and auditory data. By establishing complex, non-linear relationships, AI can construct models to assist physicians in the identification, treatment, and management of bronchial asthma. This paper primarily discusses the application and research progress of AI in pediatric bronchial asthma from the perspectives of diagnostic classification, treatment, and management and monitoring. Additionally, it briefly analyzes the advantages and limitations of various intelligent assistance methods.

Effects and mechanisms of early exposure to bisphenol substances on children's cardiac development

YANG Mei, YANG Fan, YANG Beibei, LU You

2025, 33(5):  533-536.  DOI: 10.11852/zgetbjzz2024-0945

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The early stages of life are a crucial period for individual growth and development, during which exposure to environmental endocrine-disrupting chemicals can have profound impacts on children's health. Bisphenols (BPs), such as bisphenol A (BPA) and bisphenol S (BPS), are a group of chemical compounds widely used in the manufacture of plastics, food packaging, and various consumer products.Due to its potential endocrine-disrupting properties, the impact of exposure to BPs on children's health has received widespread attention in recent years. The heart, as an important organ of the human body, has a complex and delicate development process that is regulated by various internal and external factors. Studies suggest that early-life exposure to BPs in life may affect embryonic and child cardiac development by simulating or interfering with the effects of endogenous hormones. This review aims to elucidate the impact of BPs on developing hearts and their underlying pathophysiological mechanisms, so as to provide a theoretical foundation for the development of effective preventive and interventional strategies.

Meta Analysis

Systematic review of risk factors for growing pains in children

LUO Ting, LIN Yunzhu, LIAN Xianghong, GUO Yixin, HE Hongxia

2025, 33(5):  537-543.  DOI: 10.11852/zgetbjzz2024-0529

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Objective To systematically evaluate the risk factors related to growing pains in children, in order to provide a reference for the prevention and diagnosis of growing pains. Methods Databases including PubMed, Embase, Cochrane Library, CNKI, WanFang Data, VIP and CBM were electronically searched to collect clinical studies related to risk factors for growing pains in children from database inception to June 2024. Two researchers independently screened the literature, extracted data, and assessed the quality of the studies. RevMan 5.3 software was used for Meta-analysis, and qualitative descriptive analysis was applied to data that could not be quantitatively combined. Results A total of 23 studies from 9 countries were included, covering 12 potential risk factors. The results of systematic review suggested that serum 25(OH)D concentration (MD=-30.41, 95%CI:-40.51 to -20.32,P＜0.001), family history (OR=2.12, 95%CI:1.74 - 2.57, P<0.001), picky eating (OR=2.75, 95%CI:1.62 - 4.67, P<0.001), physical exercise/joint activity (OR=1.30, 95%CI:1.14 - 1.48, P<0.001), bone mineral density (MD=-0.07, 95%CI:-0.12 to -0.02, P=0.008), and pain threshold might correlate with the occurrence of growing pain in children, and might be risk factors. Blood calcium concentration, foot or lower limb posture had different results in individual studies, and their correlation with growing pains requires further original research for confirmation. Conclusions Growing pains in children is affected by many factors. Due to limitations in the quantity and quality of existing studies, high-quality prospective research is recommended to further clarify the risk factors for growing pains in children.

Clinical Research

Correlation between characteristics of cranial morphological and neuropsychological development in 1 407 infants in Beijing

WANG Jianhong, XU Qi, ZHOU Bo, WANG Lei, ZHANG Lili, WANG Xi, JIN Chunhua, WANG Lin

2025, 33(5):  544-548.  DOI: 10.11852/zgetbjzz2024-1422

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Objectives To analyze the correlation between cranial morphology and neuropsychological development in infants aged 4 - 12 months in Beijing, in order to provide a scientific basis for clinical prevention and intervention. Methods A convenience sampling method was used to select 1 407 infants aged 4 - 12 months who underwent routine health examinations at the Center of Child Healthcare, Capital Institute of Pediatrics between November 2021 and November 2023.All participants received cranial morphology measurements and neurodevelopmental assessments using the Children's Neuropsychological and Behavioral Scale (2016 Edition).One-way ANOVA was used to compare developmental quotients (DQs) across five functional domains among different cranial morphology groups and varying cranial vault asymmetry (CVA) differences.Multiple linear regression was employed to analyze the correlation between CVA and DQs. Results 1) Among the 1 407 infants, 1 004 (71.4%) had normal cranial morphology, while 182 (12.9%) had plagiocephaly, 149 (10.6%) had scaphocephaly, and 72 (5.1%) had brachycephaly.The highest detection rate of cranial abnormalities was in the 4- to 6-month group (31.0%,171/551), whereas the lowest was in the 10- to 12-month group (23.5%,89/378), with a statistically significant difference (χ²=6.73, P=0.035).2) Pairwise comparisons revealed that infants with plagiocephaly exhibited significantly lower DQs in gross motor and fine motor skills than those with normal cranial morphology (P<0.01).The scaphocephaly group showed lower gross motor DQs (P<0.01), while the brachycephaly group demonstrated significantly lower DQs in gross motor, fine motor, and adaptive abilities (P<0.05).Infants with CVA >10mm had significantly lower DQs in gross motor, fine motor, adaptive, language, and social behavior domains compared to those with CVA ≤10mm (t=13.74, 17.84, 14.90, 8.78, 17.07, P<0.01).3) Linear regression analysis indicated that gross motor, fine motor, and adaptive DQs were negatively correlated with CVA (β=-0.32, -0.48, -0.44, P<0.05). Conclusions Infants with abnormal cranial morphology exhibit delayed motor development compared to their normal counterparts.Gross motor, fine motor, and adaptive DQs are negatively correlated with CVA.Infants with CVA >10mm require comprehensive neurodevelopmental assessment and early intervention.

Association of sleep time and screen time with overweight and obesity among primary school students

FANG Wen, LI Qin, CHEN Menghan, FU Ye, ZHANG Miao, LU Yu

2025, 33(5):  549-554.  DOI: 10.11852/zgetbjzz2024-1010

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Objective To explore the association of sleep time and screen time with overweight and obesity, and their interaction on overweight and obesity among primary school students, so as to provide the scientific basis for the prevention and control of overweight and obesity among primary school students. Methods From 2022 to 2023, a random cluster sampling method was used to select 1 102 students from grades 2 - 6 of three primary schools in Shiyan City as the study subjects. General demographic characteristics, sleep time, screen time, dietary habits and physical activity time were collected by questionnaire. The height and weight of the students were obtained by on-site physical examination. Multivariate Logistic regression was used for association analysis, and additive and multiplicative models were used for interaction analysis. Results The prevalence of overweight and obesity among primary school students in Shiyan City was 25.8% (284/1 102), the average sleep time of 868 (78.8%) primary school students was <10 hours per day, and the average screen time of 237 (21.5%) primary school students was ≥2 hours per day. There were significant differences in the prevalence of overweight and obesity among students of different genders, sleep time and screen time (χ²=22.381, 5.804, 16.081, P<0.05). Sleep time <10 hours per day (OR=1.524, 95%CI: 1.052 - 2.209) and screen time ≥2 hours per day (OR=1.839, 95%CI: 1.325 - 2.553) were risk factors for overweight and obesity in primary school students. The risk of overweight and obesity in primary students who sleep time <10 hours per day and screen time ≥2 hours per day was 1.762 times higher than those who sleep time≥10 hours per day and screen time <2 hours per day(OR=2.762, 95%CI: 1.698 - 4.495). There was no additive or multiplicative interaction between sleep time and screen time on overweight and obesity among primary school students. Conclusions There is a significant association of daily sleep duration and screen time with overweight and obesity among primary school students. Therefore, future interventions should focus on sleep duration and screen time, fostering active and healthy lifestyles to reduce the risk of overweight and obesity.

Current situation and influencing factors of screen time in children with malignant tumor

XU Jia, XIAO Yuqiao, LIU Zixuan, ZHANG Tianruixue, LIU Li, GU Can

2025, 33(5):  555-559.  DOI: 10.11852/zgetbjzz2024-0888

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Objective To investigate the current status of screen time among pediatric patients with malignant tumors, and to explore its influencing factors, so as to provide reference for the assessment and management of screen time in children with malignant tumor. Methods From November 2023 to May 2024, a convenience sampling method was used to conduct a questionnaire survey among 232 pediatric patients with malignant tumors in a tertiary hospital in Urumqi, using a General Information Questionnaire, a Screen Time Questionnaire, and the Family Adaptability and Cohesion Evaluation Scale-Ⅱ Chinese Version (FACES Ⅱ-CV). Univariate analysis and multiple linear regression analysis were employed to explore the influencing factors of screen time among pediatric patients with malignant tumors. Results The average daily screen time for pediatric patients with malignant tumors was (4.31±2.29) hours. The results of multiple linear regression analysis showed that patient age (β=0.177), more than 12 hospitalizations (β=0.184), non-nuclear family structure (β=0.114), indulgent parenting style (β=0.157), and combined entertainment and learning-related screen activities (β=0.146) were positively correlated with screen time. In contrast, low family cohesion (β=-0.309) and low family adaptability (β=-0.182) were negatively correlated with screen time (P<0.05). Conclusions Pediatric patients with malignant tumors have longer screen time compared to healthy children. Parents should be guided and encouraged to actively communicate with their children, develop personalized parent-child game intervention programs, reduce screen time, and promote the physical and mental health development of these patients.

Influencing factors of responsive feeding behavior of caregivers for infants and toddlers aged 7 - 24 months

WANG Chenpeng, WANG Jing, FAN Bingjie, KE Min, YANG Lei, QIAN Jun, ZHANG Min

2025, 33(5):  560-564.  DOI: 10.11852/zgetbjzz2024-1235

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Objectives To investigate responsive feeding behaviors among caregivers of infants aged 7 - 24 months,and to analyze influencing factors, in order to provide evidence to better guide caregivers' feeding practices and promote responsive feeding. Methods A self-designed questionnaire was administered to 306 infants aged 7 - 24 months and their caregivers, who were selected via random sampling from healthy infants receiving preventive healthcare at four community health service centers in Nanjing. Results The highest domain score in responsive feeding behaviors was "caregiver-child interaction" [4.60 (4.00, 5.00)], while the lowest was "negative feeding practices" [3.75 (3.00, 4.25)]. Significant differences were observed across dimensions based on gestational age, current age, primary caregiver type, caregiver education level, family structure, number of children, household income, and complementary feeding initiation time (P<0.05) . Multiple linear regression revealed that caregiver education level was positively associated with responsive feeding behavior scores (β= 0.200,P<0.01), whereas the timing of complementary feeding introduction was negatively associated with responsive feeding behavior scores (β =0.164,P<0.01). Conclusions Awareness of responsive feeding among caregivers needs improvement, with behaviors influenced by caregiver type, education level, family structure, and socioeconomic status. Educational interventions should be tailored to caregivers' and families' specific circumstances, adjusting guidance strategies to reduce negative feeding practices and enhance infant feeding quality.

Quality of power for monitoring the physical fitnessof Chinese children and adolescents based on 8 studies from 1985 to 2019 and long-term development forecasts

ZHANG Shuai, LI Chengyue, LI Weimin

2025, 33(5):  565-570.  DOI: 10.11852/zgetbjzz2024-0601

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Objective To investigate the long-term trend of explosive power among Chinese children and adolescents aged 7 to 18 years from 1985 to 2019, predict the status of explosive power in 2029, so as to provide reference for the formulation of future physical health policies. Methods The mean, standard deviation, and sample size data of standing long jump test results for Han Chinese children and adolescents aged 7 to 18 years from the national student physical health surveys conducted between 1985 and 2019 were selected. Descriptive and inferential analysis were conducted using t tests, χ² tests, development increments, and growth rates. Time series analysis was used to predict the mean explosive power in 2029. Results Over the 34-year period, the overall standing long jump performance of children and adolescents aged 7 to 18 years showed a declining trend. The cumulative decline for urban boys aged 7 to 18 years was 2.24 cm, with a chain growth rate of -1.77%; and for urban girls, the cumulative decline was 0.86cm, with a chain growth rate of -1.12%. For rural boys aged 7 to 18 years, the cumulative decline was 10.83 cm, with a chain growth rate of -2.39%, indicating a relatively large decline; for rural girls aged 7 to 18 years, the cumulative decline was 10.54 cm, with a chain growth rate of -2.84%. The prediction results showed that by 2029, the overall level of explosive strength among Chinese children and adolescents aged 7 to 18 years, both urban and rural, would increase. Conclusion The overall level of explosive power among Chinese children and adolescents declined from 1985 to 2019 but the rate of decline has slowed in recent years, and it is projected to increase by 2029.

Health Education

Effect of the application of KDL curriculum on the behavioral self-regulation abilities of 7- to 8-year-old children

JIN Zhuo, WU Hua, CAI Yujiang, RUAN Hui

2025, 33(5):  571-575.  DOI: 10.11852/zgetbjzz2024-0733

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Objective To explore the effect of the application of KDL curriculum in physical education(PE) classes on the behavioral self-regulation abilities of 7- to 8-year-old children, in order to provide references for promoting the development of their behavioral self-regulation abilities. Methods From September 2023 to January 2024,a quasi-experimental study was conducted, involving 140 children aged 7 - 8 from four second-grade classes in an affiliated primary school in Shenzhen, Guangdong Province. They were divided into a KDL group and a control group, with 70 children in each group. In addition to maintaining normal learning arrangements, the control group received traditional PE curriculum content during PE classes(3 times/week, 40 minutes/session), while the KDL group received PE instruction based on the content of the "Primary School KDL PE and Health Curriculum(Level One)". The "Head-Toes-Knees-Shoulders(HTKS)" test was used to assess the behavioral self-regulation abilities of the participants before and after 12 weeks of the experiment. Results Finally 128 children finished experiment.After the experiment, the HTKS scores of the children in the KDL group(64 children) were significantly higher than those before the experiment(t=9.105). There was no statistically significant difference in HTKS scores between the children in the control group(64 children) before and after the experiment(P>0.05). Before the experiment, there was no statistically significant difference in HTKS scores between the two groups(P>0.05). After the experiment, the HTKS scores of the children in the KDL group were significantly better than those in the control group(t=4.270, P<0.01). Conclusion The KDL curriculum can effectively improve the behavioral self-regulation abilities of 7- to 8-year-old children, and its effectiveness is superior to that of traditional PE curricula, further validating the positive role of the KDL curriculum in cultivating children's core competencies.