Children with autism spectrum disorder (ASD) frequently exhibit pronounced difficulties in emotion regulation, manifested as excessive emotional reactivity, slow emotional recovery, and a lack of adaptive regulatory strategies, which substantially impair social adaptation and quality of life.This article focuses on emotion regulation problems in children with ASD, systematically outlining multimodal assessment approaches and integrative intervention strategies.It further proposes that future work should strengthen the integrated use of multimodal assessment data and develop a closed-loop model that links assessment to intervention, thereby advancing early screening, precise identification, and individualized intervention for emotional difficulties in children with ASD.

Autism spectrum disorder (ASD), as a neurodevelopmental disorder, often co-occurs with other psychiatric conditions. Approximately 96% of children with ASD have at least one comorbid condition, such as attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder, intellectual disability, anxiety disorders, bipolar disorder, depression, and tic disorders, among which ADHD is the most common. ASD and ADHD have a high overlap in genetics, immune system, intestinal microbiota, environmental exposure and behavioral manifestations, and there is a lack of clear distinguishing markers. Since the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which permits comorbid diagnosis of ASD and ADHD, there has been a lack of expert consensus and guidelines, making the clinical differential diagnosis of ASD, ADHD, and their comorbidities challenging. Therefore, this article elucidates the similarities and differences among ASD, ADHD, and their comorbidities in terms of pathogenic mechanisms and clinical symptoms, which has potential significance for future research on biomarkers of the three and development of cross-diagnostic assessment tools.

This paper explores the establishment of a "Language-Social Communication-Cognition" three-dimensional model for children′s language assessment and intervention, grounded in the clinical reasoning framework for broadly defined language disorders.First, it lists the common language and communication issues in children with neurodevelopmental disorders and outlines evidence-based early language intervention approaches that align with this three-dimensional model.As children enter the preschool and school-age years, this model aids in the differential diagnosis process by analyzing the distinct root causes of language disorders, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability.Neither early language intervention approaches nor linear language intervention processes are effective in advancing the critical skills these children need for academic learning and social participation.This paper emphasizes the crucial role of "Theory of Mind" ability within the three-dimensional model during this stage and dedicates a section to its detailed elaboration.Finally, the paper proposes a narrative-based language intervention system that implements the "Language-Social Communication-Cognition" model in practice, with three dimensions advancing together and synergistically, and explains its evidence-based foundation and clinical procedures.

Naturalistic developmental behavioral interventions (NDBIs) represent one of the most promising groups of evidence-based approaches in the field of early intervention for children with autism spectrum disorder (ASD).Although individual intervention models differ in their specific features, they are all grounded in an integration of developmental and behavioral sciences.They are based on the well-established principles developed via the science of applied behavior analysis (ABA) and use developmentally based intervention strategies and sequences to guide goal development that is individualized to each child.Evidence from recent studies suggests that NDBIs produce relatively consistent effects in improving joint attention, social engagement, language, and adaptive behaviors in children with ASD, while also enhancing the quality of parent-child interactions and family involvement.This article reviews the theoretical foundations and shared features of NDBIs, summarizes representative models, and synthesizes the current evidence base.Considering child health-care and rehabilitation service systems in China, it further discusses contextual applicability, key implementation challenges and priorities for future research, so as to inform early intervention practice and related policy development for children with ASD.

Objective To investigate the effects of TAK-242, a specific Toll-like receptor 4 (TLR4) inhibitor, on autism spectrum disorder(ASD)-like behaviors and neuroinflammation in offspring rats induced by maternal immune activation (MIA), so as to provide an experimental basis for early ASD intervention. Methods Thirty pregnant SD rats were randomly divided into control group, LPS, and TAK-242 intervention group (n=10 per group).On gestational day 9.5 (G9.5), the LPS and TAK-242 groups received an intraperitoneal injection of 100μg/kg LPS, while the control group received an equivalent volume of PBS.The TAK-242 group received a pre-injection of 3mg/kg TAK-242 2 hours before LPS administration.Male offspring underwent behavioral tests at 6 - 8 weeks of age to assess their social behavior and cognitive function.Serum levels of IL-6 and TNF-α in the dams and offspring were measured using ELISA.In the offspring, the expression of inflammatory factors in the prefrontal cortex (PFC) was detected by qRT-PCR, while microglial morphology and the expression of the marker Iba-1 were examined by immunohistochemistry. Results Compared with the control group, the LPS group showed significantly elevated serum levels of IL-6 and TNF-α in both dams and offspring (P<0.001).Offspring in the LPS group exhibited ASD-like behavioral abnormalities, including increased marble burying, reduced central zone duration in the open field, decreased social index, and impaired learning and memory (F=9.811, 14.490, 31.750, 5.250, P<0.05).Furthermore, the LPS group demonstrated up-regulated mRNA expression of pro-inflammatory factors and down-regulated mRNA expression of anti-inflammatory factors in the PFC (P<0.001), along with microglial activation (characterized by enlarged cell bodies and shortened processes) and increased Iba-1 expression.TAK-242 intervention significantly ameliorated all these abnormalities (P<0.05). Conclusions TAK-242 ameliorates MIA-induced ASD-like behaviours in offspring by inhibiting the TLR4/NF-κB signalling pathway, potentially through modulating microglial polarization and attenuating neuroinflammation.

Objective To systematically evaluate the efficacy of home-based interventions in improving gross motor function and activities of daily living (ADL) in children with cerebral palsy (CP), so as to provide evidence for developing effective intervention strategies. Methods Literature on home-based interventions for children with CP were searched across databases including CNKI, VIP, Wanfang, CBM, PubMed, Embase, Web of Science, and Cochrane Library from inception to June 2024.Meta-analysis was performed using Review Manager 5.4 and Stata 17.0. Results A total of 28 studies were included.Meta-analysis revealed statistically significant differences between the home-based intervention group and conventional rehabilitation group in GMFM-88 scores (MD=10.87, 95% CI: 8.51 - 13.23), GMFM-88 E dimension scores (MD=4.71, 95% CI: 3.82 - 5.61), and ADLs scores (MD=7.63, 95% CI: 4.68 - 10.57) (P<0.001).However, no significant difference was observed in GMFM-66 scores (MD=4.43, 95% CI: －1.56 - 10.42, P=0.15)between the two groups. Conclusion Home-based interventions can effectively improve gross motor function and ADL performance in children with cerebral palsy.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with complex etiology involving dysregulated epigenetic mechanisms arising from gene-environment interactions.This review systematically examines the contributions of natural, chemical, and biological environmental exposures to ASD risk.It further analyzes the potential role of parental factors such as parental occupation, age, and history of metabolic diseases.The review focuses on three major epigenetic mechanisms: DNA methylation, histone modifications, and non-coding RNA dysregulation, elucidating their aberrant regulation during critical neurodevelopmental windows and their associations with core ASD symptoms, including social communication deficits and restricted repetitive behaviors, which provides a theoretical basis for the in-depth analysis of the pathogenesis of ASD and the development of targeted intervention strategies.

Short stature is a common reason for consultation in the field of pediatric endocrinology and genetic metabolism, and its genetic etiology has garnered increasing attention in recent years.Defects in any genes involved in the process of height growth can lead to short stature, primarily by disrupting the normal proliferation and differentiation of growth plate chondrocytes.While dysfunction of the growth hormone-insulin-like growth factor (GH-IGF) axis represents a classic mechanism, multiple other factors—such as nutritional status, inflammatory cytokines, paracrine signaling, extracellular matrix, and intracellular signaling pathways—are also jointly involved in its regulation.Affected children often present clinically with abnormal body proportions, a positive family history, multisystem malformations or functional impairments, with specific genetic variants frequently correlating with distinct phenotypic profiles.Therefore, the systematic collection of phenotypic information combined with genetic testing has become a core strategy for achieving precision diagnosis and treatment of genetic-related short stature.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits, restricted interests, and repetitive behaviors, exhibiting variable clinical manifestations and significant treatment challenges. As a non-invasive brain stimulation technique, transcranial direct current stimulation (tDCS) can alleviate clinical symptoms in individuals with ASD by modulating local cortical excitability. The underlying mechanisms involve correcting the abnormal excitation/inhibition (E/I) ratio, regulating levels of cerebral metabolites, optimizing functional brain connectivity, and improving cerebral hemodynamics. This article reviews the target selection, mechanisms of action, and clinical efficacy of tDCS in the treatment of ASD. It also explores its extended applications in other neuropsychiatric disorders such as ADHD and depression, as well as its safety profile.

Objective To evaluate the therapeutic efficacy of virtual reality (VR)-based rehabilitation training for children with autism spectrum disorder (ASD), in order to provide a theoretical foundation for digital interventions in ASD treatment. Methods From December 2023 to April 2024, a total of 60 children diagnosed with ASD at the Department of Child Health Medicine, Shanghai Children′s Hospital were randomly assigned to either an intervention group or a control group.The control group received early family intervention guided by a rehabilitation team, while the intervention group underwent VR-based rehabilitation training once a week for one hour per session additionally.Therapeutic outcomes were assessed before and after the intervention using the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Strengths and Difficulties Questionnaire (SDQ), and Social Responsiveness Scale (SRS). Results Before the intervention, there were no statistically significant differences in ABC, CARS, SDQ, and SRS scores between the intervention and control groups (P>0.05).After the intervention, the intervention group showed significantly lower scores in the sensory, social, and motor factors of the ABC, as well as in the total ABC and CARS scores, compared to the control group (t=2.253, 2.113, 2.162, 3.364, 2.742, P < 0.05).The SDQ revealed that the intervention group had significantly lower scores in hyperactivity/inattention, peer relationship problems, prosocial behavior, and total difficulties compared to the control group (t=2.084, 3.623, 2.591, 3.074, P < 0.05).The SRS results indicated that the intervention group outperformed the control group in social cognition, social communication, autistic mannerisms, and total scores after the intervention (t =2.012, 2.546, 2.126, 3.507, P<0.05). Conclusions VR-based rehabilitation training demonstrates positive effects on improving core symptoms and social functioning in children with ASD, highlighting its potential for clinical application.However, further research is needed to validate its long-term efficacy and generalizability.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core symptoms such as deficits in social interaction, impairments in verbal and nonverbal communication, and restricted interests accompanied by repetitive and stereotyped behaviors.Currently, modern medicine lacks targeted pharmacological treatments for ASD, and clinical management primarily relies on educational interventions and behavioral therapies.As an essential component of traditional Chinese medicine (TCM), scalp acupuncture therapy involves the stimulation of specific acupoints and functional regions on the scalp to directly modulate cortical activity and regulate brain function.In recent years, this therapeutic approach has demonstrated unique advantages and promising potential in the rehabilitation of children with ASD.This article systematically reviews the theoretical foundations of scalp acupuncture from both TCM and Western medical perspectives, with a focus on pediatric neurorehabilitation for ASD.It examines principles of acupoint selection, technical procedures, and key considerations in clinical practice.Furthermore, it discusses the underlying mechanisms of action, aiming to establish evidence-based protocols for the clinical application of scalp acupuncture in ASD rehabilitation.

Objective To analyze the association between childhood exposure to neonicotinoid pesticides (NEOs) and the risk of autism spectrum disorder (ASD). Methods This case-control study enrolled 30 children with ASD and 28 typically developed children from Wuhan Children′s Hospital.Serum concentrations of NEOs and their metabolites were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS).Multivariate logistic regression models were used to assess the association between individual NEO exposure and ASD risk, and the weighted quantile sum (WQS) regression model was employed to analyze the association between mixed NEO exposure and ASD risk. Results Concentrations of 5-hydroxy-imidacloprid (5-OH-IMI), desmethyl-thiamethoxam (NTHM), and sulfoxaflor (SFX) were significantly higher in the ASD group compared to controls(t=6.964, 2.276, 2.182, P＜0.05).Multivariate logistic regression analysis revealed that 5-OH-IMI and NTHM were significantly associated with increased ASD risk (OR=47.738, 3.263, P＜0.05).WQS analysis indicated that mixed NEO exposure was positively associated with ASD risk (OR=7.83, 95% CI: 0.48 - 15.18). Conclusions This study found a significant association between NEO exposure and increased ASD risk.However, the specific mechanisms underlying this association require further investigation.

Objective To investigate the causal relationship between subcortical brain structures and autism spectrum disorder (ASD) in children, in order to identify potential biomarkers for early ASD diagnosis. Methods The data related to children′s subcortical brain structure and ASD were extracted from the open data of the genome-wide association study (GWAS), and the two-sample Mendelian randomization method was used for causal inference.The inverse-variance weighted (IVW) method served as the primary analysis, supplemented by MR-Egger regression, weighted median, and weighted mode methods to address IVW limitations.Quality control was conducted using Cochran′s Q test, MR-PRESSO, and leave-one-out analysis. Results Three subcortical structural phenotypes showed causal associations with ASD: 1) The bilateral caudate nucleus volume was positively correlated with ASD (IVW: OR=1.220, 95%CI: 1.088 - 1.369, P=0.001); 2) the interaction between bilateral nucleus accumbens volume and prenatal stress exhibited a negative association with ASD (IVW: OR=0.850, 95%CI:0.734 - 0.983,P=0.029); 3) bilateral intracranial volum×postnatal stress interaction was negatively correlated with ASD (IVW: OR=0.878, 95%CI:0.780 - 0.988, P=0.031).Sensitivity analyses confirmed robust findings. Conclusions Increased bilateral caudate nucleus volume may represent a risk biomarker for ASD, while the protective interaction effects of nucleus accumbens volume × prenatal stress and intracranial volume × postnatal stress could mitigate ASD risk.These findings may provide potential neuroanatomical markers for early ASD detection.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder, and early scientific intervention can significantly improve the prognosis of children with ASD. Family intervention plays an important role in the early intervention of ASD in young children. An increasing number of research teams have developed parent-mediated intervention models based on naturalistic developmental behavioral intervention (NDBI). This review summarizes the primary evidence-based family intervention models, analyzes empirical research on these models in young children with ASD, and discusses methods to enhance the feasibility and effectiveness of interventions, so as to provide reference and insights for the better implementation of family intervention practices and research in China.

Objective To understand the impact of the family nurturing environment on the neuropsychological development level of children, so as to provide a scientific basis for family nurturing guidance in outpatient clinics. Methods From September 2021 to June 2022, developmental screening was conducted on 631 children aged 0 - 3 years at the Child Growth and Development Clinic of Shengzhou Maternal and Child Health Hospital, along with a survey on the family nurturing environment of their primary caregivers. The survey results were analyzed using univariate and multivariate methods. Results The suspected abnormality rate of the developmental quotient (DQ) among the 631 children was 15.53%. The rate of suspected and abnormal DQ was significantly higher in children aged >1 - 3 years compared to those aged 0 - 1 year (χ²=4.21, P=0.040). In both the 0 - 1 year and >1 - 3 year groups, children with low birth weight (χ²=26.739, 6.831), higher birth order (χ²=74.047, 21.840), smaller gestational age (χ²=12.495, 11.883), and lower educational level of the primary caregiver (χ²=29.968, 11.498) had significantly lower DQ scores (P<0.01). "Often/Always swaddling the child tightly, restricting limb movement" was a risk factor for suspected developmental abnormalities in children aged 0 - 1 year (OR=5.283, 95%CI: 1.317 - 21.185). "Often/Always training the child's hand manipulation skills" was associated with higher DQ in children aged 0 - 1 year (OR=0.347, 95%CI: 0.131 - 0.916). "Often/Always allowing the child to try dressing and doing things independently" was associated with higher DQ in children aged >1 - 3 years (OR=0.475, 95%CI: 0.251 - 0.898) (P<0.05). Conclusions The suspected and abnormal DQ rates are relatively high among children aged >1 - 3 years in Shengzhou. Outpatient clinics should focus on children with low birth weight, higher birth order, smaller gestational age, and lower educational levels of primary caregivers. Guidance for family caregivers can be provided using the relevant content indicated by the family nurturing environment scale.

Objective To analyze the relationship between bone mineral density (BMD) in children and factors including sex, age, body mass index (BMI), blood calcium, blood phosphorus, serum alkaline phosphatase (ALP), and serum 25-hydroxyvitamin D[25-(OH)D], in order to provide a scientific basis for promoting pediatric bone health. Methods A total of 3 024 children aged 1 - 6 years who underwent health examinations at the Child Health Care Center of the Children′s Hospital Affiliated to Zhejiang University School of Medicine from June 2018 to September 2022 were included.BMI, serum ALP, calcium, phosphorus, and 25-(OH)D levels were measured, and BMD was assessed using ultrasound bone densitometry. Results Among the3 024 participants, 578 children (19.11%) had low BMD.Male children exhibited higher BMD Z-scores than females (t=3.132, P<0.01).Significant differences in BMD Z-scores were observed across age groups (F=54.493, P<0.001).The normal BMD group had lower BMI than the low BMD group (t=7.083, P<0.001).Children with low BMD showed lower serum calcium, phosphorus, and 25-(OH)D levels compared to those with normal BMD (t=8.659, 3.479, 16.440, P<0.01).Correlation analysis revealed that BMD Z-scores were positively associated with serum calcium, phosphorus, and 25-(OH)D levels (r=0.146, 0.051, 0.240, P<0.05), negatively correlated with BMI (r=-0.128, P<0.05), and not correlated with ALP (P=0.684).Multivariate logistic regression identified BMI (OR=1.259), calcium (OR=0.025), phosphorus (OR=0.426), and 25-(OH)D (OR=0.954) levels as significant influencing factors of BMD (P<0.05). Conclusions Pediatric BMD is associated with sex, age, serum calcium, phosphorus, BMI, and 25-(OH)D, but not with serum ALP.Maintaining relatively high levels of serum calcium, phosphorus, and 25-(OH)D is crucial for sustaining normal BMD in children.

When an infant reaches 6 months of age, this milestone represents not merely a routine progression in chronological age, but a critical period marking the transition to family-led complementary feeding across all domains of infant development. To scientifically determine whether an infant′s developmental status can support a smooth initiation of complementary feeding at home, and to ensure the safety of complementary feeding while safeguarding subsequent healthy development in infants and toddlers, this consensus addresses assessment across several dimensions: feeding status, maturation of the digestive enzyme system and gastrointestinal tract, motor skill development, psychological and emotional readiness of both the infant and mother for complementary feeding, and prevention of food allergy. It further incorporates anticipatory guidance and proactive planning, proposing stratified, front-loaded, and full-cycle nutritional management strategies for special populations including preterm infants, low birth weight infants, and those with growth faltering, wasting, or overweight/obesity. Through maternal and child health institutions, this consensus aims to guide clinical child health practitioners, pediatricians, and family caregivers in identifying the appropriate timing for introducing complementary foods, progressively enhancing infants′ and toddlers′ perception and acceptance of new foods, fostering healthy dietary habits, and laying a foundation for long-term health.

This study systematically reviews the progress of acupuncture in treating autism spectrum disorder (ASD), covering its historical origins, technological innovations, proposed hypotheses, mechanistic explorations, clinical validation, and pathways for translational research.Tracing back to classical Chinese medical records from the Sui dynasty that described symptoms resembling severe ASD, such as mental obstruction and delayed speech, the study focuses on how acupuncture activates peripheral-to-central neural pathways, promoting the release of pro-social neurotransmitters to improve brain development in individuals with ASD within the framework of modern neuroscience.Building upon preclinical findings, our team developed a transcutaneous electrical acupoint stimulation (TEAS) protocol as a standardized, noninvasive adaptation of traditional acupuncture.The protocol targets four key acupoints with optimized stimulation parameters, including Hegu (LI4), Neiguan (PC6), Zusanli (ST36), and Sanyinjiao (SP6).Multicenter clinical trials demonstrate that integrating TEAS to standardized behavioral therapy significantly enhances therapeutic efficacy, particularly among children with aloof/passive social phenotypes.Consistent changes in peripheral plasma levels of oxytocin (OXT) and arginine vasopressin (AVP), alongside multi-modal brain imaging (structural MRI, resting-state fMRI, and DTI) support the hypothesis that TEAS acts via the OXT pathway to promote sensory integration, enhance social motivation, and reduce anxiety.Clinical assessments and parental follow-up data confirmed the consistent and reproducible benefits.Finally, we further outline a translational roadmap integrating phenotype-based assessment, individualized stimulation parameter optimization, multimodal biomarker systems, and home-based implementation.Large-scale, multicenter, stratified, and multi-omic studies are further warranted to validate generalizability and further elucidate the causal molecular-to-network mechanisms underlying TEAS-mediated neurobehavioral improvement.

This paper aims to explore the effects of exercise interventions on children with developmental coordination disorder (DCD) and their underlying physiological mechanisms, while systematically reviewing recent experimental studies on the impact of exercise interventions on children with DCD. Research indicates that exercise interventions can significantly improve motor coordination in children with DCD, with intervention Methods showing increasing diversity, ranging from fundamental movement training to specialized sports training (such as taekwondo, table tennis), as well as innovative training approaches combining cognitive tasks. Exercise interventions can promote brain physiological changes through inducing synaptic plasticity, restructuring neural circuits, increasing gray matter volume, and regulating neurotransmitter systems, thereby enhancing motor control abilities. These changes are achieved through the activation of multiple signaling pathways, ultimately optimizing functional connectivity in motor-related brain regions.

Objective To investigate the association between single nucleotide polymorphisms (SNPs) in the SPOCK1 and TMEM38B genes and early age at menarche (AAM) in girls from the Sunan region of Gansu Province, so as to provide evidence for the prevention of early AAM. Methods From January to July 2023, 159 menstruated girls aged 9 - 18 from Yugur Autonomous County, Zhangye City, Gansu Province were recruited. Participants were divided into an early AAM group (AAM<12.8 years, n=75) and a normal AAM group (n=84) based on the 25th percentile(12.8 years old)of their AAM. TagSNPs for the candidate genes SPOCK1 and TMEM38B were selected from public NCBI and the shared resources of the 1 000 Genomes Project. Haploview software was used to screen out loci with a minimum allele frequency (MAF) of >0.05, and linkage disequilibrium analysis was performed to finalize the TagSNP. Multivariate logistic regression was used to analyze the association between SNPs and the risk of early AAM under different genetic models. Results After adjusting for confounders, significant associations with early AAM risk were found for SPOCK1 gene SNPs rs1859345 (overdominant model: TC vs. TT+CC, OR=2.10, 95%CI: 1.01 - 4.42, P=0.046) and rs7701979 (overdominant model: GT vs. GG+TT, OR=2.18, 95%CI: 1.02 - 4.65, P=0.040). Significant associations were also identified for TMEM38B gene SNPs rs10453225 (codominant model: GT vs. GG, OR=2.83, 95%CI: 1.29 - 6.20, P=0.024; dominant model: GT+TT vs. GG, OR=2.38, 95%CI: 1.13 - 4.98, P=0.020; overdominant model: GT vs. GG+TT, OR=2.30, 95%CI: 1.21 - 4.40, P=0.011), rs4452860 (recessive model: AA vs. GG+GA, OR=0.43, 95%CI: 0.20 - 0.94, P=0.033; overdominant model: GA vs. GG+AA, OR=2.13, 95%CI: 1.12 - 4.07, P=0.021), and rs12684013 (overdominant model: CT vs. TT+CC, OR=1.96, 95%CI: 1.04 - 3.73, P=0.037). Conclusion The rs1859345 and rs7701979 loci of SPOCK gene, and the rs10453225 locus, rs4452860 locus and rs12684013 locus of TMEM38B gene are all correlated with AAM in girls in Sunan region, suggesting these genes may play a role in the genetic regulation of menarche and providing potential genetic markers for the early screening of early AAM.

Chinese developmental dyslexia (DD), characterized by its unique logographic writing system, exhibits distinct cognitive and neural mechanisms from dyslexia in alphabetic languages. Recent years have witnessed a significant broadening of research perspectives on Chinese DD, encompassing its cognitive underpinnings, cross-linguistic comparisons, objective biomarkers, and ecological support systems. These advances reveal the multidimensionality and complexity inherent in Chinese DD. This article provides an overview, concise evaluation, and recommendations regarding these research developments, aiming to offer insights for future studies on Chinese DD.

Objective To explore the association between early screen exposure and autism spectrum disorder (ASD)-like behavior in high-risk toddlers, and to examine the mediating role of the family nurturing environment, so as to provide evidence for early intervention of ASD-like behavior. Methods A total of 377 high-risk toddlers aged 18 to 35 months, who underwent re-screening at the Hefei Women and Children′s Health Center from January to December 2024, were enrolled.Data on basic information and screen exposure were collected via questionnaires.ASD-like behavior was assessed using the Autism Behavior Checklist (ABC), and the family nurturing environment was evaluated using the 1-3 Year Old Children′s Family Nurturing Environment Questionnaire (Urban Version).Logistic regression was used to analyze the association between screen exposure and ASD-like behavior.The mediating effect of the family nurturing environment was tested using Structural Equation Modeling (SEM). Results Among the 377 high-risk toddlers, 96 (25.5%) exhibited ASD-like behavior, and 182 (48.3%) had high screen exposure.The average total score of the Family Nurturing Environment Scale is (131±19.63).Compared with children without ASD-like behavior, those with ASD-like behavior had a significantly higher rate of high screen exposure and lower scores in the social adaptation/self-care dimension of the family nurturing environment (both P<0.05).Logistic regression analysis showed that high screen exposure was a risk factor for ASD-like behavior (OR=1.710, 95%CI: 1.055 - 2.771, P=0.029).Mediation analysis revealed that the social adaptation/self-care dimension of the family nurturing environment played a full mediating role between screen exposure and ASD-like behavior (significant indirect effect, 95%CI: 0.001 - 0.042). Conclusions The social adaptation/self-care dimension of the family nurturing environment fully mediates the relationship between early screen exposure and ASD-like behavior in high-risk toddlers.Optimizing the family nurturing environment, particularly enhancing the quality of parenting in the social adaptation/self-care dimension, may help alleviate the adverse effects of screen exposure on ASD-like behavior in young children.

Objective To describe the prevalence and temporal trends of overweight/obesity and cardiometabolic risk indicators (blood pressure, lipids, and glucose, etc) among primary school students in Pudong New Area, Shanghai from 2020 to 2024, and to examine longitudinal associations of overweight/obesity and body mass index (BMI) with cardiometabolic risk, so as to provide evidence for early prevention of cardiovascular diseases in children and adolescents. Methods A prospective cohort was established in 2020 using stratified cluster random sampling from 13 primary schools in Pudong New Area.Children aged 6 - 7 years were assessed at baseline (2020) and followed up in 2022 (aged 8 - 9 years) and 2024 (aged 10 - 11 years).A total of 1 483 children completed all three assessments.Height and weight were measured to calculate BMI.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured.Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were assessed at each visit.Fasting plasma glucose (FPG) was measured in 2022 and 2024 but not at baseline.Repeated-measures analysis of variance was used to compare continuous outcomes across visits.Generalized estimating equations were used to assess temporal trends in abnormal detection rate of cardiometabolic indicators.Linear mixed-effects models were used to evaluate longitudinal associations between continuous BMI and cardiometabolic measures. Results The prevalence of overweight was 18.41%, 16.93%, and 16.79% in 2020, 2022, and 2024, respectively, whereas obesity prevalence was 18.95%, 22.25%, and 21.44%.The detection rate of elevated SBP increased from 11.94% to 19.96%, while elevated DBP decreased from 18.75% to 6.07%.Hypercholesterolemia increased from 6.61% to 17.73%.Hypertriglyceridemia decreased from 9.78% to 1.69% and then rebounded to 5.73%.Elevated LDL-C was 4.25%, 11.46%, and 7.35% in 2020, 2022, and 2024, respectively, and low HDL-C was 3.57%, 1.82%, and 4.18%, respectively.The detection rate of abnormal fasting plasma glucose was 0.47% in 2022 and increased to 10.18% in 2024.Compared with normal-weight peers, overweight/obese children had higher risk of elevated systolic blood pressure at all three visits (OR=1.621, 2.564, 2.693), as well as hypertriglyceridemia (OR=1.609, 8.151, 2.814) and low HDL-C (OR=3.001, 8.927, 3.154) (P<0.05).Differences in hypercholesterolemia, elevated LDL-C, and abnormal fasting plasma glucose were not statistically significant (P>0.05).In linear mixed-effects models, each 1 kg/m² increment in BMI was associated with higher SBP (β=1.518 mmHg) and DBP (β=0.451 mmHg), higher TG (β=0.032 mmol/L), higher LDL-C (β=0.021 mmol/L), lower HDL-C (β=-0.035 mmol/L), and higher fasting plasma glucose (β=0.015 mmol/L) (P<0.001), while the association with total cholesterol was not significant (P=0.833). Conclusions Overweight and obesity are important risk factors for cardiovascular metabolic abnormalities in children, particularly associated with elevated blood pressure, increased TG, and decreased HDL-C.Continuous monitoring of BMI changes may be more sensitive than simple overweight/obesity categorization in detecting early signs of cardiometabolic risk.

Objective To examine the association between caregiver parenting stress and social-emotional development in infants and toddlers, in order to provide scientific evidence for early childhood development promotion and the creation of a fertility-friendly society. Methods During November to December 2024, a stratified sampling method was employed to survey 487 primary caregivers of children aged 0-3 years in Sheyang County, Jiangsu Province.The Ages & Stages Questionnaires: Social-Emotional, Second Edition (ASQ:SE-2) and the Parenting Stress Index-Short Form (PSI-SF) were used to assess children′s social-emotional development and caregiver parenting stress, respectively. Results In this study, 13.1% and 6.8% of children scored close to or above the ASQ:SE-2 cutoff, respectively.ASQ:SE-2 scores increased with age (β=0.260, P<0.001).The average score of PSI-SF among caregivers was 79.13±26.62, with 24.6% reporting high parenting stress.Multiple linear regression analysis revealed that overall caregiver parenting stress (β=0.371, P<0.001) and the "difficult child" subscale (β=0.253, P=0.004) were significantly positively associated with poorer social-emotional outcomes in children, indicating that higher caregiver stress correlated with lower child social-emotional competence. Conclusions Infant and toddler social-emotional development is closely linked to caregiver parenting stress.Early screening for behavioral and psychological development should be implemented, along with interventions to alleviate caregiver stress and foster supportive rearing environments, thereby promoting high-quality population development.

Objective To investigate the ameliorative effects and potential mechanisms of breast milk-derived Lactiplantibacillus plantarum FN029 on β-lactoglobulin (β-LG)-induced food allergy in mice, in order to provide reference for the prevention and treatment of food allergy. Methods BALB/c mice were randomly divided into a control group, a food allergy group (induced by β-LG), and an FN029 intervention group.FN029 was administered by oral gavage for intervention.Allergic symptom scores were evaluated.Histopathological staining was performed to assess lung and jejunal injury as well as mast cell infiltration.Serum immunoglobulin and cytokine levels were measured.In addition, mRNA expression of Th1/Th2 cytokines in the jejunum, expression of tight junction proteins, and protein levels of the AKT/mTOR and NF-κB signaling pathways were analyzed. Results Compared with the control group, mice in the food allergy group exhibited pronounced allergic symptoms, weight loss, and increased spleen index.Lung and jejunal tissues were damaged, with increased mast cell infiltration.Serum levels of total IgE, β-LG-specific IgE, IgG1, histamine, and IL-4 were significantly elevated, accompanied by upregulated jejunal Th2 cytokine IL-4 and Th1 cytokine IFN-γ levels.Furthermore, expression of intestinal tight junction proteins (ZO-1, Occludin, Claudin-1) was decreased, and phosphorylation levels of key proteins in the AKT/mTOR and NF-κB signaling pathways were abnormally increased (P<0.05).FN029 intervention significantly ameliorated allergic symptoms and signs, alleviated tissue damage and mast cell aggregation, downregulated serum IgE, histamine, and jejunal IL-4 levels, and upregulated IFN-γ, effectively correcting the Th1/Th2 imbalance.In addition, FN029 promoted the restoration of intestinal tight junction proteins and significantly inhibited phosphorylation activation of AKT and NF-κB (P<0.05). Conclusions Lactiplantibacillus plantarum FN029 effectively alleviates food allergy symptoms in mice, and its underlying mechanisms may be related to inhibition of allergen-induced activation of the AKT/mTOR and NF-κB inflammatory signaling pathways, restoration of the intestinal physical barrier, and modulation of Th1/Th2 immune balance.

Objective To develop a phonological awareness assessment scale suitable for Mandarin-speaking children aged 5-8 in China, and to examine its reliability and validity, so as to provide a scientific tool for the early clinical identification and intervention of children with reading difficulties. Methods The scale framework and items were constructed, followed by revisions through expert consultation, small-sample pilot testing, and preliminary predictive studies.Standardized audio recording processing and a playback program were also developed.Using a multi-stage sampling method, 298 children aged 5-8 were included to evaluate the scale′s reliability and validity. Results The final phonological awareness assessment scale consisted of 58 items across five dimensions.Reliability tests showed that the Cronbach′s α coefficients for each dimension ranged from 0.728 to 0.890, and test-retest reliability ranged from 0.632 to 0.760.Content validity was ensured through dual strategies of expert consultation and small-sample pilot testing.In terms of validity, construct validity analysis indicated that scores across all dimensions of the phonological awareness scale increased with age (Z=3.036, H values: 82.958-127.472, P<0.05).Using the rapid automatized naming test as the criterion tool, scores in syllable, onset, rime, and tone awareness showed significant negative correlations with naming time (r values:-0.343 to -0.617, P<0.05). Conclusions The Children′s Phonological Awareness Assessment Scale is suitable for Mandarin-speaking children aged 5-8, demonstrating good reliability and validity.It provides a theoretical basis for the early identification and intervention of children with reading difficulties.

Objective To explore whether autism spectrum disorder (ASD) children can rely on visual feedback to improve motor learning adaptability, so as to reveal the biological basis of perceptual-motor integration in ASD children and to provide empirical evidence and theoretical support for developing motor intervention based on adaptive difficulty regulation. Methods From July 2022 to December 2023, 21 children with ASD who received rehabilitation training at the Wuhan Linjie Children′s Rehabilitation Service Center, as well as 21 typically developing (TD) children attending five primary schools and kindergartens in Wuhan, participated in a computerized visuomotor adaptation experiment.The experiment consisted of three phases: baseline, adaptation (with a 30° counterclockwise rotation of visual feedback), and post-adaptation.Directional error (DE), movement time (MT), and root mean square error (RMSE) were selected to examine visuomotor learning ability. Results During the adaptation phase, as the number of exercises increased, both ASD and TD children showed significant improvements in DE, MT, and RMSE (F=5.445, 13.473, 11.196, P<0.05), and there were no significant differences between the two groups (P>0.05).In the post-adaptation phase, ASD children showed a significantly greater improvement in RMSE compared to their baseline performance (t=2.275, P<0.05) and this improvement was significantly greater than that of TD children (t=2.112, P<0.05). Conclusions ASD children can update their internal model through visual feedback, especially in motor control ability.Future motor learning and intervention programs for children with ASD should incorporate specific visual aids to improve intervention outcomes.

Objective To characterize nutritional status of children with Williams syndrome (WS), so as to provide clinical evidence for standardized nutritional management. Methods A cross-sectional survey was conducted in children with genetically confirmed WS who attended the Children′s Hospital, Zhejiang University School of Medicine, from March to September 2023.Forty-two children were enrolled; 4 did not complete the dietary survey and 6 were excluded due to incomplete dietary records, leaving 32 children for the anthropometric and dietary analysis.Nutritional risk was assessed using STRONGkids.Height and weight were measured, and Z-scores were calculated based on the WHO 2006 growth standards using WHO Anthro/AnthroPlus, including height-for-age Z score (HAZ), weight-for-height Z score (WHZ,<5 years old), and BMI-for-age Z score (BAZ, ≥5 years old).Wasting was defined as WHZ/BAZ<-2 and stunting as HAZ<-2; either criterion indicated malnutrition.Dietary intake was assessed using 3-day food records.Daily mean energy and macronutrient intakes were calculated with nutrition software, and adequacy was expressed as intake/age- and sex-specific DRIs ×100%;<80% was considered inadequate. Results Among the 32 children, 24 (75.0%) were male and 8 (25.0%) were female, with a mean age of 3.88 years old.STRONGkids indicated moderate risk in 13 (40.6%) children and high risk in 19 (59.4%) children.Malnutrition was identified in 12 (37.5%) children.Inadequate intake was observed for energy in 27 (84.4%) children, carbohydrate in 29 (90.6%) children, fat in 23 (71.9%) children, and protein in 4 (12.5%) children. Conclusions Children with WS have a high nutritional risk and a considerable prevalence of malnutrition, along with widespread inadequacy of energy and macronutrient intake.Long-term nutritional assessment and individualized interventions are warranted to improve the nutritional outcome.

Objective To construct an evaluation index system for health literacy among preschool children in Shenzhen using the Delphi method, in order to lay a foundation for establishing standardized evaluation tools in the future. Methods Based on a literature review, an initial indicator pool was developed.From September to October 2023, twenty-one experts from relevant fields were invited to conduct two rounds of consultation.The importance and feasibility of each dimension and item were scored using a 5-point Likert scale.Indicators were screened and optimized based on the results of the expert consultations. Results The experts had extensive professional experience and high engagement levels.The response rates for both rounds of questionnaires exceeded 95%, indicating a high level of expert engagement.The expert authority coefficients (Cr) were all greater than 0.90, suggesting high reliability of the opinions.The final evaluation index system for preschool children's health literacy consisted of 5 dimensions: dietary literacy, exercise literacy, safety literacy, psychological literacy (including interpersonal interaction), and basic hygiene literacy, comprising a total of 32 items. Conclusions The evaluation index system for health literacy among preschool children, preliminarily constructed based on the Delphi method, demonstrates high expert authority and scientific rigor.It covers comprehensive dimensions and provides a reference basis for the development of subsequent monitoring tools and related intervention research.

Objective To explore the association of early postnatal antibiotic exposure with the development of autism spectrum disorder (ASD) and the occurrence of gastrointestinal comorbidities in ASD, so as to provide theoretical basis for the prevention of certain cases of ASD. Methods A case-control study was conducted, including children diagnosed with ASD at the Child Psychology Clinic of the Affiliated Hospital of North Sichuan Medical College from January 2022 to December 2023 as the ASD group.Healthy children of similar gender and age were recruited from the Child Health Clinic during the same period as the control group.Data on general information, gastrointestinal symptoms, and antibiotic exposure within the first two years of life were collected through questionnaires.Logistic regression analysis was employed to explore the association between early antibiotic exposure and the occurrence of ASD, as well as its role in gastrointestinal symptoms comorbid with ASD. Results The proportion of early antibiotic exposure was significantly higher in the ASD group compared to the control group (37.2% vs. 18.8%, χ²=42.407, P<0.001).The incidence rates of overall gastrointestinal symptoms, constipation, abdominal pain, nausea and vomiting, and foul-smelling stools were significantly higher in the antibiotic-exposed ASD group compared to the non-exposed ASD group (67.6%, 42.2%, 25.4%, 9.7%, 17.3% vs. 39.4%, 25.3%, 8.7%, 5.1%, 7.1%, respectively, P<0.05).After adjusting for gender, age, early residence, maternal education, maternal age at pregnancy, gestational age, delivery mode, feeding method, and early family annual income, logistic regression analysis revealed that early antibiotic exposure was a risk factor for ASD (OR=2.21, 95%CI: 1.61 - 3.05, P<0.001) and for gastrointestinal comorbidities in ASD (OR=3.17, 95%CI: 2.14 - 4.70, P<0.001).For specific gastrointestinal symptoms, both unadjusted and adjusted models indicated that early antibiotic exposure increased the risk of constipation (OR=2.03), abdominal pain (OR=3.90), and foul-smelling stools (OR=3.06) in children with ASD(P<0.001). Conclusions Early antibiotic exposure may increase the risk of ASD and gastrointestinal comorbidities in ASD.Therefore, unnecessary antibiotic use in early life should be avoided.

Autism spectrum disorder(ASD) is a neurodevelopmental disorder primarily characterized by social impairments and repetitive, stereotyped behaviors, resulting from the combined effects of genetic and environmental factors. Maternal immune activation (MIA) has been recognized as one of the significant risk factors for the occurrence of ASD in offspring. Recent studies have implicated MIA in metabolic disorder, disrupted gut microbiota, epigenetic alterations, and neuroinflammation associated with ASD. However, the specific underlying mechanisms remain elusive. Therefore, this study aims to provide theoretical support for the etiology research of ASD by comprehensively reviewing the mechanisms pertaining to the elevated risk of ASD associated with MIA.

Autism spectrum disorder (ASD) is a severe neurodevelopmental disorder characterized by persistent deficits in social communication and interaction, as well as limited and repetitive behavioral patterns. Due to the unknown etiology and high heterogeneity, the current evaluation of the rehabilitation effect of children with ASD is still mainly based on direct observation and assessment of children′s behaviors. Exploring a more objective evaluation method of rehabilitation effect is not only a powerful evidence to judge whether the treatment is effective, but also can provide more reference indicators for the formulation of intervention plans. Eye-tracking technology, with its non-invasive nature, high precision, ease of use, and high degree of freedom, shows considerable potential for evaluating the rehabilitation outcomes in children with ASD. This article reviews the research, specific advantages, and current applications of eye-tracking technology in assessing the rehabilitation outcomes in children with ASD, aiming to provide methods and perspectives for studying the physiological and psychological characteristics of these children and the objective evaluation of clinical interventions effects.

In response to the national strategic policy on promoting the development of infant and toddler care services, and to accelerate the establishment of a scientific, standardized, and practical medical-nurturing integrated care service system, the Infant and Toddler Nurturing and Care Professional Committee of the Chinese Maternal and Child Health Association has organized experts from multiple fields including medical care and nurturing care to formulate this consensus. The consensus clarifies the core connotation of the medical-nurturing integration, elaborates on the requirements in terms of personnel capabilities, service processes, content integration, and environmental creation, defines the specific responsibilities and collaborative paths of medical institutions in health protection, development promotion, risk management, and empowerment guidance, as well as those of childcare institutions in daily care, health observation, learning support, and home-toddler care integration. It also proposes differentiated implementation strategies for four scenarios: childcare, medical care, community, and family, as well as five service models including on-site, paired, centralized,one-stop and intelligent type services. Moreover, it presents an assessment system covering three dimensions: infant and toddler health and development, institutional care quality, and family satisfaction, providing guidance and reference for the implementation of medical-nurturing integrated infant and toddler care services.

Objective To investigate the potential causal relationships between major ambient air pollutants and common neurodevelopmental disorders (NDDs), so as to explore the role of environmental exposure in the pathogenesis of NDDs from a genetic perspective. Methods A two-sample Mendelian randomization(MR) design was adopted, drawing on large-scale genome-wide association study (GWAS) summary data from individuals of European ancestry.Five common air pollutants (PM_2.5,PM_2.5-10, PM₁₀, NO₂, NO_X) served as exposures and three major NDDs including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and Tourette syndrome (TS) were considered as outcomes.The inverse-variance weighted (IVW) method was employed as the primary analytical approach, complemented by weighted median, MR-Egger regression, simple mode, and weighted mode estimators to ensure robustness.Sensitivity analysis included heterogeneity testing (Cochran's Q), horizontal pleiotropy assessment (MR-Egger intercept), MR-PRESSO analysis (global test, outlier detection, and distortion test), and leave-one-out analysis to evaluate the stability and reliability of the causal estimates. Results The MR analysis showed that exposure to PM_2.5 (OR=2.63, 95%CI: 1.73 - 4.01, P<0.01), NO₂(OR=1.56, 95%CI:1.13 - 2.16, P<0.01) and NO_x(OR=1.69, 95%CI: 1.23 - 2.34, P<0.01) was significantly associated with an increased risk of ADHD, and these associations remained consistent across multiple complementary analytical methods.No significant causal effects were observed for PM_2.5-10 or PM₁₀ on ADHD, nor for any air pollutants on ASD or TS (P>0.05).Sensitivity analysis indicated no evidence of directional pleiotropy based on the MR-Egger intercepts,and the robustness of the causl estimate was further supported by leave-one-out analysis.While some heterogeneity and potential outlier SNPs were detected, MR-PRESSO distortion tests showed no significant bias in causal estimates (P>0.05), reinforcing the robustness of the original findings. Conclusion Air pollutants PM_2.5,NO₂ and NO_X are confirmed as environmental risk factors contributing to the development of ADHD, indicating the critical public health importance of enhancing air pollution control measures for the prevention and intervention of NDDs.

Statistical learning refers to the human capacity to extract statistical information from continuous speech streams to acquire language, involving both visual and auditory modalities and is associated with specific neural mechanisms in the brain.Research indicates that early statistical learning ability is closely linked to children's acquisition of phonology, vocabulary, and grammar.Deficits in this ability are observed in children with language impairments such as autism spectrum disorder (ASD), developmental language disorder (DLD), and developmental dyslexia (DD), contributing to difficulties in language comprehension and expression.Based on previous studies and clinical applications, statistical learning tasks can serve as early screening tools.Additionally, intervention strategies related to statistical learning, such as repetitive language input and multisensory engagement training, can effectively enhance the language abilities of children with language disorders.This article reviews the impact of statistical learning on early language development in children and its applications in clinical and child healthcare settings.It provides a scientific basis for the early identification and intervention of language development issues and offers insights for future clinical practice.

Objective To explore the main influencing factors and their combined effects on tic disorder (TD) comorbid with attention-deficit/hyperactivity disorder(ADHD) in children, in order to provide a theoretical basis for developing prevention and treatment strategies for TD with ADHD (TD+ADHD). Methods A total of 80 new cases of TD+ADHD treated in the Department of Developmental and Behavioral Pediatrics of Fujian Children′s Hospital from January 2023 to April 2024 were included as the observation group, and 178 new cases of TD-only treated in the same department matched by gender and age frequency of the observation group were included as the control group. A questionnaire survey was administered. Results Univariate analysis showed that there were statistically significant differences in family history of TD (χ²=4.093), parental allergic disease (χ²=7.912), corporal punishment (χ²=10.393), criticism (χ²=19.457) and keeping pets (χ² =5.142) (P<0.05) between the TD+ADHD group and the TD-only group. Multivariate unconditional logistic regression analysis showed that the risk of ADHD comorbidity in TD children whose parents had allergic diseases and who experienced corporal punishment was 4.485 times that of TD children whose parents had no allergic diseases and who experienced no corporal punishment (95%CI: 1.915 - 10.505,P<0.01). The risk for TD children whose parents had allergic diseases and kept pets was 5.006 times that of those whose parents had no allergic diseases and did not keep pets (95%CI: 1.815 - 13.807,P<0.01). The risk for TD children whose parents had allergic diseases and who experienced both corporal punishment and pet ownership was 18.693 times that of those whose parents had no allergic diseases, experienced no corporal punishment, and did not keep pets (95%CI: 3.862 - 90.488,P<0.001). Conclusions TD comorbid with ADHD in children Results from the interaction of genetic and environmental factors. Parental allergic diseases combined with corporal punishment and pet ownership significantly increase the risk of ADHD comorbidity in children with TD.

Objective To understand the sleep problems among children aged 3 - 6 years in Central China and their association with parenting styles, in order to provide reference for improving sleep quality in preschool children. Methods Using a stratified cluster sampling method, a questionnaire survey on sleep problems among children and parenting styles was conducted among 4 246 parents of children aged 3 - 6 years in Central China (Henan, Hubei, Hunan) from April to June 2023. Univariate analysis and logistic regression analysis were used for statistical analysis. Results The detection rate of sleep problems among children aged 3 - 6 years in Central China was 15.83%. The detection rate of delayed sleep onset differed significantly among different age groups (χ²=27.649, P<0.01). Significant differences were observed between urban and rural children in sleep resistance (χ²=11.549) and sleep continuity (χ²=38.886) (P<0.01). Logistic regression analysis showed that children with higher levels of paternal hostile coercion had an increased risk of sleep problems (OR=2.21, 95%CI: 1.59 - 3.15, P<0.01). Children with higher levels of maternal hostile coercion had an increased risk of sleep problems (OR=2.56, 95%CI: 1.88 - 3.33, P<0.01). Compared with children whose parents both exhibited low levels of hostile-aggressive behavior, those whose parents both exhibited high levels of hostile-aggressive behavior also had an increased risk of sleep problems (OR=3.59, 95%CI: 2.81 - 4.48, P<0.01). Conclusions The prevalence of sleep problems among preschool children aged 3 - 6 years in Central China is relatively high. Preschool children with high levels of paternal hostile coercion, maternal hostile coercion, or parental hostile coercion all exhibit an increased risk of sleep problems.

This consensus aims to provide evidence-based, safe, and personalized practical guidelines for the nurturing care of infants and toddlers with special health needs (including those with growth deviations, mild psychological and behavioral developmental deviations, and chronic diseases in stable stages) in nursery institutions. Based on the six principles of "safety first, individualization, responsive care, integration of medical and nurturing care, developmental support, and respect for confidentiality", the consensus systematically proposes basic requirements regarding personnel qualifications, system construction, environmental facilities, and collaborative mechanisms. Furthermore, specific care objectives and recommendations are delineated for six common categories of infants and young children with special health needs: malnutrition/obesity, mild psychological and behavioral developmental deviations, food allergies, epilepsy, asthma, and preterm infants. Additionally, it emphasizes the establishment of a case management system, dynamic monitoring and early warning mechanisms, and a closed-loop referral process through the tripartite collaboration of families, nurseries, and medical institutions, ensuring continuity and high quality of care. The implementation of this consensus will provide a scientific basis for the standardization of nursery services and policy formulation, promoting the comprehensive early development of infants and toddlers with special health needs.

Disorder of written expression is a common learning disability among school-age children, with a prevalence rate ranging from 3.8% to 8.6% in China.It significantly affects children′s academic achievement and social functioning.Currently, international researchers have made some progress in the study of written expression disorder, achieving important results in the development and application of assessment tools.However, there remains a lack of a well-constructed assessment system for this disorder in China.Therefore, this paper provides a systematic review of relevant assessment tools developed domestically and internationally.Based on the linguistic features, cognitive-neurological characteristics, and clinical diagnostic criteria, we propose a strategy for the development of assessment tools for disorders of written expression in Chinese, so as to provide a basis for early detection and precise intervention for children with this disorder.

The high-frequency loose stools commonly observed in breastfed infants are not a pathological condition, but rather a specific defecation pattern resulting from the metabolic utilization of human milk oligosaccharides (HMO).As a natural prebiotic, HMO selectively promotes the proliferation of Bifidobacterium, particularly the B.longum subsp.infantis.These bacteria metabolize HMO to produce organic acids such as lactic acid and acetic acid, lowering the intestinal lumen pH and regulating water and electrolyte balance, which may be one of the reasons for the soft consistency and frequent defecation.Secondly, if HMOs are not completely metabolized, they can increase the osmotic load in the intestinal lumen, drawing in water that is then excreted as loose stools.Clinically, assessment should not rely on stool frequency alone.Instead, a stratified evaluation integrating the infant′s general condition, growth trajectory, and stool characteristics is recommended.The diagnosis of physiological diarrhea should be used cautiously to reduce overdiagnosis and unnecessary interventions and to support the continuation and implementation of breastfeeding.