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.

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.

Objective To investigate the efficacy of play therapy within the framework of family co-activities for children with autism spectrum disorder(ASD), in order to provide a scientific basis for exploring effective intervention methods that enable long-term adherence to family-based training for children with ASD. Methods A total of 120 children aged 12 to 48 months with ASD, who visited the Ganzhou Maternity and Child Healthcare Hospital from September 2022 to April 2024, were selected as study participants. They were randomly divided into three groups using a random number table. The observation group received parent training and hands-on teaching, with the subjects engaging in family co-activity play for 3 hours per day. The conventional intervention group underwent conventional applied behavior analysis(ABA) intervention therapy. The home care group did not receive any intervention treatment and was managed through routine home care practices. The intervention period lasted for 6 months, and the Gesell Developmental Scale was used to assess the treatment outcomes of the children. Results There were no statistically significant differences in gender and age distribution among children in the observation group, conventional intervention group, and home care group(P＞0.05).Before the intervention, there were no statistically significant differences in total developmental quotient(DQ), adaptability, language, and personal-social skills among children in the three groups(P＞0.05). After the intervention, statistically significant differences were observed in total DQ, adaptive DQ, language DQ, and personal-social DQ among the three groups(F=15.010, 4.942, 14.102, 22.665, P＜0.05). Compared with the home care group, the observation group had higher total DQ(69.51±9.17 vs. 60.18±9.92), adaptive DQ(62.23±10.61 vs. 54.73±11.36), language DQ(54.95±12.41 vs. 44.38±10.71), and personal-social DQ(61.21±13.58 vs. 47.81±11.74) (P＜0.05). Compared with the conventional intervention group, the observation group had higher total DQ(69.51±9.17 vs.59.65±8.56), language DQ(54.95±12.41vs.42.50±11.28), and personal-social DQ(61.21±13.58 vs.44.63±8.50)(P＜0.05). Conclusions By training parents to engage in co-activity play at home,play therapy within the framework of family co-activities can effectively improve the adaptability, language ability, and personal-social skills of children with ASD, reducing the economic burden on the family and improving the efficiency of caregiving. This model has the potential to become an effective long-term intervention method for ASD families and is worthy of widespread promotion among children with ASD and their families.

Dyslexia is the most common type of specific learning difficulty, affecting approximately 5% to 10% of school-age children.From the perspective of cognitive psychology, this paper systematically reviews the cognitive mechanisms, assessment tools, diagnostic criteria, and intervention research on dyslexia, and highlights that the primary focus of its assessment and intervention is decoding ability (character recognition).Future efforts should integrate advances in artificial intelligence and educational technology to promote the establishment of early screening and evidence-based intervention systems.

Neuroscience is one of the most promising research fields in the 21st century,holding significant importance for studies on child development and education.This article begins with findings from neuroscience research to outline the fundamental patterns of brain development in children.It then analyzes the impact of brain science on child development from three aspects:cognitive development,emotional development,and social development.Specifically,it examines influences on attention,types of memory,and thinking abilities within cognitive development.The article proposes educational recommendations based on neuroscience to promote healthy brain development in children,including providing appropriate environmental stimuli,fostering good living habits,emphasizing emotional support and guidance,and implementing personalized education.These suggestions aim to offer scientific guidance for the healthy growth of children.Additionally,the article offers a perspective on the future prospects of brain technology in the field of child health development.

Neuroscience, as a comprehensive discipline that studies the structure, function, and developmental patterns of the nervous system, provides a critical theoretical foundation for understanding human cognition, emotions, and behavior.The rapid advancements in neuroscience research have offered fresh perspectives on child health and development. This paper systematically explores the intrinsic connections between neuroscience and child health development, with a particular focus on the characteristics of brain development and its influencing factors during the critical period of 0 - 6 years.Research on children′s brain health development reveals the complexity of the interaction between neural development and environmental factors.Moving forward, it is essential to integrate multidisciplinary findings and develop neuroscience-based intervention strategies to create an optimal growth environment for children.

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.

China has a large population of children with autism spectrum disorder (ASD), yet there remains a significant gap between available service resources and the needs of these children.To enhance the capacity of the national maternal and child health system in serving children with ASD, the China Maternal and Child Health Association initiated the "Standardized Construction of a Three-Tier Autism Prevention and Intervention Network" project.The Committee on Autism Prevention and Intervention organized experts to develop this consensus, which addresses the establishment of a three-tier network and outlines standardized approaches for screening, diagnosis, rehabilitation therapy, and family support.

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.

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.

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.

Objective To investigate the serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) in early male neonates of different gestational ages and their relationships with penis length and testicular volume, so as to provide basis for the timing of early intervention in male sexual underdevelopment and fertility preservation. Methods From January 2022 to February 2023, 50 clinically stable early male neonates with a gestational age of ≥32 weeks admitted to the neonatal ward of the First Affiliated Hospital of Henan University of Science and Technology were selected into this study, and were divided into a preterm group and a term group based on their gestational age. Penis length and testicular volume were measured, and serum levels of FSH, LH, and T were tested using chemiluminescent immunoassay. The correlation of penis length and testicular volume with serum levels of FSH, LH, and T were analyzed. Results No significant differences were observed in serum levels of FSH, LH, and T between the preterm and term groups (P>0.05). Serum FSH and LH levels were positively correlated with penis length in both groups (preterm group: r=0.466, 0.632, P<0.05; term group: r=0.449, 0.501, P<0.05), while serum T levels were not significantly correlated with penis lengthand testicular volume in either group (P>0.05). Serum FSH level in the term group and serum LH level in both groups were positively correlated with (r=0.435, 0.578, 0.433, P<0.05). Conclusions Serum levels of FSH, LH, and T are not related to gestational age. FSH and LH promote the growth and development of the penis, and LH promotes testicular volume growth. Additionally, FSH is found to promote testicular volume growth only in term infants.

The metabolism of lactose primarily relies on the hydrolytic action of lactase, whose activity is regulated by genetic factors and developmental stages.Lactose intolerance can be classified into four types: primary, secondary, congenital, and developmental, with diverse clinical manifestations.Diagnostic methods include hydrogen breath test, lactose tolerance test, and genetic testing, but there is currently no simple and reliable standardized diagnostic approach.Treatment strategies encompass dietary modifications, enzyme replacement therapy, and probiotic supplementation.This article summarizes the metabolic mechanisms of lactose in the intestine, as well as recent advances in the pathophysiology, diagnosis, and treatment of lactose intolerance.A deeper understanding of lactose metabolism is crucial for improving the management of lactose intolerance.

Objective To investigate the association between different feeding methods and infant gastrointestinal health, in order to provide evidence to promote exclusive breastfeeding during early infancy. Methods Participants were recruited from November 2021 to September 2022 in Nanjing, Chengdu, Xi′an, Wuhan, Guangzhou, and Qingdao.Infant gastrointestinal health was assessed using the Infant Gastrointestinal Symptom Questionnaire (IGSQ).Generalized linear models and Logistic regression analyses were employed to examine the relationship between feeding methods and IGSQ scores, as well as common gastrointestinal symptoms. Results A total of 765 mother-infant pairs were included.The median IGSQ scores were 21.00 (17.00, 25.00) for the exclusive direct breastfeeding group, 22.00 (18.00, 26.00) for the exclusive breastfeeding (direct + bottle-fed) group, and 22.00 (18.00, 27.00) for the mixed-feeding group.The average IGSQ score of infants in the mixed feeding was 1.106 points higher than that of the exclusive direct breastfeeding group (95%CI: 0.060 - 2.152, P=0.038).Compared with exclusive direct breastfeeding, mixed feeding was associated with a higher risk of constipation in infants(AOR=1.96, 95%CI: 1.198 - 3.202, P=0.007).The risk of dysphagia in infants in the exclusive breastfeeding (direct+bottle-fed)group and mixed feeding group was 2.14 (95%CI: 1.074 - 4.256, P=0.030) and 2.52 (95%CI: 1.371 - 4.637, P=0.003) times as high as that in the exclusive direct breastfeeding group, respectively.Additionally, exclusively breastfed infants exhibited fewer signs of irritability. Conclusions Exclusive direct breastfeeding in early infancy may help reduce gastrointestinal burden and negative emotional expressions in infants, demonstrating beneficial effects on gastrointestinal health.

Objective To explore the characteristics of non-suicidal self-injury (NSSI) behaviors in children and adolescents with anxiety disorders and depressive disorders, in order to provide a theoretical basis for clinical interventions. Methods From October 2019 to October 2023, 135 subjects were investigated through convenience sampling method from the Child and Adolescent Psychological Counseling Clinic at the Shanghai Mental Health Center between October 2019 and October 2023.The Ottawa Self-Injury Questionnaire was used to measure self-injury methods and motivations.The Children′s Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders, the Parental Bonding Instrument, the Childhood Trauma Questionnaire, and the Coping Style Questionnaire for Middle School Students were employed to assess levels of anxiety and depression, parenting environment, and coping characteristics.Independent sample t-tests and chi-square tests were used to compare differences between the two groups. Results A total of 135 participants aged 9 to 17 were included, with 37 having anxiety disorders accompanied by NSSI and 98 having depressive disorders accompanied by NSSI.Compared to the anxiety disorder group, the depressive disorder group with NSSI exhibited more detection rates of self-injury on the arms (χ²=4.22, P=0.04).The rate of cutting as a method of self-injury was significantly higher in the depressive disorder group with NSSI than in the anxiety disorder group (χ²=4.92, P=0.03), while nail-biting was significantly more common in the anxiety disorder group with NSSI than in the depressive disorder group with NSSI (χ²=5.11, P=0.02).Compared to the anxiety disorder group with NSSI, the depressive disorder group with NSSI had a higher motivation for sensation-seeking (P<0.05).The depressive disorder group with NSSI also experienced more emotional neglect/abuse and physical neglect/abuse during childhood, felt less emotional warmth from both parents, and used problem-solving coping strategies less frequently (P<0.05). Conclusions Children and adolescents with anxiety disorders and depressive disorders accompanied by NSSI exhibit different characteristics in terms of self-injury locations and motivations.Therefore, targeted intervention plans should be designed.

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.

Parent-child attachment serves as the cornerstone of children′s emotional development.Parent-child attachment encompasses secure, avoidant, ambivalent, and disorganized types.Both attachment styles and age exert influences on children′s emotional growth, affective understanding, and regulation.In the digital era, phenomena such as "technoference", "excessive screen exposure" , and "behavioral modeling-enhanced control" pose significant threats to the formation of secure parent-child attachment, thereby impacting children′s emotional development.This paper proposes the STEP strategy, which includes Selecting appropriate digital content, engaging Together in digital product usage, Engineering well-designed timing and contexts for digital use, and Promoting parents′ interactive competencies scientifically.This framework aims to facilitate the scientific transition of parent-child attachment into the digital age and foster healthy emotional development in children.

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.

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.

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.

Objective To explore the characteristics of brain functional networks in preschool children with autism spectrum disorder(ASD), in order to provide a theoretical basis for the pathological mechanism of ASD. Methods From September 2022 to October 2023, 28 children aged 4 to 6 years with ASD receiving intervention in the Rehabilitation Treatment Centerfor Children with ASD of Chongqing and 20 age-matched typically developed children were selected. Resting-state functional near-infrared spectroscopy(fNIRS) imaging data were collected. Graph theory analysis was used to compare differences in brain functional topological properties between the two groups, with global indices(global efficiency, local efficiency) and nodal indices(nodal degree, nodal efficiency) as dependent variables. Results Compared with typically developed children, children with ASD exhibited higher nodal degree(t=5.570, P=0.023) and lower nodal efficiency(t=6.916, P=0.012) in the medial prefrontal cortex(mPFC). In terms of global indices, after excluding the influence of gender, ASD children had higher local efficiency(t=4.714, P=0.036) and lower global efficiency(t=5.862, P=0.020). Conclusions The mPFC serves as an important information transmission hub in preschool children with ASD. Compared with typically developed children, children with ASD have deficiencies in information integration and global information transmission but exhibit certain advantages in local information transmission and differentiation.

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.

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.

This article provides an overview and summary of the application and key influencing factors of parental involvement in cognitive behavioral therapy (CBT) for the treatment of anxiety disorders in children and adolescents. It emphasizes the critical role of parents in therapy and provides a detailed analysis of methods, effectiveness, and feasibility of parent-focused interventions based on CBT. The paper explores the importance of key factors such as parental anxiety management, emotional support, reducing accommodating behaviors, shifting control, and enhancing parental involvement. These findings deepen the understanding of the role of parents in the treatment of child and adolescent anxiety and provide directions for future research and clinical practice.

Children with cerebral palsy (CP) often have foot and ankle deformities as complications or sequelae, which is one of the main causes of motor dysfunction in children.This article provides a comprehensive review of the pathogenesis, severity classification, rehabilitation assessment, and rehabilitative therapy of foot and ankle deformities in CP children, aiming to assist clinical healthcare professionals in making decisions regarding the prevention and rehabilitation of such symptoms in CP children.

Objective To analyze the current research status of social anxiety in adolescents, and to identify research hotspots and frontiers through CiteSpace, so as to provide insights and references for the direction of scientific research in this field. Methods Relevant literature on social anxiety in adolescents from January 1st, 2003, to December 31st, 2023, was searched in the Web of Science Core Collection (WOSCC). CiteSpace was utilized to conduct co-occurrence, clustering, and burst analysis of authors, countries/regions, and keywords. Results A total of 433 articles were included. Pine Daniel S has published the most articles (15) in the field of social anxiety in adolescents, and the United States ranked first in terms of publication volume (136 articles). Keyword analysis revealed that "comorbidity", "prevalence", "risk factors", "behavioral inhibition", "social skills", "cognitive behavioral therapy", "psychopathology", and "model" were the research hotspots and trends in this field. Conclusions Popular topics in this research field focus on the prevalence, comorbidity, mechanisms of occurrence and development, and treatment of social anxiety in adolescents. Future research should further clarify the etiology of social anxiety in adolescents and explore biomarkers for social anxiety disorder in adolescents using neuroimaging techniques, as well as interventions with better therapeutic effects.

Objective To examine gender- and age-related differences in developmental levels and symptom severity among children with autism spectrum disorder (ASD), and to analyze the correlation between symptom severity and developmental levels, in order to provide theoretical support for early ASD identification, diagnosis, and intervention. Methods A total of 236 children aged 18 - 72 months who were newly diagnosed with ASD at the Developmental-Behavioral Clinic of Beijing Chaoyang Maternal and Child Health Hospital were enrolled in this study between January 2020 and July 2024.Developmental quotients (DQs) were assessed using the Gesell Developmental Schedules, while symptom severity was evaluated with the Childhood Autism Rating Scale (CARS).Comparative analysis of developmental levels and symptom severity across genders and age groups were conducted, along with correlation analyses between symptom severity and developmental levels. Results No significant gender differences were observed in adaptive, fine motor, language, or personal-social DQs, nor in total CARS scores (P>0.05).However, girls demonstrated significantly higher gross motor DQs than boys (Z=2.059, P<0.05).Significant age-related differences were found in adaptability (H=18.108), gross motor (H=68.413), fine motor (H=26.194), and personal-social (H=44.728) DQs (P<0.001), with the <2-year-old group showing the highest scores and the ≥3-year-old group the lowest.The distribution of gross motor developmental level across genders showed significant variation (χ²＝11.539, P<0.01), and boys demonstrated significantly higher rate of gross motor developmental delay than girls. Age-stratified analyses revealed statistically significant differences in adaptive (χ²=23.206), gross motor (χ²=74.583), fine motor (χ²=41.321), and personal-social (χ²=44.560) development levels (P<0.001), with the ≥3-year-old group exhibiting the highest developmental delay rates.CARS scores showed significantly negative correlations with all developmental domains (adaptive: r=-0.341, gross motor: r=-0.266, fine motor: r=-0.336, language: r=-0.331, personal-social: r=-0.399, P<0.001). Conclusions ASD children show no marked gender differences in developmental levels or symptom severity.However, older age and greater symptom severity are associated with lower developmental levels.ASD intervention programs should be individualized based on comprehensive developmental assessments and symptom.

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.

Objective To analyze the profile of inborn errors of metabolism (IEM) using tandem mass spectrometry (MSMS) screening, and to clarify the epidemiological characteristics and genetic variant spectrum in Jiaxing City, in order to provide a scientific basis for the prevention of neonatal birth defects. Methods Heel blood samples from newborns born in Jiaxing City between January 2015 and December 2022 were initially screened by MSMS.Positive cases were recalled for retesting, followed by biochemical and genetic analyses.Diagnoses were confirmed based on clinical manifestations, and the incidence rates and genetic variants were retrospectively analyzed. Results Among 376 649 live births during the study period, 375 562 neonates were screened, with 328 660 undergoing MSMS screening (average screening rate: 87.26%, increasing annually).A total of 85 cases were diagnosed with amino acid disorders (AADs), fatty acid oxidation disorders (FAOD), or organic acid disorders (OAD), yielding an overall incidence of 1/3 867.Hyperphenylalaninemia, primary carnitine deficiency, and methylmalonic acidemia were the most prevalent conditions in AADs, FAODs, and OADs, with incidences of 1/14 290, 1/21 911, and 1/54 777, respectively.Genetic analysis identified 90 pathogenic variants, with the most frequent being PAH c.728G>A, c.1068C>A, and c.721C>T; ACADSB c.1165G>A; SLC22A5 c.1400C>G and c.51C>G; and SLC25A13 c.615+5G>A. Conclusions This study clarifies the incidence and genetic variant spectrum of neonatal IEM in the region, enabling early screening, diagnosis, and intervention in Jiaxing City.These findings are critical for strengthening birth defect prevention and improving neonatal health outcomes.

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.

Neurodevelopmental disorders (NDDs) are a group of common conditions characterized by developmental and functional impairments of the nervous system beginning in childhood.There is an urgent need for practical methods for the early diagnosis and prevention of NDDs.This review discusses the current situation and prospects of wearable electronic devices in assessing neurodevelopmental disorders in children.

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.

Objective To develop a culturally appropriate, standardized, and comprehensive assessment tool for evaluating the quality of family-based infant and toddler care (0 - 3 years) in China, and to examine its reliability and validity, in order to provide a scientific foundation for research on family care quality assessment tools. Methods Based on the nurturing care framework and the Guidelines for Healthy Nurturing Care of Children Under 3 Years of Age, an initial assessment tool was constructed through literature review, expert consensus, and consideration of infant and toddler developmental characteristics.The tool was refined through pilot surveys, expert discussions, and internal group revisions.Reliability was assessed using internal consistency, test-retest reliability, and split-half reliability.Validity was examined through content validity and construct validity. Results The final scale consisted of 54 items across five dimensions: safety care, health care, nutrition care, responsive care, and early learning.The questionnaire demonstrated strong reliability, with a Cronbach's α coefficient of 0.931, split-half reliability of 0.848, and test-retest reliability of 0.613.All item factor loadings were >0.4, correlations between subscales and the total scale ranged from 0.604 to 0.751, and inter-subscale correlations mostly fell between 0.501 and 0.715 (all P<0.05).Construct validity indices indicated a good model fit (χ²/df=4.584, CFI=0.901, GFI=0.912, AGFI=0.901, IFI=0.901, RMSEA=0.035). Conclusion The family infant and toddler nurturing care scale developed in this study exhibits good reliability and validity and is suitable for assessing the quality of family-based nurturing care of infants and toddlers.

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.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder, and its prevalence has shown a sustained upward trend over the past two decades.Emerging evidence suggests a bidirectional regulatory mechanism between ASD-related behavioral manifestations and the microbiota-gut-brain axis (MGB axis), with numerous studies reporting alterations in gut microbiota composition within this axis.This article reviews the therapeutic effects of probiotics, prebiotics, synbiotics, and fecal microbiota transplantation on ASD at varying dosages and treatment durations.Post-intervention assessments using standardized scales, including the Autism Treatment Evaluation Checklist (ATEC), Childhood Autism Rating Scale (CARS), and Autism Behavior Checklist-Japanese Version (ABC-J), demonstrated symptomatic improvements in individuals with ASD.However, all four interventions share limitations, such as a lack of large-scale clinical data and inadequate personalization of dosage and treatment duration to address the heterogeneity of ASD patients.Future research is warranted to validate the efficacy of these microbiota-targeted interventions and optimize treatment protocols for broader clinical application.

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.

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.

Objective To investigate the therapeutic efficacy of infra-low frequency transcranial magnetic stimulation (ILF-TMS) combined with conventional rehabilitation training in children with autism spectrum disorder (ASD) and comorbid sleep disturbances, in order to provide a scientific basis for clinical treatment. Methods A total of 60 children with ASD and sleep disturbances, who were treated at the Nanhai Obstetrics and Gynecology Children′s Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine in 2023, were selected as study participants.They were randomly divided into a study group and a control group using a random number table, with 30 children in each group.The control group received conventional rehabilitation training, including applied behavior analysis therapy, sensory integration training, and speech therapy.The study group received ILF-TMS additionally.Both groups underwent treatment for 12 weeks.The Children′s Sleep Habits Questionnaire (CSHQ), Autism Behavior Checklist (ABC), and Childhood Autism Rating Scale (CARS) were used to assess outcomes before and after treatment.Intra-group comparisons and inter-group comparisons of score changes before and after treatment were conducted to evaluate therapeutic effects. Results In the study group, post-treatment scores for sleep resistance, sleep anxiety, sleep duration, parasomnias, daytime sleepiness, and total CSHQ scores were significantly lower than pre-treatment scores (t=2.438, 2.261, 2.295, 2.987, 5.954, 5.518, P<0.05).Moreover, the differences in the above score changes before and after treatment were significantly greater in the study group compared to the control group, with statistical significance (t=2.201, 2.218, 2.604, 3.322, 6.668, 8.216, P<0.05).Both the study and control groups showed significant reductions in CARS and ABC total scores after treatment (study group: t=3.067, 3.125; control group: t=2.098, 2.094, P<0.05).The difference in ABC total score changes before and after treatment was significantly greater in the study group compared to the control group (t=3.121, P<0.05). Conclusions ILF-TMS can effectively improve sleep disturbances and alleviate clinical symptoms in children with ASD, which provides theoretical support for the application of ILF-TMS in the treatment of children with ASD.

Objective To assess the physical activity (PA) levels in preschool children with Kawasaki disease (KD) during the early stages of the illness,in order to provide reference for making individualized exercise prescriptions. Methods Children hospitalized at the Children's Hospital of Capital Institute of Pediatrics between December 2023 and March 2024 were selected as the KD group. Healthy children matched by gender and age in a 1∶3 ratio served as the control group. The Preschooler Physical Activity Questionnaire (P-PAQ) was used to evaluate the PA levels of the KD group one month after the onset of the disease, focusing on their physical activity over the past week. The clinical data of KD patients were collected through the electronic medical system, including gender, age, height, weight, treatment, laboratory indicators (blood routine, C-reactive protein) and ultrasound results of coronary arteries. Results A total of 112 children were included in the study, comprising 28 KD patients and 84 healthy controls. One month after the onset of KD, the total out-of-school activity time was 99.36 (56.79, 130.18) minutes per day, the outdoor activity time was 12.86 (10.71, 14.29) minutes per day, and the moderate-to-vigorous physical activity (MVPA) time was 26.25 (7.50, 53.32) minutes per day. Compared to the healthy control group, the KD group showed significantly reduced total out-of-school activity time, outdoor activity time, and MVPA time (Z=5.491, 5.072, 3.726, P<0.01). All KD patients were followed up one month after the onset of the disease, and no coronary artery complications or adverse cardiovascular events were observed. Conclusions Preschool children with KD without coronary artery complications exhibit low levels of physical activity during the early stage of the disease. Actively exploring individualized exercise prescriptions based on evidence-based medicine during the recovery phase holds significant clinical importance.

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.