Neurocognitive testing is recommended for the assessment of sport-related concussions. Computerized neurocognitive tests are more sensitive and more efficient than traditional neuropsychological testing in assessing sport-related concussions.

We describe the current prevalence of computerized neurocognitive testing, the relative use of the various computerized programs, the types of clinicians interpreting test scores, and associations of computerized tests with timing of return-to-play and medical provider type managing the athlete. (Read the full article)

Media reports suggest that adolescents are being charged with sex crimes and even placed on sex offender registries because of participating in the "sexting" of sexual images, but the nature and outcomes of such incidents have not been described empirically.

This is the first study to examine types of sexting cases handled by police. It informs clinicians by identifying characteristics of "aggravated" versus milder incidents and finding that most youth were not arrested. Sex offender registration was rare. (Read the full article)

Clinical trials in children with severe traumatic brain injury (TBI) are challenging. To date, no work has been published that permits clinical investigators to estimate the number and compositional features of sites from which to recruit children with severe TBI into clinical trials.

Children with severe TBI are infrequent. Less than 5% of all US hospitals discharged more than 78% of severe TBI cases. To maximize enrollment efficiency for future clinical trials, attention has to be paid to selecting appropriate hospital sites. (Read the full article)

Although there is some older literature examining how arrest prevalence accumulates through adolescence and adulthood, there is no contemporary research examining the arrest histories of a representative sample of American youth.

Using a contemporary US sample of adolescents and young adults, we estimated the cumulative arrest prevalence through age 23. The results suggest a substantial increase in the cumulative prevalence of arrest since the 1960s. (Read the full article)

Limited data exist about the frequency and incidence of serious injuries due to physical abuse of children. Data from Child Protective Services, which are published yearly, do not have information about severity.

This is the first study to provide US estimates on the occurrence of serious injuries due to physical abuse. The incidence was highest in infants on Medicaid. Such data can be used to track changes due to prevention. (Read the full article)

Clinic-based weight control treatments for youth have largely been designed for preadolescent children and their families by using family-based care, a strategy that may be less appealing to adolescents as they become increasingly motivated by peer acceptance rather than parental influence.

To our knowledge, this is the first study to demonstrate the efficacy of a primary care–based, multicomponent lifestyle intervention specifically tailored for overweight adolescent females and demonstrating a sustained effect (at 12 months) extending beyond the active 5-month intervention. (Read the full article)

Among extremely premature infants, survival has improved, but the rate of cognitive impairment has not. Impaired cognition is the most frequent developmental problem identified in survivors. Several antenatal factors have been associated with cognitive impairment, mostly related to social disadvantage.

In addition to social disadvantage, antenatal characteristics associated with cognitive impairment include maternal obesity and thrombosis of fetal stem vessels. Prenatal infection and inflammation were not associated with impaired early cognitive function among extremely preterm infants. (Read the full article)

Survival takes precedence for adolescent patients with cancer and their families. Patients may not discuss their treatments’ potential to damage their reproductive capacity, which has significant psychological late effects in survivorship.

Strong reproductive concerns of adolescents with cancer may not be captured on current health-related quality of life instruments and may be neglected by parents’ unawareness. Parent-proxy reports of adolescent reproductive concerns are not suitable for capturing specific emotions and feelings. (Read the full article)

Preterm, growth-restricted infants are at high risk of necrotizing enterocolitis (NEC). NEC occurs most frequently in infants who have received enteral feeds. It is common practice to delay introduction of enteral feeds in these infants.

Early introduction of enteral feeds results in earlier achievement of full enteral feeding. Early feeding is not associated with a higher risk of NEC. Delayed feeding is associated with a higher risk of cholestasis. (Read the full article)

Although morbidity-free survival for preterm infants has remained constant in US NICUs when assessed collectively, morbidity-free survival differs among centers. Center-specific practices before, at, or after delivery might affect outcomes of the most premature infants.

Our findings suggest that the approach taken to infants at the limits of viability is associated with outcomes of more-mature infants. Identifying centers with higher survival and lower morbidity might lead to identification of key practices to improve morbidity-free survival. (Read the full article)

Preterm children born between 29 and 36 gestational weeks are at higher risk of developmental delay. The Ages and Stages Questionnaires (ASQ) have been recommended as a developmental screening tool.

At 12 months’ corrected age (CA), the ASQ was insufficient in identifying delays on both mental and psychomotor scales of the Bayley Scales of Infant Development but was accurate in detecting mental delay at CA of 24 months. (Read the full article)

Neonatal hearing screening occasionally fails because of several perinatal and neonatal factors. However, the effect of mode of delivery on hearing screening has not yet been established.

We show significantly more failures on hearing screening in cesarean delivery infants. Hence, the timing of screening after cesarean delivery should preferably be postponed beyond 48 hours to improve success rate, minimize maternal anxiety, and decrease costs. (Read the full article)

Providers who speak Spanish, regardless of their proficiency level, may use Spanish for clinical care without seeking professional interpretation. Failure to use professional interpretation increases the risk for miscommunication and can lead to patient harm.

Providing residents with objective feedback on Spanish language proficiency decreased willingness to use Spanish in straightforward clinical scenarios. Language proficiency testing, coupled with institutional policies requiring professional interpretation, may improve care for patients with limited English proficiency. (Read the full article)

Male circumcision reduces risk of HIV acquisition in men by 60% and is associated with other health benefits. Compared with adult circumcision, infant male circumcision is safer, less expensive, and represents a cost-saving intervention for HIV prevention in many settings.

IMC is little known in East Africa and is not routinely practiced. This is the first study to assess acceptability and uptake of IMC in East Africa among parents who were actually offered the procedure. (Read the full article)

Preterm infants from 33 gestational weeks can detect specific shape features (prism and cylinder) by touch (without visual control), and remember them; however, nothing is known about such abilities earlier in development.

The preterm infant, even when very immature (from 28 gestational weeks), is endowed with tactile sensory abilities: the exploration and memorization of an object by touch, the discrimination of a novel object, and the recognition of a familiar object after interference. (Read the full article)

Late preterm infants are at risk for a variety of developmental impairments; however, little is known about developmental differences among children born within the term range of 37 to 41 weeks’ gestation.

This study links comprehensive birth record data from 128 050 term births to children’s school records 8 years later. Analyses establish that, even among the "normal term" range, gestational age is an important independent predictor of academic achievement. (Read the full article)

Dental composites composed of bisphenol A (BPA) derivatives are common alternatives to amalgam, but may release BPA. Gestational BPA exposure has been associated with poorer behavior in children. A safety trial of amalgam found worse psychosocial outcomes for children randomized to composites.

In the trial, greater exposure to bisphenol-A-glycidyl-methacrylate-based dental composite in children aged 6 to 10 years was associated with worse self-reported psychosocial functioning at 5-year follow-up. There were no such associations with exposure to dental amalgam or urethane-dimethacrylate-based polyacid-modified composite (compomer). (Read the full article)

Birth defects are associated with preterm birth and are a major contributor to infant mortality. There are persistent black-white differences in overall infant mortality and infant mortality attributable to birth defects.

Among infants delivered at 37 to 44 weeks, blacks and Hispanics had significantly higher neonatal and postneonatal mortality attributable to birth defects than whites. Among infants delivered at 20 to 33 or 34 to 36 weeks, neonatal mortality attributable to birth defects was significantly lower among blacks. (Read the full article)

Immature animals exposed to anesthetics display apoptotic neurodegeneration and long-term cognitive deficiencies. In children, studies of cognitive deficits associated with anesthesia exposure have yielded mixed results. No studies to date have used directly administered neuropsychological assessments as outcome measures.

This study examines the association between exposure to anesthesia in children under age 3 and deficits at age 10 by using a battery of directly administered neuropsychological assessments, with deficits found in language and abstract reasoning associated with exposure. (Read the full article)

Approximately 80% of all preterm children are born moderately preterm (32–36 weeks’ gestation). Moderately preterm children are at increased risk for developmental delays, but the specific neuropsychological functions that may underlie these delays are unknown.

Moderately preterm birth is associated with poorer performance in intelligence, attention, visuospatial reasoning, and executive functioning. Using gender-specific norms, our data suggest that preterm boys catch up, whereas preterm girls lag behind their peers at 7 years of age. (Read the full article)

Children investigated for alleged maltreatment have considerable physical, mental health (MH), developmental, and educational needs and often do not receive services to address these needs. The prevalence/correlates of MH services use in the current challenging financial environment is unknown.

This study demonstrates the importance of medical providers and schools for receipt of MH services for these children, but shows disparities in MH service use between white and nonwhite children. Unlike earlier findings, MH service use declined over the follow-up. (Read the full article)

Healthy sleep is essential for supporting alertness and other key functional domains required for academic success. Research involving the impact of modest changes in sleep duration on children’s day-to-day behavior in school is limited.

This study shows that modest changes in sleep duration have significant impact on the behavior of typically developing children in school. Modest sleep extension resulted in detectable improvement in behavior, whereas modest sleep restriction had the opposite effect. (Read the full article)

Children born small for gestational age (SGA) have increased risk of perinatal morbidity and mortality, neonatal death, and cerebral palsy (CP). Causes of SGA, such as congenital malformations, intrauterine infections, and preeclampsia, are also risk factors for the same outcomes.

In 90% of singletons born SGA, CP is apparently of prenatal origin. Low proportions of intrapartum events leading to CP could not be fully explained by a higher neonatal mortality rate in SGA than in non-SGA children. (Read the full article)

Validated questionnaires can improve the identification of psychosocial problems among children. The Strengths and Difficulties Questionnaire (SDQ) 3-4 is a promising option. However, no studies are available that examine the psychometric properties of the SDQ parent form 3-4.

The results of this study show that the SDQ 3-4 is a valid tool for the identification of psychosocial problems in preschool-aged children. (Read the full article)

A number of studies have demonstrated community acceptance of Safe Routes to School interventions as well as their success in addressing perceptions about safety, but little is known about their effectiveness in reducing pedestrian injury risk in school-aged children.

Implementation of a Safe Routes to School program in New York City may have contributed to a substantial reduction in school-aged pedestrian injury rates, with the effects largely limited to school-travel hours in census tracts with these interventions. (Read the full article)

Survival estimates for preterm infants are vital for counseling parents, informing care, and planning services. Widely use estimates of in-unit survival derived from a large UK population for infants born at <33 weeks’ gestational age have been available since 1999.

These survival charts have been updated and will be of use to clinicians, parents, and managers. An alternative method for graphical representation of survival probabilities is offered: contour survival plots. (Read the full article)

Most studies focus on health of foster children or local samples of young children. One previous study examined a national cohort longitudinally but did not address the full age group or range of conditions at the time of initial investigation.

Using 2 approaches to assess children (aged 0–17.5 years) who have chronic health conditions, we found that regardless of placement, investigated children had much higher rates of these conditions than the general population at the time of initial assessment. (Read the full article)

Rapid initiation of effective chest compressions (CCs) for patients in cardiac arrest improves outcomes, yet even trained rescuers fail to provide consistently effective CCs. Pediatric data on CC quality and objective measures of CC work are limited.

CC quality deteriorates similarly in pediatric and adult models, and overall work done to compress the pediatric chest is similar to that in adults. Power output during CC performance is analogous to that generated during intense exercise such as running. (Read the full article)

Pacifiers may interfere with breastfeeding and thus are discouraged until 3 to 4 weeks of life, when they are recommended for sudden infant death syndrome risk reduction. Hospitals are restricting pacifier distribution as part of the Baby-Friendly Hospital Initiative.

We describe a temporal association between reduced exclusive breastfeeding and pacifier restriction. This observation encourages research on breastfeeding promotion and the effects of pacifiers and pacifier restriction on breastfeeding. (Read the full article)

Head circumference (HC) at birth reflects brain development in utero. However, HC charts used in Canada are either dated, mixed-gender, nonrepresentative of lower gestational ages, or reflective of other populations in the world.

We developed recent and gender-specific reference curves for HC at birth for singletons of 23 to 41 completed weeks’ gestational age, which included a large number of very prematurely born infants, reflecting the current geotemporal Canadian population and advances in obstetric care. (Read the full article)

There are no published prospective studies on the natural course and testicular growth in early childhood of spontaneously descended testes after birth compared with scrotal or surgically treated testes in boys with congenital cryptorchidism.

Data collected from this prospective study on the natural course and growth of the spontaneously descended testes add evidence-based data and recommendations on how to clinically manage boys with congenital cryptorchidism. (Read the full article)

Cognitive and motor developmental test scores of preterm and late preterm infants increase with gestational age. Developmental test scores in full-term infants have not previously been considered to relate to gestational age.

In a cohort of healthy, full-term infants, 37 to 41 weeks, 12-month mental and psychomotor scores on the Bayley Scales of Infant Development increased with gestational age, suggesting that neurodevelopment is optimal in infants born at 39 to 41 weeks. (Read the full article)

Perforation in the setting of retained esophageal foreign body is rare, but can be catastrophic. The role of imaging in screening for injury after removal has not previously been studied.

The rate of esophageal injury among children with retained esophageal foreign body is 1.3%. Intraoperative findings suggestive of injury are predictive of perforation. Routine chest radiography is not warranted in those who do not meet this criterion. (Read the full article)

The Ages and Stages Questionnaires (ASQ) has been validated in many countries and translated into numerous languages. In most publications, it has been reported that the ASQ is accurate in detecting true problems in apparently healthy children and even in children with biological risk factors.

This report compares the third version of the ASQ and the Bayley Scales of Infant and Toddler Development, Third Edition, assessments. Psychometric properties showed a tendency to improve with testing age and when comparing term versus extremely preterm children. (Read the full article)

The remarkable improvement in the survival of extremely premature infants has been well documented. However, there have been few cohort studies large enough to determine the neurodevelopmental outcomes of survivors born at 22 or 23 weeks.

The proportions of unimpaired or minimally impaired were 12.0% at 22 weeks (n = 75) and 20.0% at 23 weeks (n = 245). The outcomes were inferior compared with those for infants born at 24 and 25 weeks, but were improved compared with those in previous studies. (Read the full article)

Several risk factors for both overweight and obesity in childhood are identifiable during infancy.

A simple risk algorithm can be used to quantify risk of overweight in children. It can be used to help identify at-risk infants in a clinical setting to facilitate targeted intervention. (Read the full article)

There is wide variation in testing and treatment of children hospitalized with pneumonia. Limited data are available on diagnostic testing patterns and the association of test utilization with disposition outcomes for children with pneumonia evaluated in the emergency department (ED).

Significant variation exists in testing for pediatric pneumonia. EDs that use more testing have higher hospitalization rates. However, ED revisit rates were not significantly different between high- and low-utilizing EDs, suggesting an opportunity to reduce testing without negatively affecting outcomes. (Read the full article)

The diagnosis of urinary tract infection (UTI) is confirmed by urine testing with urinalysis and culture. No study has characterized the use of urine testing in the setting of empirical antibiotic prescription for outpatient UTI in children.

Urine tests are not performed in a substantial percentage of antibiotic-treated pediatric UTIs. Additional research is necessary to determine whether empirical antibiotic prescription for UTI in children without urine testing is safe and effective. (Read the full article)

Caregiver behavioral symptom ratings are frequently used to assist in diagnosing childhood behavioral disorders. Although behavioral disorders are highly comorbid with learning disabilities (LDs), little work has examined the utility of caregiver ratings of learning concerns for screening of comorbid LD.

The validity of a time- and cost-efficient caregiver rating of academic concerns (Colorado Learning Difficulties Questionnaire) was examined. The screening measure accurately predicted children without LD, suggesting that the absence of parent-reported difficulties may be adequate to rule out overt LD. (Read the full article)

Although providing improved survival for infants with very severe cardiorespiratory problems, the use of neonatal extracorporeal membrane oxygenation has high rates of disability in survivors. Mild hypothermia has been shown to limit brain injury in a range of patient groups, including newborns.

Infants who received extracorporeal membrane oxygenation and mild hypothermia did not show an improved neurodevelopmental outcome, and nonsignificant trends in the data suggested a small adverse effect. Use of hypothermia in other potential patient groups should be thoroughly tested. (Read the full article)

Some studies suggest a contribution of environmental exposures such as pesticides to risk of hypospadias, whereas others do not. One of the challenges that has limited current knowledge is the lack of detailed exposure data.

This study examined a more detailed assessment of exposure to pesticides than previous studies. Exposure assignments, whether to groups of chemicals, specific chemicals, or a composite involving a number of chemicals, showed a general lack of association with hypospadias. (Read the full article)

It has previously been shown that exposure to intimate partner violence and/or parental depression or anxiety may increase a child’s risk for specific adverse health outcomes.

By using a large pediatric primary care sample, this study examined associations of child exposure to intimate partner violence and parental psychological distress with developmental milestone attainment by analyzing their combined and separate effects while adjusting for other family factors. (Read the full article)

Prenatal and postnatal organophosphate (cholinesterase inhibitor) pesticide exposure has been associated with delays in attention, memory, intelligence, and inhibitory control. Two recent studies reported decreased attention and working memory with greater exposure to organophosphates in boys but not in girls.

This is the first study to report associations between decreased acetylcholinesterase activity, a stable marker of cholinesterase inhibitor pesticide exposure, and lower overall neurodevelopment, attention, inhibitory control, and memory. These associations were present in boys but not in girls. (Read the full article)

Preterm birth is associated with increased morbidity during childhood. Many studies have focused on outcomes for preterm births before 32 weeks’ gestation, but there are few follow-up data for late preterm infants (34–36 weeks’ gestation).

The risk of respiratory admission during childhood decreased with each successive week in gestation up to 40 to 42 weeks. The increased risk is small for late preterm infants, but the number affected is large and has an impact on health care services. (Read the full article)

Increasing numbers of hospitals are instituting 24/7 in-hospital pediatric intensivist coverage. Data regarding patient outcomes are mixed and the impact on housestaff education remains unknown.

This study quantifies the perceived impact of in-hospital attending coverage on pediatric resident and critical care fellow education and also investigates the growing concern that increasing supervision may contribute to housestaff being less well prepared for independent clinical practice. (Read the full article)

The management of term and near-term newborns suspected of early-onset sepsis, particularly when they are not clearly symptomatic, remains controversial. Methods for quantifying risk that combine maternal factors with a newborn's evolving clinical examination have been lacking.

This study provides a method for predicting risk of early-onset sepsis. It combines maternal risk factors with objective measures of a newborn's clinical examination and places newborns into 3 risk groups (treat empirically, observe and evaluate, and continued observation). (Read the full article)

Age-appropriate child safety seat use in the United States is suboptimal, particularly among children older than 1 year. Minority children have higher rates of inappropriate child safety seat use based on observational studies. Explanations for observed differences include socioeconomic factors.

White parents reported greater use of age-appropriate child safety seats for 1- to 7-year-old children than nonwhite parents. Race remained a significant predictor of age-appropriate restraint use after adjusting for parental education, family income, and information sources. (Read the full article)

Major depression is common among adolescents. The PHQ-9 has good sensitivity and specificity for detecting depression among adolescents in primary care settings. However, no study has examined the psychometric properties of the PHQ-9 among Chinese adolescents in school settings.

This is the first study to validate the use of the PHQ-9, Patient Health Questionnaire–2 item, and Patient Health Questionnaire–1 item among Chinese adolescents in Taiwan. The PHQ-9 and its 2 subscales have good sensitivity and specificity for detecting depression among school adolescents. (Read the full article)

Fetal growth restriction, particularly in preterm children, is associated with delayed development and poor growth. Knowledge about the consequences of fetal growth restriction if classified by symmetry is lacking, especially in preterm children.

In preterm children, symmetric and asymmetric growth restriction at birth results in poorer growth later in life. Both groups are at considerable risk of developmental delay because their long-term development is independent of their head circumference at birth. (Read the full article)

Current guidelines recommend renal ultrasound as a screening test after febrile urinary tract infection, with voiding cystourethrogram (VCUG) only if the ultrasound is abnormal. Few studies have evaluated the accuracy of ultrasound as a screening test for VCUG-identified abnormalities.

This study shows that ultrasound is a poor screening test for genitourinary abnormalities identified on VCUG, such as vesicoureteral reflux. Neither positive nor negative ultrasounds reliably identify or rule out such abnormalities. Ultrasound and VCUG provide different, but complementary, information. (Read the full article)