Mental health and social difficulties of late-diagnosed autistic children, across childhood and adolescence

BACKGROUND: Autism can be diagnosed from 2 years of age, although most autistic people receive their diagnosis later than this after they have started education. Research is required to understand why some autistic children are diagnosed late, and the level and nature of unmet need prior to diagnosis for late-diagnosed children. METHODS: We examined trajectories of emotional, behavioural and social difficulties (EBSDs) across childhood and adolescence, comparing 'earlier-diagnosed' (diagnosed 7 years or younger) with 'late-diagnosed' (diagnosed between 8 and 14 years) autistic children. Data were from the Millennium Cohort Study, a population-based UK birth cohort. EBSDs were measured using the parent-report Strengths and Difficulties Questionnaire, at 3, 5, 7, 11 and 14 years. We used Growth Curve Modelling to investigate levels and rates of change in these difficulties, and to compare earlier- (n = 146) and late-diagnosed (n = 284) autistic children. RESULTS: Aged 5, earlier-diagnosed autistic children had more emotional (i.e., internalising), conduct, hyperactivity and social difficulties; although clinical difficulties in these areas were nevertheless common in late-diagnosed children. There was a faster annual increase in scores for all domains for late-diagnosed children, and by age 14 years, they had higher levels of EBSDs. These results persisted when we ran adjusted models, to account for the late-diagnosed group having higher rates of late-diagnosed attention deficit/hyperactivity disorder, higher IQ, a higher proportion of females and older and more educated mothers. CONCLUSIONS: Emotional, behavioural and social difficulties are associated with, and may influence, the timing of autism diagnosis. Late-diagnosed autistic children often have high levels of mental health and social difficulties prior to their autism diagnosis, and tend to develop even more severe problems as they enter adolescence

Informal Caregiving in Adolescents from 10 to 16 Years Old: A Longitudinal Study Using Data from the Tokyo Teen Cohort

There is growing evidence of the impact of informal caregiving on adolescent mental health, and its role is often hidden unintentionally or intentionally, which may hamper early identification and support for young informal caregivers. However, the quantitative evidence regarding household factors relating to informal caregiving has mostly been based on cross-sectional findings. This study examines the longitudinal associations between household characteristics and the duration of informal caregiving in adolescents from 10 to 16 years of age. Child–household respondent pairs (n = 2331) from the Tokyo Teen Cohort in Japan were followed every 2 years from 10 to 16 years of age. Informal caregiving was assessed repeatedly based on the household respondent’s survey responses. Persistent caregiving was defined as daily caregiving at two or more waves. There were 2.2% of children who gave daily care at two or more waves. Cross-sectional associations with daily informal caregiving at each wave were found with girls, low household income, and cohabiting with grandparents. A significant association with persistent caregiving was found only in cohabiting with grandparents at 10 years of age after adjusting for sex, number of siblings, single parent, and household income. Our longitudinal examination highlighted cohabiting with grandparents as a preceding factor for persistent caregiving. Identification and support for young informal caregivers should be integrated into social care service systems for older adults. The mechanism of persistent caregiving requires clarification

Bullying victimisation in adolescence: prevalence and inequalities by gender, socioeconomic status and academic performance across 71 countries

Background Bullying victimisation is of global importance due to its long-term negative consequences. We examined the prevalence of victimisation and its inequalities in 15-year-olds across 71 countries. Methods Data were from the Programme for International Student Assessment (March-August 2018). Students reported frequencies of relational, physical, and verbal victimisation during the last 12 months, which were analysed separately and combined into a total score. Prevalence of frequent victimisation (> a few times a month) was estimated, followed by mean differences in total score by gender, wealth and academic performance quintiles in each country. Meta-analyses were used to examine country differences. Findings Of 421,437 students included, 113,602 (30·4%) experienced frequent victimisation, yet this varied by country—from 9·3% (Korea) to 64·8% (Philippines). Verbal and relational victimisation were more frequent (21·4%, 20.9%, respectively) than physical victimisation (15·2%). On average, boys (vs girls +0·23SD, 95%CI: 0·22–0·24), students from the lowest wealth (vs highest +0·09SD, 0·08–0·10) and with lowest academic performance (vs highest +0·49SD, 0·48–0·50) had higher scores. However, there was substantial between-country heterogeneity in these associations (I2=85%–98%). Similar results were observed for subtypes of victimisation—except relational victimisation, where gender inequalities were smaller. Interpretation Globally, bullying victimisation was high, although the size, predominant subtype and strength of associations with risk factors varied by country. The large cross-country differences observed require further replication and empirical explanation, and suggest the need to and the large scope for reducing bullying victimisation and its inequity in the future. Funding Japan Foundation for Pediatric Researc

Prevalence and risk factors of post-coronavirus disease 2019 condition among children and adolescents in Japan: A matched case-control study in the general population

ABSTRACT: Objectives: To examine prevalence and risk factors for post-COVID-19 condition (PCC) in a paediatric population. Methods: The study included patients aged 5-17 years with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between 1 March 2021 and 30 April 2022 and matched non-infected controls from Yao City, Japan. We compared parent-reported symptoms persisting ≥2 months (present at 3 months post-infection for patients) between the groups. COVID-19 vaccination data was obtained from the Vaccination Registry. Results: Among 8167 invited individuals, 3141 (1800 cases, mean age: 10.4 years, 46.1% females; 1341 controls, mean age 10.5 years, 47.1% females) participated. Patients had elapsed average 273 (185-605) days from infection, and 1708 (94.9%) experienced mild acute symptoms. Patients had higher odds of having persistent symptoms than did controls (6.3% vs 2.2%, adjusted odds ratio [aOR]: 3.15, 95% confidence interval: 2.08-4.77), with 53.6% of them reporting current disruption due to the symptoms. Older age, low household income, pre-existing allergy, and autonomic nervous system disease were associated with increased risks of developing PCC; two prior vaccination doses reduced these risks (aOR: 0.52, 0.29-0.93). Conclusion: SARS-CoV-2 infection, including omicron infections heighten persistent symptom risk in the paediatric population, necessitating preventive strategies, notably vaccination

Additional file 1 of Time trends in emotional well-being and self-esteem in children and adolescents during the COVID-19 pandemic

Additional file 1: Figure S1. Sample selection procedure. Table S1. Sociodemographic characteristics. Table S2. Weighted adjusted estimates of emotional well-being and self-esteem, excluding three municipalities participating in wave 3. Table S3. Weighted adjusted estimates of emotional well-being and self-esteem, excluding participants who reported having answered previous surveys (information only available in wave 3). Table S4. Weighted adjusted estimates and differences in emotional well-being and self-esteem, stratified by age (Fig. 2). Table S5. Weighted adjusted estimates and differences in emotional well-being and self-esteem stratified by gender (Fig. 2). Table S6. Associations between the Stringency Index and mental health outcomes and coefficients of multiplicative interaction terms between the Stringency Index and age group and gender