Prediction of psychosocial problems in adolescents: do early childhood findings of the preventive child healthcare help?

Dit proefschrift richt zich op het voorspellen van psychosociale problemen bij adolescenten op basis van gegevens over de vroege ontwikkeling zoals vastgelegd door professionals van de Jeugdgezondheidszorg (JGZ). Het gaat dan om emotionele, gedragsmatige, aandachttekort / hyperactiviteit en autisme-spectrum problemen. Ook wordt onderzocht welke indicatoren uit de vroege kindertijd voorspellend zijn voor de sociale status in de vroege adolescentie. Tot slot zijn de validiteit en nauwkeurigheid onderzocht van de gegevens die ouders zich herinneren over de leefstijl van de moeder tijdens de zwangerschap, geboortekenmerken en gedrag in de vroege kindertijd. Het in dit proefschrift beschreven onderzoek maakt deel uit van TRacking Adolescents’ Individual Lives Survey (TRAILS), een grootschalig prospectief onderzoek onder de algemene bevolking naar determinanten van geestelijke gezondheid en sociale ontwikkeling tijdens de adolescentie en jongvolwassenheid. Met steun van de instellingen voor JGZ in Drenthe, Friesland en Groningen waren we in staat de benodigde gegevens te verzamelen uit JGZ-dossiers in hun archieven. De resultaten van dit proefschrift laten zien dat vroege bevindingen van JGZ-professionals psychosociale problemen in de (pre)adolescentie voorspellen, maar slechts in beperkte mate. Gedragsproblemen, autisme spectrum en ADHD problemen kunnen beter worden voorspeld op basis van door JZG geregistreerde gegevens dan emotionele problemen. Onze resultaten laten zien hoe moeilijk het is psychosociale problemen op latere leeftijd nauwkeurig te voorspellen op basis van door de JGZ geregistreerde gegevens over de vroege ontwikkeling, ook al werden er verschillende voorspellers geïdentificeerd die het werk van JGZ-professionals kunnen ondersteunen. Verder onderzoek is nodig ter verbetering van de voorspellende waarde op langere termijn van JGZ-gegevens over de vroege ontwikkeling. De resultaten daarvan kunnen JGZ-professionals ondersteunen in hun zorg voor kinderen en adolescenten

Trajectories of Psychosocial Problems in Adolescents Predicted by Findings From Early Well-Child Assessments

Purpose: To describe trajectories of emotional and behavioral problems in adolescents and to identify early indicators of these trajectories using data from routine well-child assessments at ages 0-4 years.Methods: Data from three assessment waves of adolescents (n = 1,816) of the TRAILS were used (ages: 11-17 years). Information on early indicators (at ages 0-4 years) came from the records of the well-child services. Trajectories of emotional and behavioral problems were based on the parent-reported Child Behavior Checklist and the adolescent-reported Youth Self-Report, filled out at ages 11, 14, and 17 years. Multinomial logistic regression analysis was used to examine the predictive value of these early indicators on trajectories.Results: For boys and girls, we found four trajectories for each outcome: one with high problem levels, and three with middle-high, middle-low, and low levels. For emotional problems, the type of trajectory was predicted by parental educational level and parental divorce or single parents, for both genders. Moreover, sleep problems were predictive in boys and language problems in girls (odds ratios between 1.53 and 7.42). For behavioral problems, the type of trajectory was predicted by maternal smoking during pregnancy, parental educational level, and parental divorce or single parents, for both genders. Moreover, for boys, early behavioral problems and attention hyperactivity problems were predictive (odds ratios between 1.64 and 5.43).Conclusions: Trajectories of emotional and behavioral problems during adolescence are rather stable and can be predicted by a parsimonious set of data from early well-child assessments. (C) 2012 Society for Adolescent Health and Medicine. All rights reserved.</p

Preventive Child Health Care Findings on Early Childhood Predict Peer-Group Social Status in Early Adolescence

Purpose: A disputed social status among peers puts children and adolescents at risk for developing a wide range of problems, such as being bullied. However, there is a lack of knowledge about which early predictors could be used to identify (young) adolescents at risk for a disputed social status. The aim of this study was to assess whether preventive child health care (PCH) findings on early childhood predict neglected and rejected status in early adolescence in a large longitudinal community-based sample. Methods: Data came from 898 participants who participated in TRAILS, a longitudinal study. Information on early childhood factors was extracted from the charts of routine PCH visits registered between infancy and age of 4 years. To assess social status, peer nominations were used at age of 10-12 years. Results: Multinomial logistic regression showed that children who had a low birth weight, motor problems, and sleep problems; children of parents with a low educational level (odds ratios [ORs] between 1.71 and 2.90); and those with fewer attention hyperactivity problems (ORs = .43) were more likely to have a neglected status in early adolescence. Boys, children of parents with a low educational level, and children with early externalizing problems were more likely to have a rejected status in early adolescence (ORs between 1.69 and 2.56). Conclusions: PCH findings on early childhood-on motor and social development-are predictive of a neglected and a rejected status in early adolescence. PCH is a good setting to monitor risk factors that predict the social status of young adolescents. (C) 2012 Society for Adolescent Health and Medicine. All rights reserved

Growth during Infancy and Childhood, and Adiposity at Age 16 Years:Ages 2 to 7 Years Are Pivotal

<p>Objective To assess the period during infancy and childhood in which growth is most associated with adolescent adiposity and the metabolic syndrome (MS) and whether this differs depending on maternal smoking during pregnancy.</p><p>Study design A longitudinal population-based cohort study among 772 girls and 708 boys.</p><p>Results Weight gains between ages 2-4 years and ages 4-7 years were most strongly associated with higher body mass index (BMI), sum of skinfold measurements, body fat percentage, and waist circumference at age 16. A one SD increase in weight between ages 2-4 and 4-7 years was associated with increases in outcome measures of +0.82 to +1.47 SDs (all P <.001), and with a less favorable MS score. In children whose mothers smoked during pregnancy, the association of relative weight gain during ages 2-4 years with adolescent BMI was stronger than in children whose mothers did not smoke. For adolescent BMI, the increase was 0.42 SD higher (P = .01). This was similar for the other adiposity measures.</p><p>Conclusions Large relative increases in weight from ages 2 to 7 years are associated with adolescent adiposity and MS. This is more pronounced in adolescents whose mothers smoked during pregnancy. (J Pediatr 2013;162:287-92).</p>

Early Childhood Assessments of Community Pediatric Professionals Predict Autism Spectrum and Attention Deficit Hyperactivity Problems

<p>For clinically referred children with Autism Spectrum Disorder (ASD) or Attention Deficit/Hyperactivity Disorder (ADHD) several early indicators have been described. However, knowledge is lacking on early markers of less severe variants of ASD and ADHD from the general population. The aim of the present study is to identify early indicators of high risk groups for ASD and ADHD problems based on routine data from community pediatric services between infancy and age four. Data are from 1,816 participants who take part in Tracking Adolescents' Individual Lives Survey (TRAILS), a longitudinal study. Information on early developmental factors was extracted from charts of routine Preventive Child Healthcare (PCH) visits. To assess ASD and ADHD problems, respectively, we used the Children's Social Behavior Questionnaire (CSBQ) and the Child Behavior Checklist (CBCL), filled out by parents three times between the ages of 11 and 17. Note that these are parent ratings and not diagnostic instruments performed by trained clinicians. Male gender, low birth weight, low level of education of the mother, social, behavioral, language, psychomotor and eating problems significantly predicted ASD problems (odds ratios (OR) between 1.34 and 2.41). ADHD problems were also predicted by male gender and low level of education of the mother and by maternal smoking during pregnancy, good gross motor skills in first year, early attention and hyperactivity problems, and absence of parent-reported positive behavior (ORs between 1.36 and 1.74). Routine data on early childhood from PCH services are predictive for ASD and ADHD problems in adolescents in the general population. The PCH services are a useful setting to identify high risk groups, and to monitor them subsequently.</p>