A Longitudinal Study of the Relation between Childhood Activities and Psychosocial Adjustment in Early Adolescence

Background: Although an increasing body of research shows that excessive screen time could impair brain development, whereas non-screen recreational activities can promote the development of adaptive emotion regulation and social skills, there is a lack of comparative research on this topic. Hence, this study examined whether and to what extent the frequency of early-life activities predicted later externalizing and internalizing problems. Methods: In 2012/13, we recruited Kindergarten 3 (K3) students from randomly selected kindergartens in two districts of Hong Kong and collected parent-report data on children’s screen activities and parent–child activities. In 2018/19, we re-surveyed the parents of 323 students (aged 11 to 13 years) with question items regarding their children’s externalizing and internalizing symptoms in early adolescence. Linear regression analyses were conducted to examine the associations between childhood activities and psychosocial problems in early adolescence. Results: Early-life parent–child activities (β = −0.14, p = 0.012) and child-alone screen use duration (β = 0.15, p = 0.007) independently predicted externalizing problems in early adolescence. Their associations with video game exposure (β = 0.19, p = 0.004) and non-screen recreational parent–child activities (β = −0.14, p = 0.004) were particularly strong. Conclusions: Parent–child play time is important for healthy psychosocial development. More efforts should be directed to urge parents and caregivers to replace child-alone screen time with parent–child play time

Associations of family meals with adolescent perception of family relationship and compliance with parental guidance in Hong Kong: results of a representative cross-sectional survey

Family meals are beneficial for adolescent development, but evidence from Chinese populations has been limited. This study aimed to examine the associations between family meal frequency and adolescent perception of family relationship and compliance with parental guidance in Hong Kong. During the period from October to December 2016, a stratified random sample of 3359 students were recruited from 25 secondary schools in Hong Kong. Students completed questionnaires about family characteristics, relationship quality, and meal frequency by paper-and-pencil in class. Multiple regression analyses were conducted to examine the associations between family meal frequency and perceived family relationship and compliance with parental guidance overall and by subgroups. After adjusting for sociodemographic and school confounders, family breakfast and dinner frequency were significantly associated with adolescent compliance (breakfast: B = 0.07, p < 0.001; dinner: B 0.07, p < 0.001) and perception of family relationship (breakfast: B = 0.10, p < 0.001; dinner: B = 0.25, p < 0.001). Risk factors for infrequent family meals included older age, not born in Hong Kong, less educated fathers, and unmarried parents. Our findings support the associations of regular family meals with adolescent perception of high family bond and compliance with parental guidance. Interventions are needed to enhance quality family meal interactions in disadvantaged families

The clinical impact of chromosomal microarray on paediatric care in Hong Kong.

OBJECTIVE: To evaluate the clinical impact of chromosomal microarray (CMA) on the management of paediatric patients in Hong Kong. METHODS: We performed NimbleGen 135k oligonucleotide array on 327 children with intellectual disability (ID)/developmental delay (DD), autism spectrum disorders (ASD), and/or multiple congenital anomalies (MCAs) in a university-affiliated paediatric unit from January 2011 to May 2013. The medical records of patients were reviewed in September 2013, focusing on the pathogenic/likely pathogenic CMA findings and their "clinical actionability" based on established criteria. RESULTS: Thirty-seven patients were reported to have pathogenic/likely pathogenic results, while 40 had findings of unknown significance. This gives a detection rate of 11% for clinically significant (pathogenic/likely pathogenic) findings. The significant findings have prompted clinical actions in 28 out of 37 patients (75.7%), while the findings with unknown significance have led to further management recommendation in only 1 patient (p < 0.001). Nineteen out of the 28 management recommendations are "evidence-based" on either practice guidelines endorsed by a professional society (n = 9, Level 1) or peer-reviewed publications making medical management recommendation (n = 10, Level 2). CMA results impact medical management by precipitating referral to a specialist (n = 24); diagnostic testing (n = 25), surveillance of complications (n = 19), interventional procedure (n = 7), medication (n = 15) or lifestyle modification (n = 12). CONCLUSION: The application of CMA in children with ID/DD, ASD, and/or MCAs in Hong Kong results in a diagnostic yield of ∼ 11% for pathogenic/likely pathogenic results. Importantly the yield for clinically actionable results is 8.6%. We advocate using diagnostic yield of clinically actionable results to evaluate CMA as it provides information of both clinical validity and clinical utility. Furthermore, it incorporates evidence-based medicine into the practice of genomic medicine. The same framework can be applied to other genomic testing strategies enabled by next-generation sequencing

Prevalence of Child Maltreatment and Its Association with Parenting Style: A Population Study in Hong Kong

Previous studies point to a link between parenting style and child maltreatment, but evidence from a Chinese context is lacking. We investigated the association between parenting style and child maltreatment in Hong Kong, and examined whether family socio-economic status and child gender moderate this relationship. Using stratified random sampling, 7585 children in Grade 1 to Grade 3 of 51 schools in Hong Kong were recruited and their parents were invited to complete the questionnaire. The past year weighted prevalence for minor physical abuse, severe/very severe physical abuse, psychological abuse, and neglect were 63.9%, 23.4%, 84.1%, and 23.2%, respectively. Authoritarian parenting was associated with all types of child maltreatment (prevalence ratio (PR) range: 1.10&#8211;1.53; p &lt; 0.001), whereas authoritative parenting was associated with a lower risk of all types of child maltreatment (PR range: 0.89&#8211;0.97; p &lt; 0.001). Child maltreatment is prevalent in Hong Kong and is strongly associated with parenting style. The association was significantly stronger among girls and those with higher family socioeconomic status. Education to empower parenting skills may alleviate the burden of child maltreatment

Family Financial Pressure in Childhood and Telomere Length in Early Adolescence: A Prospective Study

Much research on children in high-risk environments has focused on the biological consequences of maltreatment, adversity, and trauma. Whether other early-life stress sources such as family financial hardship are implicated in the cellular mechanism of disease development remains unclear. This study investigated the long-term effect of childhood exposure to family financial pressure on telomere length. It involved two waves of data collection occurring when participants reached Grade 3 (W1) and 7 (W2), respectively. In W1, parents reported family demographics and perceived financial stressors and pressure. In W2, participants provided buccal swab samples for measurement of their telomere length. Data from 92 participants (Mage in W2 = 13.2 years; 56.5% male) were analyzed. The main type of stressors reported by parents who perceived high family financial pressure in W1 were child-level stressors including affordability of their medical and educational expenses. Participants exposed to high parent-perceived family financial pressure in W1 had shorter telomeres in W2 when compared to those exposed to low parent-perceived family financial pressure (&beta; = &minus;0.61, p = 0.042). Subgroup analyses revealed stronger associations in girls than boys. These findings reveal an important spillover effect between parental financial perceptions and stress and children&rsquo;s health at the cellular level

Impact of COVID-19 Pandemic on School-Aged Children&rsquo;s Physical Activity, Screen Time, and Sleep in Hong Kong: A Cross-Sectional Repeated Measures Study

Despite concerns about the negative effects of social distancing and prolonged school closures on children&rsquo;s lifestyle and physical activity (PA) during the COVID-19 pandemic, robust evidence is lacking on the impact of the pandemic-related school closures and social distancing on children&rsquo;s wellbeing and daily life. This study aimed to examine changes in the PA levels, sleep patterns, and screen time of school-aged children during the different phases of the COVID-19 outbreak in Hong Kong using a repeated cross-sectional design. School students (grades 1 to 12) were asked to report their daily electronic device usage and to fill in a sleep diary, recording their daily sleep onset and wake-up time. They were equipped with a PA monitor, Actigraph wGT3X-BT, to obtain objective data on their PA levels and sleep patterns. Students were recruited before the pandemic (September 2019&ndash;January 2020; n = 577), during school closures (March 2020&ndash;April 2020; n = 146), and after schools partially reopened (October 2020&ndash;July 2021; n = 227). Our results indicated lower PA levels, longer sleep duration, and longer screen time among participants recruited during school closures than those recruited before the COVID-19 outbreak. Primary school students were found to sleep on average for an extra hour during school closures. The later sleep onset and increased screen time documented during school closures persisted when schools partially reopened. Our findings illustrate the significant impact of social distancing policies during the COVID-19 pandemic on the sleep pattern, screen time, and PA level in school-aged children in Hong Kong. Professionals should urgently reinforce the importance of improving physically activity, good sleep hygiene, and regulated use of electronic devices for parents and school-aged children during this unprecedented time

Disentangling the effects of exposure to maternal substance misuse and physical abuse and neglect on child behavioral problems

There is inconsistent evidence on the association between prenatal substance exposure and child behavioral problems. Children affected by maternal substance misuse are vulnerable to physical abuse and neglect. Few studies have examined factors contributing to internalizing and externalizing problems in these children. This study, with a focus on children with prenatal substance exposure, investigated whether family characteristics (the duration of maternal substance misuse postpartum or the existence of a sibling) moderated the association between adverse exposure (physical abuse or neglect) and behavior (internalizing or externalizing problems). We recruited 54 Hong Kong Chinese mothers with registered records of substance misuse during pregnancy and their children (2-9 years). Mothers completed questionnaires on drug use patterns during pregnancy and postpartum, abusive and neglectful parenting behaviors in the preceding year, and children’s current behavioral problems. Moderated regression analyses tested whether abusive and neglectful parenting behavior interacted with family characteristics to affect child behavioral problems. The existence of a sibling moderated the relationship between neglect experience and internalizing problems, with a positive relationship observed only among single children (adjusted B [95% confidence interval] = 3.70 [0.98, 6.41], p = .012). The duration of maternal substance misuse postpartum moderated the relationship between physical abuse experience and externalizing problems, with a positive relationship observed only among children of mothers abusing substances beyond the child’s infancy period (adjusted B [95% confidence interval] = 6.86 [2.34, 11.38], p = .008). The results show that the impact of physical abuse and neglect experiences depend on the type of behavior assessed and family and child characteristics. Positive sibling relationship and early detoxification in the mother can foster healthy behavioral development for children exposed prenatally to maternal substance misuse

Management recommendations for clinically significant CNVs and recommendation according to the level of evidence.

<p>Abbreviations: MCA = Multiple Congenital Anomalies; DD = Developmental Delay; ASD = Autism Spectrum Disorders; Dys = Dysmorphism; UCS = Uncertain Clinical Significance.</p><p>Abbreviations: S = Surveillance; R =  specialist Referral/assessment; D = Diagnostic testing; P = medical/surgical Procedure; M = Medication administration; L = Lifestyle recommendation; O = Other interventions.</p><p>* = pathogenic CNVs, ∧ = likely pathogenic CNVs.</p><p>N = not tested; Mat  =  maternal inheritance; Pat  =  paternal inheritance.</p><p>Management recommendations for clinically significant CNVs and recommendation according to the level of evidence.</p

Additional file 1 of Evidence of individual differences in the long-term social, psychological, and cognitive consequences of child maltreatment

Additional file 1: Table S1. Comparison of long-term outcomes between exposed and unexposed individuals (based on original data). Table S2. Comparison of long-term outcomes between exposed and unexposed individuals (based on imputed data) stratified by follow-up time and age of onsetTable S3.Comparison of long-term outcomes between exposed and unexposed individuals (based on original data) stratified by follow-up time and age of onse