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The COVID-19 pandemic and resulting mitigation measures have led to increased vulnerabilities in early child development. However, research is scarce and there are no studies on the persistence of these losses three years into the pandemic among young children. To fill in this gap, we examined census-like evaluations of school readiness carried out among preschoolers in Uruguay. The assessments were carried out among 5 cohorts of 5-year-olds: who were assessed prior to the pandemic (2018, 2019); during the pandemic (2020, 2021); and after the health emergency declaration ended in Uruguay (2022). A total of 180,984 teacher evaluations were included covering cognitive, motor and socio-emotional development, as well as attitudes toward learning. Overall, we found that scores in most spheres of child development decreased from before to during the pandemic in 2020 and 2021. In 2022, scores returned to pre-pandemic levels. Our findings suggest the recovery of developmental losses among cohorts of children in kindergarten took more than two years in a country that experienced a mild-to-moderate impact of the COVID-19 pandemic.

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INTRODUCTION: Previous functional near-infrared spectroscopy (fNIRS) studies using Go/No-Go (GNG) tasks have focused on brain activation in relation to cognitive processes, particularly inhibitory control (IC). The results of these studies commonly describe right hemispheric engagement of the dorsolateral, ventromedial, or inferior frontal regions of the prefrontal cortex. Considering that typical healthy cognitive development is negatively correlated with higher cortisol levels (which may alter brain development), the overarching aim of the current study was to investigate how elevated stress (due to unforeseeable events such as the pandemic) impacts early cognitive development. METHOD: In this study, we examined fNIRS data collected from a sample of children (aged 2-4 years) during a GNG task relative to the response to stressors measured via hair cortisol concentrations. We acquired data in an ecological setting (Early Childhood Education and Care) during the coronavirus pandemic. RESULTS: We found that children with higher stress levels and a less efficient IC recruited more neural terrain and our group-level analysis indicated activation in the left orbitofrontal area during IC performance. CONCLUSIONS: A contextual stressor may disrupt accuracy in the executive function of IC early in development. More research efforts are needed to understand better how an orbitofrontal network subserves goal-directed behavior.

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BACKGROUND: Research has consistently shown that some children are more vulnerable at the time of school readiness. Better understanding the characteristics of these children is therefore important. Most studies have used a variable-based approach, which may mask the presence of small but important subgroups of children with mixed patterns of readiness strengths and weaknesses. Identifying subgroups with mixed readiness patterns using a person-centered approach matters because their developmental trajectories might differ in important ways from children with broader difficulties across all readiness domains. OBJECTIVE: This systematic review attempts to synthesize existing profiles of school readiness conducted on preschool-aged children and to describe how these various profiles are associated with children's academic achievement and social adjustment during their school years. Specifically, we described how the school readiness profiles vary in number of profiles identified and differences in the specific domains of school readiness. We further describe the school readiness profiles and how they predict later academic and social outcomes. Furthermore, we focus on profile differences between at-risk and non-at-risk preschoolers. METHODS: Longitudinal studies published between 2005 and 2022 on profiles of school readiness before school entry and at least one subsequent academic and/or social outcomes were extracted from five databases. Eight articles were included in this systematic review out of the 117 screened peer-reviewed articles. RESULTS: All the studies incorporated both the cognitive and socioemotional domains of school readiness in their profiles. Fifteen profiles of school readiness at preschool age were identified based on the child level of cognitive and socioemotional skills, with 7 profiles at risk of later academic and social difficulties. Despite variation, children in these at-risk profiles of school readiness shared similar features. CONCLUSION: This literature review provides an exhaustive summary on the number of profiles and domains of school readiness most frequently reported in studies using a person-centered approach. Yielding an in-depth description of at-risk profiles of school readiness can help designing early preventive intervention for these children.

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Abstract Background Research has consistently shown that some children are more vulnerable at the time of school readiness. Better understanding the characteristics of these children is therefore important. Most studies have used a variable-based approach, which may mask the presence of small but important subgroups of children with mixed patterns of readiness strengths and weaknesses. Identifying subgroups with mixed readiness patterns using a person-centered approach matters because their developmental trajectories might differ in important ways from children with broader difficulties across all readiness domains. Objective This systematic review attempts to synthesize existing profiles of school readiness conducted on preschool-aged children and to describe how these various profiles are associated with children's academic achievement and social adjustment during their school years. Specifically, we described how the school readiness profiles vary in number of profiles identified and differences in the specific domains of school readiness. We further describe the school readiness profiles and how they predict later academic and social outcomes. Furthermore, we focus on profile differences between at-risk and non-at-risk preschoolers. Methods Longitudinal studies published between 2005 and 2022 on profiles of school readiness before school entry and at least one subsequent academic and/or social outcomes were extracted from five databases. Eight articles were included in this systematic review out of the 117 screened peer-reviewed articles. Results All the studies incorporated both the cognitive and socioemotional domains of school readiness in their profiles. Fifteen profiles of school readiness at preschool age were identified based on the child level of cognitive and socioemotional skills, with 7 profiles at risk of later academic and social difficulties. Despite variation, children in these at-risk profiles of school readiness shared similar features. Conclusion This literature review provides an exhaustive summary on the number of profiles and domains of school readiness most frequently reported in studies using a person-centered approach. Yielding an in-depth description of at-risk profiles of school readiness can help designing early preventive intervention for these children.

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Parents' academic socialization of their young children is a critical yet understudied area, especially in the context of vulnerable parent-child dyads. The current longitudinal study examined factors that informed mothers' beliefs and practices concerning children's kindergarten readiness in a sample of 204 Mexican-origin adolescent mothers (M age = 19.94). Adolescent mothers' individual characteristics and assets (i.e., parental self-efficacy, educational attainment, educational utility beliefs, knowledge of child development) and sources of stress (i.e., economic hardship, coparenting conflict) were related to the importance they placed on children's social-emotional and academic readiness for kindergarten, their provision of cognitive stimulation and emotional support to their children in the home, and their enjoyment of literacy activities with their child. Moreover, adolescents' perception of parenting daily hassles emerged as a mediator in this process. Findings underscore the importance of considering Mexican-origin adolescent mothers' strengths and assets along with their unique contextual stressors as they relate to beliefs and practices that could have implications for their children's school success.

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OBJECTIVE: To explore patterns in parent-reported child sleep health and to investigate connections between such patterns and school readiness for newly enrolled prekindergarten (PreK) attendees from racially and ethnically diverse, low-income backgrounds. STUDY DESIGN: In a secondary analysis from a larger multiple-cohort longitudinal observational study of prekindergartners in low-income families, parental reports of sleep health for 351 children (mean age, 52.8 ± 3.5 months) during the first month of PreK were analyzed. Children also had completed direct assessments measuring language, literacy, mathematics, and executive functioning, and teachers rated children's social-emotional-behavioral competencies and approaches to learning at PreK entry. We performed latent class analyses to identify patterns in sleep health and used regression models to examine concurrent associations between child sleep health patterns and school readiness competencies across 6 domains: language, literacy, mathematics, executive functioning, social-emotional-behavioral, and approaches to learning. RESULTS: Two classes emerged reflecting more and less desirable patterns of sleep health. Children classified in the earlier, longer, consistent sleep health class (87% of children) experienced earlier bedtimes, longer night-time sleep durations, more consistent sleep routines, less caffeine consumption ≤3 hours before bedtime, and scored higher on a direct assessment of expressive vocabulary and on teacher-reported measures of social-emotional-behavioral competencies and learning approaches than their peers in the later, shorter, inconsistent sleep health class (13% of children). CONCLUSIONS: Consistent sleep routines and more optimal sleep health may serve as a protective mechanism for the language development, social-emotional-behavioral regulation, and approaches to learning of PreK from racially and ethnically diverse, low-income backgrounds. Clinician-parent discussions regarding optimal sleep health may provide key opportunities for targeted education that promotes school readiness skill development.

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OBJECTIVE: To examine the association between preschool-aged children's exposure to adverse childhood experiences (ACEs) and multiple, intersecting domains of school readiness using a nationally representative sample. STUDY DESIGN: A sample of 15 402 preschool-aged children (3-5 years) in the US from the 3 most recent cohorts (2016-2018) of the National Survey of Children's Health were employed. Primary caregivers were asked survey questions about the adversities experienced by focal children. Four distinct domains of school readiness among the children were also derived from the survey: early learning skills, self-regulation, social-emotional development, and physical health and motor development. RESULTS: Although nearly one-half of children who had not been exposed to ACEs were on-track across all domains, only 1 in 5 children exposed to 3 or more ACEs were on-track across all domains. Follow-up analyses identified parenting stress and reduced positive parenting practices as significant mediators of this association. Multivariate results also indicated that, regardless of the school readiness domain examined, an accumulation of ACEs increased the rate of items on which a child needs support or is at-risk. CONCLUSIONS: An accumulation of ACEs among preschool-aged children elevates risk within and across school readiness domains. These findings highlight the urgent need to identify best practices to reduce ACE exposure, as well as improve school readiness during early childhood.

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BACKGROUND: Barriers to early childhood development (ECD) are a global concern. Limited research exists on prenatal smoking and ECD in vulnerable populations, especially as it relates to school readiness (SR). AIMS: To examine how maternal cigarette use during pregnancy is associated with SR in a sample of Brazilian preschool-age children. STUDY DESIGN: We used the Brazilian Preschool Mental Health Study, a cross-sectional, epidemiological study of preschool-age children in Embu das Artes, São Paulo. SR was assessed using the Engle Scale of Child Development (ESCD). We restricted analyses to biological mothers, who represented 81.9% (n = 591) of the total 722 with ESCD data. Logistic regression models, adjusting for birth and child characteristics (year of preschool, sex, race, history of head trauma, coma, convulsions or epilepsy), sociodemographic factors and school environment, were used to estimate odds ratios and 95% confidence intervals. RESULTS: Prenatal smoking was negatively associated with SR. Children of mothers who smoked during pregnancy were more likely to be in the lowest ESCD quartile (aOR = 1.26, 95%CI: [1.02-1.55]) compared to those of non-smoking mothers, and each cigarette resulted in additional risk (aOR = 1.03, 95%CI:[1.01-1.05]). Children of heavy smokers had worse ESCD scores compared to children of non-smokers (aOR = 1.69, 95%CI:[1.18-2.44]), as well as when compared to children of moderate and non-smokers combined (aOR = 1.77, 95%CI:[1.22-2.57]). This relationship was not seen when comparing children of moderate smokers to children of non-smokers. Inferences were robust when examining very heavy smoking. CONCLUSION: Maternal tobacco use during pregnancy may affect child SR. Additional studies in other populations are needed to corroborate these results.

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OBJECTIVE: To examine the association of gestational age with school readiness in kindergarten reading and math skills. We hypothesized that compared with infants born at 39-41 weeks, infants born at lower gestational ages would have poorer school readiness. STUDY DESIGN: The study sample comprised 5250 children from the Early Childhood Longitudinal Study, Birth Cohort, assessed with specialized reading and math assessments at kindergarten. Poor school readiness was characterized by reading and math theta scores ≥1.5 SD below the sample mean. The aOR and 95% CI of poor school readiness were estimated using multivariate logistic regression, examining gestational age continuously and categorically (very preterm [VPT], moderate/late preterm [M/LPT], early term [ET], and term). Pairwise comparisons were performed to test for differences by gestational age category. RESULTS: There was an association between gestational age and poor school readiness for reading and math, with the suggestion of a threshold effect in children born at ≥32 weeks gestation. In adjusted models, in VPT infants, the aORs of poor school readiness in reading and math were 2.58 (95% CI, 1.29-5.15) and 3.38 (95% CI, 1.66-6.91), respectively. For infants born M/LPT and ET, the odds of poor school readiness in reading did not differ from those of children born full-term, however. CONCLUSIONS: Compared with term infants, the highest odds of poor school readiness in reading and math were seen in VPT infants, with lower odds of poor school readiness in children born at ≥32 weeks gestation. Ongoing developmental surveillance before kindergarten is indicated for VPT infants.

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Abstract Objective: To review the epidemiology and update the scientific knowledge on the problems of development and behavior in childhood, and the recommendations for the role of the pediatrician in identifying and managing delays and disturbances in child development and mental health. Sources: A search for relevant literature was performed in the PubMed and Scopus databases and publications of the National Scientific Council on the Developing Child. Summary of the findings: With the decline in the incidence of communicable diseases in children, problems with development, behavior, and emotional regulation are increasingly becoming a part of the work of pediatricians, yet many are not trained and feel uncomfortable about this extension of their role. The available screening tools for child development and behavior are reviewed, and a ‘school readiness’ checklist is presented, together with recommendations on how the pediatrician can incorporate developmental surveillance into routine practice, aware of the need for children to acquire social, emotional, and cognitive skills so that they can develop their full potential. Conclusions: The pediatrician's role in the future will include both physical and mental health, recognizing that social development, resilience, and emotional maturity are as important as physical growth and neuromotor skills in a child's life course.

Resumo Objetivo: Revisar a epidemiologia e atualizar os conhecimentos científicos sobre os problemas do desenvolvimento e do comportamento na infância e das recomendações do papel do pediatra na identificação e conduta frente aos transtornos da saúde mental infantil. Fontes de dados: Pesquisamos a literatura relevante nas bases de dados PubMed e Scopus e em publicações do National Scientific Council on the Developing Child. Síntese dos dados: Com o declínio na incidência de doenças transmissíveis em crianças, problemas do desenvolvimento, comportamento e regulação emocional fazem cada vez mais parte do trabalho do pediatra, mas muitos ainda não estão treinados e se sentem desconfortáveis com essa extensão do seu papel. Os instrumentos de triagem do desenvolvimento e comportamento foram revisados e uma lista de verificação da “prontidão escolar” foi apresentada, juntamente com orientações sobre como o pediatra pode incorporar a vigilância da saúde mental em sua de rotina de atendimento, consciente da necessidade da aquisição das habilidades sociais, emocionais e cognitivas para que a criança possa desenvolver toda sua potencialidade. Conclusões: O papel do pediatra no futuro irá abranger tanto a saúde física quanto a mental e reconhecer que o desenvolvimento social, a resiliência e o amadurecimento emocional são tão importantes quanto o crescimento físico e as habilidades neuromotoras no curso da vida de uma criança.

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OBJECTIVE: To review the epidemiology and update the scientific knowledge on the problems of development and behavior in childhood, and the recommendations for the role of the pediatrician in identifying and managing delays and disturbances in child development and mental health. SOURCES: A search for relevant literature was performed in the PubMed and Scopus databases and publications of the National Scientific Council on the Developing Child. SUMMARY OF THE FINDINGS: With the decline in the incidence of communicable diseases in children, problems with development, behavior, and emotional regulation are increasingly becoming a part of the work of pediatricians, yet many are not trained and feel uncomfortable about this extension of their role. The available screening tools for child development and behavior are reviewed, and a 'school readiness' checklist is presented, together with recommendations on how the pediatrician can incorporate developmental surveillance into routine practice, aware of the need for children to acquire social, emotional, and cognitive skills so that they can develop their full potential. CONCLUSIONS: The pediatrician's role in the future will include both physical and mental health, recognizing that social development, resilience, and emotional maturity are as important as physical growth and neuromotor skills in a child's life course.

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