WCS38 Child Health

Question 1

Factors influencing Early Child Development

Answer 1

1. Poverty
2. Education
3. Health
4. Home and Family environment (Parent-child interactions)
5. Maternal factors (Mental and physical health)
6. Nutrition

Question 2

Under-nutrition

Answer 2

Underlying cause of child deaths associated with ***infectious diseases

• Pneumonia, Diarrhoea: remain diseases often associated with child deaths

Severe malnutrition is a major threat in developing countries —> Refeeding programme

Question 3

Children’s right

Answer 3

1. Survival rights
   - rights to food, shelter, access to health care
2. Developmental rights
   - right to education, play and special services for disabled
3. Protection rights
   - right to be protected against all form of abuse, neglect, discrimination, exploitation
4. Participation rights
   - right to freedom of thought, conscience, religion, expression of their views freely in all matters affecting them

Question 4

***Leading cause of death in Neonates and Children

Answer 4

Neonates (0-27 days):

• Preterm birth complications
• Birth asphyxia (suffocation)

Children (1-59 days) (Mostly Infective cause):

• Diarrhoea
• Pneumonia
• Malaria

Question 5

Mortality rate among children under 5 (U5MR)

Answer 5

Measures end result of development rather than input
- ***more sensitive in regards to children’s health

Aim to reduce by 2/3

Barriers:

• Low income (lowest rate of change in U5MR over the years)
• Gender inequality

Question 6

Effective interventions to reduce U5MR

Answer 6

Most successful program are related to Pregnancy + Neonatal period

1. ***Breastfeeding
2. ***Complementary feeding
3. ***Water, sanitation, hygiene

Question 7

Most effective intervention in Diarrhoea

Answer 7

Oral rehydration therapy

Question 8

Most effective intervention in preventing infection

Answer 8

Hand washing, personal hygiene, water sanitation

Question 9

Hong Kong situation

Answer 9

• Long life expectancy at birth
• High Gini coefficient
• High Child poverty rate: single families, U5MR, child maltreatment rate, poverty
• ↑ U5MR

Question 10

Neuroscience of Brain Development

Answer 10

• Brain is changed by experiences - early years of life impacts on long term outcomes (life course model)
• Relationships —> Social-emotional function development

Transactional model: Child development
1. **Constitution
2. **Environment
—> How children turn out is outcome of transaction between biology and environment

Question 11

Plasticity of brain

Answer 11

Ability to adopt and adapt to stimulus

Neuronal networks are continuously shaped by genetic, environmental, experiential stimulus and strengthened through repetition

• brain plasticity reduces as we age

Question 12

Synaptogenesis and Apoptosis - developing, tuning and pruning our neuronal networks

Answer 12

• Born with many more neurons than we will ever need
• Genes, Environment and Experience affect density of neuronal networks
• As we develop and grow —> ***Some networks are pruned (e.g. babies are tuned into every human sound but gradually prune out the ones not needed / used for their mother tongue)
  —> give out space for further differentiation of specific network
• “Use it / Lose it, Neurons that fire together wire together”

Question 13

Early years matter

Answer 13

• Windows of opportunity
• Patterns of early caregiving matters
• Across species similar bio-behavioural systems are involved in parenting
• Significant adverse impairs development in first 3 years
  —> Elevated risk for depression, adult heart disease
• Rates of return to human capital investigation highest in Preschool programs

Question 14

Parental and Societal expectation

Answer 14

What do we want from our children?

• Excellent academic performance
• Good career prospect
• Good health
• ***Positive holistic development (physical, mental, emotional)

Question 15

ADHD

Answer 15

1. Attention deficit
2. Hyperactivity
3. Impulsivity

• difficult to learn new skills
• hard to maintain social relationships

Question 16

***Early Development Instrument (EDI)

Answer 16

Population measure of school readiness and holistic development of young children:

1. ***Physical health + Well-being
2. ***Social competence
3. ***Emotional maturity
4. ***Language and cognitive development
5. ***Communication skills and general knowledge

Socioeconomic gradients:
Wealthier family —> Better school readiness

Factors affecting CEDI score:

1. Family processes
   - frequency of parent-child interactions
   - management of child’s digital use
2. Kindergarten level
   - annual school fees
   - teacher education, background and working experience

—> Double jeopardy!

Question 17

Digital device use and School readiness

Answer 17

1. TV in child’s bedroom
   —> parental control of watching TV is protective for language domain
2. PC in child’s bedroom
   —> parental control of PC use is protective for language domain
3. Smartphone ownership
   - lower school readiness in physical health and well-being domain

Question 18

Sleep and Early child development

Answer 18

Sleep: most important period of a day affecting growth and development

• detrimental effects of insufficient sleep on adolescent health well documented
• most ready for school if have optimal sleep duration

Sleep duration ↓ —> School readiness ↓ (particularly true for children from wealthy families), ↑ risk of vulnerability
Sleep duration ↑ —> Academic performance ↑ (widening gap between wealthy / poor family)
Sleep duration ↓ —> Hyperactivity and Inattention ↑
Sleep duration ↑ —> Prosocial and helping behaviour ↑

Sleep duration:

• Positively associated with good family functioning (more parent-child activities, higher family SES)
• Negatively associated with use of digital device