One in five preschool-aged children in the United States is obese, and children with disabilities are significantly impacted. This study aimed to determine the association between age at solid food initiation and obesity prevalence in preschool-aged children while considering disability status, ethnicity, gestational age, and birth weight. Analysis was conducted on a sample of 145 children aged 2 to 5 years who were enrolled in ten childcare centers. Parents completed a survey assessing disability status, race and ethnicity, birth weight, gestational age, and age of solid food initiation. Height and weight were collected concurrently. Multivariable logistic regression models generated the odds of developing obesity based on age at solid food initiation, disability status, ethnicity, gestational age, and birth weight. There was no significant difference in the odds of being obese based on age at solid food introduction. Children with disabilities (OR = 0.17, 95% CI 0.04–0.6, p = 0.01) and children born preterm (OR = 0.28, 95% CI 0.08–0.79, p = 0.03) had significantly lower odds of being obese. Hispanic children (OR = 4.93, 95% CI 1.91–15.32, p = 0.002) and children with higher birth weights (OR = 1.47, 95% CI 1.17–1.92, p = 0.002) were more likely to be obese. With pediatric obesity rates continuing to rise, these findings can inform future intervention efforts.

The COVID-19 pandemic has negatively impacted the childcare industry over the past two years. This study examined how pandemic-related challenges impacted preschool-aged children by disability and obesity status. Participants were 216 children (80% Hispanic, 14% non-Hispanic Black) aged 2 to 5 years in 10 South Florida childcare centers. In November/December 2021, parents completed a COVID-19 Risk and Resiliency Questionnaire, and body mass index percentile (BMI) was collected. Multivariable logistic regression models examined the association of COVID-19 pandemic-related social challenges (transportation, employment) and child BMI and disability status. As compared to normal-weight children, those families with a child who was obese were more likely to report pandemic-related transportation (OR: 2.51, 95% CI: 1.03–6.28) challenges and food insecurity (OR: 2.56, 95% CI: 1.05–6.43). Parents of children with disabilities were less likely to report that food did not last (OR: 0.19, 95% CI: 0.07–0.48) and that they could not afford balanced meals (OR: 0.33, 95% CI: 0.13–0.85). Spanish-speaking caregivers were more likely to have a child who was obese (OR: 3.04, 95% CI: 1.19–8.52). The results suggest that COVID-19 impacts obese preschool children from Hispanic backgrounds, while disability was a protective factor.

Importance: Selective, modified radical, and radical neck dissections are common surgical procedures that can result in significant musculoskeletal issues of the neck and shoulder. Quality-of-life evaluations after neck dissection must assess and quantify these dysfunctions to allow subsequent comparison of outcomes after different treatments. Objective: There is no validated Spanish-language questionnaire designed to evaluate neck and shoulder dysfunction after cervical lymphadenectomy. We therefore sought to translate a version of the Neck Dissection Impairment Index (NDII) into Spanish. Design, Settings, and Participants: A three-phased approach was used. Phase 1: The NDII was translated from English to Spanish using a “forward and backward” translational technique following international guidelines. Phase 2: The questionnaire was administered to six patients from our head and neck surgery clinic who were bilingual and fluent in both English and Spanish. Phase 3: The final version was administered prospectively to 34 patients with prior history of neck dissection (ND). These patients were asked to complete the questionnaire a second time 3 to 6 weeks after their first response. Test–retest reliability was calculated with Spearman’s correlation. Internal consistency was elicited using Cronbach’s alpha. Main Outcome(s) and Measure(s): NDII score at initial administration and follow-up administration 6 weeks later, demographic data. Results: NDII was successfully translated and validated into Spanish. Cronbach’s alpha revealed high internal consistency at both the first time point 0.95 (mean standardized score: 95 (88.1, 97.5), 95% CI: 0.89, 0.97) and at the second time point 0.90 (mean standardized score: 92.5 (80.6, 100.0), 95% CI: 0.81, 0.95). The Spearman’s correlation for test–retest reliability of overall score was strong (rho = 0.772, P < 0.001). The intraclass correlation coefficient of the overall score was moderate (ICC = 0.683, P < 0.001). Conclusions and Relevance: NDII is a recognized, previously validated quality-of-life (QOL) tool for the identification of ND-related dysfunction. This validated Spanish version will allow clinicians to adequately assess the neck and shoulder-related QOL for the Spanish-speaking population who are under-represented in head and neck research.

Background/Objectives: Excessive screen time and inadequate sleep are well-established developmental risk factors, yet limited research has examined the relationship between adherence to national sleep and screen time guidelines and language outcomes in children with mild language delays. This study examined sleep, screen time, and language outcomes in 765 children aged 1–5 with mild language delays enrolled in the Early Discovery Program. Methods: Sleep and screen time were categorized according to American Academy of Pediatrics and Caring for Our Children guidelines. Language outcomes were measured using standardized scores from the Preschool Language Scales–Fifth Edition. Results: Sociodemographic factors, including race, insurance status, and caregiver education, were significantly associated with sleep and screen behaviors. Excessive screen time was negatively associated with expressive language scores, while sleep duration showed no significant relationship. Conclusions: Findings highlight the need for early interventions that promote adherence to national health guidelines and address sociodemographic factors influencing language development in young children.

This mixed methods study examined the impact of a multi-faceted professional development (PD) program for preschool teachers and classroom assistants on teacher-supported assistive technology (AT) use and early literacy development of children with disabilities. Four special education preschools were randomized into intervention (2 schools, 9 teachers, 50 children) and waitlist control (2 schools, 17 teachers, 42 children) groups. The 24-week PD included online modules, coaching, and AT device kits. Pre-post gains in children's AT use and early literacy skills were analyzed using χ2 and repeated measures ANOVA. Teacher interviews and reflective commentaries were analyzed using Framework Analysis methodology. From pre- to post-test, the percent of children in the intervention group using some form of AT rose from 36 to 80%. The percent of children using AT in the control group went from 45 to 62%. The difference in change between the two groups was statistically significant, χ² = 13.93, p=.001. Gains in early literacy skills were not significantly different across groups, F(1,90)=0.010, p=.922. Analysis of the qualitative data revealed three themes: the positive impact of AT on child engagement and participation, the importance of individualizing AT for each student, and barriers teachers faced in AT implementation. The PD program had a positive effect on children's AT use but not on gains in early literacy. Teachers' comments highlighted the nuanced relationship between AT use and literacy outcomes, suggesting the need for more targeted implementation of AT during literacy activities.