Background: Early childhood caries is considered one of the most prevalent diseases in childhood, affecting almost half of preschool-age children globally. In the Netherlands, approximately one-third of children aged 5 years already have dental caries, and dental care providers experience problems reaching out to these children. Objective: Within the proposed trial, we aim to test the hypothesis that, compared to children who receive usual care, children who receive the Toddler Oral Health Intervention as add-on care will have a reduced cumulative caries incidence and caries incidence density at the age of 48 months. Methods: This pragmatic, 2-arm, individually randomized controlled trial is being conducted in the Netherlands and has been approved by the Medical Ethics Research Board of University Medical Center Utrecht. Parents with children aged 6 to 12 months attending 1 of the 9 selected well-baby clinics are invited to participate. Only healthy children (ie, not requiring any form of specialized health care) with parents that have sufficient command of the Dutch language and have no plans to move outside the well-baby clinic region are eligible. Both groups receive conventional oral health education in well-baby clinics during regular well-baby clinic visits between the ages of 6 to 48 months. After concealed random allocation of interventions, the intervention group also receives the Toddler Oral Health Intervention from an oral health coach. The Toddler Oral Health Intervention combines behavioral interventions of proven effectiveness in caries prevention. Data are collected at baseline, at 24 months, and at 48 months. The primary study endpoint is cumulative caries incidence for children aged 48 months, and will be analyzed according to the intention-to-treat principle. For children aged 48 months, the balance between costs and effects of the Toddler Oral Health Intervention will be evaluated, and for children aged 24 months, the effects of the Toddler Oral Health Intervention on behavioral determinants, alongside cumulative caries incidence, will be compared. Results: The first parent-child dyads were enrolled in June 2017, and recruitment was finished in June 2019. We enrolled 402 parent-child dyads. Conclusions: All follow-up interventions and data collection will be completed by the end of 2022, and the trial results are expected soon thereafter. Results will be shared at international conferences and via peer-reviewed publication.
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Following on from successful early intervention programs abroad, the Netherlands also introduced a number of different programs to tackle educational disadvantage in preschool and early years education. Studies that investigate the effects of Dutch early childhood interventions have been published since 2000. This meta-analytic review study summarizes the findings from 21 experimental comparisons which study some 50,000 children in the period between 2000–2015, with a total of 165 outcome measures. The aggregate effect of early childhood interventions compared with standard preschool and early years groups is not statistically significant. The disappointing results indicate that special early childhood education programs currently offer no added value for the development of young children in the Dutch context over and above regular preschool and early years groups. A focus for Dutch policy is to improve future practice based on scientific evidence around effective approaches to ECEC. Further, the implementation of study designs with more experimental control would strengthen the current knowledge base.
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The need for excess weight gain prevention in disadvantaged young children is widely recognised. Early Childhood Education and Care teachers are potential key actors in early interventions to prevent overweight and obesity. This study examines the effects of a preschool-based intervention for teachers in promoting healthy eating and physical activity in young children. A cluster randomised controlled trial was conducted at 41 preschools in a deprived area of Amsterdam, The Netherlands. The intervention consisted of 2 programmes that were applied in succession: A Healthy Start and PLAYgrounds for TODdlers. The study period was 9 months. Primary outcomes were assessed via questionnaires and included teachers’ knowledge, attitude, food/activity-related practices, and level of confidence in promoting healthy behaviours. Secondary outcomes in this study were teachers’ and children’s BMI (z-score), body composition, dietary intake and physical activity level. Intention-to-treat analyses were performed using linear mixed models. In total, 115 teachers and 249 children (mean age 3.0 (0.2) years) were included. A positive effect on teachers’ knowledge about the Dutch dietary guidelines was found after the programme A Healthy Start (difference = 1.38; 1-sided 95% CL = 0.29; p = 0.02). This effect was not sustained at 9 months (difference = 0.34; 1-sided 95% CL = -0.76; p = 0.31). The overall intervention had a positive effect on 3 of the 5 attitude statements regarding a healthy lifestyle (difference ranged from 0.34 to 0.55) and on the practice scale Activity-related-Modelling (difference = 0.16; 1-sided 95% CL = 0.06; p = 0.01). No intervention effects were observed on food-related practice scales and the level of confidence in promoting healthy behaviours. At this stage, no effects were seen on teachers’ and children’s BMI (z-score). This study contributes to the professional development of Early Childhood Education and Care teachers and addresses the call for interventions to prevent overweight/obesity and to minimise health inequalities in young children.
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The (pre)school environment is an important setting to improve children’s health. Especially, the (pre)school playground provides a major opportunity to intervene. This review presents an overview of the existing evidence on the value of both school and preschool playgrounds on children’s health in terms of physical activity, cognitive and social outcomes. In addition, we aimed to identify which playground characteristics are the strongest correlates of beneficial effects and for which subgroups of children effects are most distinct. In total, 13 experimental and 17 observational studies have been summarized of which 10 (77%) and 16 (94%) demonstrated moderate to high methodological quality, respectively. Nearly all experimental studies (n = 11) evaluated intervention effects on time spent in different levels of physical activity during recess. Research on the effects of (pre)school playgrounds on cognitive and social outcomes is scarce (n = 2). The experimental studies generated moderate evidence for an effect of the provision of play equipment, inconclusive evidence for an effect of the use of playground markings, allocating play space and for multi-component interventions, and no evidence for an effect of decreasing playground density, the promotion of physical activity by staff and increasing recess duration on children’s health. In line with this, observational studies showed positive associations between play equipment and children’s physical activity level. In contrast to experimental studies, significant associations were also found between children’s physical activity and a decreased playground density and increased recess duration. To confirm the findings of this review, researchers are advised to conduct more experimental studies with a randomized controlled design and to incorporate the assessment of implementation strategies and process evaluations to reveal which intervention strategies and playground characteristics are most effective. https://doi.org/10.1186/1479-5868-11-59 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
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The Internet offers many opportunities to provide parenting support. An overview of empirical studies in this domain is lacking, and little is known about the design of webbased parenting resources and their evaluations, raising questions about its position in the context of parenting intervention programs. This article is a systematic review of empirical studies (n = 75), published between 1998 and 2010, that describe resources of peer and professional online support for parents. These studies generally report positive outcomes of online parenting support. A number of recent experimental studies evaluated effects, including randomized controlled trials and quasi-experimental designs (totaling 1,615 parents and 740 children). A relatively large proportion of the studies in our sample reported a content analysis of emails and posts (totaling 15,059 coded messages). The results of this review show that the Internet offers a variety of opportunities for sharing peer support and consulting professionals. The fi eld of study refl ects an emphasis on online resources for parents of preschool children, concerning health topics and providing professional support. A range of technologies to facilitate online communication is applied in evaluated websites, although the combination of multiple components in one resource is not very common. The fi rst generation of online resources has already changed parenting and parenting support for a large group of parents and professionals. Suggestions for future development and research are discussed.
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Given the substantial increase in children attending center-based childcare over the past decades, the consequences of center-based childcare for children’s development have gained more attention in developmental research. However, the relation between center-based childcare and children’s neurocognitive development remains relatively underexplored. The aim of this study was therefore to examine the relations between quantity of center-based childcare during infancy and the neurocognitive development (both functional brain networks and self-regulation) of 584 Dutch children. Small-world brain networks and children’s self-regulation were assessed during infancy (around 10 months of age) and the preschool period (2–6 years of age). The findings revealed that the quantity of center-based childcare during infancy was unrelated to individual differences in children’s functional brain networks. However, spending more hours per week in center-based childcare was positively related to the development of self-regulation in preschool age children, regardless of children’s sex or the levels of exposure to risk and maternal support in the home environment. More insight into the positive effects of center-based childcare on children’s development from infancy to toddlerhood can help to increase our insight into a better work–life balance and labor force participation of parents with young children. Moreover, this study highlights that Dutch center-based childcare offers opportunities to invest in positive child outcomes in children, including self-regulation.
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The Internet offers many opportunities to provide parenting support. An overview of empirical studies in this domain is lacking, and little is known about the design of web based parenting resources and their evaluations, raising questions about its position in the context of parenting intervention programs. This article is a systematic review of empirical studies (n = 75), published between 1998 and 2010, that describe resources of peer and professional online support for parents. These studies generally report positive outcomes of online parenting support. A number of recent experimental studies evaluated effects, including randomized controlled trials and quasi-experimental designs (totaling 1,615 parents and 740 children). A relatively large proportion of the studies in our sample reported a content analysis of e-mails and posts (totaling 15,059 coded messages). The results of this review show that the Internet offers a variety of opportunities for sharing peer support and consulting professionals. The field of study reflects an emphasis on online resources for parents of preschool children, concerning health topics and providing professional support. A range of technologies to facilitate online communication is applied in evaluated Web sites, although the combination of multiple components in one resource is not very common. The first generation of online resources has already changed parenting and parenting support for a large group of parents and professionals. Suggestions for future development and research are discussed.
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In het onderwijsbeleid wordt veel belang gehecht aan een soepele overgang van de voorschoolse periode naar de basisschool. Bij kinderen met een speciale onderwijsbehoefte verloopt de start op de basisschool echter niet altijd zo optimaal als gewenst, waardoor de ontwikkeling van deze kinderen verstoord kan raken, met stress en handelingsverlegenheid bij kinderen, ouders en professionals als gevolg. Het doel van dit onderzoek is om de ervaringen van ouders/verzorgers van kinderen met speciale onderwijsbehoeften bij deze transitie in kaart te brengen. Uit de voorlopige resultaten blijkt dat voor veel ouders de overgang naar de basisschool zelf vrijwel normaal verloopt, maar dat hun kinderen op school al snel vastlopen. Bij het organiseren van passend onderwijs lopen ouders tegen verschillende hindernissen aan zoals gebrek aan kennis, tijd en ervaring op school, een gebrek aan initiatief bij professionele partijen, en negatief geformuleerde communicatie. Helpende eigenschappen van docenten en zorgverleners zijn welwillendheid, positiviteit en de bereidheid om zich kwetsbaar op te stellen. Op basis van deze ervaringen kunnen aanknopingspunten gevonden worden voor het versoepelen van de transitie naar de basisschool, zodat kinderen met speciale onderwijsbehoeften vanaf de start van de basisschool een billijke kans krijgen om zich optimaal te ontwikkelen.
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Background: Although research on children's motor competence is a growing field of interest, especially among young children (4-6 years), several questions remain to be answered. Differences in children’s motor competence and their determinants, must be made transparent since early childhood is a critical period for the development of fundamental movement skills, and thereby a lifelong active lifestyle and health. Objective: The purpose of this cross-sectional study was to determine differences in actual motor competence (AMC), perceived motor competence (PMC) and enjoyment of physical activity among young children with different weight status. Methods: AMC, PMC and enjoyment were measured among 1708 children (50.4% male, mean age: 5.34 ± 0.73 years) from 36 primary schools in The Netherlands. AMC was measured by using the Athletic Skills Track (AST-1). The Pictorial Scale of Perceived Movement Skill Competence for Young Children was used for determining PMC and enjoyment of physical activity was measured using a Visual Analogue Scale. The data were analyzed using a three-way ANOVA to examine the differences between AMC, PMC and enjoyment by sex (boys/girls), age (4, 5, 6 years) and weight status (normal, overweight, obesity). Results: Overall, AMC was ranked as ‘average motor gifted’. Average PMC and enjoyment scores were 3.31 (SE 0.01) (1-4 scale) and 4.41 (SE 0.02) (1-5 scale) respectively. No interaction effects were found between sex, age and weight status on AMC or PMC. However, there was a statistically significant two-way interaction effect for enjoyment between age and weight status (F (4,1454) =2.464, p =.043). Relative enjoyment scores for normal weight and overweight groups between high and low enjoyment were distributed 99% to 1%. However, in the obese group there was a distribution of 92% to 8% between high and low enjoyment. Conclusions: The results of this study suggest that there are no significant differences in AMC and PMC between children of different sex, ages (4, 5 and 6 years), and weight status in this age group. However, children with obesity more often experience less enjoyment during physical activity than children with another weight status. Targeted intervention for increasing enjoyment during physical activity in combination with reducing obesity seems advisable even at young age.
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AIM To examine which instruments used to assess participation of children with acquired brain injury (ABI) or cerebral palsy (CP) align with attendance and/or involvement constructs of participation; and to systematically review measurement properties of these instruments in children with ABI or CP, to guide instrument selection. METHOD Five databases were searched. Instruments that quantified ‘attendance’ and/or ‘involvement’ aspects of participation according to the family of participation-related constructs were selected. Data on measurement properties were extracted and methodological quality of the studies assessed. RESULTS Thirty-seven instruments were used to assess participation in children with ABI or CP. Of those, 12 measured attendance and/or involvement. The reliability, validity, and responsiveness of eight of these instruments were examined in 14 studies with children with ABI or CP. Sufficient measurement properties were reported for most of the measures, but no instrument had been assessed on all relevant properties. Moreover, most psychometric studies have marked methodological limitations. INTERPRETATION Instruments to assess participation of children with ABI or CP should be selected carefully, as many available measures do not align with attendance and/or involvement. Evidence for measurement properties is limited, mainly caused by low methodological study quality. Future studies should follow recommended methodological guidelines.
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