Though the use of mobile devices (eg, tablets, smartphones) by young children is pervasive and increasing, research relating children's use of mobile devices to their development is only beginning to emerge. Learning, language development, and self-regulation skills among children aged 0 to 5 are of particular interest to pediatric clinicians, researchers, parents, and policymakers, as these skills foreshadow important outcomes across the lifespan. Experimental research reviewed herein suggests that the interactivity allowed by mobile devices has benefits over passive viewing (for example, of television) for young children's learning and self-regulation, but studies of naturalistic use suggest increased use of mobile devices is associated with poorer language and self-regulation. Pediatric clinicians can be important sources of support for families endeavoring to navigate their children's use of mobile devices by providing advice and resources, such as communicating reasonable time limits and sharing sources of developmentally appropriate content. Future research should implement innovative, rigorous research designs and methods to clarify mechanisms underlying potential negative effects of naturalistic use of mobile devices by young children and investigate how content and context of young children's mobile-device use may influence relations between such use and children's skills.

Higher TV exposure has been repeatedly linked to poorer self-regulation among young children. Recent studies show that the use of mobile screen media devices is also negatively related to self-regulation in early childhood. Despite the proliferation of mobile devices in households with young children, it is unclear whether children’s use of smartphones and tablets predicts their self-regulation independently of TV use and parents’ screen media use or when also considering evocative effects of children’s dysregulation. This multimethod, cross-sectional study with a racially diverse sample (N = 72) in the western United States examines parents’ (86.3% mothers) leisure media use and preschool-aged children’s (M = 38.02 months, 55.6% girls, 47.2% racial-ethnic minority) mobile media use, TV use, and dysregulation as predictors of their behavioral battery-assessed self-regulation. As hypothesized, path models show that the amounts of children’s mobile media use, TV use, and dysregulation negatively predict their self-regulation, and mobile media use is a stronger predictor than TV use. We conclude with future directions to yield stronger inferences of screen media effects on child development that can inform interventions and screen time guidelines.

This study examines the association of parent-reported and behaviorally assessed child self-regulation with their use of mobile devices, including mean weekly exposure and age at first use.

Infants are uniquely vulnerable to maternal depression's noxious effects, but few longitudinal studies have tried to identify discrete postnatal trajectories of maternal depressive symptoms (MDS) beginning in infancy. This study extends evidence of heterogeneous change in postnatal MDS by examining their cross-contextual antecedents in infancy and their consequences for children's early behavior problems and language skills in late toddlerhood. A community sample of mother-child dyads (N = 235, 72% Caucasian) was assessed when children were 7, 15, and 33 months old. Mothers reported their socioeconomic status (SES), social support, marital relationship quality, family dysfunction, parenting stress, and infants' functional regulatory problems at 7 months postpartum, and children's internalizing and externalizing symptoms at 33 months. Children completed a receptive vocabulary assessment at 33 months in the lab. Latent class growth analysis identified three postnatal MDS trajectory classes that fit the data best: low-decreasing, moderate, and increasing. Psychosocial measures at seven months postpartum primarily predicted membership to these postnatal trajectory classes, which subsequently differed in children's internalizing, externalizing, and receptive vocabulary in late toddlerhood, controlling for family SES and functional regulatory problems in infancy. We discuss salient antecedents and consequences of postnatal depression for mothers and their offspring.

Abstract

BACKGROUND

Chemotherapy for high grade gliomas (HGG) is limited by the blood-brain-barrier (BBB). Convection enhanced delivery (CED) improves chemotherapy delivery by utilizing fluid convection obviating the challenges of crossing the BBB while minimizing systemic toxicity. CED of nanoliposomal-irinotecan (Onivyde) showed to be a superior delivery route for anti-tumor activity in animal models. An advance of this trial is the development and use of real time CED, which utilizes MRI to visualize the CED process with the aid of co-convected contrast agents, monitoring delivery into the brain and affording for corrective action.

METHODS

This is a 3 + 3 single dose escalation trial with 2 cohorts: 20mg/ml and 40mg/ml. Onivyde and GAD were co-infused via the same catheters in a one-time delivery. The total volume of infusate, and consequently total dose, were personalized based on the patient’s tumor volume, and ranged from 20–680 mg of Onivyde, given via up to 4 catheters. Tumor diameters were allowed to be 1 – 4 cm, with injection volumes ranging from 2 – 17 mL of infusate.

RESULTS

10 patients have been treated on this protocol, all in under 5 hours. There were 7 GBs, 2 anaplastic astrocytomas, and 1 oligoastrocytoma. Seven patients lived over a year after treatment, which is remarkable since median survival rates for multiply recurrent: GBs = 8 months, AAs = 11 months. Utilizing imaging software, we correlated pre-infusion modeling of the drug distribution with post-infusion imaging. A number of technical challenges were overcome by real time monitoring; the total volume of distribution (Vd), and the Vd to volume infused (Vi) ratio for each infusion was ~2.

CONCLUSIONS

Image-guided distribution allows for safe real-time placement and adjustment of CED cannula of Onivyde into patient’s brains. Such methods allow for maximum tumor coverage and warrant further studies with repeat dosing.