BACKGROUND:Observational evidence suggests that increasing fruit and vegetable (FV) intake has the potential to improve children's cognitive function and mental well-being, but this has not yet been empirically tested in intervention research. This study assessed the feasibility and acceptability of a multi-component FV intervention which measures mental and cognitive health outcomes in children. METHODS:The 'Feel Good Study' was a cluster-randomised controlled feasibility study conducted in four New Zealand primary schools, with equal allocation of schools to intervention and wait-list control arms. The intervention group received a 10-week FV programme informed by behavioural theory, including school- and home-based components designed to improve FV availability and acceptance. The wait-list control group received a simplified 5-week version of the intervention. Dietary, cognitive, and mental health outcomes were completed by children and parents/caregivers at the start and end of the 10-week study period. Primary outcomes of this feasibility study were recruitment, retention, and data collection rates. Process evaluation captured measures of intervention fidelity and dose, acceptability, reach, and barriers or facilitators to implementation. RESULTS:Seventy children were recruited (79% of target recruitment rate), with an average retention rate of 89%. Diet, cognitive, and mental health data collection procedures were feasible, with all data valid for analysis except for 6% of children's dietary questionnaires. All intervention components were delivered (100% dose delivered), with high levels of fidelity (82% - 100% of components implemented as planned). All teachers and parents strongly agreed that they would recommend other schools/families take part in the study, indicating high levels of acceptability. Process evaluation revealed areas for refinement including more cohesive connections between school- and home-based intervention components, strengthening or adding new intervention components, and simplifying enrolment procedures with longer recruitment periods. CONCLUSION:Having satisfied key feasibility and acceptance measures in the Feel Good Study, we recommend intervention refinement and progression to a definitive trial where the efficacy of increased FV intake for mental health and cognitive function can be tested in children for the first time. TRIAL REGISTRATION:The trial protocol was prospectively registered with the Australia and New Zealand Clinical Trials Registry (ACTRN12623000533695) on 2 May 2023, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385829&isReview=true .

This study explored gross motor development (GMD) trajectories among 6359 children, with and without autism, from the Growing Up in New Zealand longitudinal cohort study. By the age of 8, 173 children had either an autism diagnosis (n = 108) or parent-reported autism concerns (n = 65). Gross motor milestones were reported by mothers when children were 9, 24, and 54 months of age. We found that irrespective of autism diagnosis, GMD delays at 24 months of age were more likely among girls, children born preterm, and those whose mothers identified as European. A mixed-effect logistic regression model, controlling for antenatal maternal and child covariates, revealed that the proportion of children with GMD delay (relative to their peers) increased significantly from 9 to 54 months for all three groups, but the increase was greater for those with autism concerns (OR = 1.28, 95% CI = 1.08-1.52) or an autism diagnosis (OR = 1.26, 95% CI = 1.10-1.43) compared to the no autism group (OR = 1.06, 95% CI = 1.02-1.10). Differences in the changes in GMD performance among children with an autism diagnosis compared to those without autism occurred between 9 and 24 months (OR = 2.16, 95% CI = 1.13-4.13). No significant GMD delay differences were found at any time between children with an autism diagnosis versus those with autism concerns. Children with a GMD delay should be screened for autism at 24 m. Early identification is the first step toward knowledge-based, effective intervention of developmental difficulties.

Background:Significant intimate partner aggression (IPA) has been found to negatively impact outcomes of children, such as increased conduct problems (CP). However, it is unclear if forms of IPA that are less severe (e.g., shoving, pushing or yelling) have no, little, or substantial impact on child CP, which would indicate that the intensity (i.e., dosage) of IPA matters. In addition, it is unknown if the impact of IPA on child CP depends on the reporter (mother vs. partner) and on variables such as maternal depression and parenting. Methods:We investigated the impact of IPA (both mother- and partner-reported), assessed during pregnancy and 9 months postpartum, on child CP at ages 2, 4.5, and 8 years. We also tested both the potential mediating role of maternal depression and moderating role of maternal warmth, reflecting risk and protective factors, respectively. Using longitudinal data from the Growing Up in New Zealand study, we tested path models with 5298 children. Results:IPA predicted greater child CP for both mother- and partner-reported IPA, but at different age. Maternal depression partly mediated this effect, which was not moderated by maternal warmth. Conclusion:These findings underscore the importance of exposure to IPA on child development and provides evidence for that impact on behaviour independent of the effects of maternal depression. Positive parenting like maternal warmth seems not to buffer those negative effects.

BACKGROUND:Depression and anxiety often co-occur, resulting in a more severe prognosis than either condition alone. Identifying the impact of risk factors on this comorbidity is essential for guiding early interventions. METHOD:Data from 4563 young participants in the Growing Up in New Zealand (GUiNZ) longitudinal study were analysed to identify risk factors associated with comorbid depression and anxiety. Scores for depression and anxiety symptoms were converted into binary variables using the cut-off of 10 and 60, respectively, and then combined to create the comorbidity outcome. A Cumulative Risk (CR) score was used to measure the impact of multiple risk factors from prenatal to childhood on the likelihood of this comorbidity. CR scores were further grouped into three levels of risk, and their association with comorbidity was examined using univariable and multivariable logistic regression analyses. RESULTS:The prevalence of comorbidity at age 12 years was 8.9% (406/4563). Among young people, 14.2% (647/ 4563) had no risk factors, 64.7% (2953/4563) had one to three (low CR score level), and 21.1% (963/4563) had four or more risk factors (high CR score level). In the adjusted analyses, young people in the low and high CR levels had 2.6 times and 4.6 times higher odds, respectively, of experiencing comorbidity compared to those with no risk factors. DISCUSSION:The risk of comorbid depression and anxiety symptoms increases with the number of risk factors experienced from prenatal to childhood. Multi-faceted interventions targeting several risk factors are recommended to improve youth mental health.

To test the transmission of mental health difficulties from mother to child, we examined mediation through emotion reminiscing conversations and child language. Maternal depression symptoms were measured at 9 months post-partum, and child mental health outcomes were measured at age 8 years. Emotion reminiscing conversations between 1,234 mother-child pairs (624 boys, 610 girls) were recorded as part of a large, diverse, longitudinal cohort Growing Up in New Zealand. The 1,234 reminiscing conversations were transcribed and coded for maternal elaboration and emotion resolution quality (mother and child). The coded reminiscing variables did not mediate the pathway from maternal depression to child mental health outcomes; however, each maternal reminiscing variable together with child language skill serially mediated the relationship from maternal depression symptoms to child-reported anxiety and depression symptoms, and parent-reported child externalizing symptoms. Language as a skill and it's use as a tool for making shared meaning from past events are highlighted as possible mechanisms for the intergenerational transmission of mental health difficulties. These findings point to potential opportunities for early interventions, including prevention of and support for postnatal depression, family intervention in reminiscing training, and supporting child language development.

Background The Aggressive Student Culture Scale (ASCS) is a survey designed to measure the extent to which New Zealand (NZ) students experience aggressive behaviours within the school environment. The aim of this study is to assess the psychometric properties of the ASCS in the multidisciplinary Growing Up in NZ longitudinal study. Methods We used data from 4938 children from the Growing Up in NZ study to examine the psychometric properties of ASCS for 8-year-old children. Confirmatory factor analysis was conducted, and measurement invariance was tested across sex, ethnicity, and deprivation levels. Results The ASCS tool comprises a single latent factor: aggressive student behaviour. The ASCS provides an adequate and satisfactory measure for student aggression experiences. Full measurement invariance was supported for child’s sex, but only configural invariance was confirmed across ethnicity and area-level deprivation. Males reported higher levels of aggressive experiences than females. Conclusions The one-factor model structure offers an excellent fit to our data with good internal consistency. Comparisons across sex are valid; however, direct comparisons across ethnicity and deprivation levels should be approached with caution. We recommend replication studies and encourage further research involving participants from different age groups to better understand the factor structure across diverse demographic variables.

Objective To synthesize evidence from fruit and vegetable intervention studies investigating mental and/or cognitive health outcomes in children ≤10 years. Our aim was to understand the efficacy of such interventions in improving measures of cognitive performance or mental health, and to identify successful intervention elements to inform future research. Research Methods We conducted a systematic search of Cochrane, Embase, PubMed, and CINAHL databases for articles published before August 2022 (PROSPERO registration: CRD42022356571). A narrative synthesis was conducted according to SWiM (Synthesis without Meta-Analysis) guidelines. Results From 4686 articles identified, only 7 of the 17 full texts screened were included in the final review. No studies investigated the efficacy of interventions using ‘whole’ fruits or vegetables. Six studies examined the effects of blueberries using drinks made from fresh (1 cup) or freeze-dried (30g) blueberries, and one study evaluated a mulberry powder-based drink. Sample sizes ranged from 14-54, and most studies were acute interventions with outcomes measured in a 2–3-hour window (n=6). Through a narrative synthesis of direction of responses, measures of executive function appeared sensitive to intervention effects in both acute and longer-term settings. Some concerns with risk of bias were evident according to the ROB2 tool, related to incomplete reporting of methodological aspects. Conclusions The studies identified through this systematic review could not directly address the planned research question, resulting in a poor certainty of evidence. Future research with whole fruit and vegetable interventions could better inform population health strategies for improved mental and cognitive health outcomes in children.

BACKGROUND:Adolescent depression has increased markedly over the last decade and often persists into adulthood with a range of adverse outcomes. Identifying the perinatal risk factors contributing to adolescent depression is crucial to advise early interventions. METHODS:The study included 4563 young people from the Growing Up in New Zealand (GUiNZ) longitudinal study who completed a questionnaire on depression symptoms at age 12 years (Centre for Epidemiological Studies Depression Scale for Children (CESD-10). Cumulative Risk (CR) scores were created by combining the perinatal risk factors significantly associated with depression symptoms. Then, these CR scores were grouped into three levels and their association with depression symptoms was investigated in univariable and multivariable analyses. RESULTS:We found a statistically significant association between the CR scores (from one to six perinatal risk factors) and depression score at age 12, compared to the no-risk factor group, suggesting a dose-response relationship. In the adjusted analysis, young people exposed to the lower CR score (1-3 risk factors) had a 0.85 unit increase in depression score (p- < .001), and those exposed to the higher CR (4 ≥ risk factors) had a 1.70 unit increase (p < .001) compared to no perinatal risk factors. LIMITATIONS:Our model was focused on the perinatal CR score without including the effects of childhood risk factors. CONCLUSIONS:The perinatal CR score is a valuable approach to identifying the subgroup of young people who are most at risk for depression symptoms. As such, early interventions that simultaneously address multiple perinatal risk factors for depression are recommended.

Aims and objectives: In this study, we investigated the neural oscillatory patterns occurring during sentence-level overt bilingual processing tasks on 46 German-English bilinguals with the intention of finding out if there were task-specific oscillations for this language pair. Methodology: Four tasks, including Language 2 (L2) listening, Language 1 (L1) speaking, L2 shadowing (i.e., repeating a segment of an utterance), and backward interpreting (i.e., orally translating L2 sentences to L1), were implemented with the technique of electroencephalography (EEG). Data and analysis: Data included demographic indices, neural oscillation metrics, and oral production scores from participants. Static spectral analysis, time-frequency analysis, principal components analysis, cross-frequency coupling, and inferential statistics were applied to the data. Findings: The sensory task and articulatory tasks differed greatly in the delta-theta band and the beta-gamma band in terms of time-frequency dynamics. Analyses also revealed variations in a frontal/prefrontal theta component and a distinct gamma component across the four tasks. Moreover, we found a right fronto-temporal theta-gamma coupling unique to backward interpreting. Originality: The task-wise comparison experiment paradigm has rarely been implemented in neuroimaging research on language, especially so in EEG research on bilingualism. Significance: The findings provide novel insights for the understanding of language conversion mechanism and may benefit the training of professional interpreters.

PurposeThis study retrospectively investigates the parenting experiences of mothers of two-year-old children who expressed concerns that their child may have autism up to when they were 4.5 years old. This study aims to identify early parenting challenges and joys and explore whether certain challenges are associated with a subsequent autism diagnosis.Design/methodology/approachUsing a longitudinal design, this study draws from a cohort of 6,853 children, focusing on 103 mothers who reported concerns that their child may have autism when they were between 2 and 4.5 years old, compared to a demographically matched control group. It also tracks whether children initially flagged for autism concerns at 2 to 4.5 years had received a formal diagnosis by age eight.FindingsMothers of autistic children were more likely to mention early challenges with their child's psychosocial development and family cohesion. However, the nature of the challenges discussed within these categories were similar across the two groups, suggesting that these two challenges, while important, are not definitive indicators of autism on their own. Many mothers highlighted their love and joy in watching their child develop. By age eight, 56% of the children who were flagged with autism concerns at aged 4.5 had an autism diagnosis, underscoring the importance of early concerns.Originality/valueThis novel research leverages a large, diverse longitudinal cohort to retrospectively explore mothers' views on raising two-year-old children who were subsequently recognised as being autistic. It uniquely balances the exploration of parenting challenges with the highlights, offering a more holistic view of parenting a child who may later be diagnosed with autism, and considers the link between early parental concerns and challenges and subsequent autism diagnosis.

Autism spectrum disorder is an increasingly prevalent and debilitating neurodevelopmental condition and an electroencephalogram (EEG) diagnostic challenge. Despite large amounts of electrophysiological research over many decades, an EEG biomarker for autism spectrum disorder (ASD) has not been found. We hypothesized that reductions in complex dynamical system behaviour in the human central nervous system as part of the macroscale neuronal function during cognitive processes might be detectable in whole EEG for higher-risk ASD adults. In three studies, we compared the medians of correlation dimension, largest Lyapunov exponent, Higuchi's fractal dimension, multiscale entropy, multifractal detrended fluctuation analysis and Kolmogorov complexity during resting, cognitive and social skill tasks in 20 EEG channels of 39 adults over a range of ASD risk. We found heterogeneous complexity distribution with clusters of hierarchical sequences pointing to potential cognitive processing differences, but no clear distinction based on ASD risk. We suggest that there is indication of statistically significant differences between complexity measures of brain states and tasks. Though replication of our studies is needed with a larger sample, we believe that our electrophysiological and analytic approach has potential as a biomarker for earlier ASD diagnosis.

The foundational skills that children begin formal schooling with are subject to persistent inequities, and can have long-term academic, occupational and health consequences. Early learning is conceptualised as encompassing social, emotional, behavioral and motor functioning in addition to more traditional formal academic skills. Within a large, diverse, longitudinal child cohort - Growing Up in New Zealand - the aims of the current study were to examine: (1) how multiple indicators of children's social, emotional, behavioral, motor and cognitive development relate to one another at age four years prior to beginning formal schooling; and (2) whether parent behavior during an observed writing interaction at age 4 was associated with these early learning factors. Children (n = 4,697) and their primary caregiving parent were visited at home and completed the interactive writing task. Children completed direct assessments of language, executive functioning, self-regulation, writing (name and numbers) and emotion knowledge. The parent reported on the child's language, motor skills and social, emotional and behavioral functioning. Exploratory Factor Analysis indicated four early learning factors: literacy and numeracy skills; oral language and regulation; behavior difficulties; and interpersonal and motor skills. After controlling for multiple covariates, hierarchical regression analyses indicated that parent verbalisations during the writing interaction task predicted small but significant variance in children's early learning across all four factors. The current findings support holistic models of early learning and demonstrate associations with parent verbalisations during learning-based interactions.

Background: Early life environments can have long-lasting impacts on future health and wellbeing. Maternal health during pregnancy, including experiencing stress or mood disorders, has been associated with psychopathology in later life. Anxiety disorders are one of the most prevalent mental health conditions, affecting approximately 7 % of children and adolescents globally, with a lifetime prevalence of 15-20 %. Identifying prenatal risk factors can support future and current public health interventions and maternity care. Methods: Data were obtained from the Growing Up in New Zealand longitudinal study of child development. Prenatally, mothers provided sociodemographic information as well as data on their mental health, potential teratogens, and lifestyle factors such as supplement intake and exercise levels. At 8-years old, 4922 children selfcompleted the PROMIS-SF anxiety measure. Bivariate analyses and backward stepwise regression were used to determine the best multivariable model. Results: Significant prenatal predictors of anxiety symptoms at 8-years old included elevated maternal depression symptoms, body mass index in the overweight/obese range, exercise patterns, and paracetamol, antiinflammatory and alcohol intake. Limitations: Sample attrition from baseline to 8-year may have affected statistical power. To further untangle the effect of timing and duration of the exposures reported in this study, larger sample sizes would be required. Conclusions: Prenatal mental health and wellbeing was significantly associated with child anxiety symptoms at 8years of age. This study highlights the importance of supporting expectant mothers' health and wellbeing during pregnancy to ensure children have the best opportunity to have good mental health.

The biological mechanisms that explain how adverse early life events influence adult disease risk are poorly understood. One proposed mechanism is via the induction of accelerated biological aging, for which telomere length is considered a biomarker. We aimed to determine if maternal depression pre- and post-partum was associated with telomere length in children at 4 years of age (n=4299). Mothers completed structured questionnaires assessing depression during pregnancy (Edinburgh Depression Scale), at 9 months (Edinburgh Depression Scale), and at 54 months postpartum (Patient Health Questionnaire 9). Regression methods were used to investigate the relationship between telomere length (DNA from saliva) and maternal depression score recorded at each stage. Significant covariates included in the final model were: maternal age at pregnancy; child sex; child ethnicity; gestational age group, and rurality group. Child telomere length was found to be longer if their mother had a higher depression score at both postpartum time points tested (9 months of age; coefficient 0.003, SE=0.001, P=0.01, 54 months of age; coefficient 0.003, SE=0.002, P=0.02). Although these findings seem paradoxical, increased telomere length may be an adaptive response to early life stressors. We propose several testable hypotheses for these results and to determine if the positive association between depression and telomere length is a developmental adaptation or an indirect consequence of environmental factors.

This exploratory study investigated the self-reported reading difficulties and compensatory strategies of monolingual and bilingual adults with dyslexia. Twenty monolinguals and six bilinguals answered a questionnaire that collected socio-demographic data as well as information regarding their reading difficulties, experiences, and possible comorbidities. Data were analyzed using thematic analysis. Four themes were determined: (a) reading difficulties may be pervasive but can be circumvented with effective coping strategies; (b) individuals with dyslexia can succeed academically and obtain a university degree, but they most likely have to work harder than typical readers; (c) dyslexia has an impact on reading habits, and reading is a challenge; and (d) comorbidities are a part of life for people with dyslexia. Our results highlight the struggles that individuals with dyslexia continue to have, regardless of when they were diagnosed, whether they received literacy assistance, and whether they learned a second language. Most important, this study shows that individuals with dyslexia, both monolinguals and bilinguals, are able to use effective coping strategies and obtain academic and professional success.

The current study used data from the Growing Up in New Zealand birth cohort to investigate whether antenatal depression or antidepressant use influences children’s cognitive outcomes.Cognitive measures included receptive language, early literacy, and executive control at 4.5- years (N = 5,626) and The Cognition Battery from the National Institutes of Health Toolbox® at 8-years of age (N = 4,775). Based on self-reported antidepressant intake and the Edinburgh Postnatal Depression Scale, mothers were categorized as experiencing unmedicated depression, on antidepressants, or neither. Adjusting for later life depression in the mother and a range of birth and sociodemographic control variables, multiple regression analyses indicated that neither exposure to unmedicated depression nor antidepressants during pregnancy were associated with children’s cognitive outcomes at 4.5 or 8 years of age. Findings add to a growing literature regarding the safety of antidepressant use during pregnancy in relation to child neurodevelopmental outcomes.

Viral illnesses in children are common and are frequently treated with antibiotic medication. Antibiotics reduce the diversity and composition of the gut microbiota, leading to poor developmental outcomes. To investigate the relationship between age at first exposure to antibiotics and cognitive and behavioural development at 4.5 years while controlling for multiple confounders, including otitis media. Study participants were 5589 children enrolled in the broadly generalisable Growing Up in New Zealand cohort study, with antibiotic exposure data, maternal antenatal information, and age 4.5-year behaviour and cognitive outcome data. Children were categorised as first exposed to antibiotics according to the following mutually exclusive ages: 0–2 months; 3–5 months; 6–8 months; 9–11 months; 12–54 months or not exposed by 54 months. Developmental outcome measures included the Strengths and Difficulties Questionnaire, Luria hand clap task, and the Peabody Picture Vocabulary Test-III. In univariate analysis, there was an evident dose–response relationship where earlier exposure to antibiotics in the first year of life was associated with behavioural difficulties, lower executive function scores, and lower receptive language ability. After adjusting for confounders, pairwise comparisons showed that first antibiotic exposure between birth and 3 months or between 6 and 9 months was associated with lower receptive vocabulary. Antibiotic exposure at any age prior to 12 months was associated with increases in behavioural difficulties scores at 4.5 years. Following adjustment for socioeconomic factors and otitis media, there is evidence that antibiotic exposure during potentially sensitive windows of development is associated with receptive language and behaviour later in childhood.

There is growing interest in child socio-emotional competence from parents, educators, employers and policy makers, with emphasis on developing it as early as possible. The aim of the present study was to examine contextual and proximal factors that influence socio-emotional competence development across the first five years of a child’s life. We used data from 3200 mothers and their children drawn mostly from four major data collection waves (antenatal, 9 months, 2 years and 4.5 years) of the population-based longitudinal study, Growing Up in New Zealand . Regression analyses were carried out to identify the predictors of socio-emotional competence after controlling for demographics and prior score(s) of socio-emotional competence. We found that specific maternal behaviours, such as playing games and playing with toys with children, singing songs or telling stories to them, reading books with them, having rules around viewing TV, DVDs and videos, and praising children have a positive effect on socio-emotional competence. Parental relationship warmth and less family stress at 9 months also made positive contributions to socio-emotional competence at 9 months and 2 years. In contrast, attending childcare and having more siblings at home negatively predicted socio-emotional competence at 9 months. Mother’s unemployment, living in neighbourhoods perceived as negative and being in contact with family and social services were negatively associated with concurrent socio-emotional competence at 2 years. Overall, more and/or stronger contemporaneous effects were found suggesting that negative effects of contextual factors may not have lasting impact on socio-emotional competence. In addition, the results showed that maternal behaviours need to be practised regularly to have positive impact on child’s socio-emotional development.

Maternal depressive symptoms (MDS) in the postnatal period may impact children's later development through poorer quality parent-child interactions. The current study tested a specific pathway from MDS (child age 9 months) to child receptive vocabulary (4 ½ years) through both self-reported and observed parent-child verbal interactions (at both 2 and 4 ½ years). Participants (n = 4,432) were part of a large, diverse, contemporary pre-birth national cohort study: Growing Up in New Zealand. Results indicated a direct association between greater MDS at 9 months and poorer receptive vocabulary at age 4 ½ years. There was support for an indirect pathway through self-reported parent-child verbal interactions at 2 years and through observed parent-child verbal interactions at 4 ½ years. A moderated mediation effect was also found: the indirect effect of MDS on child vocabulary through observed verbal interaction was supported for families living in areas of greater socioeconomic deprivation. Overall, findings support the potential role of parent-child verbal interactions as a mechanism for the influence of MDS on later child language development. This pathway may be particularly important for families experiencing socioeconomic adversity, suggesting that effective and appropriate supportive parenting interventions be preferentially targeted to reduce inequities in child language outcomes.

The aim of the present study was to explore how maternal reminiscing relates to socioemotional development during middle childhood. Specifically, analyses explored the link between maternal reminiscing and children’s internalizing (emotional problems and peer problems), externalizing (hyperactivity and conduct problems) and prosocial behavior within a large and diverse sample of New Zealand families, after controlling for a range of child and maternal sociodemographic factors. A subset of 1404 mother-child dyads (663 boys) were selected from the longitudinal study Growing Up in New Zealand’s 8-year data collection wave. Mother-child reminiscing conversations about a past negative emotional event were coded using a scale-based measure of maternal elaboration. After controlling for child and maternal sociodemographic characteristics, regression analyses identified unique associations between maternal reminiscing style and children’s concurrent scores on the Strengths and Difficulties Questionnaire. Overall, greater maternal elaboration was associated with fewer child emotional problems and greater child prosocial behavior. This study presents novel data exploring the importance of mother-child reminiscing interactions at a critical and sensitive time in child development. Future research should explore bidirectional influences across time between mothers’ elaborative reminiscing and children’s socioemotional development.