Malnutrition is frequent in neurologically impaired (NI) children. Enteral feeding via gastrostomy tube is increasingly being used to provide adequate nutrition. Our aim was to assess the outcomes of exclusive gastrostomy tube feeding with standard polymeric formula in children with NI, severe oro-motor dysfunction, and malnutrition, and to investigate the role of the underlying NI-associated disease. A five-year retrospective study from January 2013 to November 2017 was conducted. The primary aim was to assess the nutritional outcomes of exclusive gastrostomy tube feeding with standard polymeric formula in malnourished NI children. The secondary aim was to investigate gastrostomy complications and the impact of the underlying NI-associated disease on the nutritional outcomes. We enrolled 110 consecutive children with NI. Of these patients, 34.5% (N = 38) were categorized as malnourished and started exclusive enteral feeding with a standard (1.0 kcal/mL) polymeric formula (Nutrini, Nutricia) after percutaneous endoscopic gastrostomy (PEG) placement. Seventy-three percent of patients (N = 28) had cerebral palsy (CP); other diagnoses included metabolic (13%, N = 5) and genetic (13%, N = 5) diseases. Tricep skinfold thickness had significantly improved in all patients at 12-months follow-up, while body weight and body mass index showed significant increases mainly in children with CP. No serious complications occurred. We found that standard polymeric formula via gastrostomy tube represents a safe and efficient nutritional intervention in children with NI and malnutrition.

Purpose: Modified ride-on cars have emerged as an early powered mobility option for young children with disabilities. The purpose of this study was to identify, extract, and synthesize perceived barriers of modified ride-on car use reported in previous studies. Methods: This study was descriptive using a qualitative content analysis of previously published studies identified from a systematic literature search. Results: Categories of perceived barriers were identified: device, environmental, child-related perceived barriers regarding health, tolerance, and abilities, and caregiver-related perceived barriers regarding physical requirements, time, and motivation. Device and environmental perceived barriers were the most reported. Conclusions: Pediatric physical therapists play a critical role in working with families to promote their self-efficacy for using the modified ride-on car and their capacity for overcoming the inherent difficulties associated with use. Most of the reported perceived barriers are modifiable, at least to some degree, with likely effects on modified ride-on car use.

Purpose: The purpose of the study is to examine how perceived barriers change before and after a 3-month period of modified ride-on car use. Methods: This study used a qualitative content analysis of perceived barriers. Fourteen caregivers (13 mothers; 1 grandmother) responded to a single-question, free-response survey before and after a 3-month period of modified ride-on car use. Results: A total of 11 and 20 perceived barriers were reported before and after the 3-month period. Environmental barriers were the most frequently reported before and after the 3-month period. Conclusions: Pediatric physical therapists need to be aware of the potential perceived barriers that families may experience in regard to young children with disabilities using modified ride-on cars and determine strategies to support families on an individual basis.

To our knowledge, this is the first reported paediatric case of pericarditis as a possible complication of infliximab therapy in IBD. Among infliximab-related delayed adverse reactions, cardiac complications should be monitored in the paediatric population.

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BackgroundSocial mobility is defined as the co-occurrence of self-directed locomotion and direct peer interaction. Social mobility is a product of dynamic child–environment interactions and thus likely to vary across contexts (e.g., classroom, gymnasium, and playground).PurposeThe purpose of this present study was to examine differences in children’s social mobility: (1) across contexts by age and (2) between non-disabled and disabled children.MethodParticipants (n = 55 non-disabled and three disabled children; Mage = 3.1 years, SD = 1.4) were video recorded within a university-based early learning center. Children were recorded for 20 min in each context: classroom, gymnasium, and playground. A 15-s momentary time sampling method was used to code social mobility, the simultaneous occurrence of self-directed locomotion, and direct peer interaction. This variable was calculated as percent time within each context.ResultsA planned Friedman’s rank ANOVA (n = 55), stratified by age, indicated that older children (3–5 years old) differed across contexts in their social mobility [χ2(2) ~ 7.3–10.5, p < 0.025], whereas younger children (1–2 years old) were similar across contexts. Social mobility was significantly lower in the classroom compared with the playground and gymnasium (with no difference between the latter contexts) for older children. Visual analysis confirmed that disabled children (n = 3) engaged in substantially less time in social mobility (average 0–1%), compared with non-disabled, age-similar peers (2–3 years old average 1–12%) across all contexts.ConclusionA substantial gap exists between non-disabled and disabled children for social mobility. There is an increase in magnitude and variability of social mobility around age three that suggests the gap between non-disabled and disabled children will continue to widen.

Background: Go Baby Go is a community program that provides modified ride-on cars to young children with disabilities. Aims: (1) To describe the real world modified ride-on car usage of young children with disabilities; (2) To compare subjectively reported modified ride-on car usage recorded by parents with objectively reported usage based on electronic tracking data. Methods: 14 young children (1–3 years old) with disabilities used a modified ride-on car for three months. Results: On average, parent-reported activity log data indicated that children used the modified ride-on car for 17.8 minutes per session (SD = 9.9) and 195.1 total minutes (SD = 234.8) over three months. Objective tracking data indicated 16.5 minutes per session (SD = 8.6) and 171.4 total minutes (SD = 206.1) over three months. No significant difference of modified ride-on car usage was found between parent-reported activity log data and objective tracking; yet, the mean absolute difference between tracking methods was 96 minutes (SD = 8.6) and suggests over- or under-reporting of families. Children used the modified ride-on car more in the first half compared to the second half of the three-month period (p < .05). Conclusions: This study may inform future research studies and local chapters of the Go Baby Go community program.

Purpose: The purpose of this study was to determine the feasibility of infants with Down syndrome to use a modified ride-on car with seated and standing modes. Methods: Participants included 4 infants with Down syndrome. Families were asked to provide at least 8 minutes of modified ride-on car driving per day, at least 5 times per week throughout the 9-month intervention. Results and Conclusions: Families demonstrated a variety of adherence rates to the intervention. Infants demonstrated independent activation of the modified ride-on car in seated and standing modes and enjoyed driving. The modified ride-on car intervention was feasible and warrants further testing to address barriers that influence adherence to the intervention.