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Introduction: The gut microbiome is believed to have a significant impact on health throughout the lifespan, and the influence of infant nutrition and other environmental factors are of particular interest in its development. The aim of this research project was to learn more about the microbiome and short chain fatty acid (SCFA) composition of toddlers of differing weights, considering birth history, environment, and diet. In East Tennessee, opioid misuse is a growing issue, and a number of participants in this study were exposed in utero. We also hoped to identify related effects on infant’s SCFA composition. Finally, it is known that twins share a variety of traits, but much about their microbiome is unknown. With several pairs of twins in the sample, we aimed to identify any associations with SCFAs in this group. Methods: With informed consent, the child’s history was obtained, including age, birth length and weight, delivery type (C-section or vaginal), and feeding method (breast, bottle fed, or both). The child’s current weight, height, and BMI percentile were determined. Caregivers completed a 90-question Block Questionnaire for Ages 2-7 Kids food frequency questionnaire, and results were analyzed by Berkeley Analytics Inc (dba NutritionQuest). Participant-provided stool samples were freeze-dried and ground, and SCFAs were extracted and analyzed by content area % and concentration ppm. Data analysis was generated using SAS software, Version 9.4 of the SAS System, Copyright © 2013 SAS Institute Inc. Results: Nine SCFAs were measured in duplicate, and the concentrations averaged. Statistical analysis included comparisons of SCFAs related to factors including weight status, infant feeding modality, twin status, and intrauterine drug exposure, and significance determined with a p value < 0.05. Results did not identify significant differences in individual SCFA concentrations between obese and non-obese toddlers, however concentrations of isobutyrate, isovaleric acid, and octanoic acid were greater in toddlers who were formula fed as infants versus toddlers who were breastfed, and those fed a combination of breastmilk, and formula. Analysis further revealed a higher mean concentration of caproic and propionic acid in twin subjects. Of particular interest, toddlers with a history of opioid exposure had higher mean concentrations of isovaleric and octanoic acids, but less isocaproic acid when compared to those who were not drug exposed. Further analysis will help determine if these findings may be related to nutrient intake, in particular dietary fiber intake.

The aim of this qualitative research was to gain an in-depth understanding of how teachers of toddlers (aged 25-36 months) described sound and music learning opportunities and experiences provided to children in their learning environments. In this research, teachers were asked how their personal and professional experiences with sound and music influenced their planning of toddlers’ sound and music learning opportunities. The design of this study was in-depth interviews of six toddler lead teachers in three childcare sites. Data were gathered through photographs, planning documents, and in-depth interviews using a university IRB-approved video conferencing program. Findings showed that all participants valued the significance of sound and music and considered them to be sources of enjoyment and appreciation. However, participants provided sound and music learning opportunities based on their individual interpretations of sound and music. These interpretations were informed by their personal experiences with sound and music and their childcare sites' underlying philosophy and curricula. The findings of this study have relevance for various stakeholders, including early childhood educators, music teachers, school administrators, policymakers, and researchers, as they address issues related to sound and music teacher preparation, specifically in terms of providing consistent sound and music experiences for toddlers, designing optimal sound and music learning environments for them, and developing comprehensive curricula to provide a variety of opportunities for sound and music exploration.

This study was an examination of responses to a standardized assessment of social-emotional behaviors and correlation with speech and language development in young children with cleft palate and/or lip. Twenty-eight participants aged 14-35 months with nonsyndromic cleft palate and or lip were included in this study. The Infant-Toddler Social and Emotional Assessment (ITSEA) was used to identify emerging social and emotional behaviors. Descriptive analysis of ITSEA results was completed. Pearson correlation coefficient and effect size estimates were calculated between ITSEA domain raw scores and measures of speech and language development. A small proportion of participants (14%) showed ITSEA scores beyond the test cut-off scores across all domains ; 43% demonstrated concerns at the subdomain level. Correlational analysis indicated significant relationships between Externalizing, Dysregulation, and Competence Domains and speech accuracy and language measures. Interpretation of the outcomes suggests that early social emotional behaviors are emerging simultaneously with speech and language skills during early communicative development.

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This dissertation is a qualitative study of the relationship between a mother and a toddler with a disability. This study was conducted with both a mother and toddler at the Baby Therapy Centre in Pretoria, a facility that caters for babies and toddlers between the ages of birth to three years with special needs and developmental delays. The purpose of this research was to explore how the medium of music throughout a process of eight music therapy sessions might afford a mother and toddler with a disability opportunities for relating. Throughout the course of the music therapy process, moments of play, communication and meaningful interaction occurred between the mother and toddler, indicating a shift in the mother-toddler relationship, thereby advocating for the inclusion of mothers in music therapy sessions. The research approach adopted in this dissertation includes an in-depth case study of one mother-toddler pair, using interviews and thick descriptions of video excerpts as the main data sources. The findings from this research indicate that music therapy affords a mother and toddler with a disability opportunities to relate within sessions through play, musical interaction, instrumental play, vocal use and improvisation. The inclusion of the mother in music therapy sessions appeared to enhance the mother-toddler relationship, in addition to the learned transference of skills that the toddler acquired during the process. Copyright / Dissertation (MMus)--University of Pretoria, 2012. / Music / unrestricted

Externalizing behavior is stable as early as 2 years of age and is a precursor to many childhood and adult negative outcomes. Although global self report data show a relationship between parenting and children's externalizing, few studies have examined the proximal effect of observed mother's parenting on children's expression of aggression. A sample of 55 primarily African American, toddler-mother dyads were observed in their homes. Data was collected on the 2-year-old children's emotional reactivity, externalizing behavior, social competence and mother's harsh and supportive parenting. A second wave of data was collected one year later with a smaller sample, n=37.Children who were boys and more emotionally reactive had higher Externalizing scores on the CBCL, both at age 2 and 3. Mothers who used contingent harsh parenting in response to child noncompliance had children who were higher on Externalizing behavior concurrently, but not across time. Mother's contingent supportive parenting in response to child compliance at age 2 predicted children's Social Competence at age 3. Results lend support to a transactional model of parent-child interaction very early in development that can be linked variously to children's aggressive, acting out and prosocial behaviors.

The aim of the study was to investigate peer interaction among toddlers 12 to 30 months of age and the teachers’ ways to direct the children’s play in outdoor free play situations in a Swedish preschool. Data was gathered through direct observation, and the phenomenology of Merleau-Ponty in combination with the assumption of children as social actors built the theoretical framework of the study. The results showed that the toddlers used different strategies to invite peers to interaction and made use of strategies in entering ongoing play that previously have been observed among older preschoolers. These strategies, bodily and therefore in accordance with the phenomenological approach, support the assumption of toddlers as social actors that actively engage in and make sense of their life worlds in the preschool. The teachers showed less interference in the children’s play compared with earlier studies. The results of the study stress the significance of free play as an arena for learning of different social skills and importance of the preschool teachers being conscious of these young children’s life worlds.

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Background and Aims: There is an increasing awareness that, in order to monitor health outcomes both mortality and morbidity need to be assessed. A common metric used to measure morbidity and functional limitation is the quality adjusted life year or QALY, which incorporates time spent in a health condition and Health-Related Quality of Life (HRQoL) into the measure. This is of increasing importance in Low Income Countries (LIC) where programmes have been adopted and implemented to address the high burden of child mortality. The ‘first 1000 days’ is one such initiative which has been adopted by the WHO to improve nutritional support, health care and social support for both the mother and child. One of the aims is to improve quality of life during this vulnerable period. As there is currently no appropriate measure of HRQoL in this age group, we set out to develop a valid and reliable, HRQoL instrument for children from 1 month to 3 years old, amenable to the elicitation of preference weights. Methods: The new HRQoL instrument, HRQoL-6D-IT, was based firstly on a mapping review of HRQoL measures for children. The next stage involved eliciting options through cognitive review from caregivers of very young children regarding HRQoL dimensions included in the EQ-5D-Y an existing validated HRQoL measure for older children. The care-givers were requested to identify items to be considered for inclusion, the wording and layout of the new measure. The item pool generated from the literature reviews and cognitive interviews were then assessed through a Delphi study with experts in the field. These items were further reduced through subsequent testing of items and retesting of a preliminary measure. The final items on the HRQoL-6D-IT included: movement, play, pain, relationships, communication and eating and, apart from pain, the descriptors referenced the behaviour of the child to age appropriate behaviour. The HRQoL-6D-IT was then tested for validity and reliability in a group of acutely-ill (AI), chronically-ill (CI) and typically developing (TD) children in two provinces in South Africa: Western and Eastern Cape. Results: The methodology used to identify candidate items was rigorous and yielded items which were developed to be observable with dimension descriptors referring to ‘age appropriate behaviour’. Caregivers were able to reliably report on HRQoL of their very young children from age 1-36 months. The content validity had been established during the development of the instrument. Concurrent validity of the different items (dimensions) was tested between the HRQoL-6D-IT and relevant items from the ASQ, FLACC and NIPS pain scale and Diet History.