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Effects of Hospital Early Childcare Intervention in Young Children with Cancer

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Title: Effects of Hospital Early Childcare Intervention in Young Children with Cancer
Language: English
Authors: Zucchetti, G., Ciappina, S., Geuna, T., Nichelli, F., Biondi, A., Camera, F., Ripaldi, M., Fagioli, F.
Source: Child Care in Practice. 2022 28(3):321-332.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 12
Publication Date: 2022
Document Type: Journal Articles
Reports - Research
Education Level: Early Childhood Education
Descriptors: Early Intervention, Young Children, Cancer, Early Childhood Education, Hospitalized Children, Foreign Countries, Child Development
Geographic Terms: Italy
DOI: 10.1080/13575279.2020.1792840
ISSN: 1357-5279
1476-489X
Abstract: Purpose: Oncological diseases, especially if experienced in the first 3 years of life, expose young children to conditions of serious physical and emotional stress causing delays in their physical development, cognitive acquisitioning and issues related to their emotional and social functioning. This study examines the effects of the participation in an early childcare intervention to support the children's development, which was proposed to children from 0 to 36 months, at the moment of cancer diagnosis in their hospital setting. Method: A prospective multicenter programme was offered to young children (<3 years) newly diagnosed with cancer. These children were treated in three pediatric oncology centers affiliated to the Italian Association of Pediatric Hematology-Oncology. The children's strengths and weaknesses, in different developmental areas, were examined pre-programme and 6 months post-programme. Results: Fifty-three young children were enrolled in the study. The data showed that at the moment of diagnosis the majority of the children demonstrated low scores across all the abilities in the subscales examined, highlighting a mental age below their chronological age ([delta][subscript T0] = 3.5 months). However, post-programme, the children were shown to have significantly reduced the gap between their chronological and mental age ([delta][subscript T1] = 1 month), demonstrating improvements in all their developmental abilities. Conclusion: The study confirms significant implications for early childcare programmes, delivered in hospitals for young children with cancer, in terms of support for their ongoing physical, cognitive and social development. Therefore, the study demonstrated the necessity, for all pediatric oncology centers, to invest in early childhood education programmes.
Abstractor: As Provided
Entry Date: 2022
Accession Number: EJ1353268
Database: ERIC
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  Value: &lt;anid&gt;AN0157177216;j2301jul.22;2022Jun03.03:18;v2.2.500&lt;/anid&gt; &lt;title id=&quot;AN0157177216-1&quot;&gt;Effects of hospital early childcare intervention in young children with cancer&#160;&lt;/title&gt; &lt;p&gt;Purpose: Oncological diseases, especially if experienced in the first 3 years of life, expose young children to conditions of serious physical and emotional stress causing delays in their physical development, cognitive acquisitioning and issues related to their emotional and social functioning. This study examines the effects of the participation in an early childcare intervention to support the children&#39;s development, which was proposed to children from 0 to 36 months, at the moment of cancer diagnosis in their hospital setting. Method: A prospective multicenter programme was offered to young children (&amp;lt;3 years) newly diagnosed with cancer. These children were treated in three pediatric oncology centers affiliated to the Italian Association of Pediatric Hematology-Oncology. The children&#39;s strengths and weaknesses, in different developmental areas, were examined pre-programme and 6 months post-programme. Results: Fifty-three young children were enrolled in the study. The data showed that at the moment of diagnosis the majority of the children demonstrated low scores across all the abilities in the subscales examined, highlighting a mental age below their chronological age (Δ&amp;lt;sub&amp;gt;T0 &amp;lt;/sub&amp;gt;= 3.5 months). However, post-programme, the children were shown to have significantly reduced the gap between their chronological and mental age (Δ&amp;lt;sub&amp;gt;T1 &amp;lt;/sub&amp;gt;= 1 month), demonstrating improvements in all their developmental abilities. Conclusion: The study confirms significant implications for early childcare programmes, delivered in hospitals for young children with cancer, in terms of support for their ongoing physical, cognitive and social development. Therefore, the study demonstrated the necessity, for all pediatric oncology centers, to invest in early childhood education programmes.&lt;/p&gt; &lt;p&gt;Keywords: Childhood cancer; early childhood development; early intervention; infants and toddlers&lt;/p&gt; &lt;hd id=&quot;AN0157177216-2&quot;&gt;Introduction&lt;/hd&gt; &lt;p&gt;Cancer is a major cause of death in children and adolescents worldwide. Approximately 300,000 children aged 0–19 years old are diagnosed with cancer each year, and the recorded incidence rate tends to increase over time (Steliarova-Foucher et al., [&lt;reflink idref=&quot;bib23&quot; id=&quot;ref1&quot;&gt;23&lt;/reflink&gt;]). This increase is particularly reported in infants (&amp;lt;1 years of age) with a peak of approximately 350 cases per million in 2001, with the rate in 2008 (&amp;lt;200 cases/1,000,000) showing the values observed in around 1990. Brain tumors and acute leukemia combined, account for almost half of all diagnoses in early childhood, while non-central nervous system (CNS) solid tumor diagnoses such as Neuroblastoma, Retinoblastoma and Wilms tumor, tend to only occur during this stage of life (Robison &amp;amp; Hudson, [&lt;reflink idref=&quot;bib21&quot; id=&quot;ref2&quot;&gt;21&lt;/reflink&gt;]; Ward, DeSantis, Robbins, Kohler, &amp;amp; Jemal, [&lt;reflink idref=&quot;bib24&quot; id=&quot;ref3&quot;&gt;24&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Life from birth to 36 months is a delicate phase during which motor, cognitive, affective-relational and psychological development follows a natural process of harmonious and rapid maturation in the healthy child. A diagnosis of cancer in this phase of life is critical because it puts this developmental process at risk, thus hindering their developmental process. Cancer treatment, with its frequent and long hospitalizations, plus the serious side effects caused by the therapies, and the diseases&#39; significant impact on the family as a whole, has a prohibiting impact on the physical, cognitive and relational development of the child, leading to a possible slowing down of the development process. More specifically, a child&#39;s sensory-motor experiences are drastically reduced by hospitalization. In fact, this, coupled with a lowering of their immune defenses, prevents the normal functioning of their sensory systems (such as the gustatory system and the use of the mouth) they require to explore and learn about their surrounding environment. In addition, the children&#39;s relationships with their peers and other significant adults (e.g. nursery teachers) are also impaired during treatment, as the children experience an exclusive relationship with their caregiver.&lt;/p&gt; &lt;p&gt;Young children (under 3 years of life) diagnosed with cancer constitute a group particularly at risk both for the specific clinical and biological features of the diseases and for the several side effects that the treatment modalities produce (e.g. chemotherapy&#39;s ototoxicity, motor impairment due to stem cell transplantation and cognition delays due to cranial radiation) (Gurney et al., [&lt;reflink idref=&quot;bib13&quot; id=&quot;ref4&quot;&gt;13&lt;/reflink&gt;]; Langer et al., [&lt;reflink idref=&quot;bib17&quot; id=&quot;ref5&quot;&gt;17&lt;/reflink&gt;]). These side effects also persist in the long-term, in particular among brain tumor or acute Lymphoblastic Leukemia (ALL) survivors who have been diagnosed at a young age (Jacola et al., [&lt;reflink idref=&quot;bib16&quot; id=&quot;ref6&quot;&gt;16&lt;/reflink&gt;]; Schreiber et al., [&lt;reflink idref=&quot;bib22&quot; id=&quot;ref7&quot;&gt;22&lt;/reflink&gt;]). More precisely, problems in their motor and mental development, including language, were longitudinally observed among children ages 4–48 months at diagnosis, compared to their same-aged healthy peers (Quigg, Mahajerin, Sullivan, Pradhan, &amp;amp; Bauer, [&lt;reflink idref=&quot;bib19&quot; id=&quot;ref8&quot;&gt;19&lt;/reflink&gt;]). Other studies have shown that cancer survivors diagnosed (Neuroblastoma, Wilms&#39; tumor or ALL) in the first years of life have worse educational, academic and social outcomes (Barrera, Shaw, Speechley, Maunsell, &amp;amp; Pogany, [&lt;reflink idref=&quot;bib1&quot; id=&quot;ref9&quot;&gt;1&lt;/reflink&gt;]). Furthermore, they also met the criteria for post-traumatic stress disorder (Graf, Bergstraesser, &amp;amp; Landolt, [&lt;reflink idref=&quot;bib11&quot; id=&quot;ref10&quot;&gt;11&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Consequently, it is clear that early childcare investment, that supports the spontaneous child&#39;s development, is crucial. In fact, several empirical studies have been underline that the possibility of children to participate in activities with educators and peers is able to stimulate cognitive (i.e. hearing, language) and non-cognitive skills (i.e. socio-emotional maturity) (Carneiro &amp;amp; Heckman, [&lt;reflink idref=&quot;bib3&quot; id=&quot;ref11&quot;&gt;3&lt;/reflink&gt;]; Cunha &amp;amp; Heckman, [&lt;reflink idref=&quot;bib4&quot; id=&quot;ref12&quot;&gt;4&lt;/reflink&gt;]; Del Boca, Martino, &amp;amp; Pronzato, [&lt;reflink idref=&quot;bib5&quot; id=&quot;ref13&quot;&gt;5&lt;/reflink&gt;]; Heckman, Stixrud, &amp;amp; Urzua, [&lt;reflink idref=&quot;bib15&quot; id=&quot;ref14&quot;&gt;15&lt;/reflink&gt;]). Italian research has highlighted that children who participate in early childcare programmes demonstrate above average listening skills, concentration and creativity, as well as a healthy capacity to establish cooperative peer relationships (Del Boca &amp;amp; Pasqua, [&lt;reflink idref=&quot;bib6&quot; id=&quot;ref15&quot;&gt;6&lt;/reflink&gt;]). In contrast, a delay in early childcare investment can lead to high-costs that are often associated with irreparable, negative outcomes (e.g. dropping out of school, teenage pregnancy, welfare dependency and crime) (Del Boca, Pasqua, &amp;amp; Suardi, [&lt;reflink idref=&quot;bib7&quot; id=&quot;ref16&quot;&gt;7&lt;/reflink&gt;]). It has also been demonstrated that a positive association between early childcare programmes and child favorable outcomes is more significant among children from disadvantaged backgrounds than among children from socially and culturally standard backgrounds. The disadvantaged background of a children does not only deal with unfavorable environmental conditions (for social and cultural issues), but it can also affect children who, due to illnesses occurring during early life, find themselves in living conditions and in situations that inhibit their opportunities to develop their abilities. These limitations, typical of children with severe organic diseases, make them a development-risk group.&lt;/p&gt; &lt;p&gt;Although the important critical aspects of this age group have been widely recognized, early or preventive educational programmes are almost non-existent in the current literature. In pediatric oncology centers in Italy, the &quot;hospital school&quot;, regulated by the Ministry of Education, University and Research (MIUR), was created around twenty years ago. The school covers the compulsory education of cancer children (from 6 to 16 years) where their learning and assessment is guaranteed through a continuous collaboration between hospital teachers and school teachers. However, no education programme is currently available to children with cancer under three years of age. Their education is undertaken off-site and solely the responsibility of regional and local authorities. The need for programmes dedicated to young children under three is becoming increasingly urgent. Moreover, early childcare for young patients provided inside the hospital can support their current development, by responding holistically and in a multidisciplinary manner, to the actual needs of the families involved.&lt;/p&gt; &lt;p&gt;Intesa Sanpaolo, a key financial institution for the needs of early childhood, has conceived and promoted the &quot;Intesa Sanpaolo Educational Program for Long-Term Young Patients&quot;, an initiative with the purpose of establishing nursery facilities of excellence in Italian hospitals, accredited at European level by PAN brand—Childcare services. The first nursery school for long-term children patients was inaugurated in 2016 in Turin at Regina Margherita Children&#39;s Hospital. Other nurseries were opened in Naples (Ospedale Santobono Pausilipon, 2017), in Monza (Ospedale San Gerardo, 2017), Padua (Azienda Ospedaliera, 2018) and in Bologna (Policlinico Sant&#39; Orsola Malpighi, 2018). This commitment from Intesa Sanpaolo is to extend this initiative to other hospitals throughout Italy and raise awareness among public administrations of the importance of an educational programme that helps children, aged 0–3 years, to overcome the social and psychological isolation resulting from their illness and the exhaustive and long-term care, and at the same time encouraging their cognitive and affective development.&lt;/p&gt; &lt;p&gt;Intesa Sanpaolo has also commissioned a research project with the Italian Association of Pediatric Hematology-Oncology (AIEOP). This is a study with the aim of assessing the effectiveness of its early years&#39; education initiative. This study was conducted in the nursery schools opened in the first three pediatric oncology divisions in Turin, Naples and Monza.&lt;/p&gt; &lt;p&gt;This article examines the benefits of those programmes in terms of the physical, cognitive and social development of children with cancer who participated in an educational programme for early childhood, delivered in a hospital setting.&lt;/p&gt; &lt;hd id=&quot;AN0157177216-3&quot;&gt;Methods&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0157177216-4&quot;&gt;Participants&lt;/hd&gt; &lt;p&gt;The study was conducted following the Transparent Reporting of Evaluations with Non-Randomized Design Statement (Des Jarlais, Lyles, Crepaz, &amp;amp; Group, [&lt;reflink idref=&quot;bib8&quot; id=&quot;ref17&quot;&gt;8&lt;/reflink&gt;]). The study was conducted in three pediatric oncology centers (Turin, Naples, and Monza) affiliated to the Italian Association of Pediatric Hematology-Oncology (AIEOP) and it included all new junior cancer patients diagnosed from 1st December 2017 to 1st December 2018, in an age range from 0 to 36 months and the following criteria for inclusion:&lt;/p&gt; &lt;p&gt;&lt;/p&gt; &lt;ulist&gt; &lt;item&gt; aged 0–36 months;&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; diagnosis of oncological disease except Central Nervous System disease;&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; chemotherapy treatment;&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; understanding of the Italian language;&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; obtaining informed consent;&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; at least 6 months of treatment pathway;&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; no previous developmental disorders (e.g. Downs syndrome; Autism spectrum disorders).&lt;/item&gt; &lt;/ulist&gt; &lt;p&gt;The patients enrolled participated in the early childcare education programme, on a daily basis, in the hospital setting. The programme was presented to parents during the diagnosis meeting with the doctor and psychologist. Adherence to the study and informed consent were collected the following day by professionals. Children were tested at &lt;emph&gt;Time0&lt;/emph&gt; (cancer diagnosis and enrollment in early childcare programme) and at &lt;emph&gt;Time1&lt;/emph&gt; (5 months from &lt;emph&gt;Time0&lt;/emph&gt;).&lt;/p&gt; &lt;hd id=&quot;AN0157177216-5&quot;&gt;Early childcare education programme&lt;/hd&gt; &lt;p&gt;The programme is managed by two educators and two psycho-oncologists; educational activities are proposed daily by one educator and one psycho-oncologist. The proposed activities last about 45 min and are delivered in the nursery space within the pediatric oncology ward or in the patient&#39;s room. Usually activities are proposed individually because children are immunosuppressed due to the cancer treatment. When patient achieve adequate medical values (platelets &amp;gt; 20,000 and Hb &amp;gt; 8.0) they can participate in activities in small groups of about 2 or 3 in the nursery space.&lt;/p&gt; &lt;p&gt;Alternatively, the programme could also be delivered in the day hospital and in the day service area.&lt;/p&gt; &lt;p&gt;The activities proposed were aimed at strengthening and developing the main skills that are important for the children&#39;s harmonious development. The professionals presented children with different educational activities aimed at stimulating their linguistic, creative, social and locomotors skills.&lt;/p&gt; &lt;hd id=&quot;AN0157177216-6&quot;&gt;Outcome measure&lt;/hd&gt; &lt;p&gt;The children&#39;s developmental abilities were assessed using the Griffiths Mental Developmental Scale-Extend Revised (GMDS-ER). With respect to the scale&#39;s psychometric properties, it has been demonstrated that it has construct validity across cultures and over time (Luiz, Foxcroft, &amp;amp; Stewart, [&lt;reflink idref=&quot;bib18&quot; id=&quot;ref18&quot;&gt;18&lt;/reflink&gt;]; Reyes et al., [&lt;reflink idref=&quot;bib20&quot; id=&quot;ref19&quot;&gt;20&lt;/reflink&gt;]), and there is further favorable evidence of its validity and accuracy (Ferreira, Carvalh&#227;o, Gil, Ulrich, &amp;amp; Fernandes, [&lt;reflink idref=&quot;bib9&quot; id=&quot;ref20&quot;&gt;9&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib10&quot; id=&quot;ref21&quot;&gt;10&lt;/reflink&gt;]; Griffiths, [&lt;reflink idref=&quot;bib12&quot; id=&quot;ref22&quot;&gt;12&lt;/reflink&gt;]). The GMDS-ER can be used to measure the rate of development for children from birth to 8 years of age by assessing the child&#39;s strengths and weaknesses in different developmental areas. The GMDS-ER includes 6 subscales:&lt;/p&gt; &lt;p&gt;&lt;/p&gt; &lt;ulist&gt; &lt;item&gt; Locomotor, measuring the gross motor development&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; Personal–Social, examining the social and daily living skills&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; Hearing and Speech, measuring language&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; Eye-Hand Coordination, focusing on fine motor skills, manual dexterity and visual monitoring skills&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; Performance, focusing on manipulation of objects&lt;/item&gt; &lt;p&gt;&lt;/p&gt; &lt;item&gt; Practical Reasoning, measuring the mathematic ability and abstract reasoning.&lt;/item&gt; &lt;/ulist&gt; &lt;p&gt;Each subscale contains several items that express a score of presence/absence of the ability reached by the child. These scores are &quot;age equivalents&quot; which means they are calculated in months for each developmental area and thus correspond to the mental age children reached in each area. For each subscale it was possible to gain a Subscale Developmental Quotient (S-DQ) and a Total Developmental Quotient (T-DQ) which derived from the total average of each developmental area. The scores were calculated according to Chronological Age (CA). The test was administrated by two trained psychologists and the scores were attributed only when consensus among the psychologists was reached. The Italian-validated translation of the administration manuals was used. The scale was administered at Time 0, coinciding with the diagnosis and with the enrollment in the intervention and at Time 1, 5 months from Time 0. The objective was to examine the trend of the S-DQ of patients between Time 0 and Time 1 in all the subscales and to compare the T-DQ with the CA, observing the differences in the development of the children after the participation in the early childcare programme in hospital.&lt;/p&gt; &lt;hd id=&quot;AN0157177216-7&quot;&gt;Data analysis&lt;/hd&gt; &lt;p&gt;Mean differences were used to evaluate the trend of S-DQ in the various subscales over time and the differences between the chronological age (CA) and the T-DQ over time. The delta of these differences, expressed in terms of months, was also calculated. The comparison with CA assures a reliable and objective benchmark.&lt;/p&gt; &lt;hd id=&quot;AN0157177216-8&quot;&gt;Results&lt;/hd&gt; &lt;p&gt;The subjects under observation consisted of 63 children between the ages of 0 and 36 months, newly diagnosed with an oncological disease between 1 December 2017 and 1 December 2018, in 3 pediatric oncology centers affiliated with AIEOP. Five children did not meet the inclusion criteria (2 children had a CNS tumor diagnosis, 2 children had Downs Syndrome, 1 had an autism spectrum disorder) and 2 refused to participate. Table 1 displays the passage of the participants through each stage of the study. The final cohort who participated in the programme consisted of 53 children with cancer of whom 51% were female. The most common pathologies were acute Lymphoblastic Leukemia (50%), Neuroblastoma (21%) and other tumors such as Wilms tumor and Hepatoblastoma tumor (29%). The cohort characteristics (age, gender, diagnosis, etc.) are shown in Table 2.&lt;/p&gt; &lt;p&gt;Table 1. Consort Diagram Flow For Children Enrollment.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;&amp;lt;graphic href=&quot;cccp&amp;amp;#95;a&amp;amp;#95;1792840&amp;amp;#95;ilg0001.gif&quot; content-type=&quot;Graph&quot; /&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;Table 2. Socio-demographics characteristics of participants.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;Gender &amp;amp; Age&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Male&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;26&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;49%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Female&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;27&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;51%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Mean age at diagnosis&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;22 months&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;Type of diagnosis&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Acute lymphoblastic leukemia&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;26&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;50%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Neuroblastoma&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;12&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;21%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Other tumors&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;15&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;29%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;&amp;lt;italic&amp;gt;AIEOP Center&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Turin&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;26&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;50%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Monza&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;14&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;26%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Naples&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;13&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;24%&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;At Time 0, the mean Chronological Age (CA) of the children was 22 months (range 4–36; SD = 10) while the mean of Total Development Quotient measured with the GMDS-ER was 18.5 months (range 1–34; SD = 10.5). At the baseline, on average, the children were showing a developmental delay of 3.5 months.&lt;/p&gt; &lt;p&gt;At Time 1, post early childcare programme, the mean of Chronological Age (CA) of children was 27 months (range 9–41; SD = 10.1) while the mean of Total Developmental Quotient (T-DQ) was 26 (range 4–45; SD = 10.2). The developmental delay was reduced to 1 month (Time 0Δ&lt;subs&gt;CA-T-DQ &lt;/subs&gt;= 3.5 vs Time 1Δ&lt;subs&gt;CA-T-DQ &lt;/subs&gt;= 1) (Table 3).&lt;/p&gt; &lt;p&gt;Table 3. Delta score between chronological age and developmental quotient in months from Time 0 To Time 1.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead valign=&quot;bottom&quot;&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;Time 0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#916;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Time 1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#916;&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;Mean Chronological Age (CA)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Total Developmental Quotient (TDQ)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Developmental Delay CA-TDQ T0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Mean Chronological Age (CA)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Total Developmental Quotient (TDQ)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Developmental Delay CA-TDQ T1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Total Sample&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;22&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;18.5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3.5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;27&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;26&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Male&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;24&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;19&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;30&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;27&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Female&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;21&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;16&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;The results showed an increase in the S-DQ in all the subscales analyzed from Time0 to Time1. In particular locomotor, personal–social and eye-hand coordination abilities reached the highest average increase (Table 4).&lt;/p&gt; &lt;p&gt;Table 4. Mean values of subscale developmental quotient from Time 0 to Time 1 for each subscale.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead valign=&quot;bottom&quot;&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;Time 0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#916;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Time 1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#916;&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;Mean Chronological Age (CA)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Subscale Developmental Quotient (TDQ)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Developmental Delay CA-TDQ T0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Mean Chronological Age (CA)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Subscale Developmental Quotient (TDQ)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Developmental Delay CA-TDQ T1&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Locomotor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;22 months&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;18&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;27 months&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;25.5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.5&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Personal&amp;amp;#8211;Social&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;20&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;27&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Hearing and speech&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;20.5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.5&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Eye-hand coordination&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;20&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;27.5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Performance&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;17.5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4.5&amp;lt;/td&amp;gt;&amp;lt;td char=&quot;.&quot;&amp;gt;23.2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3.8&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;hd id=&quot;AN0157177216-9&quot;&gt;Discussion&lt;/hd&gt; &lt;p&gt;This study shows the importance of an early childcare programme for young children, up to three years of age, with oncological diseases.&lt;/p&gt; &lt;p&gt;An initial finding of particular interest is that the children in our study appeared to demonstrate a delay in their developmental process at the moment of their diagnosis. It is possible, therefore, to hypothesize that children with a newly diagnosed cancer present a small regression in their development. We may therefore suppose that the disease can generate an initial regression of physical, cognitive and social development in some children, as well as difficulties from an affective-relational point of view. These children often come to us after periods of general unwellness, having already made numerous visits to A&amp;amp;E and had frequent check-ups in search of the cause of this unwellness. This period of unwellness implies that the children do not benefit from typical social opportunities such as daily nursery attendance because of those frequent interruptions, with the subsequent risk that children may develop a delay in their educational development. Children with oncological diseases may have to be away from home and hospitalized for extended periods of time. Their social and learning experience (e.g. typical exploration of their environment, daycare attendance, etc.) may be missed, often changed or postponed for long periods (Harman, Wise, &amp;amp; Willard, [&lt;reflink idref=&quot;bib14&quot; id=&quot;ref23&quot;&gt;14&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;After an initial general developmental regression had been observed and noted in our study cohort, just a few months after enrollment, a reduction of the gap between Chronological Age and Total Developmental Quotient was observed. This reduction of the regression highlights the positive effects of the programme, especially in some areas: locomotor, eye-hand coordination, and personal and social areas.&lt;/p&gt; &lt;p&gt;The improvement in their locomotor area is significant. A study (Bornstein et al., [&lt;reflink idref=&quot;bib2&quot; id=&quot;ref24&quot;&gt;2&lt;/reflink&gt;]) highlights that young children with non-CNS cancers demonstrated deficits in motor and mental development, as well as in their language, and compared to their peers were developing as is considered standard for their age. In our study, it was observed that the children, after the first stages of treatment and therapy, were often sedentary and confined to their beds which significantly hindered and reduced a natural tendency at early stages to explore the surrounding environment. Instead, most of them, after a period of attending an early childcare programme in hospital, re-acquired their natural potential and autonomy in movement, improved their locomotion, posture and desire to explore their environment.&lt;/p&gt; &lt;p&gt;Initially, in the personal and social skills area, greater difficulties and more resistance was observed in the children, which was particularly surprising considering the creation of strong relationships with hospital staff. However, the participation and attendance of the early childcare programme favored such personal and social interactions: moments of sharing and cooperation, promoting a greater climate of trust and serenity between the children and their educators. Furthermore, games were seen to have played a positive role in this sharing and cooperation with other children, and mitigated some of the difficulty of separation from the mother, who tended to be the main family caregiver, at the beginning of their hospitalization. This data is in line with observations and findings from a study in Northern Italy (Del Boca et al., [&lt;reflink idref=&quot;bib5&quot; id=&quot;ref25&quot;&gt;5&lt;/reflink&gt;]) in a sample of healthy children whose results highlighted the positive impact of early childcare on various non-cognitive behaviors, such as generosity and the inclination to form social relationships with other children. From the point of view of cognitive-linguistic competences, thanks to stimuli provided by the educators in the study, most children improved their vocabulary, verbal expression and their eye-hand coordination too.&lt;/p&gt; &lt;p&gt;For future research we would highlight the importance in obtaining a homogeneous sample with different cancer pathologies to observe any differences in terms of benefits.&lt;/p&gt; &lt;p&gt;To this end it could be useful using the Development score (D score), a new unit measurement with the aim of making a global comparisons of children&#39;s development (Weber et al., [&lt;reflink idref=&quot;bib25&quot; id=&quot;ref26&quot;&gt;25&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Furthermore, it would be interesting to highlight the parental variables that can influence the development of the child such as economical, psychological or social weaknesses.&lt;/p&gt; &lt;p&gt;Our results are particularly relevant considering the presence of an early childcare programme and of new professionals dedicated to children development in a pediatric hospital. This represents an evolution for children with oncological diseases and it has a significant impact both from a clinical and scientific point of view. First, from a clinical point of view, an improvement in the quality of life of the patients and their families is thus obtained. Secondly, from a scientific point of view, the results obtained are significant as they represent the first available data, and moreover on a national scale.&lt;/p&gt; &lt;hd id=&quot;AN0157177216-10&quot;&gt;Acknowledgements&lt;/hd&gt; &lt;p&gt;We would like to thank Intesa Sanpaolo for having conceived and promoted the &quot;Intesa Sanpaolo Educational Program for Long-Term Young Patients&quot; with the purpose of establishing nursery facilities for long-term young patients in Italian hospitals of excellence and for having commissioned a study on the evaluation of the effectiveness of the initiative to AIEOP, which is the basis of this article.&lt;/p&gt; &lt;hd id=&quot;AN0157177216-11&quot;&gt;Disclosure statement&lt;/hd&gt; &lt;p&gt;No potential conflict of interest was reported by the author(s).&lt;/p&gt; &lt;ref id=&quot;AN0157177216-12&quot;&gt; &lt;title&gt; Footnotes &lt;/title&gt; &lt;blist&gt; &lt;bibl id=&quot;bib1&quot; idref=&quot;ref9&quot; type=&quot;bt&quot;&gt;1&lt;/bibl&gt; &lt;bibtext&gt; Abbreviations AIEOP: Italian Association of Pediatric Hematology-Oncology; CNS: Non-central nervous system; ALL: Acute lymphoblastic leukemia; MIUR: Ministry of Education, University and Research; GMDS-ER: Griffiths Mental Developmental Scale-Extend Revised; S-DQ: Subscale Developmental Quotient; T-DQ:Total Developmental Quotient; CA: Chronological Age&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;ref id=&quot;AN0157177216-13&quot;&gt; &lt;title&gt; References &lt;/title&gt; &lt;blist&gt; &lt;bibtext&gt; Barrera, M., Shaw, A. 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The Lancet Oncology, 18 (6), 719 – 731. doi: 10.1016/S1470-2045(17)30186-9&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Ward, E., DeSantis, C., Robbins, A., Kohler, B., &amp;amp; Jemal, A. (2014). Childhood and adolescent cancer statistics, 2014. CA: a Cancer Journal for Clinicians, 64 (2), 83 – 103.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Weber, A. M., Rubio-Codina, M., Walker, S. P., et al. (2019). The D-score: A metric for interpreting the early development of infants and toddlers across global settings. BMJ Global Health, 4, 6. doi: 10.1136/bmjgh-2019-001724&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;aug&gt; &lt;p&gt;By G. Zucchetti; S. Ciappina; T. Geuna; F. Nichelli; A. Biondi; F. Camera; M. Ripaldi and F. Fagioli&lt;/p&gt; &lt;p&gt;Reported by Author; Author; Author; Author; Author; Author; Author; Author&lt;/p&gt; &lt;p&gt;&lt;/p&gt; &lt;p&gt;G. Zucchetti , PhD, is a clinical and researcher psychologist with a particular expertise in pediatric oncology. She conducted several projects to promote the quality of life of hospitalized children, adolescents with cancer and of their parents.&lt;/p&gt; &lt;p&gt;S. Ciappina , PhD, is a clinical and researcher psychologist with a particular expertise in pediatric oncology. She conducted several projects to promote the quality of life of hospitalized children, adolescents with cancer and of their parents.&lt;/p&gt; &lt;p&gt;T. Geuna , Psy, is a clinical psychologist with a particular expertise in early childhood support in pediatric oncology.&lt;/p&gt; &lt;p&gt;F. Nichelli , Psy, is a clinical psychologist with a particular expertise in early childhood support in pediatric oncology.&lt;/p&gt; &lt;p&gt;A. Biondi , MD, is the Director of the Pediatric Department, University of Milano-Bicocca, San Gerardo Hospital, Monza (MI), Italy and Full Professor at the University of Milano-Bicocca, Monza, Italy.&lt;/p&gt; &lt;p&gt;F. Camera , Psy, is a clinical psychologist with a particular expertise in early childhood support in pediatric oncology.&lt;/p&gt; &lt;p&gt;M. Ripaldi , MD, is the Director of the Peduiatric Trasplant Unit of the AORN SANTOBONO Pausilipon hospital, Napoli, Italy.&lt;/p&gt; &lt;p&gt;F. Fagioli , MD, is a full professor of Pediatrics and the head of Pediatric Onco-hematology and trasplant Centre of Regina Margherita Children&#39;s hospital, Torino, Italy. She has a specific expertise in clinical and traslational research focused on the study of new therapeutic strategies for the treatment of tumors in children.&lt;/p&gt; &lt;/aug&gt; &lt;nolink nlid=&quot;nl1&quot; bibid=&quot;bib23&quot; firstref=&quot;ref1&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl2&quot; bibid=&quot;bib21&quot; firstref=&quot;ref2&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl3&quot; bibid=&quot;bib24&quot; firstref=&quot;ref3&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl4&quot; bibid=&quot;bib13&quot; firstref=&quot;ref4&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl5&quot; bibid=&quot;bib17&quot; firstref=&quot;ref5&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl6&quot; bibid=&quot;bib16&quot; firstref=&quot;ref6&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl7&quot; bibid=&quot;bib22&quot; firstref=&quot;ref7&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl8&quot; bibid=&quot;bib19&quot; firstref=&quot;ref8&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl9&quot; bibid=&quot;bib11&quot; firstref=&quot;ref10&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl10&quot; bibid=&quot;bib15&quot; firstref=&quot;ref14&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl11&quot; bibid=&quot;bib18&quot; firstref=&quot;ref18&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl12&quot; bibid=&quot;bib20&quot; firstref=&quot;ref19&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl13&quot; bibid=&quot;bib10&quot; firstref=&quot;ref21&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl14&quot; bibid=&quot;bib12&quot; firstref=&quot;ref22&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl15&quot; bibid=&quot;bib14&quot; firstref=&quot;ref23&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl16&quot; bibid=&quot;bib25&quot; firstref=&quot;ref26&quot;&gt;&lt;/nolink&gt;
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  Data: Effects of Hospital Early Childcare Intervention in Young Children with Cancer
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zucchetti%2C+G%2E%22&quot;&gt;Zucchetti, G.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ciappina%2C+S%2E%22&quot;&gt;Ciappina, S.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Geuna%2C+T%2E%22&quot;&gt;Geuna, T.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nichelli%2C+F%2E%22&quot;&gt;Nichelli, F.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Biondi%2C+A%2E%22&quot;&gt;Biondi, A.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Camera%2C+F%2E%22&quot;&gt;Camera, F.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ripaldi%2C+M%2E%22&quot;&gt;Ripaldi, M.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fagioli%2C+F%2E%22&quot;&gt;Fagioli, F.&lt;/searchLink&gt;
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  Data: &lt;searchLink fieldCode=&quot;SO&quot; term=&quot;%22Child+Care+in+Practice%22&quot;&gt;&lt;i&gt;Child Care in Practice&lt;/i&gt;&lt;/searchLink&gt;. 2022 28(3):321-332.
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  Label: Availability
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  Data: Routledge. Available from: Taylor &amp; Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 12
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2022
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles&lt;br /&gt;Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: &lt;searchLink fieldCode=&quot;EL&quot; term=&quot;%22Early+Childhood+Education%22&quot;&gt;Early Childhood Education&lt;/searchLink&gt;
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Early+Intervention%22&quot;&gt;Early Intervention&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Young+Children%22&quot;&gt;Young Children&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cancer%22&quot;&gt;Cancer&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Early+Childhood+Education%22&quot;&gt;Early Childhood Education&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hospitalized+Children%22&quot;&gt;Hospitalized Children&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Foreign+Countries%22&quot;&gt;Foreign Countries&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Child+Development%22&quot;&gt;Child Development&lt;/searchLink&gt;
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Italy%22&quot;&gt;Italy&lt;/searchLink&gt;
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/13575279.2020.1792840
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1357-5279&lt;br /&gt;1476-489X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: Oncological diseases, especially if experienced in the first 3 years of life, expose young children to conditions of serious physical and emotional stress causing delays in their physical development, cognitive acquisitioning and issues related to their emotional and social functioning. This study examines the effects of the participation in an early childcare intervention to support the children&#39;s development, which was proposed to children from 0 to 36 months, at the moment of cancer diagnosis in their hospital setting. Method: A prospective multicenter programme was offered to young children (&lt;3 years) newly diagnosed with cancer. These children were treated in three pediatric oncology centers affiliated to the Italian Association of Pediatric Hematology-Oncology. The children&#39;s strengths and weaknesses, in different developmental areas, were examined pre-programme and 6 months post-programme. Results: Fifty-three young children were enrolled in the study. The data showed that at the moment of diagnosis the majority of the children demonstrated low scores across all the abilities in the subscales examined, highlighting a mental age below their chronological age ([delta][subscript T0] = 3.5 months). However, post-programme, the children were shown to have significantly reduced the gap between their chronological and mental age ([delta][subscript T1] = 1 month), demonstrating improvements in all their developmental abilities. Conclusion: The study confirms significant implications for early childcare programmes, delivered in hospitals for young children with cancer, in terms of support for their ongoing physical, cognitive and social development. Therefore, the study demonstrated the necessity, for all pediatric oncology centers, to invest in early childhood education programmes.
– Name: AbstractInfo
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  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2022
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1353268
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1353268
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      – Type: doi
        Value: 10.1080/13575279.2020.1792840
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 321
    Subjects:
      – SubjectFull: Early Intervention
        Type: general
      – SubjectFull: Young Children
        Type: general
      – SubjectFull: Cancer
        Type: general
      – SubjectFull: Early Childhood Education
        Type: general
      – SubjectFull: Hospitalized Children
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Child Development
        Type: general
      – SubjectFull: Italy
        Type: general
    Titles:
      – TitleFull: Effects of Hospital Early Childcare Intervention in Young Children with Cancer
        Type: main
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            NameFull: Ciappina, S.
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            NameFull: Geuna, T.
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            NameFull: Ripaldi, M.
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            NameFull: Fagioli, F.
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              Type: published
              Y: 2022
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