{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:56:03Z","timestamp":1790571363777,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["493624047 (Clinician Scientist CareerS M\u00fcnster)"],"award-info":[{"award-number":["493624047 (Clinician Scientist CareerS M\u00fcnster)"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Childcare centres for toddlers and preschool\u2010aged children serve as a setting crucial to mental development, as stable relationships with caregivers and peers outside the family form. Children with early mental health disorders, especially externalising behaviours, are at increased risk of being excluded from access to these institutional services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The retrospective study investigates partial or full exclusion from childcare centre attendance among toddlers and preschoolers (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009177) who received psychiatric day clinic treatment within two periods (2018\/2019 and 2023\/2024). We compared excluded and non\u2010excluded children regarding clinical parameters in a binary logistic regression. Furthermore, treatment trajectories were examined to assess reintegration into childcare settings as a potential therapeutic outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the patients in the psychiatric day clinic for toddlers and preschoolers, the rate of exclusion from childcare centre attendance was 25.5% (2023\/2024) and 8.0% (2018\/2019), respectively. Boys were predominantly excluded from childcare centre attendance with 66.7% (2018\/2019) and 92.3% (2023\/2024). Overall for both cohorts, while male sex (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028) and cohort membership in the 2023\/24 cohort (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) predicted exclusion, other investigated variables (i.e., socioeconomic status, migration status, parental psychiatric condition) did not show an effect. In 78.1% of the excluded patients in the combined samples, (partial) reintegration or improvement of social integration was recorded or initiated during treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our study, exclusion from childcare attendance differed between 2018\/2019 and 2023\/2024 in toddler and preschool children, especially affecting boys. In line with the UN Convention on the Rights of the Child, 1989, ensuring inclusive access to early education regardless of physical or mental impairments should be an important therapeutic goal. Mental health professionals should pay special attention to and actively support prevention and reintegration regarding early life exclusion experiences from childcare centres.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cch.70330","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T07:29:28Z","timestamp":1786692568000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exclusion From Childcare Centre Attendance in Toddler and Preschool Patients in a Psychiatric Day Clinic: Patterns From Comparison of a 2018\/2019 and a 2023\/2024 Cohort"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4560-7039","authenticated-orcid":false,"given":"Linda Meredith","family":"Bonnekoh","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster Germany"},{"name":"Institute for Translational Psychiatry University of M\u00fcnster  M\u00fcnster Germany"},{"name":"LWL\u2010University Hospital for Child and Adolescent Psychiatry Ruhr\u2010University Bochum  Hamm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4034-447X","authenticated-orcid":false,"given":"Lennart","family":"Friese","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6724-5200","authenticated-orcid":false,"given":"Ruth Helena","family":"Fellmeth","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor Andr\u00e9s","family":"S\u00e1nchez Guerrero","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0841-8618","authenticated-orcid":false,"given":"Selina","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster Germany"},{"name":"Institute for Biomagnetism and Biosignalanalysis University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5972-7621","authenticated-orcid":false,"given":"J\u00f6rg Michael","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Hubbert","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster Germany"},{"name":"Institute for Translational Psychiatry University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo","family":"Dannlowski","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry University of M\u00fcnster  M\u00fcnster Germany"},{"name":"Department of Psychiatry, Protestant Hospital of the Bethel Foundation, Medical School and University Medical Center OWL Bielefeld University  Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Romer","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8111-5744","authenticated-orcid":false,"given":"Marius","family":"Jan\u00dfen","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinic M\u00fcnster University of M\u00fcnster  M\u00fcnster 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