{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T06:13:29Z","timestamp":1776579209130,"version":"3.51.2"},"reference-count":52,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Rights, Equality and Citizenship (REC) Programme of the European Union","award":["101005642"],"award-info":[{"award-number":["101005642"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Child maltreatment is considered a pressing social question, compromising the present and future mental and physical health of one in four children in Europe. While children younger than three years of age are especially vulnerable, few screening instruments are available for the detection of risk in this age group. The purpose of this research was to develop a screening tool for childcare professionals working in public and private daycare settings to support them in the early identification and referral of infants and toddlers exposed to emotional and physical abuse and neglect by primary caregivers, to be used in different settings across four European countries: Belgium, Italy, Latvia, and Hungary. Method: A stratified process was used to create the screening tool: We started by using Living lab methodology to co-create the screening tool with its final users, which was followed by testing the tool with a total of 120 childcare professionals from the four participating countries. Results: During the Living Lab phase, a screening tool with three layers was developed. The initial layer includes five \u201cred flags\u201d that signal particular concern and require immediate action. The second layer is a quick screener with twelve items focused on four areas: neglect of basic needs, delays in development, unusual behaviors, and interaction with caregivers. The third layer is an in-depth questionnaire that aids in formalizing a thorough observation of twenty-five items within the same four areas as the quick screener. After a one-day training session, 120 childcare professionals caring for children aged 0\u20133 from four countries assessed the screening tool and their overall training experience. Childcare professionals reported great satisfaction with the three-layered structure, which made the tool versatile, and agreed on its content, which was considered helpful in the daycare setting for the regular evaluation of the behavior of children and their primary caregivers, thus improving the early observation of change from the normal behavior of the infant or toddler. Conclusion: The three-layered screening tool was reported as feasible, practical, and with great content validity by childcare professionals working in four European countries.<\/jats:p>","DOI":"10.3390\/children10050858","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T04:29:01Z","timestamp":1683779341000},"page":"858","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Development of a Screening Tool for Childcare Professionals to Detect and Refer Infant and Toddler Maltreatment and Trauma: A Tale of Four Countries"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2109-7652","authenticated-orcid":false,"given":"Elisa","family":"Bisagno","sequence":"first","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3374-2348","authenticated-orcid":false,"given":"Alessia","family":"Cadamuro","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9406-8919","authenticated-orcid":false,"given":"Dierickx","family":"Serafine","sequence":"additional","affiliation":[{"name":"Expertise Centre Resilient People, University Colleges Leuven-Limburg (UCLL), 3001 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bou Mosleh","family":"Dima","sequence":"additional","affiliation":[{"name":"Expertise Centre Resilient People, University Colleges Leuven-Limburg (UCLL), 3001 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Groenen","family":"Anne","sequence":"additional","affiliation":[{"name":"Expertise Centre Resilient People, University Colleges Leuven-Limburg (UCLL), 3001 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0987-8851","authenticated-orcid":false,"given":"Linde-Ozola","family":"Zane","sequence":"additional","affiliation":[{"name":"Department of Anthropology, Faculty of Humanities, University of Latvia, LV-1586 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8924-9869","authenticated-orcid":false,"given":"Kand\u0101te","family":"Annija","sequence":"additional","affiliation":[{"name":"Center Dardedze, LV-1002 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varga-Sabj\u00e1n","family":"D\u00f3ra","sequence":"additional","affiliation":[{"name":"Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morva","family":"Dorottya","sequence":"additional","affiliation":[{"name":"Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"No\u00e9mi","sequence":"additional","affiliation":[{"name":"Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rozsa","family":"Monika","sequence":"additional","affiliation":[{"name":"Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gruber","family":"Andrea","sequence":"additional","affiliation":[{"name":"Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3412-3784","authenticated-orcid":false,"given":"De Fazio","family":"Giovanna Laura","sequence":"additional","affiliation":[{"name":"Department of Law, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4974-1964","authenticated-orcid":false,"given":"Blom","family":"Johanna Maria Catharina","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy"},{"name":"Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0749-3797(98)00017-8","article-title":"Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study","volume":"14","author":"Felitti","year":"1998","journal-title":"Am. J. Prev. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e517","DOI":"10.1016\/S2468-2667(19)30145-8","article-title":"Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: A systematic review and meta-analysis","volume":"4","author":"Bellis","year":"2019","journal-title":"Lancet Public Health"},{"key":"ref_3","unstructured":"Sethi, D., Yon, Y., Parekh, N., Anderson, T., Huber, J., Rakovac, I., and Meinck, F. (2018). European Status Report on Preventing Child Maltreatment, World Health Organisation\u2014Regional Office for Europe. Available online: https:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0017\/381140\/wh12-ecm-rep-eng.pdf."},{"key":"ref_4","unstructured":"(2020, March 03). U.S. Department of Health & Human Services (USDHHS), Administration for Children and Families, Administration on Children, Youth and Families, Children\u2019s Bureau. Child Maltreatment 2019, Available online: https:\/\/www.acf.hhs.gov\/cb\/research-data-technology\/statistics-research\/child-maltreatment."},{"key":"ref_5","unstructured":"(2020, March 03). U.S. Department of Health & Human Services (USDHHS), Administration for Children and Families, Administration on Children, Youth and Families, Children\u2019s Bureau. Child Maltreatment 2020, Available online: https:\/\/www.acf.hhs.gov\/cb\/data-research\/child-maltreatment."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1097\/PEC.0b013e31818e9f5d","article-title":"Fatal Abusive Head Trauma Cases: Consequence of medical staff missingmilde forms of physical abuse","volume":"24","author":"Oral","year":"2008","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1001\/jamapediatrics.2013.192","article-title":"Emotional, behavioral, and developmental features indicative of neglect or emotional abuse in preschool children: A systematic review","volume":"167","author":"Naughton","year":"2013","journal-title":"JAMA Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Norman, R.E., Byambaa, M., De, R., Butchart, A., Scott, J., and Vos, T. (2012). The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis. PLoS Med., 9.","DOI":"10.1371\/journal.pmed.1001349"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1080\/03004430.2017.1353978","article-title":"Adverse childhood experiences, parenting, and child executive function","volume":"189","author":"Treat","year":"2019","journal-title":"Early Child Dev. Care"},{"key":"ref_10","unstructured":"(2020, March 03). U.S. Department of Health & Human Services (USDHHS), Administration for Children and Families, Administration on Children, Youth and Families, Children\u2019s Bureau. Child Maltreatment 2015, Available online: https:\/\/www.anotpertinentcf.hhs.gov\/cb\/research-data-technology\/statistics-research\/child-maltreatment."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1002\/imhj.21741","article-title":"Early maltreatment and current quality of relational care predict socioemotional problems among institutionalized infants and toddlers","volume":"39","author":"Baptista","year":"2018","journal-title":"Infant Ment. Health J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1258\/jrsm.2011.110222","article-title":"The link between child abuse and psychopathology: A review of neurobiological and genetic research","volume":"105","author":"McCrory","year":"2012","journal-title":"J. R. Soc. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e20193845","DOI":"10.1542\/peds.2019-3845","article-title":"Leveraging the Biology of Adversity and Resilience to Transform Pediatric Practice","volume":"147","author":"Shonkoff","year":"2021","journal-title":"Pediatrics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e232","DOI":"10.1542\/peds.2011-2663","article-title":"The lifelong effects of early childhood adversity and toxic stress","volume":"129","author":"Shonkoff","year":"2012","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/S0140-6736(16)31702-0","article-title":"Expanding the evidence base to drive more productive early childhood investment","volume":"389","author":"Shonkoff","year":"2017","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/1097-0355(199524)16:4<271::AID-IMHJ2280160404>3.0.CO;2-B","article-title":"Childhood trauma, the neurobiology of adaptation, and \u201cuse-dependent\u201d development of the brain: How \u201cstates\u201d become \u201ctraits\u201d","volume":"16","author":"Perry","year":"1995","journal-title":"Infant Ment. Health J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1001\/jamapediatrics.2015.2206","article-title":"Implementing a Trauma-Informed Approach in Pediatric Health Care Networks","volume":"170","author":"Marsac","year":"2016","journal-title":"JAMA Pediatr."},{"key":"ref_18","unstructured":"World Health Organization (2021, April 04). Child Maltreatment. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/child-maltreatment."},{"key":"ref_19","unstructured":"National Health Service Education for Scotland (2020, March 03). Transforming Psychological Trauma: A Knowledge and Skills Framework for the Scottish Workforce. Available online: https:\/\/www.nes.scot.nhs.uk\/media\/rgxngvpv\/nationaltraumatrainingframework-execsummary-web.pdf."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Bisagno, E., Cadamuro, A., Dierickx, S., Mosleh, D.B., Linde-Ozola, Z., Kand\u0101te, A., Varga-Sabjan, D., Morva, D., Laszlo, N., and Rozsa, M. (2023). A European comparison of screening and referral by childcare professionals of maltreatment in children aged 0\u20133: A wild goose chase or maybe not. Child Abus. Rev., e2812.","DOI":"10.1002\/car.2812"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1016\/j.chiabu.2014.03.008","article-title":"Long-term effects of child abuse and neglect on emotion processing in adulthood","volume":"38","author":"Young","year":"2014","journal-title":"Child Abus. Negl."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e193","DOI":"10.1097\/JNR.0000000000000475","article-title":"Screening Tools for Child Abuse Used by Healthcare Providers: A Systematic Review","volume":"30","author":"Chen","year":"2022","journal-title":"J. Nurs. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/cch.12416","article-title":"Development of a screening tool enabling identification of infants and toddlers at risk of family abuse and neglect: A feasibility study from three South European countries","volume":"43","author":"Ezpeleta","year":"2017","journal-title":"Child Care Health Dev."},{"key":"ref_24","unstructured":"Administration for Children and Families (2021, April 04). Child Abuse, Neglect Data Released, Available online: https:\/\/www.acf.hhs.gov\/media\/press\/2020\/child-abuse-neglect-data-released."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1016\/j.chiabu.2013.11.005","article-title":"Accuracy of a screening instrument to identify potential child abuse in emergency departments","volume":"38","author":"Louwers","year":"2014","journal-title":"Child Abus. Negl."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1542\/peds.2011-3527","article-title":"Effects of Systematic Screening and Detection of Child Abuse in Emergency Departments","volume":"130","author":"Louwers","year":"2012","journal-title":"Pediatrics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.psychres.2018.12.068","article-title":"Systematic review and critical appraisal of child abuse measurement instruments","volume":"272","author":"Saini","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1542\/peds.2008-3632","article-title":"Bruising Characteristics Discriminating Physical Child Abuse from Accidental Trauma","volume":"125","author":"Pierce","year":"2010","journal-title":"Pediatrics"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e215832","DOI":"10.1001\/jamanetworkopen.2021.5832","article-title":"Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics","volume":"4","author":"Pierce","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_30","unstructured":"Essau, C.A. (2020, March 03). Guidelines for the INTOVIAN Screening Tool. Available online: https:\/\/www.intovian.eu\/."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e5218","DOI":"10.1097\/MD.0000000000005218","article-title":"Child protection medical service demonstration centers in approaching child abuse and neglect in Taiwan","volume":"95","author":"Chang","year":"2016","journal-title":"Medicine"},{"key":"ref_32","unstructured":"(2020, March 03). Independent Authority for Children and Adolescents; Terre des Hommes Italia; Cismai. Second National Study on Child and Adolescent Maltreatment in Italy. Findings and Perspectives. Available online: https:\/\/terredeshommes.it\/comunicati\/presentazione-della-ii-indagine-nazionaale-sul-maltrattamento-bambini-adolescenti-italia."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/JFN.0000000000000136","article-title":"Screening Children for Abuse and Neglect: A Review of the Literature","volume":"13","author":"Hoft","year":"2017","journal-title":"J. Forensic Nurs."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"A18","DOI":"10.1136\/archdischild-2014-307384.58","article-title":"IS-058 Screening On Child Abuse In Europe","volume":"99","author":"Moll","year":"2014","journal-title":"Arch. Dis. Child."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s12955-015-0323-4","article-title":"Adverse childhood experiences and health-related quality of life in adulthood: Revelations from a community needs assessment","volume":"13","author":"Salemi","year":"2015","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_36","unstructured":"Macmillan, H.L., and Wathen, C.N. (2014). Research Brief: Interventions to Prevent Child Maltreatment. Preventing Violence across the Lifespan Research Network, PreVAiL."},{"key":"ref_37","unstructured":"Mansell, R., and Ang, P.H. (2015). The International Encyclopedia of Digital Communication and Society, Wiley & Sons."},{"key":"ref_38","unstructured":"Eriksson, M., Niitamo, V.P., and Kulkki, S. (2005). State-of-the-Art in Utilizing Living Labs Approach to User-Centric ICT Innovation\u2014A European Approach, CDT at Lule\u00e5 University of Technology."},{"key":"ref_39","unstructured":"Abdoh, N., Bernardi, E., and Mccarthy, A. (2017). Knowledge, Attitudes, and Practices of Trauma Informed Practice: A Survey of Health Care Professionals and Support Staff at Alexander Street Community, University of British Columbia Library. NURS Synthesis Project."},{"key":"ref_40","first-page":"375","article-title":"Een zelfrapportage-onderzoek naar slachtofferschap van geweld bij Vlaamse scholieren: Een blik op de resultaten met een ethische reflectie. Kindvriendelijk en participatief bevragen in een stedelijke context","volume":"4","author":"Verdonck","year":"2019","journal-title":"Tijdschrift voor Jeugd en Kinderrechten"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1177\/0886260515618946","article-title":"Beyond \u201cWitnessing\u201d: Children\u2019s Experiences of Coercive Control in Domestic Violence and Abuse","volume":"33","author":"Callaghan","year":"2018","journal-title":"J. Interpers. Violence"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"8960","DOI":"10.1177\/0886260519863724","article-title":"Developing and Validating a New Scale to Assess Signs of Neglect of Infants and Caregivers","volume":"36","author":"Arimoto","year":"2021","journal-title":"J. Interpers. Violence"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s10643-009-0342-z","article-title":"Inter-Parental Violence: The Pre-Schooler\u2019s Perspective and the Educator\u2019s Role","volume":"37","author":"Baker","year":"2009","journal-title":"Early Child. Educ. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2512","DOI":"10.1177\/0886260516628286","article-title":"The Effect of Intimate Partner Violence on the Psychosocial Development of Toddlers","volume":"33","author":"Harper","year":"2018","journal-title":"J. Interpers. Violence"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"McTavish, J.R., Gonzalez, A., Santesso, N., MacGregor, J.C.D., McKee, C., and Macmillan, H.L. (2020). Identifying children exposed to maltreatment: A systematic review update. BMC Pediatr., 20.","DOI":"10.1186\/s12887-020-2015-4"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1177\/070674371105600505","article-title":"Resilience following Child Maltreatment: A Review of Protective Factors","volume":"56","author":"Afifi","year":"2011","journal-title":"Can. J. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1007\/s10566-015-9302-5","article-title":"How childcare providers interpret \u2018reasonable suspicion\u2019 of child abuse","volume":"44","author":"Levi","year":"2015","journal-title":"Child Youth Care Forum"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.chiabu.2018.10.011","article-title":"Factor analysis and predictive validity of the Early Risks of Physical Abuse and Neglect Scale (ERPANS): A prospective study in Dutch public youth healthcare","volume":"88","author":"Schols","year":"2019","journal-title":"Child Abus. Negl."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.chiabu.2017.05.016","article-title":"Screening for potential child maltreatment in parents of a newborn baby: The predictive validity of an Instrument for early identification of Parents at Risk for child Abuse and Neglect (IPARAN)","volume":"70","author":"Wit","year":"2017","journal-title":"Child Abus. Negl."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Mathews, B., Yang, C., Lehman, E.B., Mincemoyer, C., Verdiglione, N., and Levi, B.H. (2017). Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0177777"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Yang, C., Panlilio, C., Verdiglione, N., Lehman, E.B., Hamm, R.M., Fiene, R., Dore, S., Bard, D.E., Grable, B., and Levi, B. (2020). Generalizing findings from a randomized controlled trial to a real-world study of the iLookOut, an online education program to improve early childhood care and education providers\u2019 knowledge and attitudes about reporting child maltreatment. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227398"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Dierickx, S., Bisagno, E., Varga-Sabj\u00e1n, D., Morva, D., Linde-Ozola, Z., L\u00e1szl\u00f3, N., Cadamuro, A., Mosleh, D.B., R\u00f3zsa, M., and De Fazio, G.L. (2023). Trauma-informed care to support children exposed to child abuse in childcare organizations: A qualitative comparison of four European countries. Child Abus. Rev., e2821.","DOI":"10.1002\/car.2821"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/5\/858\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:32:48Z","timestamp":1760124768000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/5\/858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,11]]},"references-count":52,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["children10050858"],"URL":"https:\/\/doi.org\/10.3390\/children10050858","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,11]]}}}