example of case study about child

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Case Studies and Scenarios

Case studies.

Each case study describes the real experience of a Registered Early Childhood Educator. Each one profiles a professional dilemma, incorporates participants with multiple perspectives and explores ethical complexities. Case studies may be used as a source for reflection and dialogue about RECE practice within the framework of the Code of Ethics and Standards of Practice​.

Scenarios are snapshots of experiences in the professional practice of a Registered Early Childhood Educator. Each scenario includes a series of questions meant to help RECEs reflect on the situation.

Case Study 1: Sara’s Confusing Behaviour

Case study 2: getting bumps and taking lumps, case study 3: no qualified staff, case study 4: denton’s birthday cupcakes, case study 5: new kid on the block, case study 6: new responsibilities and challenges, case study 7: valuing inclusivity and privacy, case study 8: balancing supervisory responsibilities, case study 9: once we were friends, ​​​​scenarios​​, communication and collaboration.

Barbara, an RECE, is working as a supply staff at various centres across the city. During her week at a centre where she helps out in two different rooms each day, she finds that her experience in the school-age program isn’t as straightforward as when she was in the toddler room. Barbara feels completely lost in this program.

Do You Really Know Who Your Friends Are?

Joe is an RECE at an elementary school and works with children between the ages of nine and 12 years old. One afternoon, he finds a group of children huddled around the computer giggling and whispering. Joe quickly discovers they’re going through his party photos on Facebook as one of the children’s parents recently added him as a friend.

Conflicting Approaches

Amina, an experienced RECE, has recently started a new position with a child care centre. She’s assigned to work in the infant room with two colleagues who have worked in the room together for ten years. As Amina settles into her new role, she is taken aback by some of the child care approaches taken by her colleagues.

What to do about Lisa?

Shane, an experienced supervisor at a child care centre, receives a complaint about an RECE who had roughly handled a child earlier that day. The interaction had been witnessed by a parent who confronted the RECE. After some words were exchanged, the RECE left in tears.

Duty to Report

Zoë works as an RECE in a drop-in program at a family support centre. She has a great rapport for a family over a 10-month period and beings to notice a change in the mom and child. One day, as the child is getting dressed to go home for the day, she notices something alarming and brings it to the attention of her supervisor.

Posting on Social Media

Allie, an RECE who has worked at the same child care centre for the last three years, recently started a private social media group to collaborate and discuss programming ideas. As the group takes a negative turn with rude and offensive comments, it’s brought to her supervisor’s attention.

Early Childhood Education: How to do a Child Case Study-Best Practice

• Creating an Annotated Bibliography
• Lesson Plans and Rubrics
• Children's literature
• Podcasts and Videos
• Cherie's Recommended Library
• Great Educational Articles
• Great Activities for Children
• Professionalism in the Field and in a College Classroom
• Professional Associations
• Pennsylvania Certification
• Manor's Early Childhood Faculty
• Manor Lesson Plan Format
• Manor APA Formatting, Reference, and Citation Policy for Education Classes
• Conducting a Literature Review for a Manor education class
• Manor College's Guide to Using EBSCO Effectively
• How to do a Child Case Study-Best Practice
• ED105: From Teacher Interview to Final Project
• Pennsylvania Initiatives

Description of Assignment

During your time at Manor, you will need to conduct a child case study. To do well, you will need to plan ahead and keep a schedule for observing the child. A case study at Manor typically includes the following components: 

• Three observations of the child: one qualitative, one quantitative, and one of your choice. 
• Three artifact collections and review: one qualitative, one quantitative, and one of your choice. 
• A Narrative

Within this tab, we will discuss how to complete all portions of the case study.  A copy of the rubric for the assignment is attached. 

• Case Study Rubric (Online)
• Case Study Rubric (Hybrid/F2F)

Qualitative and Quantitative Observation Tips

Remember your observation notes should provide the following detailed information about the child:

• child’s age,
• physical appearance,
• the setting, and
• any other important background information.

You should observe the child a minimum of 5 hours. Make sure you DO NOT use the child's real name in your observations. Always use a pseudo name for course assignments. 

You will use your observations to help write your narrative. When submitting your observations for the course please make sure they are typed so that they are legible for your instructor. This will help them provide feedback to you. 

Qualitative Observations

A qualitative observation is one in which you simply write down what you see using the anecdotal note format listed below. 

Quantitative Observations

A quantitative observation is one in which you will use some type of checklist to assess a child's skills. This can be a checklist that you create and/or one that you find on the web. A great choice of a checklist would be an Ounce Assessment and/or work sampling assessment depending on the age of the child. Below you will find some resources on finding checklists for this portion of the case study. If you are interested in using Ounce or Work Sampling, please see your program director for a copy. 

Remaining Objective 

For both qualitative and quantitative observations, you will only write down what your see and hear. Do not interpret your observation notes. Remain objective versus being subjective.

An example of an objective statement would be the following: "Johnny stacked three blocks vertically on top of a classroom table." or "When prompted by his teacher Johnny wrote his name but omitted the two N's in his name." 

An example of a subjective statement would be the following: "Johnny is happy because he was able to play with the block." or "Johnny omitted the two N's in his name on purpose." 

• Anecdotal Notes Form Form to use to record your observations.
• Guidelines for Writing Your Observations
• Tips for Writing Objective Observations
• Objective vs. Subjective

Qualitative and Quantitative Artifact Collection and Review Tips

For this section, you will collect artifacts from and/or on the child during the time you observe the child. Here is a list of the different types of artifacts you might collect: 

Potential Qualitative Artifacts 

• Photos of a child completing a task, during free play, and/or outdoors. 
• Samples of Artwork 
• Samples of writing 
• Products of child-led activities 

Potential Quantitative Artifacts 

• Checklist 
• Rating Scales
• Product Teacher-led activities 

Examples of Components of the Case Study

Here you will find a number of examples of components of the Case Study. Please use them as a guide as best practice for completing your Case Study assignment. 

• Qualitatitive Example 1
• Qualitatitive Example 2
• Quantitative Photo 1
• Qualitatitive Photo 1
• Quantitative Observation Example 1
• Artifact Photo 1
• Artifact Photo 2
• Artifact Photo 3
• Artifact Photo 4
• Artifact Sample Write-Up
• Case Study Narrative Example Although we do not expect you to have this many pages for your case study, pay close attention to how this case study is organized and written. The is an example of best practice.

Narrative Tips

The Narrative portion of your case study assignment should be written in APA style, double-spaced, and follow the format below:

• Introduction : Background information about the child (if any is known), setting, age, physical appearance, and other relevant details. There should be an overall feel for what this child and his/her family is like. Remember that the child’s neighborhood, school, community, etc all play a role in development, so make sure you accurately and fully describe this setting! --- 1 page
• Observations of Development :   The main body of your observations coupled with course material supporting whether or not the observed behavior was typical of the child’s age or not. Report behaviors and statements from both the child observation and from the parent/guardian interview— 1.5  pages
• Comment on Development: This is the portion of the paper where your professional analysis of your observations are shared. Based on your evidence, what can you generally state regarding the cognitive, social and emotional, and physical development of this child? Include both information from your observations and from your interview— 1.5 pages
• Conclusion: What are the relative strengths and weaknesses of the family, the child? What could this child benefit from? Make any final remarks regarding the child’s overall development in this section.— 1page
• Your Case Study Narrative should be a minimum of 5 pages.

Make sure to NOT to use the child’s real name in the Narrative Report. You should make reference to course material, information from your textbook, and class supplemental materials throughout the paper . 

Same rules apply in terms of writing in objective language and only using subjective minimally. REMEMBER to CHECK your grammar, spelling, and APA formatting before submitting to your instructor. It is imperative that you review the rubric of this assignment as well before completing it. 

Biggest Mistakes Students Make on this Assignment

Here is a list of the biggest mistakes that students make on this assignment: 

• Failing to start early . The case study assignment is one that you will submit in parts throughout the semester. It is important that you begin your observations on the case study before the first assignment is due. Waiting to the last minute will lead to a poor grade on this assignment, which historically has been the case for students who have completed this assignment. 
• Failing to utilize the rubrics. The rubrics provide students with guidelines on what components are necessary for the assignment. Often students will lose points because they simply read the descriptions of the assignment but did not pay attention to rubric portions of the assignment. 
• Failing to use APA formatting and proper grammar and spelling. It is imperative that you use spell check and/or other grammar checking software to ensure that your narrative is written well. Remember it must be in APA formatting so make sure that you review the tutorials available for you on our Lib Guide that will assess you in this area. 
• << Previous: Manor College's Guide to Using EBSCO Effectively
• Next: ED105: From Teacher Interview to Final Project >>
• Last Updated: Jul 5, 2024 9:53 AM
• URL: https://manor.libguides.com/earlychildhoodeducation

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• Case report
• Open access
• Published: 11 September 2017

A case of a four-year-old child adopted at eight months with unusual mood patterns and significant polypharmacy

• Magdalena Romanowicz   ORCID: orcid.org/0000-0002-4916-0625 1 ,
• Alastair J. McKean 1 &
• Jennifer Vande Voort 1  

BMC Psychiatry volume  17 , Article number:  330 ( 2017 ) Cite this article

Long-term effects of neglect in early life are still widely unknown. Diversity of outcomes can be explained by differences in genetic risk, epigenetics, prenatal factors, exposure to stress and/or substances, and parent-child interactions. Very common sub-threshold presentations of children with history of early trauma are challenging not only to diagnose but also in treatment.

Case presentation

A Caucasian 4-year-old, adopted at 8 months, male patient with early history of neglect presented to pediatrician with symptoms of behavioral dyscontrol, emotional dysregulation, anxiety, hyperactivity and inattention, obsessions with food, and attachment issues. He was subsequently seen by two different child psychiatrists. Pharmacotherapy treatment attempted included guanfacine, fluoxetine and amphetamine salts as well as quetiapine, aripiprazole and thioridazine without much improvement. Risperidone initiated by primary care seemed to help with his symptoms of dyscontrol initially but later the dose had to be escalated to 6 mg total for the same result. After an episode of significant aggression, the patient was admitted to inpatient child psychiatric unit for stabilization and taper of the medicine.

Conclusions

The case illustrates difficulties in management of children with early history of neglect. A particular danger in this patient population is polypharmacy, which is often used to manage transdiagnostic symptoms that significantly impacts functioning with long term consequences.

Peer Review reports

There is a paucity of studies that address long-term effects of deprivation, trauma and neglect in early life, with what little data is available coming from institutionalized children [ 1 ]. Rutter [ 2 ], who studied formerly-institutionalized Romanian children adopted into UK families, found that this group exhibited prominent attachment disturbances, attention-deficit/hyperactivity disorder (ADHD), quasi-autistic features and cognitive delays. Interestingly, no other increases in psychopathology were noted [ 2 ].

Even more challenging to properly diagnose and treat are so called sub-threshold presentations of children with histories of early trauma [ 3 ]. Pincus, McQueen, & Elinson [ 4 ] described a group of children who presented with a combination of co-morbid symptoms of various diagnoses such as conduct disorder, ADHD, post-traumatic stress disorder (PTSD), depression and anxiety. As per Shankman et al. [ 5 ], these patients may escalate to fulfill the criteria for these disorders. The lack of proper diagnosis imposes significant challenges in terms of management [ 3 ].

J is a 4-year-old adopted Caucasian male who at the age of 2 years and 4 months was brought by his adoptive mother to primary care with symptoms of behavioral dyscontrol, emotional dysregulation, anxiety, hyperactivity and inattention, obsessions with food, and attachment issues. J was given diagnoses of reactive attachment disorder (RAD) and ADHD. No medications were recommended at that time and a referral was made for behavioral therapy.

She subsequently took him to two different child psychiatrists who diagnosed disruptive mood dysregulation disorder (DMDD), PTSD, anxiety and a mood disorder. To help with mood and inattention symptoms, guanfacine, fluoxetine, methylphenidate and amphetamine salts were all prescribed without significant improvement. Later quetiapine, aripiprazole and thioridazine were tried consecutively without behavioral improvement (please see Table  1 for details).

No significant drug/substance interactions were noted (Table 1 ). There were no concerns regarding adherence and serum drug concentrations were not ordered. On review of patient’s history of medication trials guanfacine and methylphenidate seemed to have no effect on J’s hyperactive and impulsive behavior as well as his lack of focus. Amphetamine salts that were initiated during hospitalization were stopped by the patient’s mother due to significant increase in aggressive behaviors and irritability. Aripiprazole was tried for a brief period of time and seemed to have no effect. Quetiapine was initially helpful at 150 mg (50 mg three times a day), unfortunately its effects wore off quickly and increase in dose to 300 mg (100 mg three times a day) did not seem to make a difference. Fluoxetine that was tried for anxiety did not seem to improve the behaviors and was stopped after less than a month on mother’s request.

J’s condition continued to deteriorate and his primary care provider started risperidone. While initially helpful, escalating doses were required until he was on 6 mg daily. In spite of this treatment, J attempted to stab a girl at preschool with scissors necessitating emergent evaluation, whereupon he was admitted to inpatient care for safety and observation. Risperidone was discontinued and J was referred to outpatient psychiatry for continuing medical monitoring and therapy.

Little is known about J’s early history. There is suspicion that his mother was neglectful with feeding and frequently left him crying, unattended or with strangers. He was taken away from his mother’s care at 7 months due to neglect and placed with his aunt. After 1 month, his aunt declined to collect him from daycare, deciding she was unable to manage him. The owner of the daycare called Child Services and offered to care for J, eventually becoming his present adoptive parent.

J was a very needy baby who would wake screaming and was hard to console. More recently he wakes in the mornings anxious and agitated. He is often indiscriminate and inappropriate interpersonally, unable to play with other children. When in significant distress he regresses, and behaves as a cat, meowing and scratching the floor. Though J bonded with his adoptive mother well and was able to express affection towards her, his affection is frequently indiscriminate and he rarely shows any signs of separation anxiety.

At the age of 2 years and 8 months there was a suspicion for speech delay and J was evaluated by a speech pathologist who concluded that J was exhibiting speech and language skills that were solidly in the average range for age, with developmental speech errors that should be monitored over time. They did not think that issues with communication contributed significantly to his behavioral difficulties. Assessment of intellectual functioning was performed at the age of 2 years and 5 months by a special education teacher. Based on Bailey Infant and Toddler Development Scale, fine and gross motor, cognitive and social communication were all within normal range.

J’s adoptive mother and in-home therapist expressed significant concerns in regards to his appetite. She reports that J’s biological father would come and visit him infrequently, but always with food and sweets. J often eats to the point of throwing up and there have been occasions where he has eaten his own vomit and dog feces. Mother noticed there is an association between his mood and eating behaviors. J’s episodes of insatiable and indiscriminate hunger frequently co-occur with increased energy, diminished need for sleep, and increased speech. This typically lasts a few days to a week and is followed by a period of reduced appetite, low energy, hypersomnia, tearfulness, sadness, rocking behavior and slurred speech. Those episodes last for one to 3 days. Additionally, there are times when his symptomatology seems to be more manageable with fewer outbursts and less difficulty regarding food behaviors.

J’s family history is poorly understood, with his biological mother having a personality disorder and ADHD, and a biological father with substance abuse. Both maternally and paternally there is concern for bipolar disorder.

J has a clear history of disrupted attachment. He is somewhat indiscriminate in his relationship to strangers and struggles with impulsivity, aggression, sleep and feeding issues. In addition to early life neglect and possible trauma, J has a strong family history of psychiatric illness. His mood, anxiety and sleep issues might suggest underlying PTSD. His prominent hyperactivity could be due to trauma or related to ADHD. With his history of neglect, indiscrimination towards strangers, mood liability, attention difficulties, and heightened emotional state, the possibility of Disinhibited Social Engagement Disorder (DSED) is likely. J’s prominent mood lability, irritability and family history of bipolar disorder, are concerning for what future mood diagnosis this portends.

As evidenced above, J presents as a diagnostic conundrum suffering from a combination of transdiagnostic symptoms that broadly impact his functioning. Unfortunately, although various diagnoses such as ADHD, PTSD, Depression, DMDD or DSED may be entertained, the patient does not fall neatly into any of the categories.

This is a case report that describes a diagnostic conundrum in a young boy with prominent early life deprivation who presented with multidimensional symptoms managed with polypharmacy.

A sub-threshold presentation in this patient partially explains difficulties with diagnosis. There is no doubt that negative effects of early childhood deprivation had significant impact on developmental outcomes in this patient, but the mechanisms that could explain the associations are still widely unknown. Significant family history of mental illness also predisposes him to early challenges. The clinical picture is further complicated by the potential dynamic factors that could explain some of the patient’s behaviors. Careful examination of J’s early life history would suggest such a pattern of being able to engage with his biological caregivers, being given food, being tended to; followed by periods of neglect where he would withdraw, regress and engage in rocking as a self-soothing behavior. His adoptive mother observed that visitations with his biological father were accompanied by being given a lot of food. It is also possible that when he was under the care of his biological mother, he was either attended to with access to food or neglected, left hungry and screaming for hours.

The current healthcare model, being centered on obtaining accurate diagnosis, poses difficulties for treatment in these patients. Given the complicated transdiagnostic symptomatology, clear guidelines surrounding treatment are unavailable. To date, there have been no psychopharmacological intervention trials for attachment issues. In patients with disordered attachment, pharmacologic treatment is typically focused on co-morbid disorders, even with sub-threshold presentations, with the goal of symptom reduction [ 6 ]. A study by dosReis [ 7 ] found that psychotropic usage in community foster care patients ranged from 14% to 30%, going to 67% in therapeutic foster care and as high as 77% in group homes. Another study by Breland-Noble [ 8 ] showed that many children receive more than one psychotropic medication, with 22% using two medications from the same class.

It is important to note that our patient received four different neuroleptic medications (quetiapine, aripiprazole, risperidone and thioridazine) for disruptive behaviors and impulsivity at a very young age. Olfson et al. [ 9 ] noted that between 1999 and 2007 there has been a significant increase in the use of neuroleptics for very young children who present with difficult behaviors. A preliminary study by Ercan et al. [ 10 ] showed promising results with the use of risperidone in preschool children with behavioral dyscontrol. Review by Memarzia et al. [ 11 ] suggested that risperidone decreased behavioral problems and improved cognitive-motor functions in preschoolers. The study also raised concerns in regards to side effects from neuroleptic medications in such a vulnerable patient population. Younger children seemed to be much more susceptible to side effects in comparison to older children and adults with weight gain being the most common. Weight gain associated with risperidone was most pronounced in pre-adolescents (Safer) [ 12 ]. Quetiapine and aripiprazole were also associated with higher rates of weight gain (Correll et al.) [ 13 ].

Pharmacokinetics of medications is difficult to assess in very young children with ongoing development of the liver and the kidneys. It has been observed that psychotropic medications in children have shorter half-lives (Kearns et al.) [ 14 ], which would require use of higher doses for body weight in comparison to adults for same plasma level. Unfortunately, that in turn significantly increases the likelihood and severity of potential side effects.

There is also a question on effects of early exposure to antipsychotics on neurodevelopment. In particular in the first 3 years of life there are many changes in developing brains, such as increase in synaptic density, pruning and increase in neuronal myelination to list just a few [ 11 ]. Unfortunately at this point in time there is a significant paucity of data that would allow drawing any conclusions.

Our case report presents a preschool patient with history of adoption, early life abuse and neglect who exhibited significant behavioral challenges and was treated with various psychotropic medications with limited results. It is important to emphasize that subthreshold presentation and poor diagnostic clarity leads to dangerous and excessive medication regimens that, as evidenced above is fairly common in this patient population.

Neglect and/or abuse experienced early in life is a risk factor for mental health problems even after adoption. Differences in genetic risk, epigenetics, prenatal factors (e.g., malnutrition or poor nutrition), exposure to stress and/or substances, and parent-child interactions may explain the diversity of outcomes among these individuals, both in terms of mood and behavioral patterns [ 15 , 16 , 17 ]. Considering that these children often present with significant functional impairment and a wide variety of symptoms, further studies are needed regarding diagnosis and treatment.

Abbreviations

Attention-Deficit/Hyperactivity Disorder

Disruptive Mood Dysregulation Disorder

Disinhibited Social Engagement Disorder

Post-Traumatic Stress Disorder

Reactive Attachment disorder

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We are also grateful to patient’s legal guardian for their support in writing this manuscript.

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MR, AJM, JVV conceptualized and followed up the patient. MR, AJM, JVV did literature survey and wrote the report and took part in the scientific discussion and in finalizing the manuscript. All the authors read and approved the final document.

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Correspondence to Magdalena Romanowicz .

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Romanowicz, M., McKean, A.J. & Vande Voort, J. A case of a four-year-old child adopted at eight months with unusual mood patterns and significant polypharmacy. BMC Psychiatry 17 , 330 (2017). https://doi.org/10.1186/s12888-017-1492-y

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Received : 20 December 2016

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Published : 11 September 2017

DOI : https://doi.org/10.1186/s12888-017-1492-y

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Module 13: Disorders of Childhood and Adolescence

Case studies: disorders of childhood and adolescence, learning objectives.

• Identify disorders of childhood and adolescence in case studies

Case Study: Jake

Jake was born at full term and was described as a quiet baby. In the first three months of his life, his mother became worried as he was unresponsive to cuddles and hugs. He also never cried. He has no friends and, on occasions, he has been victimized by bullying at school and in the community. His father is 44 years old and describes having had a difficult childhood; he is characterized by the family as indifferent to the children’s problems and verbally violent towards his wife and son, but less so to his daughters. The mother is 41 years old, and describes herself as having a close relationship with her children and mentioned that she usually covers up for Jake’s difficulties and makes excuses for his violent outbursts. [1]

During his stay (for two and a half months) in the inpatient unit, Jake underwent psychiatric and pediatric assessments plus occupational therapy. He took part in the unit’s psycho-educational activities and was started on risperidone, two mg daily. Risperidone was preferred over an anti-ADHD agent because his behavioral problems prevailed and thus were the main target of treatment. In addition, his behavioral problems had undoubtedly influenced his functionality and mainly his relations with parents, siblings, peers, teachers, and others. Risperidone was also preferred over other atypical antipsychotics for its safe profile and fewer side effects. Family meetings were held regularly, and parental and family support along with psycho-education were the main goals. Jake was aided in recognizing his own emotions and conveying them to others as well as in learning how to recognize the emotions of others and to become aware of the consequences of his actions. Improvement was made in rule setting and boundary adherence. Since his discharge, he received regular psychiatric follow-up and continues with the medication and the occupational therapy. Supportive and advisory work is done with the parents. Marked improvement has been noticed regarding his social behavior and behavior during activity as described by all concerned. Occasional anger outbursts of smaller intensity and frequency have been reported, but seem more manageable by the child with the support of his mother and teachers.

In the case presented here, the history of abuse by the parents, the disrupted family relations, the bullying by his peers, the educational difficulties, and the poor SES could be identified as additional risk factors relating to a bad prognosis. Good prognostic factors would include the ending of the abuse after intervention, the child’s encouragement and support from parents and teachers, and the improvement of parental relations as a result of parent training and family support by mental health professionals. Taken together, it appears that also in the case of psychiatric patients presenting with complex genetic aberrations and additional psychosocial problems, traditional psychiatric and psychological approaches can lead to a decrease of symptoms and improved functioning.

Case Study: Kelli

Kelli may benefit from a course of comprehensive behavioral intervention for her tics in addition to psychotherapy to treat any comorbid depression she experiences from isolation and bullying at school. Psychoeducation and approaches to reduce stigma will also likely be very helpful for both her and her family, as well as bringing awareness to her school and those involved in her education.

• Kolaitis, G., Bouwkamp, C.G., Papakonstantinou, A. et al. A boy with conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), borderline intellectual disability, and 47,XXY syndrome in combination with a 7q11.23 duplication, 11p15.5 deletion, and 20q13.33 deletion. Child Adolesc Psychiatry Ment Health 10, 33 (2016). https://doi.org/10.1186/s13034-016-0121-8 ↵
• Case Study: Childhood and Adolescence. Authored by : Chrissy Hicks for Lumen Learning. Provided by : Lumen Learning. License : CC BY: Attribution
• A boy with conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), borderline intellectual disability.... Authored by : Gerasimos Kolaitis, Christian G. Bouwkamp, Alexia Papakonstantinou, Ioanna Otheiti, Maria Belivanaki, Styliani Haritaki, Terpsihori Korpa, Zinovia Albani, Elena Terzioglou, Polyxeni Apostola, Aggeliki Skamnaki, Athena Xaidara, Konstantina Kosma, Sophia Kitsiou-Tzeli, Maria Tzetis . Provided by : Child and Adolescent Psychiatry and Mental Health. Located at : https://capmh.biomedcentral.com/articles/10.1186/s13034-016-0121-8 . License : CC BY: Attribution
• Angry boy. Located at : https://www.pxfuel.com/en/free-photo-jojfk . License : Public Domain: No Known Copyright
• Frustrated girl. Located at : https://www.pickpik.com/book-bored-college-education-female-girl-1717 . License : Public Domain: No Known Copyright

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Casebook: Developmentally Appropriate Practice in Early Childhood Programs Serving Children from Birth Through Age 8

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About the book.

• Make connections to the fourth edition of Developmentally Appropriate Practice in Early Childhood Programs 
• Think critically about the influence of context on educator, child, and family actions 
• Discuss the effectiveness of the teaching practices and how they might be improved 
• Support your responses with evidence from the DAP position statement and book 
• Explore next steps beyond the case details 
• Apply the learning to your own situation 

Table of Contents

• Editors, Contributors, and Reviewers
• Introduction and Book Overview | Jennifer J. Chen and Dana Battaglia
• 1.1 Missed Opportunities: Relationship Building in Inclusive Classrooms | Julia Torquati
• 1.2 “My Name Is Not a Shame” | Kevin McGowan
• 1.3 Fostering Developmentally Appropriate Practice Through Virtual Family Connections | Lea Ann Christenson
• 1.4 Counting Collections in Community | Amy Schmidtke
• 1.5 The Joy Jar: Celebrating Kindness | Leah Schoenberg Muccio
• 1.6 Prioritizing Listening to and Learning from Families | Amy Schmidtke 
• 2.1 Julio’s Village: Early Childhood Education Supports for Teen Parents | Donna Kirkwood
• 2.2 Healthy Boundaries: Listening to Children and Learning from Families | Jovanna Archuleta
• 2.3 Roadmap of Family Engagement to Kindergarten: An Ecological Systems Approach | Marcela Andrés
• 2.4 Taking Trust for Granted? The Importance of Communication and Outreach in Family Partnerships | Suzanna Ewert
• 2.5 Book Reading: Learning About Migration and Our Family Stories | Sarah Rendón García 
• 3.1 Pairing Standardized Scale with Observation | Megan Schumaker-Murphy
• 3.2 The Power of Observing Jordan | Marsha Shigeyo Hawley and Barbara Abel
• 3.3 “But What Is My Child Learning?” | Janet Thompson and Jennifer Gonzalez
• 3.4 Drawing and Dialogue: Using Authentic Assessment to Understand Children’s Sense of Self and Observe Early Literacy Skills | Brandon L. Gilbert
• 3.5 The ABCs of Kindergarten Registration: Assessment, Background, and Collaboration Between Home and School | Bridget Amory
• 3.6 Creating Opportunities for Individualized Assessment Activities for Biliteracy Development | Esther Garza
• 3.7 Observing Second-Graders’ Vocabulary Development | Marie Ann Donovan
• 3.8 Writing Isn’t the Only Way! Multiple Means of Expressing Learning | Lee Ann Jungiv 
• 4.1 Engaging with Families to Individualize Teaching | Marie L. Masterson 
• 4.2 Tumbling Towers with Toddlers: Intention and Decision Making Over Blocks | Ron Grady  
• 4.3 What My Heart Holds: Exploring Identity with Preschool Learners | Cierra Kaler-Jones 
• 4.4 “I See a Really Big Gecko!” When Background Knowledge and Teaching Materials Don’t Match | Germaine Kaleilehua Tauati and Colleen E. Whittingham 
• 4.5 Using a Humanizing and Restorative Approach for Young Children to Develop Responsibility and Self-Regulation | Saili S. Kulkarni, Sunyoung Kim, and Nicola Holdman 
• 4.6 Joyful, Developmentally Appropriate Learning Environments for African American Youth | Lauren C. Mims, Addison Duane, LaKenya Johnson, and Erika Bocknek 
• 5.1 Using the Environment and Materials as Curriculum for Promoting Infants’ and Toddlers’ Exploration of Basic Cause-and-Effect Principles | Guadalupe Rivas 
• 5.2 Social Play Connections Among a Small Group of Preschoolers | Leah Catching 
• 5.3 Can Preschoolers Code? A Sneak Peek into a Developmentally Appropriate Coding Lesson | Olabisi Adesuyi-Fasuyi 
• 5.4 Everyday Gifts: Children Show Us the Path—We Observe and Scaffold | Martha Melgoza 
• 5.5 Learning to Conquer the Slide Through Persistence and Engaging in Social Interaction | Sueli Nunes 
• 5.6 “Sabes que todos los caracoles pueden tener bebés? Do You Know that All Snails Can Have Babies?” Supporting Children’s Emerging Interests in a Dual Language Preschool Classroom | Isauro M. Escamilla 
• 5.7 “Can We Read this One?” A Conversation About Book Selection in Kindergarten | Larissa Hsia-Wong  
• 6.1 Take a Chance on Coaching: It’s Worth It! | Lauren Bond 
• 6.2 It Started with a Friendship Parade | Angela Vargas 
• 6.3 The World Outside of the Classroom: Letting Your Voice Be Heard | Meghann Hickey 
• 7.1 Communication as a Two-Way Street? Creating Opportunities for Engagement During Meaningful Language Routines | Kameron C. Cardenv 
• 7.2 Eli Goes to Preschool: Inclusion for a Child with Autism Spectrum Disorder | Abby Hodges
• 7.3 Preschool Classroom Supports and Embedded Interventions with Coteaching | Racheal Kuperus and Desarae Orgo
• 7.4 Addressing Challenging Behavior Using the Pyramid Model | Ellie Bold
• 7.5 Dual Language or Disability? How Teachers Can Be the First to Help | Alyssa Brillante
• 7.6 Adapting and Modifying Instruction Using Reader’s Theater | Michelle Gonzalez
• 7.7 Supporting Children with Learning Disabilities in Mathematics: The Importance of Observation, Content Knowledge, and Context | Renee B. Whelan 
• 8.1 Facilitating a Child’s Transition from Home to Group Care Through the Use of Cultural Caring Routines | Josephine Ahmadein
• 8.2 Engaging Dual Language Learners in Conversation to Support Translanguaging During a Small Group Activity | Valeria Erdosi and Jennifer J. Chen
• 8.3 Incorporating Children’s Cultures and Languages in Learning Activities | Eleni Zgourou
• 8.4 Adapting Teaching Materials for Dual Language Learners to Reflect Their Home Languages and Cultures in a Math Lesson | Karen Nemeth
• 8.5 Studying Celestial Bodies: Science and Cultural Stories | Zeynep Isik-Ercan
• 8.6 Respecting Diverse Cultures and Languages by Sharing and Learning About Cultural Poems, Songs, and Stories From Others | Janis Strasser

Book Details

Faculty resources.

To access tips and resources for teaching the cases, please complete this brief form.  You’ll be able to download the items after you complete the form. 

Teacher Inquiry Group Resources

To access reflection questions to deepen your learning, please click here.

More DAP Resources

To read the position statement, access related resources, and stay up-to-the-minute on all things DAP, visit  NAEYC.org/resources/developmentally-appropriate-practice .

Pamela Brillante,  EdD, is professor in the Department of Special Education, Professional Counseling and Disability Studies, at William Paterson University. She has worked as an early childhood special educator, administrator, and New Jersey state specialist in early childhood special education. She is the author of the NAEYC book The Essentials: Supporting Young Children with Disabilities in the Classroom. Dr. Brillante continues to work with schools to develop high-quality inclusive early childhood programs. 

Jennifer J. Chen, EdD, is professor of early childhood and family studies at Kean University. She earned her doctorate from Harvard University. She has authored or coauthored more than 60 publications in early childhood education. Dr. Chen has received several awards, including the 2020 NAECTE Foundation Established Career Award for Research on ECTE, the 2021 Kean Presidential Excellence Award for Distinguished Scholarship, and the 2022 NJAECTE’s Distinguished Scholarship in ECTE/ECE Award. 

Stephany Cuevas, EdD, is assistant professor of education in the Attallah College of Educational Studies at Chapman University. Dr. Cuevas is an interdisciplinary education scholar whose research focuses on family engagement, Latinx families, and the postsecondary trajectories of first-generation students. She is the author of Apoyo Sacrifical, Sacrificial Support: How Undocumented Parents Get Their Children to College (Teachers College Press). 

Christyn Dundorf, PhD, has more than 30 years of experience in the early learning field as a teacher, administrator, and adult educator. She serves as codirector of Teaching Preschool Partners, a nonprofit organization working to grow playful learning and inquiry practices in school-based pre-K programs and infuse those practices up into the early grades.

Emily Brown Hoffman, PhD, is assistant professor in early childhood education at National Louis University in Chicago. She received her PhD from the University of Illinois at Chicago in Curriculum & Instruction, Literacy, Language, & Culture. Her focuses include emergent literacy, leadership, play and creativity, and school, family, and community partnerships. 

Daniel R. Meier, PhD, is professor of elementary education at San Francisco State University. His publications include Critical Issues in Infant-Toddler Language Development: Connecting Theory to Practice (editor), Supporting Literacies for Children of Color: A Strength-Based Approach to Preschool Literacy (author), and Learning Stories and Teacher Inquiry Groups: Reimagining Teaching and Assessment in Early Childhood Education (coauthor). 

Gayle Mindes, EdD, is professor emerita, DePaul University. She is the author of Assessing Young Children , fifth edition (with Lee Ann Jung), and Social Studies for Young Children: Preschool and Primary Curriculum Anchor, third edition (with Mark Newman). Dr. Mindes is also the editor of Teaching Young Children with Challenging Behaviors: Practical Strategies for Early Childhood Educators and Contemporary Challenges in Teaching Young Children: Meeting the Needs of All Students . 

Lisa R. Roy, EdD, is executive director for the Colorado Department of Early Childhood. Dr. Roy has supported families with young children for over 30 years, serving as the director of program development for the Buffett Early Childhood Institute, as the executive director of early childhood education for Denver Public Schools, and in various nonprofit and government roles.

• Children's mental health case studies
• Parenting and caregiving
• Mental health

Explore the experiences of children and families with these interdisciplinary case studies. Designed to help professionals and students explore the strengths and needs of children and their families, each case presents a detailed situation, related research, problem-solving questions and feedback for the user. Use these cases on your own or in classes and training events

Each case study:

• Explores the experiences of a child and family over time.
• Introduces theories, research and practice ideas about children's mental health.
• Shows the needs of a child at specific stages of development.
• Invites users to “try on the hat” of different specific professionals.

By completing a case study participants will:

• Examine the needs of children from an interdisciplinary perspective.
• Recognize the importance of prevention/early intervention in children’s mental health.
• Apply ecological and developmental perspectives to children’s mental health.
• Predict probable outcomes for children based on services they receive.

Case studies prompt users to practice making decisions that are:

• Research-based.
• Practice-based.
• Best to meet a child and family's needs in that moment.

Children’s mental health service delivery systems often face significant challenges.

• Services can be disconnected and hard to access.
• Stigma can prevent people from seeking help.
• Parents, teachers and other direct providers can become overwhelmed with piecing together a system of care that meets the needs of an individual child.
• Professionals can be unaware of the theories and perspectives under which others serving the same family work
• Professionals may face challenges doing interdisciplinary work.
• Limited funding promotes competition between organizations trying to serve families.

These case studies help explore life-like mental health situations and decision-making. Case studies introduce characters with history, relationships and real-life problems. They offer users the opportunity to:

• Examine all these details, as well as pertinent research.
• Make informed decisions about intervention based on the available information.

The case study also allows users to see how preventive decisions can change outcomes later on. At every step, the case content and learning format encourages users to review the research to inform their decisions.

Each case study emphasizes the need to consider a growing child within ecological, developmental, and interdisciplinary frameworks.

• Ecological approaches consider all the levels of influence on a child.
• Developmental approaches recognize that children are constantly growing and developing. They may learn some things before other things.
• Interdisciplinary perspectives recognize that the needs of children will not be met within the perspectives and theories of a single discipline.

There are currently two different case students available. Each case study reflects a set of themes that the child and family experience.

The About Steven case study addresses:

• Adolescent depression.
• School mental health.
• Rural mental health services.
• Social/emotional development.

The Brianna and Tanya case study reflects themes of:

• Infant and early childhood mental health.
• Educational disparities.
• Trauma and toxic stress.
• Financial insecurity.
• Intergenerational issues.

The case studies are designed with many audiences in mind:

Practitioners from a variety of fields. This includes social work, education, nursing, public health, mental health, and others.

Professionals in training, including those attending graduate or undergraduate classes.

The broader community.

Each case is based on the research, theories, practices and perspectives of people in all these areas. The case studies emphasize the importance of considering an interdisciplinary framework. Children’s needs cannot be met within the perspective of a single discipline.

The complex problems children face need solutions that integrate many and diverse ways of knowing. The case studies also help everyone better understand the mental health needs of children. We all have a role to play.

These case has been piloted within:

Graduate and undergraduate courses.

Discipline-specific and interdisciplinary settings.

Professional organizations.

Currently, the case studies are being offered to instructors and their staff and students in graduate and undergraduate level courses. They are designed to supplement existing course curricula.

Instructors have used the case study effectively by:

• Assigning the entire case at one time as homework. This is followed by in-class discussion or a reflective writing assignment relevant to a course.
• Assigning sections of the case throughout the course. Instructors then require students to prepare for in-class discussion pertinent to that section.
• Creating writing, research or presentation assignments based on specific sections of course content.
• Focusing on a specific theme present in the case that is pertinent to the course. Instructors use this as a launching point for deeper study.
• Constructing other in-class creative experiences with the case.
• Collaborating with other instructors to hold interdisciplinary discussions about the case.

To get started with a particular case, visit the related web page and follow the instructions to register. Once you register as an instructor, you will receive information for your co-instructors, teaching assistants and students. Get more information on the following web pages.

• Brianna and Tanya: A case study about infant and early childhood mental health
• About Steven: A children’s mental health case study about depression

Cari Michaels, Extension educator

Reviewed in 2023

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Case studies in child welfare

About this guide, child welfare case studies, real-life stories, and scenarios, social services and organizational case studies, other case studies, using case studies.

This guide is intended as a supplementary resource for staff at Children's Aid Societies and Indigenous Well-being Agencies. It is not intended as an authority on social work or legal practice, nor is it meant to be representative of all perspectives in child welfare. Staff are encouraged to think critically when reviewing publications and other materials, and to always confirm practice and policy at their agency.

Case studies and real-life stories can be a powerful tool for teaching and learning about child welfare issues and practice applications. This guide provides access to a variety of sources of social work case studies and scenarios, with a specific focus on child welfare and child welfare organizations.

• Real cases project Three case studies, drawn from the New York City Administration for Children's Services. Website also includes teaching guides
• Protective factors in practice vignettes These vignettes illustrate how multiple protective factors support and strengthen families who are experiencing stress. From the National Child Abuse Prevention Month website
• Child welfare case studies and competencies Each of these cases was developed, in partnership, by a faculty representative from an Alabama college or university social work education program and a social worker, with child welfare experience, from the Alabama Department of Human Resources

• Immigration in the child welfare system: Case studies Case studies related to immigrant children and families in the U.S. from the American Bar Association
• White privilege and racism in child welfare scenarios From the Center for Advanced Studies in Child Welfare more... less... https://web.archive.org/web/20190131213630/https://cascw.umn.edu/wp-content/uploads/2013/12/WhitePrivilegeScenarios.pdf
• You decide: Would you remove these children from their families? Interactive piece from the Australian Broadcasting Corporation featuring cases based on real-life situations
• A case study involving complex trauma This case study complements a series of blog posts dedicated to the topic of complex trauma and how children learn to cope with complex trauma
• Fostering and adoption: Case studies Four case studies from Research in Practice (UK)
• Troubled families case studies This document describes how different families in the UK were helped through family intervention projects
• Parenting case studies From of the Pennsylvania Child Welfare Resource Center's training entitled "Understanding Reactive Attachment Disorder"
• Children’s Social Work Matters: Case studies Collections of narratives and case studies

• Race for Results case studies Series of case studies from the Annie E. Casey Foundation looking at ways of addressing racial inequities and supporting better outcomes for racialized children and communities
• Systems of care implementation case studies This report presents case studies that synthesize the findings, strategies, and approaches used by two grant communities to develop a principle-guided approach to child welfare service delivery for children and families more... less... https://web.archive.org/web/20190108153624/https://www.childwelfare.gov/pubPDFs/ImplementationCaseStudies.pdf
• Child Outcomes Research Consortium: Case studies Case studies from the Child Outcomes Research Consortium, a membership organization in the UK that collects and uses evidence to improve children and young people’s mental health and well-being
• Social work practice with carers: Case studies
• Social Care Institute for Excellence: Case studies
• Learning to address implicit bias towards LGBTQ patients: Case scenarios [2018] more... less... https://web.archive.org/web/20190212165359/https://www.lgbthealtheducation.org/wp-content/uploads/2018/10/Implicit-Bias-Guide-2018_Final.pdf
• Using case studies to teach
• Last Updated: Aug 12, 2022 11:21 AM
• URL: https://oacas.libguides.com/case-studies

CHILD CASE STUDY-ASSESSMENT AND INTERVENTION

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Case Studies and Success Stories, Reports

Advocating for and with Children: Six case studies from Save the Children

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Save the Children

Six case studies have been selected to highlight and demonstrate the enhancement of children’s right to protection through Save the Children’s advocacy around the world. These case studies fall within the scope of the Save the Children’s priority areas operational in 2011: Children without Appropriate Care (Including Children on the Move), and Child Protection in Emergencies.

The culmination of these case studies revealed a set of elements that led to successful child protection advocacy. These include the meaningful participation of children; development of strong partnerships with governments, civil society, and communities; facilitating community ownership of advocacy activities and ensuring that advocacy activities are firmly grounded on the principles of the Convention on the Rights of the Child.

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DBP Community Systems-Based Cases

Introduction.

Following are case studies of children with typical developmental behavioral issues that may require a host of referrals and recommendations.

Case Studies

Case 1:                    case 2:                      case 3: sophie                     mark                     alejandro.

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Food neophobia in children: a case study in federal district/brazil.

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1. Introduction

2. materials and methods, 2.1. participants, 2.2. instruments and application, 2.3. statistical analysis, 4. discussion, 5. conclusions, supplementary materials, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest.

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De Almeida, P.C.; Nakano, E.Y.; Vasconcelos, I.A.L.; Zandonadi, R.P.; Raposo, A.; Saraiva, A.; Alturki, H.A.; Botelho, R.B.A. Food Neophobia in Children: A Case Study in Federal District/Brazil. Nutrients 2024 , 16 , 2962. https://doi.org/10.3390/nu16172962

De Almeida PC, Nakano EY, Vasconcelos IAL, Zandonadi RP, Raposo A, Saraiva A, Alturki HA, Botelho RBA. Food Neophobia in Children: A Case Study in Federal District/Brazil. Nutrients . 2024; 16(17):2962. https://doi.org/10.3390/nu16172962

De Almeida, Priscila Claudino, Eduardo Yoshio Nakano, Ivana Aragão Lira Vasconcelos, Renata Puppin Zandonadi, António Raposo, Ariana Saraiva, Hmidan A. Alturki, and Raquel Braz Assunção Botelho. 2024. "Food Neophobia in Children: A Case Study in Federal District/Brazil" Nutrients 16, no. 17: 2962. https://doi.org/10.3390/nu16172962

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Oral issues and childhood stress in eight-to-ten-year-old schoolchildren: a case–control study

• Published: 31 August 2024
• Volume 28 , article number  509 , ( 2024 )

Cite this article

• Antônio Lopes Beserra Neto 1 ,
• Raquel Gonçalves Vieira-Andrade 2 ,
• José Klidenberg de Oliveira Junior 3 ,
• Lívia Pereira Brocos Pires 3 ,
• Dhelfeson Willya Douglas-de-Oliveira 4 ,
• Maria Letícia Ramos-Jorge 4 ,
• Rômulo Lustosa Pimenteira de Melo 5 &
• Clarissa Lopes Drumond 3  

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The aim of the present study was to investigate whether oral problems, harmful oral habits, and sociodemographic factors are associated with the occurrence of stress in schoolchildren.

Materials and methods

A case–control study nested within a cross-sectional study was conducted with a sample of 375 schoolchildren eight to ten years of age in the city of Diamantina, Brazil. The case group (with childhood stress) and control group (without childhood stress) were matched for age and sex at a 1:4 ratio (75 cases to 300 controls). Data collection involved the self-administration of a questionnaire by parents/caregivers addressing sociodemographic characteristics and the child's history of harmful oral habits. The children answered the Child Stress Scale (CSS) and underwent a clinical oral examination to determine the presence/absence of dental caries, malocclusion, and traumatic dental injuries. Data analysis involved the calculation of frequencies, the chi-square test, and conditional logistic regression (95% CI; p ≤ 0.05).

The final adjusted conditional logistic regression model showed that dental caries (OR = 1.78, 95% CI: 1.01 – 3.14, p = 0.044) and biting objects (OR = 1.81, 95% CI: 1.02 – 3.22, p = 0.041) remained associated with stress in the schoolchildren analysed.

The present results showed that children with dental caries and the habit of biting objects were more likely to have childhood stress.

Clinical relevance

The study allows paediatric dentists to expand their knowledge with regards to the influence of oral problems and harmful habits on the occurrence of childhood stress and serves as a guide for decision-making related to oral problems in schoolchildren.

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Acknowledgements

The authors appreciate the support of the Brazilian fostering agencies Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES [Coordination for the Advancement of Higher Education Personnel]) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq [National Council of Scientific and Technological Development]).

This work received funding from the Brazilian fostering agencies Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)  – Finance Code 001,  Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) - Finance Code (153137/2018–5) .

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School of Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil

Antônio Lopes Beserra Neto

Department of Oral Health for Child and Adolescent, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

Raquel Gonçalves Vieira-Andrade

University Centre Santa Maria, Cajazeiras, PB, Brazil

José Klidenberg de Oliveira Junior, Lívia Pereira Brocos Pires & Clarissa Lopes Drumond

School of Dentistry, Federal University of Vales Do Jequitinhonha E Mucuri, Diamantina, MG, Brazil

Dhelfeson Willya Douglas-de-Oliveira & Maria Letícia Ramos-Jorge

School of Psychology, Federal University of Paraíba, João Pessoa, PB, Brazil

Rômulo Lustosa Pimenteira de Melo

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Contributions

Antonio Lopes Beserra Neto : search and selection of articles for theoretical basis, contact with schoolchildren, organisation and randomisation of participants, organisation of data in database, drafting the manuscript and revising it critically for important intellectual content, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that issues related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Raquel Gonçalves Vieira-Andrade : substantial contributions to the conception and design of the work, search and selection of articles for theoretical basis, statistical analysis, interpretation of data for the work, drafting the manuscript, revising the manuscript critically for important intellectual content, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that issues related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

José Klidenberg de Oliveira Júnior : search and selection of articles for theoretical basis, analysis and interpretation of data for the work, drafting the manuscript and revising it critically for important intellectual content, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that issues related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Lívia Pereira Brocos Pires : search and selection of articles for theoretical basis, analysis and interpretation of data, drafting the manuscript and revising it critically for important intellectual content, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that issues related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Dhelfeson Willya Douglas-de-Oliveira : substantial contributions to the data analysis, calibration of the oral examiner, revising the manuscript critically for important intellectual content, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that issues related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Maria Letícia Ramos-Jorge : substantial contributions to the conception and design of the work, search and selection of articles for theoretical basis, revising the manuscript critically for important intellectual content, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that issues related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Rômulo Lustosa Pimenteira de Melo : substantial contributions to the research design, search and selection of articles for theoretical basis, assessment of psychological tests, interpretation of data, critical review of the manuscript with respect to the psychology field, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that issues related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Clarissa Lopes Drumond : search and selection of articles for theoretical basis, clinical examination of the sample, organisation of data in database, drafting the manuscript and revising it critically for important intellectual content, final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that issues related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Raquel Gonçalves Vieira-Andrade .

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Ethical approval and consent to participate.

This study received approval from the Human Research Ethics Committee of Universidade Federal dos Vales do Jequitinhonha e Mucuri (Brazil) (certificate nº 370.291). The parents/guardians signed a statement of informed consent prior to the children's participation and the children signed an assent form.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Author A. L. B. N declares no conflict of interest. Author R. G. V-A declares no conflict of interest. Author J. K. O. J declares no conflict of interest. Author L. P. B. P declares no conflict of interest. Author D. W. D. O declares no conflict of interest. Author M. L. R-J declares that she has no conflict of interest. Author R. L. P. M declares no conflict of interest. Author C. L. D declares no conflict of interest.

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● The results of this study showed that children with dental caries and those with habit of biting objects were more likely to have childhood stress.

● The study enables paediatric dentists to expand their knowledge with regards to the influence of oral problems and harmful habits on the occurrence of childhood stress and can serve as a guide for decision-making related to oral problems in schoolchildren.

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Beserra Neto, A.L., Vieira-Andrade, R.G., de Oliveira Junior, J.K. et al. Oral issues and childhood stress in eight-to-ten-year-old schoolchildren: a case–control study. Clin Oral Invest 28 , 509 (2024). https://doi.org/10.1007/s00784-024-05889-8

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Received : 27 February 2023

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Published : 31 August 2024

DOI : https://doi.org/10.1007/s00784-024-05889-8

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What to take away?  

• Embed shareability for virality: Spotify Wrapped is highly shareable. The content is perfectly optimized for social media. The app even encourages you to share your Wrapped summary. Crafting personalized content that people are excited to share is a successful social media strategy , as active participation naturally follows when you engage your audience. 
• Create rituals: While Spotify Wrapped's format remains consistent, it gains more traction on social media each year. Annual campaigns, particularly those towards the year's end, establish a sense of ritual, and consumers are conditioned to anticipate them. Ritualized content gives your audience something to look forward to, year after year. 
• Jump on that bandwagon: Making brand-specific versions of popular content is a fantastic way to participate in the conversation. For instance, SEMRush used the Wrapped format to create unique content tailored to its audience. 

Deep Dive: How to adopt trends and broaden your channel coverage mix (while staying on brand)  

#2: The Barbie Movie 

The 2023 film Barbie brought the beloved Mattel doll to life in a dazzling, contemporary adventure. Starring Ryan Gosling and Margot Robbie, the movie seamlessly blends fantasy and reality as Barbie embarks on a transformative journey from her idyllic, pink-hued world to the real one. 

Why this campaign?  The Barbie marketing campaign was a masterclass in leveraging nostalgia, contemporary pop culture and innovative social media promotion strategies. It generated a massive buzz and captured the imagination of audiences worldwide. 

What did they do?    Warner Brothers and Mattel collaborated to create a multifaceted campaign. This included vibrant teasers, interactive social media content and high-profile brand partnerships. Here are the specifics:  

• Shared behind-the-scenes content, trailers and other promotional materials on all social media platforms 
• Engaged influencers and celebrities to create inspired memes and generate excitement 
• Created a sense of community by reflecting the diversity of its audience   
• Barbie-themed Malibu DreamHouse listed by Airbnb 
• Barbie-styled clothing line launched by Forever21 
• Barbie-themed meals offered by Burger King in Brazil 

• Utilized innovative tactics like a selfie generator to keep fans engaged 
• Benefitted from the unplanned "Barbenheimer" phenomenon 

The simultaneous release of Oppenheimer and Barbie really captured the public’s imagination. It sparked an unexpected cultural phenomenon known as "Barbenheimer." Christopher Nolan's intense biographical drama "Oppenheimer" explored the life of J. Robert Oppenheimer and the creation of the atomic bomb, while Greta Gerwig's "Barbie" was inspired by the iconic doll. The stark contrast between the two films captivated both audiences and the media.  

The phenomenon was fueled by social media buzz, memes and fans' enthusiasm for the unique cinematic experience of watching two drastically different films back-to-back. This boosted box office numbers for both movies and created a shared cultural moment transcending typical movie-going experiences. The playful rivalry and the combined marketing efforts led to unprecedented social media engagement , making "Barbenheimer" a standout event in 2023. 

How did it help?    The movie had grossed $1.45 billion worldwide , including $636 million in North America. Barbie was the top-grossing film of 2023, largely due to its strong social media engagement. In fact, in a Statista survey, more than half of the respondents claimed that they primarily learned about the movie through social media. 

• Generate buzz: The Barbie social media marketing campaign is a true masterclass in creating viral content. It clearly demonstrates that, when utilized effectively, social media can be an incredibly powerful tool for bringing a brand, product or film into the spotlight. Your marketing message becomes more powerful when it consistently appears in the feeds of your target audience .   

🤔 Are you looking to be in the public eye consistently?   

To be the talk of the “global town,” you need to be steady with your posting and ensure that your content is delivered at the ideal times. However, keeping track of all your social media posts and activities can often seem like a Herculean task. Though, there is a quick way to simplify all that manual heavy lifting.  

Sprinklr's Social Media Publishing & Engagement tool helps you streamline the organization, planning and execution of your social media content. With it, you can:

👁️ Get a complete overview of your posts, events and campaigns  

📚 Publish across 30+ channels at the same time 

🖼️ View comments, mentions and messages across channels in a single space 

🔎 Monitor the performance of your paid, owned and earned media in one single dashboard 

Pro Tip💡: Ensure your top content receives the exposure it merits. Influencers offer a distinctive viewpoint that authentically resonates with customers and potentially influences purchasing decisions. As such, using a tool like Sprinklr's AI-led Influencer Marketing Platform can help you find the right influencers across multiple demographics. It identifies the best-suited influencers to maximize the reach, authenticity and impact of your marketing message, and it also gives deeper insights into their performance. 

• Innovate to resonate: Barbie's marketing campaign showcased various inventive strategies to captivate fans. Due to the interactive experiences offered through the film's promotion, audiences remained eagerly anticipating its release. For instance, typing "Barbie," "Margot Robbie," "Ryan Gosling" or "Greta Gerwig" into Google search triggered a magical makeover and turned the screen pink with sparkles, thrilling fans worldwide. 
• Be inclusive: The Barbie campaign embraced inclusivity by appealing to various audiences. By featuring diverse characters and themes in its marketing materials, Barbie made audiences feel represented and included in the brand's narrative. The propagation of social media accessibility and inclusivity strengthened Barbie's connection with its fan base and drew new audiences.

Related Read: 10+ Ideas for Social Media Posts That Move the Needle  

#3: Shiseido Japan 

Shiseido Japan is a renowned global beauty and cosmetics company with a rich heritage of combining Eastern aesthetics and Western science. The company has established itself as a leader in the beauty industry and is known for its innovative skincare, makeup and fragrance products.  

Why this campaign?    Historically, Shiseido Japan's makeup marketing teams collaborated with agencies to monitor social media performance. They relied on agency-provided reports or manually checked each social account, which prevented them from responding quickly to any issues. In 2021, Shiseido Japan decided to overhaul the marketing strategies for makeup brands like MAQuillAGE, Snow Beauty, INTEGRATE and MAJOLICA MAJORCA. 

What did they do?    Shiseido adopted Sprinklr's Unified-CXM platform to transform its marketing teams. It helped them collaborate effortlessly by combining tools and data on a single platform.

Pro Tip💡: Automate and manage workflows , such as campaign deployment and reporting, to free up time for teams to focus on strategic initiatives. Look for platforms or software solutions that offer features such as campaign scheduling, account addition via emails and customizable dashboards. Modern platforms like Sprinklr Social and Sprinklr Insights are purpose-built for this task, with all the aforementioned offerings and more. They unify channels, tools and data, providing a comprehensive view of the customer.

How did it help?    Sprinklr significantly enhanced Shiseido's social media management by centralizing all media accounts on a single platform. It allowed the marketing teams to access real-time data through customized dashboards and generate automated, shareable reports, enabling better social media measurement. This resulted in a 244% increase in overall owned media account performance in 2022.  

The shift to Sprinklr also facilitated a new data-driven culture for social campaigns, moving away from guesswork. Teams could validate ideas, check for viral potential using past trends and analyze campaign performance against social media KPIs (key performance indicators), making the necessary adjustments for future campaigns. This structured approach resulted in better campaign outcomes. Mentions of Shiseido's makeup brands on social media through user-generated content (UGC) increased by 406% in 2022, when compared to 2021. 

• Facilitate data-driven decision-making: Like Shiseido, consider investing in technologies like Sprinklr's Unified-CXM platform . It will transform your decision-making processes by providing real-time actionable insights by analyzing data collected across multiple channels.  
• Prioritize social listening : Make sure you prioritize social listening to analyze audience sentiment, track trends and identify opportunities for brand engagement. By actively monitoring social media conversations, engaging with your audience and leveraging UGC, you can foster authentic connections with your customers. 
• Customize your dashboards: Tailor your social media analytics tools to your unique needs, just like Shiseido did with Sprinklr's dashboards. By customizing metrics and dashboards to track social media KPIs relevant to your business goals, you'll gain deeper insights into your social performance. 

Read More : Sprinklr’s Social Media Case Study on Shiseido Japan

How do you write a social media growth case study?  

Now that we’ve examined some great social media case studies, let's explore how you can create one. Here’s how you can structure and populate one on your own:  

1. Introduction 

• Introduce the brand: Start by briefly introducing the brand whose social media growth you are examining. 
• State the purpose: Explain the purpose of the case study and what you aim to demonstrate. 

2. Background

• Ground zero: Describe the initial state of the brand's social media presence. Include metrics like follower count, engagement rates and notable challenges. 
• Objectives: Clearly outline the brand's goals for social media growth. These could be increasing followers, boosting engagement or enhancing brand awareness . 

3. Strategy 

• Target audience: Define the target audience for social media efforts. 
• Platform selection: Explain which social media platforms were chosen and why. 
• Content strategy: Explain what types of content were created and their messaging. 
• Campaigns: Describe the brand’s advertising campaigns, apart from influencer partnerships, paid advertising or user-generated content campaigns. 

4. Implementation 

• Timeline: Provide a timeline of key activities and milestones. 
• Resources: Discuss the resources used, including team members, tools and budget. 

5. Metrics 

• Growth metrics: Present metrics that indicate growth, such as changes in follower count, engagement rates, reach and impressions . 
• Additional metrics: Include other relevant metrics like click-through rates, conversion rates and social media ROI . 

6. Results 

• Compare and contrast: Compare the initial metrics with the final results to show the growth. 
• Achievements: Highlight major achievements and milestones reached during the campaign. 

7. Solutions 

• Obstacles: Discuss any challenges faced during the campaign. 
• Fixes: Explain how these challenges were addressed and what solutions were implemented. 

8. Takeaways 

• Successful strategies: Summarize the social media growth strategies that worked well and contributed to success. 
• Lessons learned: Reflect on what could have been done differently and any lessons learned for future campaigns. 

9. Conclusion 

• Summary: Recap the main points and results of the case study. 
• The future: Briefly mention any next steps for the brand’s social media strategy. 

10. Visual elements  

• Charts and graphs: Use reporting charts and graphs to visually represent the data and growth metrics. 
• Screenshots: Include screenshots of successful posts, campaign highlights and other visual elements.  

Final thoughts  

These social media case studies showcase innovative strategies for capturing audience attention and driving significant engagement. However, this is easier said than done. The challenge for large brands in social media marketing lies in effectively leveraging data insights and managing multiple channels. 

Sprinklr Social can help you with this. It offers real-time actionable data insights, streamlines social media management and enables personalized engagement with audiences. The platform is trusted by global companies for its in-depth listening, unmatched channel coverage of 30+ digital channels and enterprise-grade configurability. This is so you’re always in the know of every customer interaction. The best part? It automates your end-to-end social media management with the industry-leading Sprinklr AI and accelerates content creation with top-tier generative AI capabilities. 

Keen to find out how this software can elevate your social media marketing efforts?  

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• Published: 02 September 2024

A streamlined culturomics case study for the human gut microbiota research

• Hyunjoon Park 1   na1 ,
• Soyoung Yeo 1 , 2   na1 ,
• Chang Beom Ryu 3 &
• Chul Sung Huh 1 , 4  

Scientific Reports volume  14 , Article number:  20361 ( 2024 ) Cite this article

• Microbial communities
• Microbial ecology
• Microbiology

Bacterial culturomics is a set of techniques to isolate and identify live bacteria from complex microbial ecosystems. Despite its potential to revolutionize microbiome research, bacterial culturomics has significant challenges when applied to human gut microbiome studies due to its labor-intensive nature. Therefore, we established a streamlined culturomics approach with minimal culture conditions for stool sample preincubation. We evaluated the suitability of non-selective medium candidates for maintaining microbial diversity during a 30-day incubation period based on 16S rRNA gene amplicon analysis. Subsequently, we applied four culture conditions (two preincubation media under an aerobic/anaerobic atmosphere) to isolate gut bacteria on a large scale from eight stool samples of healthy humans. We identified 8141 isolates, classified into 263 bacterial species, including 12 novel species candidates. Our analysis of cultivation efficiency revealed that seven days of aerobic and ten days of anaerobic incubation captured approximately 91% and 95% of the identified species within each condition, respectively, with a synergistic effect confirmed when selected preincubation media were combined. Moreover, our culturomics findings expanded the coverage of gut microbial diversity compared to 16S rRNA gene amplicon sequencing results. In conclusion, this study demonstrated the potential of a streamlined culturomics approach for the efficient isolation of gut bacteria from human stool samples. This approach might pave the way for the broader adoption of culturomics in human gut microbiome studies, ultimately leading to a more comprehensive understanding of this complex microbial ecosystem.

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Introduction.

The isolation and identification of all bacteria within a specific microbial ecosystem are challenging as they require extensive culturing conditions and boundless labor and time 1 . Next-generation sequencing (NGS) has emerged as an effective strategy for determining microbial communities without the need for cultivation work, playing a significant role in advancing human gut microbiome research over the past two decades 2 , 3 . Notably, 16S rRNA gene amplicon sequencing offers low-cost and high-throughput advantages, making it a valuable tool for analyzing numerous samples 4 , 5 . Additionally, shotgun metagenomic sequencing provides high resolution at the species level and even enables the prediction of unknown bacteria’s taxonomic position and function 6 , 7 . However, culture-independent methods have limitations, including the inability to cultivate and directly study bacteria assembling incomplete sequences, binning errors, and the failure to capture mobile genetic elements 8 , 9 . Furthermore, it is essential to note that since NGS technology relies on genetic information to predict bacterial characteristics and functions, experimental observation and verification are necessary 10 . Therefore, the limitations inherent in these genome-based approaches should be considered to achieve a robust analysis of the human gut microbiome.

Bacterial culturomics is a high-throughput-oriented cultivation strategy aiming to isolate, cultivate, and identify large-scale living bacterial strains or species from environments or tissue samples, such as the human intestine 11 . The resulting comprehensive bacterial culture collection is valuable for analyzing viable microbial composition within an ecosystem. This approach enables experimental verification of bacterial characteristics and interactions at the strain level, along with obtaining complete genomes of individual microorganisms, thus establishing a high-accuracy reference genome database 12 . Previous culturomics studies have shown its potential to address or complement the limitations of conventional cultivation methods and 16S rRNA gene amplicon/shotgun metagenome sequencing 13 , 14 . However, large-scale bacterial cultivation and identification still demand significant resources and workload 15 . The number of samples and culture conditions are critical factors in determining project scale 16 , while predicting and optimizing the most efficient culture conditions for specific microbial ecosystems remains a formidable challenge 17 , 18 .

In this study, we aimed to establish a streamlined culturomics approach with limited culture conditions. We evaluated three non-selective media based on their ability to maintain microbial diversity for a 30-day incubation period. In addition, we confirmed the efficiency and effectiveness of the simplified culture conditions by isolating bacteria in a large-scale. We presented the relationship between overall bacterial species diversity, the number of isolates and samples, and the isolation efficiency based on the preincubation period. Furthermore, we compared the culturomics results with 16S rRNA gene amplicon sequencing data to demonstrate the complementarity of both approaches and their implications for human gut microbiome research. The findings from our streamlined culturomics approach with minimal culture conditions not only showed the significant diversity of isolated species but also highlighted the practical applications of this approach in understanding the human gut microbiome.

Study design and ethical approval

This study involved collecting stool samples from healthy individuals. To evaluate the preincubation media, stool samples ( n  = 6) were obtained from three individuals at two different time points, with approval from the Institutional Review Board of Seoul National University (IRB no. 2104/003-014). For the culturomics study, stool samples ( n  = 8) were collected from eight healthy individuals under approval from the Institutional Review Board of Soon Chun Hyang University Bucheon Hospital (IRB no. 2021–01-028–002). The protocols were conducted in accordance with the guidelines and regulations approved by each ethics committee. All participants provided informed and signed consent, with no biological samples collected from them other than fecal matter.

Sample collection and processing

The selection criteria for donors in this study included individuals who had resided in South Korea, had no medical history of metabolic or gastrointestinal diseases, and had abstained from fermented milk or probiotics for no less than three weeks prior to sample collection. Following the stool collection protocol of the Human Microbiome Project 19 , the donors were advised to store their samples immediately after defecation in a vacuum refrigerated container with a GasPak EZ anaerobe container system (Becton Dickinson, MD, USA) at 4 °C. The samples were transported to a laboratory within 24 h. All samples were processed in an anaerobic chamber containing 5% CO 2 , 10% H 2 , and 85% N 2 . The specimens were homogenized with sterilized saline and centrifuged at 15,000× g for 15 min at 4 °C. The supernatants were discarded, and the pellets were resuspended in saline to a 0.25 g/L concentration and immediately used for preincubation. The remaining samples were stored at − 80 °C for DNA extraction later.

Preincubation of gut microbiota in vitro

The fecal suspension was mixed in 1–2 mm polysaccharide gel beads composed of 2.5% gellan gum, 0.25% xanthan gum, and 0.2% sodium citrate (w/v, Sigma-Aldrich, MO, USA) for long-term cultivation 20 . These fecal gel beads were inoculated at a final concentration of 5 g of feces/L into a preincubation medium that was supplemented with 10% (v/v) of 0.22 μm-filtered rumen fluid and 10% (v/v) of defibrinated sheep blood. Rumen fluid supplementation was used to enhance the growth and diversity of bacteria by mimicking the gut environment 21 . The preparation process of rumen fluid and its ingredients are described in Supplementary Fig. S1 and Table S1 . To evaluate the effectiveness of the preincubation medium, gut microbiota medium (GMM), blood culture tubes (BCT; BACT/ALERT FAN plus culture bottles, BioMérieux, Marcy l’Etoile, France), and modified Gifu Anaerobic Medium (mGAM; Nissui Pharmaceutical, Tokyo, Japan) were used. Supplementary Table S2 describes the detailed constituents of each medium. Preincubation was conducted at 37 °C in an anaerobic atmosphere. The culture solution was collected every five days during a 30-day incubation period to extract DNA for 16S rRNA gene amplicon sequencing. Samples without preincubation were designated as day 0 or ‘initial.’

A streamlined bacterial culturomics approach

Our culturomics workflow is described in Fig.  1 . Preincubation under anaerobic conditions was conducted at 37 °C in BCT and mGAM, supplemented with rumen fluid and sheep blood. Additionally, the same process was carried out under aerobic conditions to isolate aerotolerant and obligate aerobes simultaneously. The cultured medium was collected at regular intervals for 30 days, and then spread onto mGAM agar plates without any supplement after serial dilution in saline. We used mGAM as the sole medium for colony isolation and pure culture to enhance culturomics accessibility. To mitigate the number of species that become extinct due to dilution, we implemented a strategy to reduce the dilution factor by expanding the spreading area via a 500 cm 2 square dish. The colonies were preferentially picked based on variations in colony morphology, as determined by the experimenter, with the remaining colonies being chosen randomly, which resulted in an average of 74 and 93 colonies for each plate collected from aerobic and anaerobic conditions, respectively. The isolates were identified using MALDI-TOF MS on a Biotyper Sirius system (Bruker Daltonics, Bremen, Germany). The spectra were compared with the MBT 8,468 MSPs library to obtain a score value for identification. Cases with score values below 1.69 were considered bacteria that did not have sufficient spectra or were not included in the library, such as new species. Some isolates with low scores were identified with 16S rRNA gene sequencing. Genomic DNA was extracted using Chelex 100 resin (Bio-Rad Laboratories, CA, USA), and the 16S rRNA gene was amplified by PCR using primers 27F (5′-AGAGTTTGATCCTGGCTCAG-3′) and 1492R (5′-GGTTACCTTGTTACGACTT-3′), yielding over 1,350 bp of 16S rRNA gene. Sequencing was conducted using an ABI PRISM 3730XL DNA analyzer (Applied Biosystems, CA, USA) at Solgent (Daejeon, South Korea). Strains with less than 98.65% sequence similarity to the phylogenetically closest type strain in the 16S rRNA gene were classified as potential new species. All identified isolates were cryopreserved in 10% glycerol at − 80 °C for long-term storage.

Streamlined culturomics workflow. Blood culture tubes (BCT; BACT/ALERT FAN plus culture bottles, BioMérieux, Marcy l’Etoile, France) for aerobic and anaerobic cultivation were FA PLUS (Ref. 410,851) and FN PLUS (Ref. 410,852), respectively. mGAM, modified Gifu anaerobic medium. Created with BioRender.com .

16S rRNA gene amplicon sequence-based analysis

The 16S rRNA gene amplicon was sequenced, targeting the V3–V4 regions using the Illumina MiSeq system (Illumina Inc., CA, USA) by Macrogen (Seoul, South Korea). Genomic DNA from the fecal suspension was extracted using a ZymoBIOMICS™ DNA Miniprep Kit (Zymo Research, CA, USA). Templates were prepared using the Illumina Nextera XT protocol with two amplification cycles and two clean-ups with AMPure XP beads (Beckman Coulter, Inc., CA, USA) 22 . Sequence data was processed in the Integrated Microbial Next-Generation Sequencing pipeline 23 , demultiplexing sequences with a minimum read length of 200 bp. Before conducting sequence pairing, we trimmed the five bp-length of each side of the sequences. Clustering zero-radius operational taxonomic units (zOTUs) with a 97% sequence similarity was performed using USEARCH v.11.0. The minimum relative abundance of zOTU cutoff was set to 0.001. Sequence alignment and taxonomic classification were conducted based on SILVA (release 128) using the RDP classifier 24 . Processed files were imported into R and analyzed using the Rhea script 25 . Microbial alpha diversity was calculated after filtering based on a cutoff of a relative abundance of 0.25% in each community, which has been suggested as an “effective” portion of the community 25 , 26 . The neutral community model (NCM) was predicted within the phyloseq package 27 , 28 .

Statistical analysis and visualization

Statistical significance between the groups was calculated using one-way ANOVA and the Kruskal–Wallis test. In beta diversity analysis, permutational multivariate analysis of variance and permutational multivariate analysis of dispersion were used to determine the significance of the group distribution. Graphical visualization was performed in GraphPad Prism v.9.4.1, except for Venn diagrams, which were generated using Venny v.2.1 29 .

Evaluation of base medium for human stool preincubation

The primary purpose of preincubation is to distribute the workload while maintaining bacterial diversity for an extended period. We used 16S rRNA gene amplicon sequencing to evaluate non-selective media, BCT, mGAM, and GMM, as base media candidates for preincubation. As a result, BCT and mGAM exhibited significantly higher effective microbial richness compared to GMM (Fig.  2 a). In addition, BCT and mGAM showed significantly higher Shannon effective number of species compared to initial fecal samples and GMM (Fig.  2 a). In the BCT and mGAM groups, effective microbial richness maintained a constant level throughout the incubation period. In contrast, the Shannon effective index showed a tendency to increase rapidly until about ten days of incubation (Fig.  2 b). At the phylum level, BCT and mGAM showed Bacillota and Bacteroidota relative abundances similar to initial fecal samples, while GMM resulted in significant Bacillota dominance (Fig.  2 c). Pseudomonadota populations increased during cultivation in BCT and mGAM. A 30-day preincubation did not induce the expansion of Actinomycetota in any tested media. We divided the incubation period into three sections and analyzed population changes at the phylum level (Fig.  2 d). From the early incubation stage (Sect. 1), Bacillota dominance was observed in GMM, while Pseudomonadota population increased in BCT and mGAM. Analysis of zOTU occurrence frequency and their relative abundances using the NCM revealed rapid convergence toward a neutral process in BCT and mGAM in Sect. 1, while GMM exhibited a pattern consistent with a niche-based process and did not achieve the same level of fitness as the NCM observed for BCT and mGAM (Fig.  2 e). Upon analyzing the phylogenetic distance in microbial communities between media during preincubation, BCT and mGAM groups clustered similarly to the initial gut microbiota, whereas GMM formed a distinct cluster (Fig.  2 f). In addition, microbial compositions in BCT and mGAM were changed from the initial samples as the incubation period increased, with mGAM showing more pronounced shift than BCT (Fig.  2 g). Overall, GMM exhibited a selective influence on microbial populations during the 30-day human stool preincubation period, while BCT and mGAM showed a gradual change in microbial composition from the initial fecal microbiota, accompanied by an increase in microbial diversity. Furthermore, to determine whether the combined use of BCT and mGAM could be advantageous for obtaining microbial diversity, we compared bacterial composition detected in each medium for 30 days (Fig.  3 ). The proportion of common zOTUs was 40.8% in BCT and 37.5% in mGAM during the entire cultivation period (Fig.  3 a, b). BCT showed higher coverage of initial fecal zOTUs than mGAM (97.1% vs. 92.8%). Notably, the proportion of unique zOTUs was highest in the early stage (5 and 10 days of cultivation) in both media (4.6% in BCT and 5.7% in mGAM). During a 30-day incubation period, 14.6% and 12.7% of unique zOTUs were detected in BCT and mGAM, respectively (Fig.  3 c). These findings suggest that using both media in parallel allows for acquiring a wider variety of bacteria than using each medium alone.

Comparison of bacterial diversity estimated by 16s rRNA gene amplicon sequence-base analysis in three nonselective media. Effective microbial richness and Shannon effective number of species ( a ) across media and ( b ) by incubation days. Relative abundances (%) of major phyla ( c ) across media and ( d ) according to the period of incubation divided into three sections: Sect. 1 (days 5 and 10), Sect. 2 (days 15 and 20), and Sect. 3 (days 25 and 30). ( e ) Predicted R-Squared values across the incubation period (initial and three sections), showing fitness to the NCM. Group distribution based on phylogenetical differences between ( f ) media and ( g ) by the cultivated period of each medium from initial stool samples. ( a, c ) Statistical significance between the groups was calculated using one-way ANOVA with the Kruskal–Wallis test. ( f, g ) The significance of the group distribution was determined by permutational multivariate analysis of variance (PERMANOVA) and permutational multivariate analysis of dispersion (PERMDISP).

Venn diagrams showing unique and shared OTUs. Venn diagrams for ( a ) BCT and ( b ) mGAM showing unique and shared OTUs across three sections of cultivation period. ( c ) Venn diagram comparing the OTUs of the initial stool sample with those recovered in both BCT and mGAM media.

A streamlined culturomics approach for investigating human gut microbiota

Using the streamlined culturomics approach, we obtained 11,107 isolates from stool samples of eight healthy individuals. Among these, 8141 isolates were identified, resulting in an average of 66 species per sample, comprising 27 aerotolerant and 39 non-aerotolerant species per sample (Fig.  4 a). On average, 19 unique species were isolated from each donor, with an additional average of two potential novel species per sample. Notably, when frequency is defined as the number of donors from which each species was isolated, the number of species with a frequency of one was the highest at 153 (Fig.  4 b), suggesting the advantages of more sample numbers for isolating bacterial diversity in this culturomics method. However, the number of identified isolates per individual, which varied from as few as 710 to as many as 1,629 (Fig.  4 c), did not significantly correlate with cultured species diversity (Pearson correlation coefficient = 0.36, P  = 0.38). The identified species were classified into Actinomycetota, Bacillota, Bacteroidota, and Pseudomonadota , which are known as the major phyla in the human intestine, including Fusobacteriota . Among these, Bacillota were the most predominant species across all identified subjects (Fig.  4 d). Among the 263 species in the culture collection, 119 aerotolerant species were identified, including 74 unique species and one novel species candidate (Fig.  4 e). The 144 non-aerotolerant species included 69 unique species, along with 11 novel species candidates (Fig.  4 f). Detailed information on potential novel species isolated in this study is provided in Table 1 . Subject information (age and gender) and detailed isolation numbers in each sample were described in Supplementary Table S3 . Cultured bacterial species from healthy individuals were listed in Supplementary Table S4 .

Cultured isolates and species information. ( a ) Number of species classified into aerotolerant, non-aerotolerant, unique species isolated from only one donor, and novel species candidates. ( b ) Number of species based on frequency, which is the number of donors from which each species was isolated. ( c ) Relationship between the number of species and the number of isolates in each subject. ( d ) Number of species in each donor at the phylum level. ( e ) Classification of cultured aerotolerant species into unique, non-unique, and unique and novel species. ( f ) Classification of cultured non-aerotolerant species into unique, non-unique, novel, and unique and novel species.

Stool preincubation conditions using BCT and mGAM provided advantages, which are scattering isolation workload and obtaining a wider range of species compared to direct isolation from stool samples without preincubation (Fig.  5 ). Notable was the enhancement of isolated species diversity, especially under anaerobic conditions (Fig.  5 a). When considering the overall efficiency of our cultivation conditions, cultivation for seven days under aerobic conditions and ten days under anaerobic conditions was the point at which we could obtain approximately 91% (91/100) and 95% (203/213) of the species identified in each condition, respectively (Fig.  5 b). Notably, ten days of preincubation under anaerobic condition enabled to obtain twice the number of species (105 vs. 203) compared to the number of species obtained without preincubation. Moreover, more various species could be isolated at that point than when each medium was used alone (168 species in BCT, 163 species in mGAM). Nevertheless, some species were isolated after ten days of preincubation, and detailed isolation profiles of identified bacteria, based on preincubation medium and period, were presented in Supplementary Fig. S2 and S3 . Moreover, a synergistic effect of species diversity expansion using BCT and mGAM was confirmed, enhancing species isolation by 36% and 50.7% under aerobic and anaerobic conditions, respectively (Fig.  5 c). The cumulative bacterial species diversity showed a significant positive correlation with the cumulative number of samples (Pearson correlation coefficient = 0.98, P  < 0.0001) (Fig.  5 d).

Impact of streamlined culturomics approach on enhancing cultured bacterial species diversity. ( a ) Effect of preincubation on bacterial species diversity. The statistical significance between the groups was calculated using one-way ANOVA with the Kruskal–Wallis test. ( b ) Percentage of total species isolated according to preincubation days. ( c ) Venn diagrams showing the unique and shared species isolated from initial stool samples directly and after preincubation in BCT and mGAM media, respectively. ( d ) Relationship between cumulative sample number and cumulative species count.

In addition, we compared the culturomics data with 16S rRNA gene amplicon sequence-based analysis results. Although the effective microbial richness level estimated in a culture-independent method was consistent across subjects (Fig.  6 a), the diversity of cultured species varied among individuals (Fig.  6 b). Nonetheless, a comparison of the genera identified in two methods revealed that a substantial proportion of the genera were uniquely identified by each method (Fig.  6 c).

Comparison of microbial diversity between streamlined culturomics and 16S rRNA gene amplicon analysis results. ( a ) Effective microbial richness in 16S rRNA gene amplicon-sequence-based analysis. ( b ) Cultured species diversity in culturomics. ( c ) Proportion of genera (%) found in each approach.

Culture-independent techniques have significantly expanded our understanding of the human gut microbiome. However, recent emphasis has highlighted the necessity of complementing genome-based findings with culture-dependent studies and experimental validation 10 , 11 , 30 , 31 , 32 . High-throughput microbial identification methods, such as MALDI-TOF MS, have notably improved efficiency in culture-based bacterial ecology research 11 . However, the culture-dependent approach remains labor-intensive, posing challenges for gut microbiome research 15 . Hence, efforts are needed to reduce workload and establish streamlined culture conditions tailored to gut-derived samples. Moreover, sharing such efforts among researchers could contribute to lowering the barrier to entry for researchers interested in culture-based studies. In this context, we simplified culture conditions and evaluated the practical outcomes in culturomics.

We applied stool preincubation as an effective strategy for isolating diverse microorganisms by distributing workload 11 . The main factors considered for the preincubation medium were as follows. First, the medium should be non-selective to support the growth of a wide range of gut bacteria. Second, utilizing existing commercial media was preferable to enhance convenience and reproducibility. Although BCT was initially designed for microbial cultivation in clinical blood samples, it has been used in previous culturomics studies due to its suitability for a broad range of microbial cultures 15 , 21 , 33 . In addition, mGAM is a commercial medium initially developed for cultivating anaerobic bacteria and has demonstrated high efficacy in recovering gut microbiota 18 , 34 , 35 . Despite being a noncommercial medium, we compared GMM to other media as it has been widely used in gut microbiome research 18 , 36 , 37 , 38 . Consequently, GMM induced a high dominance of Bacillota , while BCT and mGAM maintained microbial diversity during a 30-day incubation period (Fig.  2 ). Additionally, the combined use of BCT and mGAM demonstrated a synergistic effect, particularly effective in isolating various species under anaerobic conditions (Figs.  3 , Fig.  5 b,c). These findings demonstrate the potential of BCT and mGAM in culturomics, focusing on gut-derived samples from healthy individuals where anaerobic bacteria predominate 39 .

In this study, we immobilized gut microbiota within gel beads consisting of gellan and xanthan gums 20 . This method was developed to sustain bacterial diversity in long-term cultures in bioreactors. The main advantage of immobilization was preserving slow-growing or temperature-sensitive bacteria (e.g., Bifidobacterium spp.), which have limited ability to compete for nutrients. By incorporating this procedure into culturomics, we aimed to maintain bacterial diversity during preincubation. For instance, we observed the recovery of some Bifidobacterium species even after seven days of preincubation (Supplementary Fig. S3 ). This result could be enhanced by evaluating the effects of immobilization under our conditions in the future.

Moreover, we found that preincubation up to ten days efficiently facilitated bacterial isolation (Fig.  5 b). During the early stages of preincubation, we were able to isolate most novel species candidates and low-abundance gut bacteria (Supplementary Figs. S2 and S3 ) 40 . Commercial or clinical species of interest, such as next-generation probiotics, were also isolated within ten days of cultivation (Supplementary Figs. S2 and S3 ). However, the task of colony picking is arbitrary, and there is no standardized method to determine the colonies for picking the specific or various species. Therefore, researchers must rely on their experience, such as visible morphological differences, which is one of the significant limitations of the culture-dependent approach. Our results demonstrated that isolating more colonies does not necessarily result in obtaining more diverse species in individual samples (Fig.  4 c). Consistent with previous studies 16 , we found a significant positive correlation between the number of samples and overall microbial species diversity (Fig.  5 d). Therefore, while applying multiple cultivation conditions may be appropriate if the goal is to isolate a large number of microbial species from a single sample, increasing the number of samples is a more favorable strategy for capturing overall microbial species diversity, as demonstrated in our study with minimal conditions. Additionally, sample-specific characteristics can play a significant role in determining culture conditions for human gut-derived samples. There is variation in results due to individual differences in gut microbiota (Supplementary Fig. S4 ), which directly affects the outcomes of the culturomics approach.

Culture-dependent and culture-independent approaches can provide complementary perspectives on the human gut microbiota. This study compared culturomics results and 16S rRNA gene amplicon analysis results. The 16S rRNA genomic analysis provides information on species diversity based on sequence-based zOTUs, while culturomics reveals the diversity of cultivable bacterial species under the given culture conditions (Fig.  6 a,b). Interestingly, a substantial proportion of genera were found only by either approach (Fig.  6 c). This highlights each approach’s unique strengths and limitations. The culture-dependent approach offers information that the culture-independent approach cannot provide, such as not-yet-cultured species, bacterial viability, and low-abundance bacteria 12 . However, the culture-dependent approach is limited to providing information only on culturable bacteria under the applied culture conditions. Bacteria that require specific cultivation conditions or cannot be recovered under cultivation conditions may be missed. Therefore, both approaches are complementary to each other, and their strengths can be leveraged to gain a more comprehensive understanding of the gut microbiome.

One limitation of this study is that we could not quantify the total viable microbial population of the eight stool samples. While our culturomics results were compared with the 16S rRNA gene amplicon sequencing data (Fig.  6 c), DNA-based analysis does not guarantee the viability of microorganisms. This led to a significant challenge in quantifying the isolation efficiency of diverse gut bacteria from the proposed simplified cultivation conditions. Using flow cytometry to distinguish live and dead cells could be an alternative approach to address this limitation 41 .

We introduced a streamlined culturomics approach with preincubation to investigate the human gut microbiome. This model distributed workload and reduced overall culturing labor by applying preincubation and a minimal base media, resulting in a diverse collection of 263 species from a large number of bacterial isolates. To further broaden species diversity, culture conditions can be modified by adding growth factors, incorporating antibiotics with different spectrums, or applying physical interventions. However, a high number of factors and parameters can be involved in culture conditions, and increasing the number of variables directly decreases work efficiency. Sharing culturomics research and cases with details is essential to overcoming this problem. Streamlining and optimizing culturomics protocols, developing automated cultivation technologies, and integrating machine learning can further broaden culturomics accessibility to a broader range of researchers 16 , 17 , 42 . Employing these strategies alongside culture-independent methods can yield novel insights into the human gut microbiome and propel microbiome research advancements.

Data availability

The 16S rRNA gene amplicon sequences of preincubated stool samples were deposited in the GenBank SRA database (PRJNA1094612). The 16S rRNA gene amplicon sequences of stool samples from healthy individuals in a culturomics study were deposited in GenBank SRA database (PRJNA975692). The 16S rRNA gene of potential novel species were deposited in GenBank (OP753574, OP753719, OP753729, OP753730, OP753734–OP753736, OP753744, OP753822, OP762691, OP763639, and OP811536). Draft genome sequences of potential novel species were deposited in the SRA database (SRR28033821–SRR28033827, SRR28033829, SRR28033830, SRR28033832, SRR28033834, SRR28033835) under the BioProject no. PRJNA975692 and BioSample no. SAMN39987472, SAMN39987473, SAMN39987475–SAMN39987481, SAMN39987483, SAMN39987485, and SAMN39987486.

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Acknowledgements

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2021R1A6A3A13038425 and 2021R1I1A1A01057496). We also thank Doctor Tae Kyu Lee and Yu Min Han for their support in recruiting volunteers.

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These authors contributed equally: Hyunjoon Park and Soyoung Yeo.

Authors and Affiliations

Research Institute of Eco-Friendly Livestock Science, Institute of Green-Bio Science and Technology, Seoul National University, Pyeongchang, 25354, South Korea

Hyunjoon Park, Soyoung Yeo & Chul Sung Huh

Department of Agricultural Biotechnology, College of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, South Korea

Soyoung Yeo

Department of Internal Medicine, Digestive Disease Center and Research Institute, Soon Chun Hyang University School of Medicine, Bucheon, 14584, South Korea

Chang Beom Ryu

Graduate School of International Agricultural Technology, Seoul National University, Pyeongchang, 25354, South Korea

Chul Sung Huh

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HP and SY conceived and designed the study. SY and CBR managed the approval process related to the IRB and collected the stool samples. HP and SY performed the culturomics experiments, 16S rRNA gene amplicon sequence-based analysis, and interpreted the data and wrote the manuscript. HP, SY, and CSH reviewed and finalized the manuscript. All authors have read and approved the final version of the manuscript.

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Correspondence to Hyunjoon Park or Chul Sung Huh .

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Park, H., Yeo, S., Ryu, C.B. et al. A streamlined culturomics case study for the human gut microbiota research. Sci Rep 14 , 20361 (2024). https://doi.org/10.1038/s41598-024-71370-x

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