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This paper applies a posthumanist lens, informed by the work of Hollett and Ehret and of Ingold, to consider children's playful affective entanglements with the human and the more-than-human during fluctuating periods of social distancing in the COVID-19 pandemic. Through this refracting theoretical lens, I (re)examine a selection of play and leisure experiences of an emergent subject -- the pandemic child -- during the national U.K. lockdowns of 2020 and 2021. Via a national online, qualitative survey, children and families were invited to share examples of their play and leisure experiences during the pandemic to the Play Observatory, a U.K. research project that ran from 2020 to 2022. These survey contributions provide portals through which to (re)consider children's connection, participation and emergent becomings, attuning analytical attention towards children's affective place-event entanglements during pandemic times. A posthumanist (re)telling of children's Play Observatory contributions demonstrates how children were imbricated in constantly emergent affects, meanings, becomings and potentialities, that waxed and waned, intensified and dissipated, transcending the physical locus of lockdown. This paper contributes to the field by unsettling discourses of rupture, loss and deficit that have tended to dominate public and policy discussions of children's experience of lockdowns. It contributes to ongoing, collective attempts to interrupt policy responses to the pandemic that centre individualising practices of curriculum 'catch-up' and fail to invite into the debate consideration of the potential richness of experiences and events encountered by the pandemic child outside of the strictures of normal schooling and curriculum.

This paper presents an overview of the arts-based methodology used in a research project that aimed to explore the impact of the lived experiences of racism on 10- and 11-year-old children in the United Kingdom. The research responds to the relative lack of literature concerning the racialised experiences of young children. We discuss how we developed the arts-based method of body mapping as an ethical approach to foregrounding the children's voices. We consider that this approach contributes to knowledge and understanding about exploring the nuanced and complex relationship between the children's external worlds and their internal feelings, and supporting them to process and communicate this. We suggest that the method presented is transferable, and present our ethically engaged, arts-based planning framework that can be used if others wish to adopt this way of working.

Background: The most impactful research on pediatric type 1 diabetes (T1D) remains unknown. Objective: We aimed to evaluate the characteristics and impact of the 100 most-cited articles on pediatric T1D. Materials and Methods: Using a predefined bibliometric strategy, the Scopus database was searched for high-cited papers (HCPs) published from 2001 to 2020. Articles were evaluated for data on the publication year, countries, authors, journals, topics, and types. Social network analysis was performed to visualize the interaction among countries, organizations, and authors using VOSviewer software. Results: The top 100 HCPs received 390 to 4634 citations, averaging 773.5 citations per paper (CPP). The funded HCPs (n = 50) had a higher impact (CPP 791.5). The majority of HCPs (n = 83) were collaborative. Classifying by research type, 65 studies were clinical (n = 65), risk factors (n = 27), epidemiology (n = 26), pathophysiology (n = 16), treatment outcome (n = 13), genetics (n = 12), complications (n = 3), quality of life (n = 2), and prognosis (n = 1). The number of authors involved was 1,101, affiliated with 545 organizations in 27 countries; the USA (n = 64) and the UK (n = 24) were the most productive countries, whereas Australia and the UK were the most impactful. D.M. Nathan and J.M. Lawrence were the most prolific authors, while P. Raskin and J.M. Lachin were the most impactful. Conclusions: High-income countries such as the USA, UK, and Australia contribute significantly to high-impact pediatric T1D research. Funding and collaboration improve the impact of citations in publications. Less researched areas such as treatment outcomes, genetics, complications, quality of life, and prognosis should be the focus of future research on pediatric T1D. [ABSTRACT FROM AUTHOR]

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases--PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs.

Autobiographical memory supports three functions of remembering past, the self, social, and directive. Previous studies undertaken with adults recalling their play experiences have identified three aspects: the ages between 7 and 12 years are key; there are significant adults involved in the play and location that play talks place. This paper, drawing on an online questionnaire (n = 55), explores adult memories of attending an after-school club as a child between 1990 and 2010. A thematic analysis was undertaken on the responses from the fifty-five participants. The results from this study found adults had predominately positive memories of their time at the after-school club in respect of the activities that were on offer, the supervising adults, the food provided, and friendships made. One negative theme of boredom was identified. This study has implications for professional practice in after-school provision in supporting children's play.

The article focuses on the prevalence and challenges of diagnosing Long Covid Syndrome in children and adolescents, highlighting the varied symptoms, the scarcity of literature on the subject, and the potential risk factors, including age, gender, allergies, and persistent symptoms.

Background: Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges, which require complex packages of multidisciplinary care. Part of the holistic care required includes supporting the families and parents/caregivers. The aim of the wider study was to introduce a new programme ('Ubuntu') to parents/caregivers and healthcare professionals (HCPs) in order to test the feasibility and acceptability of the concept and content, with the goal of potential adaptation for the UK in mind. Data collection and analysis uncovered rich data on caregiving journeys, navigation of health services, and perceived service gaps. This paper focuses solely on these topics. Further papers will report on the feasibility and adaptation data. Methods: Two rounds of semi‐structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six HCPs from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open‐ended questions to explore caregiving journeys, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data‐driven inductive thematic analysis. Results: Three themes were identified that related to the aim of understanding caregivers' experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) The Information Gap and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate. Conclusions: The delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP. [ABSTRACT FROM AUTHOR]

Schools are increasingly positioned as sites for intervening on the bodies and minds of children in the here and now in order to bring about health gain for the future. Public health interventions for schools bring together coalitions of commercial, statutory and philanthropic actors with children and their teachers and carers. Drawing on ethnographic case studies in London, UK, this paper explores two such interventions: one aiming to increase levels of physical activity and one to reduce exposure to air pollution. Both interventions not only evoke care for children's own current and future wellbeing but also fold in imaginaries of collective health futures, which orient and legitimise particular intervention logics and actions. As interventions unfold, children are recruited as monitors of health risks in the present. They are also positioned as risk ambassadors, who will leverage care about unhealthy environments and lifestyles across space, to risky domestic environments, and into imagined health futures. These 'futuring' school‐based interventions open up small alternative spaces in which imaginaries of collective and resistant public health practices emerge. However, in the here and now, children appear to be bearing a disproportionate burden of responsibility, as ambassadors for, and imagined saviours of, public and environmental health. [ABSTRACT FROM AUTHOR]

Background: Oral comprehension difficulties are prevalent in preschool children with language difficulties and are frequently the target of speech and language therapy (SLT) intervention. To support the implementation of research to practice, there is a need to identify effective interventions for this population and to describe their components. To date, reviews of oral comprehension intervention have not used inclusion criteria aligned with common clinical practice, particularly in the United Kingdom. No studies have previously used the Template for Intervention Description and Replication (TIDieR) checklist to describe developmental SLT interventions. Aims: To identify intervention studies effective for oral comprehension in preschool children with language difficulties, using the UK definition of 'preschool' as children under 5 years; to describe the components of these interventions. Method: This followed two phases: (1) an International Prospective Register of Systematic Reviews registered search, which identified 20 systematic reviews; and (2) an exploration of individual studies within these reviews. Seventeen individual studies described effective intervention for children from 1 to 5 years old with language difficulties. Data were extracted from each study against headings from the TIDieR checklist. Findings were analysed and reported using narrative synthesis. Main contribution: A wide variety of rationales, techniques, procedures, settings and intensities were associated with effective intervention. The TIDieR checklist highlighted components that were unreported or under‐described. Conclusions: Studies show that intervention can be effective for improving oral comprehension in preschool children with language difficulties. Analysis of intervention components has relevance to clinical practice and research, and highlights the importance of naturally occurring interactions, cross‐over between oral comprehension and expressive language and the variety in delivery models and dosage. WHAT THIS PAPER ADDS: What is already known on this subject: There is a reported lack of research into interventions developing oral comprehension in children with language difficulties. Intervention checklists such as the Template for Intervention Description and Replication are valuable tools for understanding interventions and supporting the application of research to practice, but none have been used to describe interventions for children with language difficulties. What this study adds: There is evidence that intervention developing oral comprehension in preschool children (using UK definition, those under 5 years) with language difficulties can be effective. Analysing intervention components reveals key points for consideration by clinicians. What are the clinical implications of this work?: Intervention components identified by this study support the implementation of research to practice by highlighting particular areas for consideration by clinicians. For researchers, gaps in reporting demonstrate the need to describe all aspects of intervention to support replication and implementation. [ABSTRACT FROM AUTHOR]

This paper is concerned with the relationship between financial socialization and financial understanding among young children. Measures of financial understanding, appropriate for 4–6 year olds, are developed. Regression analysis is used to relate these measures statistically to a set of financial socialization variables and control variables related to the child, their parents, and their household. Data collected in the nationally representative child and parent 2016 UK Children and Young People's Financial Capability Survey are used. A key empirical finding is that financial understanding is about 10% higher for children whose parents regularly discuss with their children how they spend their money. The analysis suggests that around 20% of parents do not discuss financial matters with their children. It is likely that variation in early‐life financial socialization is important in explaining variation in later‐life financial understanding. Further research is needed to establish if this relationship is causal. [ABSTRACT FROM AUTHOR]

This paper presents an overview of the arts‐based methodology used in a research project that aimed to explore the impact of the lived experiences of racism on 10‐ and 11‐year‐old children in the United Kingdom. The research responds to the relative lack of literature concerning the racialised experiences of young children. We discuss how we developed the arts‐based method of body mapping as an ethical approach to foregrounding the children's voices. We consider that this approach contributes to knowledge and understanding about exploring the nuanced and complex relationship between the children's external worlds and their internal feelings, and supporting them to process and communicate this. We suggest that the method presented is transferable, and present our ethically engaged, arts‐based planning framework that can be used if others wish to adopt this way of working. [ABSTRACT FROM AUTHOR]

Children who use augmentative and alternative communication (AAC) are multimodal communicators. However, in classroom interactions involving children and staff, achieving mutual understanding and accomplishing task-oriented goals by attending to the child's unaided AAC can be challenging. This study draws on excerpts of video recordings of interactions in a classroom for 6–9-year-old children who used AAC to explore how three child participants used the range of multimodal resources available to them – vocal, movement-based, and gestural, technological, temporal – to shape (and to some degree, co-control) classroom interactions. Our research was concerned with examining achievements and problems in establishing a sense of common ground and the realization of child agency. Through detailed multimodal analysis, this paper renders visible different types of practices rejecting a request for clarification, drawing new parties into a conversation, disrupting whole-class teacher talk-through which the children in the study voiced themselves in persuasive ways. It concludes by suggesting that multimodal accounts paint a more nuanced picture of children's resourcefulness and conversational asymmetry that highlights children's agency amidst material, semiotic, and institutional constraints. [ABSTRACT FROM AUTHOR]

This paper focuses on the experiences of children and young people whose parents employ personal assistant(s) (PAs). It describes findings from a UK‐based qualitative doctoral research study which explored the significance, influence and meaning of the PA role in supporting family life. Ten children and young adults aged 8–28 years with lived experience were interviewed face to face as part of this study, which also explored the perspectives of disabled parents and PAs. Findings reveal that PA support can alter both the quality and nature of the parent/child relationship. The provision of personal assistance can support family life and prevent children from becoming 'young carers'; however, it can also create tension, anxiety and even destabilise family life. [ABSTRACT FROM AUTHOR]

In the realm of emergency medicine, the swift adoption of lung ultrasound (LU) has extended from the adult population to encompass pediatric and neonatal intensivists. LU stands out as a bedside, replicable, and cost-effective modality, distinct in its avoidance of ionizing radiations, a departure from conventional chest radiography. Recent years have witnessed a seamless adaptation of experiences gained in the adult setting to the neonatal and pediatric contexts, underscoring the versatility of bedside Point of care ultrasound (POCUS). This adaptability has proven reliable in diagnosing common pathologies and executing therapeutic interventions, including chest drainage, and central and peripheral vascular cannulation. The surge in POCUS utilization among neonatologists and pediatric intensivists is notable, spanning economically advanced Western nations with sophisticated, high-cost intensive care facilities and extending to low-income countries. Within the neonatal and pediatric population, POCUS has become integral for diagnosing and monitoring respiratory infections and chronic and acute lung pathologies. This, in turn, contributes to a reduction in radiation exposure during critical periods of growth, thereby mitigating oncological risks. Collaboration among various national and international societies has led to the formulation of guidelines addressing both the clinical application and regulatory aspects of operator training. Nevertheless, unified guidelines specific to the pediatric and neonatal population remain lacking, in contrast to the well-established protocols for adults. The initial application of POCUS in neonatal and pediatric settings centered on goal-directed echocardiography. Pivotal developments include expert statements in 2011, the UK consensus statement on echocardiography by neonatologists, and European training recommendations. The Australian Clinician Performed Ultrasound (CPU) program has played a crucial role, providing a robust academic curriculum tailored for training neonatologists in cerebral and cardiac assessment. Notably, the European Society for Paediatric and Neonatal Intensive Care (ESPNIC) recently disseminated evidence-based guidelines through an international panel, delineating the use and applications of POCUS in the pediatric setting. These guidelines are pertinent to any professional tending to critically ill children in routine or emergency scenarios. In light of the burgeoning literature, this paper will succinctly elucidate the methodology of performing an LU scan and underscore its primary indications in the neonatal and pediatric patient cohort. The focal points of this review comprise as follows: (1) methodology for conducting a lung ultrasound scan, (2) key ultrasonographic features characterizing a healthy lung, and (3) the functional approach: Lung Ultrasound Score in the child and the neonate. Conclusion: the aim of this review is to discuss the following key points: How to perform a lung ultrasound scan Main ultrasonographic features of the healthy lung The functional approach: Lung Ultrasound Score in the child and the neonate What is Known: • Lung Ultrasound (LUS) is applied in pediatric and neonatal age for the diagnosis of pneumothorax, consolidation, and pleural effusion. • Recently, LUS has been introduced into clinical practice as a bedside diagnostic method for monitoring surfactant use in NARDS and lung recruitment in PARDS. What is New: • Lung Ultrasound (LUS) has proven to be useful in confirming diagnoses of pneumothorax, consolidation, and pleural effusion. • Furthermore, it has demonstrated effectiveness in monitoring the response to surfactant therapy in neonates, in staging the severity of bronchiolitis, and in PARDS. [ABSTRACT FROM AUTHOR]

This paper reports on a feasibility study for an evaluation of a UK primary school‐based prevention programme that addresses multiple forms of abuse and neglect, identifying research design and ethical issues and exploring research practice. For this feasibility study, 194 children aged 6–11 years completed a baseline survey and 113 did so following the intervention. Eight focus groups were undertaken with 52 children and nine interviews with school staff. We highlight key considerations for conducting large‐scale mixed‐method research on sensitive topics with younger children, a focus that is largely absent from the extant research methods literature. The feasibility study showed that younger children can contribute their views on sensitive topics in ways that are measurable, replicable and reliable, contesting ideas that certain topics are too sensitive to explore with younger children. [ABSTRACT FROM AUTHOR]

This paper explores whether a structured history-taking tool yields useful descriptions of children's looking skills. Parents of 32 children referred to a specialist communication clinic reported their child's looking skills using the Functional Vision for Communication Questionnaire (FVC-Q), providing descriptions of single object fixation, fixation shifts between objects and fixation shifts from object to person. Descriptions were compared with clinical assessment. 24/32 children were reported to have some limitation in fixation. Limitation was subsequently seen in 30/32 children. Parental report and assessment agreed fully in 23/32 (72%). The largest area of discrepancy was object-person fixation shifts, with five children not observed to show this behavior despite its being reported. Findings indicate a structured questionnaire yields description of fixations, which correspond well with clinical assessment. Descriptions supported discussion between parents and clinicians. It is proposed that the FVC-Q is a valuable tool in supporting clinicians in eliciting information about fixation skills. [ABSTRACT FROM AUTHOR]

Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]

• Many mental health disorders first emerge during early childhood or adolescence. • Wait times for children's mental health services have been an international and widespread problem. • Long wait times prolong the emotional distress of children and/or adolescents and their caregivers which can exacerbate mental health difficulties. • The majority of research in this area has been conducted in the United Kingdom and Canada and focus on one waitlist strategy. • Common strategies include alternative service delivery models, increasing system capacity, and improving intake and assessment processes. Background: Although many mental health disorders first emerge during early childhood or adolescence, there is a significant gap between demand and availability of mental health resources, leading to long waitlists for services. Objective: The objective of this scoping review was to identify and characterize the research literature related to the range of waitlist management strategies that have been implemented in outpatient child and adolescent mental health care. Methods: Electronic databases reviewed included: Medline (Ovid), Embase (Ovid), PubMed, PsychINFO, SCOPUS, CINAHL, and ISI Web of Science. Grey literature databases included: OpenGrey, Conference Papers Index, and Proquest Digital Dissertations. Articles were screened by two reviewers in two steps: first by title and abstract, then full text level. Data were extracted using an a-priori developed data extraction framework, which was piloted and modified iteratively. Results: A total of 119 papers related to waitlist interventions in child and adolescent mental health were reviewed. Of these 119 papers, 11% were reviews, summary, or theoretical papers; 8% used a randomized control trial design and 2.5% were trial protocols. Most studies used less rigorous designs, such as uncontrolled before-and- after designs. The large majority focused on just one waitlist strategy each. The most commonly used approaches included: prioritization/triage and initial assessment; brief consultation and advice or brief therapy approaches; group-based models; interim services; increasing capacity; and strategies to decrease non-attendance. Most studies were conducted in the United Kingdom or Canada. Discussion: While mental health systems are complex, most studies examining waitlist initiatives explored the implementation of single initiatives. It is unlikely that a single waitlist strategy can be effective in managing wait times for children's mental health. Rather, consistent and systemic approaches to address wait times that consider the impact of the reduction approach on the patient, the program, and the community are needed. [ABSTRACT FROM AUTHOR]

Introduction: Children and young people experiencing chronic pain are at greater risk of inequitable and poor-quality pain management, which has implications for future management of pain in adulthood. Most chronic pain research is conducted with adults who are more likely to be middle-class, white and monocultured. Inclusive and diverse recruitment practices in paediatric pain research can be an area in which we can address this imbalance of representation. The aim of this current work was to explore these practices and to co-produce recommendations regarding recruitment strategies for paediatric pain research. Methods: The research team worked with Your Rheum, a United Kingdom young person's advisory group (ages 11-24 years) and diagnosed with rheumatic condition(s), the opportunity to input into rheumatology research. At a virtual Your Rheum meeting, eight young people (female = 7, male = 1, age range 12-24) took part in group discussions, sharing their experiences of taking part in research and their decision process. Online tools, including Mentimeter and Miro, were used to aid conversations and share ideas. Results: Most young people had experience of taking part in research as a study participant (n = 5). Recommendations synthesised included increased awareness of research in general. The young people discussed being open to hearing about research opportunities; they reflected that they are rarely exposed to these invitations or hear about current research. The clinic environment was highlighted as a "good and trustworthy" recruitment area - being approached by a member of the research team was considered ideal, even if it was someone they had not met previously. Many young people recalled little discussions of research at their clinical appointments. Deciding to participate in research included the following considerations: benefit/impact; connecting with others; research topic; which is then balanced against convenience, and reimbursement. The young people felt that taking part in research was empowering and helped them take ownership of their pain management. Conclusion: It is essential to understand the perspectives of potential study participants, to plan successful recruitment strategies. Ensuring we consider these factors when designing our studies and recruitment strategies is beneficial to all involved. Co-produced recruitment strategies would aid inclusive (and increased) research participation. [ABSTRACT FROM AUTHOR]

(1) Background: Preterm premature rupture of membranes (PPROM) has been associated with increased perinatal morbidity, but the effect of PPROM on respiratory disease has not been previously quantified. We hypothesised that PPROM would be associated with a higher incidence of invasive ventilation. (2) Methods: A retrospective cohort study at the Neonatal Unit at King's College Hospital NHS Foundation Trust, London, UK, was conducted on infants born before 37 weeks of gestation. PPROM was defined as the rupture of membranes for >48 h. (3) Results: We reviewed 1901 infants (434 with PPROM) with a median (IQR) gestational age of 32.4 (28.7–35.0) weeks. The median (IQR) duration of rupture of membranes in the infants with PPROM was 129 (78–293) h. The incidence of invasive ventilation was 56% in the infants with PPROM and 46% in the infants without PPROM (p < 0.001). Following regression analysis, PPROM was significantly related to a higher incidence of invasive ventilation (odds ratio: 1.48; 95% CI: 1.13–1.92, adjusted p = 0.004) after adjusting for birth weight [odds ratio = 0.34; 95% CI: 0.33–0.43, adjusted p < 0.001], Apgar score at 10 min [odds ratio =0.61; 95% CI: 0.56–0.66, adjusted p < 0.001] and antenatal corticosteroid use (adjusted p = 0.939). (4) Conclusions: PPROM was associated with a 1.48-fold higher risk of needing invasive ventilation. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the effectiveness of a highly individualized morphosyntactic intervention using the SHAPE CODING™ system delivered at different dosages. Method: Eight children with developmental language disorder aged 8;0–10;10 (years;months) received 10 hr of explicit individualized intervention for morphosyntax delivered in 30-min individual sessions once per week for 20 weeks. Following at least four baseline probe tests, two grammatical targets per session received explicit instruction until they reached criterion (90%), when the next target was introduced. To control for session length and teaching episode density, either both targets received 20 teaching episodes per session or one target received 10 teaching episodes and the other 30. Maintenance testing of completed targets was also carried out. Results: Scores on probe tests post-intervention were significantly higher than during the baseline phase (d = 1.6) with no change during the baseline or maintenance phases. However, progress during the intervention phase was highly significant. One participant showed significantly faster progress with intervention, while one (with the lowest attention score) made little progress. When considering progress relative to cumulative intervention sessions, progress was faster with 30 teaching episodes per session and slower with 10. However, when cumulative teaching episodes were used as the predictor, all three within-session dosages showed very similar rates of progress, with the odds of a correct response increasing by 3.9% for each teaching episode. The targets that were achieved required an average of 40–60 teaching episodes. Conclusions: With the exception of one participant, the individualized intervention was highly effective and efficient. Thus, the individualized target identification process and intervention method merit further research in a larger group of children. The cumulative number of teaching episodes per target provided across sessions appeared to be key. Thus, clinicians should aim for high teaching episode rates, particularly if the number of sessions is constrained. Otherwise, intervention scheduling can be flexible. [ABSTRACT FROM AUTHOR]

Background: Islamic leaders, staff, and Muslim parents in the UK are supportive of healthy lifestyle intervention delivery through Islamic Religious Settings. Such interventions are necessary given high obesity rates in British South Asian (40%) compared to White British (32%) children of equivalent age. Co-production can facilitate the development of culturally appropriate health interventions, however it can be theoretically and practically challenging, and evaluation of co-production within an Islamic Religious Setting context is lacking. The aim of this study was to examine the feasibility and acceptability of taking a co-production approach to develop an obesity-prevention toolkit for Islamic Religious Settings. Methods: An obesity-prevention toolkit for use in Islamic Religious Settings, incorporating physical activity, healthy diet, and organisational change, has been co-produced to be evidence-informed and contextually relevant. A qualitative process evaluation was employed to examine experiences of co-production. Semi-structured interviews (n = 15) and a focus group (n = 5) were conducted with toolkit co-production stakeholders, e.g., subject experts, an Islamic scholar, and Islamic Religious Setting staff. Transcripts were analysed inductively using reflexive thematic analysis. Results: The analysis revealed four major themes regarding stakeholders' experiences of co-producing a childhood obesity-prevention toolkit for Islamic Religious Settings. These themes are: (1) attitudes towards obesity-prevention through Islamic Religious Settings, (2) benefits of co-production including capacity building and ownership (3) negotiating involvement, power, and perspectives within the co-production process, and (4) the complexities of effective communication in co-production. Conclusion: This study adds to the evidence-base in support of delivering health promotion through faith settings. Taking a co-production approach to develop an obesity-prevention toolkit for Islamic Religious Settings provided benefit to the toolkit product and local stakeholders. The toolkit is currently being implemented across Bradford, UK and there is potential to adapt the toolkit to other geographical contexts, and for evaluating effectiveness for preventing obesity in British Muslim families. [ABSTRACT FROM AUTHOR]

Mycotoxins are potent fungal toxins that frequently contaminate agricultural crops and foods. Mycotoxin exposure is frequently reported in humans, and children are known to be particularly at risk of exceeding safe levels of exposure. Urinary biomonitoring is used to assess overall dietary exposure to multiple mycotoxins. This study aims to quantify multi-mycotoxin exposure in UK children and to identify major food groups contributing to exposure. Four repeat urine samples were collected from 29 children (13 boys and 16 girls, aged 2.4–6.8 years), and food diaries were recorded to assess their exposure to eleven mycotoxins. Urine samples (n = 114) were hydrolysed with β-glucuronidase, enriched through immunoaffinity columns and analysed by LC-MS/MS for deoxynivalenol (DON), nivalenol (NIV), T-2/HT-2 toxins, zearalenone (ZEN), ochratoxin A (OTA) and aflatoxins. Food diaries were analysed using WinDiet software, and the daily intake of high-risk foods for mycotoxin contamination summarised. The most prevalent mycotoxins found in urine samples were DON (95.6% of all samples), OTA (88.6%), HT-2 toxin (53.5%), ZEN (48.2%) and NIV (26.3%). Intake of total cereal-based foods was strongly positively associated with urinary levels of DON and T-2/HT-2 and oat intake with urinary T-2/HT-2. Average daily mycotoxin excretion ranged from 12.10 µg/d (DON) to 0.03 µg/d (OTA), and co-exposure to three or more mycotoxins was found in 66% of samples. Comparing mycotoxin intake estimates to tolerable daily intakes (TDI) demonstrates frequent TDI exceedances (DON 34.2% of all samples, T-2/HT-2 14.9%, NIV 4.4% and ZEN 5.2%). OTA was frequently detected at low levels. When mean daily OTA intake was compared to the reference value for non-neoplastic lesions, the resulting Margin of Exposure (MoE) of 65 was narrow, indicating a health concern. In conclusion, this study demonstrates frequent exposure of UK children to multiple mycotoxins at levels high enough to pose a health concern if exposure is continuous. [ABSTRACT FROM AUTHOR]

Infants, children and young people with life-limiting or life-threatening conditions often experience acute, transient pain episodes known as breakthrough pain. There is currently no established way to assess breakthrough pain in paediatric palliative care. Anecdotal evidence suggests that it is frequently underdiagnosed and undertreated, resulting in reduced quality of life. The development of a standardised paediatric breakthrough pain assessment, based on healthcare professionals' insights, could improve patient outcomes. This study aimed to explore how healthcare professionals define and assess breakthrough pain in paediatric palliative care and their attitudes towards a validated paediatric breakthrough pain assessment. This was a descriptive qualitative interview study. Semi-structured interviews were conducted with 29 healthcare professionals working in paediatric palliative care across the UK. An inductive thematic analysis was conducted on the data. Five themes were generated: 'the elusive nature of breakthrough pain', 'breakthrough pain assessment', 'positive attitudes towards', 'reservations towards' and 'features to include in' a paediatric breakthrough pain assessment. The definition and assessment of breakthrough pain is inconsistent in paediatric palliative care. There is a clear need for a validated assessment questionnaire to improve assessment, diagnosis and management of breakthrough pain followed by increased healthcare professional education on the concept. [ABSTRACT FROM AUTHOR]

Background: 16p11.2 proximal deletion and duplication syndromes (Break points 4–5) (593KB, Chr16; 29.6-30.2mb - HG38) are observed to have highly varied phenotypes, with a known propensity for lifelong psychiatric problems. This study aimed to contribute to a research gap by qualitatively exploring the challenges families with 16p11.2 deletion and duplication face by answering three research questions: (1) What are parents' perceptions of the ongoing support needs of families with children who have 16p11.2 living in the UK?; (2) What are their experiences in trying to access support?; (3) In these regards, do the experiences of parents of children with duplication converge or vary from those of parents of children with 16p11.2 deletion? Methods: 33 parents with children (aged 7–17 years) with 16p11.2 deletion or duplication participated in structured interviews, including the Autism Diagnostic Interview– Revised (ADI-R). Their answers to the ADI-R question 'what are your current concerns' were transcribed and subsequently analysed using Braun and Clarke's six step reflexive thematic analysis framework. Results: Three themes were identified: (1) Child is Behind Peers (subthemes: developmentally; academically; socially; emotionally); (2) Metabolism and Eating Patterns and; (3) Support (subthemes: insufficient support available; parent has to fight to access support; COVID-19 was a barrier to accessing support; 16p11.2 diagnosis can be a barrier to support, child is well-supported). Conclusions: Parents of children with either 16p11.2 deletion or duplication shared similar experiences. However, metabolism concerns were specific to parents of children with 16p11.2 deletion. The theme Child is Behind Peers echoed concerns raised in previous Neurodevelopmental Copy Number Variant research. However, there were some key subthemes relating to research question (2) which were specific to this study. This included parents' descriptions of diagnostic overshadowing and the impact of a lack of eponymous name and scant awareness of 16p11.2. [ABSTRACT FROM AUTHOR]

Background: Children and young people with life-limiting and life-threatening conditions have multidimensional needs and heterogenous cognitive and communicative abilities. There is limited evidence to support clinicians to tailor their communication to each individual child. Aim: To explore the language children and young people use to describe their own condition, to inform strategies for discussing needs and priorities. Design: Positioned within a s ocial constructivist paradigm, a secondary discourse analysis of s emi-structured interview data was conducted incorporating the discourse dynamics approach for figurative language. Setting/participants: A total of 26 children and young people aged 5–17 years with life-limiting or life-threatening conditions (6 cancer; 20 non-cancer) were recruited from nine clinical services (six hospitals and three hospices) across two UK nations. Results: The language children and young people use positions them as 'experts in their condition'. They combine medical terminology with their preferred terms for their body to describe symptoms and treatments, and use comparatives and superlatives to communicate their health status. Their language depicts their condition as a 'series of (functional and social) losses', which single them out from their peers as 'the sick one'. Older children and young people also incorporate figurative language to expand their descriptions. Conclusion/discussion: Children and young people can provide rich descriptions of their condition. Paying attention to their lexical choices, and converging one's language towards theirs, may enable more child-centred discussions. Expanding discussions about 'what matters most' with consideration of the losses and differences they have experienced may facilitate a fuller assessment of their concerns, preferences and priorities. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to examine whether the moderating role of social support on the negative association between school-age bullying victimization and life satisfaction in middle-age was different by age of victimization. Methods: A longitudinal study was conducted using data collected at the ages of 7, 11 and 50 years in the 1958 British birth cohort (N = 18,558). Frequency of bullying victimization (never, sometimes, or frequently) was assessed by parental interviews at ages seven and 11. A self-reported questionnaire assessed life satisfaction and perceived social support (instrumental and emotional) at age 50. To determine the moderating effect of social support on the association between bullying victimization and life satisfaction, hierarchical multiple linear regression analyses were conducted in which two interaction terms, victimization at age seven by social support and victimization at age 11 by social support, were simultaneously entered into the models. Results: Among 5304 respondents subjected to the statistical analysis, 34% had bullying victimization at age 7 years; 23% had bullying victimization at age 11 years. Instrumental support significantly buffered the effect of frequent victimization at age 11 (β = 0.03, p = 0.03) and significantly deteriorated the effect of frequent victimization at age 7 years (β = −0.04, p = 0.01), after adjusting for childhood confounders. No significant moderating effect was observed for emotional support. Conclusions: Instrumental support in middle-age may more effectively buffer the effect of late school-age victimization than of early school-age victimization, while both effect sizes were small and additional research is needed. [ABSTRACT FROM AUTHOR]

Appropriate allegation investigations within social care are paramount to protect children. However, many allegations are unsubstantiated (Biehal et al., 2014) and result in stress and anxiety for fostering families (Adams, Hassett and Lumsden, 2018), financial uncertainty (Boffey, Stanton and Thomas, 2019), unplanned endings and foster carers leaving their role (Adams, Hassett and Lumsden, 2018). There is little research into the prevalence, nature and outcomes of allegations against foster carers. This UK-based study uses The Fostering Network's State of the Nation's Foster Care (SOTN) 2021 survey and analyses responses from 3,352 UK foster carers and 99 fostering service staff. Qualitative findings reflect six themes: (1) emotional impacts, (2) financial implications, (3) independent support, (4) social services involvement, (5) understanding allegations, and (6) children being removed or foster carers leaving their role. Quantitative findings show only 25% of those experiencing an allegation believed they were sufficiently communicated with, only 20% believed specified timescales were adhered to, 57% did not receive independent support, and 36% said no support was offered to children in their home. Poor information-sharing and lack of support were found to have exacerbated the stress experienced. Plain Language Summary: When someone accuses a foster carer of being unsuitable to care for children or of harming a child, it is crucial to investigate these claims thoroughly. These investigations play a vital role in keeping children in foster care safe from harm. Listening to the concerns of children and young people and taking their opinions seriously can also contribute to their improved self-esteem, confidence and wellbeing. Research shows that many of the allegations made against foster carers are unsubstantiated, meaning there is not enough evidence to decide if the event occurred or not. Regardless of the outcome, these investigations often have negative side effects for foster carers and their families including stress, anxiety and financial uncertainty. In addition, allegation investigations can lead to children and young people's placements ending and foster carers stopping fostering. The Fostering Network's State of the Nation's Foster Care (SOTN) 2021 survey in the UK asked foster carers and fostering services about their experiences of allegations. This study looked at the responses to the survey, which found that allegation investigations were often very difficult and emotional experiences for foster carers and their families and sometimes caused financial difficulty. There seemed to be a lack of independent support, and foster carers often felt unsupported by social services. Foster carers' understanding of allegation processes was sometimes unclear, and it seemed that allegations could lead to children being abruptly removed from their placements as well as foster carers ending their fostering role. The strengths and limitations of the study are discussed and suggestions are made to improve how foster carers are supported through allegation investigations. [ABSTRACT FROM AUTHOR]

• This study reviewed the prevalence of mental health disorders among Looked After Children in the UK. • Prevalence rates varied across studies. • The Strengths and Difficulties Questionnaire (SDQ) was the most frequently used tool to assess mental health. • There is still uncertainty about the scale and nature of mental health difficulties in this group. Care-experienced children and young people are more likely to experience poorer mental health relative to the general population. Some of the most highly cited literature in this area is becoming increasingly outdated, however, and as the gap between mental health service availability and provision is steadily growing, it is imperative that we understand the scale and nature of the mental health needs of this group. A systematic review of all literature published from the UK was conducted in March 2022 using APA PsycINFO, ASSIA, Cochrane Library, Medline, PubMed, Scopus, Social Policy and Practice, Social Services Abstracts, and Web of Science. Papers were included if they 1) sampled young people (aged 0 to 18 years) with care experience and, 2) used either a standard or non-standardised measurement tool, or health records to assess mental health prevalence rates (reported as a percentage). Risk of bias assessed used the QuADS tool (Harrison et al., 2021) and data was extracted. Thirty-nine studies were included and summarised. The estimated prevalence of mental health disorders of young people in care ranged from 1 to 82 %. The most frequently used tool to assess mental health was the Strengths and Difficulties Questionnaire (Goodman, 1997) and, while over half of studies utilised prevalence information from a comparator group, this was most commonly young people in the general population. The results of the systematic review demonstrate that estimates of mental health disorders among care-experienced young people in the UK vary considerably. Further consideration should be given toward what measures are used to assess mental health in this population and how we can optimally assess and characterise their support needs. [ABSTRACT FROM AUTHOR]

Objectives: To determine the UK prevalence of behavioral problems in 5-year-old children born with isolated or syndromic cleft lip and/or palate (CL/P) compared to the general population and identify potentially associated factors. Design: Observational study using questionnaire data from the Cleft Collective 5-Year-Old Cohort study and three general population samples. Main Outcome Measure: The Strengths and Difficulties Questionnaire (SDQ). Participants: Mothers of children (age: 4.9-6.8 years) born with CL/P (n = 325). UK general population cohorts for SDQ scores were: Millennium Cohort Study (MCS) (n = 12 511), Office of National Statistics (ONS) normative school-age SDQ data (n = 5855), and Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 9386). Results: By maternal report, 14.2% of children born with CL/P were above clinical cut-off for behavioral problems, which was more likely than in general population samples: 7.5% of MCS (OR = 2.05 [1.49-2.82], P < 0.001), 9.8% of ONS (OR = 1.52 [1.10-2.09], P = 0.008), and 6.6% of ALSPAC (OR = 2.34 [1.70-3.24], P < 0.001). Children in the Cleft Collective had higher odds for hyperactivity, emotional and peer problems, and less prosocial behaviors. Maternal stress, lower maternal health-related quality of life and family functioning, receiving government income support, and maternal smoking showed evidence of association (OR range: 4.41-10.13) with behavioral problems, along with maternal relationship status, younger age, and lower education (OR range: 2.34-3.73). Conclusions: Findings suggest elevated levels of behavioral problems in children born with CL/P compared to the general population with several associated maternal factors similar to the general population. [ABSTRACT FROM AUTHOR]

The long-awaited national Paediatric Early Warning Score (PEWS) to pick up deterioration in children has been published by NHS England and will now be rolled out to hospitals across the country. [ABSTRACT FROM AUTHOR]