Search

Background: Evaluating individual health outcomes does not capture co-morbidities children experience. Purpose: We aimed to describe profiles of child neurodevelopment and anthropometry and identify their predictors. Methods: Using data from 501 mother-child pairs (age 3-years) in the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a prospective cohort study, we developed phenotypic profiles by applying latent profile analysis to twelve neurodevelopmental and anthropometric traits. Using multinomial regression, we evaluated odds of phenotypic profiles based on maternal, sociodemographic, and child level characteristics. Results: For neurodevelopmental outcomes, we identified three profiles characterized by Non-optimal (9%), Typical (49%), and Optimal neurodevelopment (42%). For anthropometric outcomes, we observed three profiles of Low (12%), Average (61%), and Excess Adiposity (27%). When examining joint profiles, few children had both Non-optimal neurodevelopment and Excess Adiposity (2%). Lower household income, lower birthweight, younger gestational age, decreased caregiving environment, greater maternal depressive symptoms, and male sex were associated with increased odds of being in the Non-optimal neurodevelopment profile. Higher pre-pregnancy body mass index was associated with increased odds of being in the Excess Adiposity profile. Conclusions: Phenotypic profiles of child neurodevelopment and adiposity were associated with maternal, sociodemographic, and child level characteristics. Few children had both non-optimal neurodevelopment and excess adiposity. [ABSTRACT FROM AUTHOR]

Aim: To develop a trigger tool for parents and lay caregivers of children with medical complexity (CMC) at home and to validate its content. Design: This was a multi‐method study, using qualitative data, a Delphi method and a concept mapping approach. Methods: A three‐round electronic Delphi was performed from December 2021 to April 2022 with a panel of 23 expert parents and 30 healthcare providers, supplemented by a preliminary qualitative exploration of children's signs of deterioration and three consensus meetings to develop the PArents' Trigger Tool for Children with Medical Complexity (PAT‐CMC). Cognitive interviews with parents were performed to assess the comprehensiveness and comprehensibility of the tool. The COREQ checklist, the COSMIN guidelines and the CREDES guidelines guided the reporting respectively of the qualitative study, the development and content validity of the trigger tool and the Delphi study. Results: The PAT‐CMC was developed and its content validated to recognize clinical deterioration at home. The tool consists of 7 main clusters of items: Breathing, Heart, Devices, Behaviour, Neuro‐Muscular, Nutrition/Hydration and Other Concerns. A total of 23 triggers of deterioration were included and related to two recommendations for escalation of care, using a traffic light coding system. Conclusion: Priority indicators of clinical deterioration of CMC were identified and integrated into a validated trigger tool designed for parents or other lay caregivers at home, to recognize signs of acute severe illness and initiate healthcare interventions. Impact: The PAT‐CMC was developed to guide families in recognizing signs of deterioration in CMC and has potential for initiating an early escalation of care. This tool may also be useful to support education provided by healthcare providers to families before hospital discharge. Patient or Public Contribution: Parents of CMC were directly involved in the selection of relevant indicators of children's clinical deterioration and the development of the trigger tool. They were not involved in the design, conducting, reporting or dissemination plans of this research. [ABSTRACT FROM AUTHOR]

Aims: Non-suicidal self-injury (NSSI) is a serious issue that is increasingly prevalent among children and adolescents, especially in rural areas. Developing a suitable predictive model for NSSI is crucial for early identification and intervention. Methods: This study included 2090 Chinese rural children and adolescents. Participants' sociodemographic information, symptoms of anxiety as well as depression, personality traits, family environment and NSSI behaviors were collected through a questionnaire survey. Gender, age, grade, and all survey results except sociodemographic information were used as relevant factors for prediction. Support vector machines, decision tree and random forest models were trained and validated by the train set and valid set, respectively. The metrics of each model were tested and compared to select the most suitable one. Furthermore, the mean decrease Gini index was calculated to measure the importance of relevant factors. Results: The prevalence of NSSI was 38.3%. Out of the 6 models assessed, the random forest model demonstrated the highest suitability in predicting the prevalence of NSSI. It achieved sensitivity, specificity, AUC, accuracy, precision, and F1 scores of 0.65, 0.72, 0.76, 0.70, 0.57, and 0.61, respectively. Anxiety and depression were the top two contributing factors in the prediction model. Neuroticism and conflict were the factors that contributed the most to personality traits and family environment, respectively, in terms of prediction. In addition, demographic factors contributed little to the prediction in this study. Conclusion: This study focused on Chinese children and adolescents in rural areas and demonstrated the potential of using machine learning approaches in predicting NSSI. Our research complements the application of machine learning methods to psychiatric and psychological problems. [ABSTRACT FROM AUTHOR]

Background: The Child Opportunity Index (COI) is a new and innovative tool designed to assess the environment in which children grow up, offering a broad evaluation of the opportunities available to them in different neighborhoods. This initiative aims to ensure improvements in children's living conditions and future health outcomes. Methods: The study was performed in the cities of Palermo and Rome. Our Italian COI consists of three main domains: education, health and environment, and economy, each subdivided into specific indicators. We collected information, when available, useful for our indicators from institutional sites and municipal archives. Furthermore, in the city of Rome, we distributed a questionnaire through local pediatricians, collecting data in 2 randomly chosen neighborhoods with questions on children's health and quality of life, proposing an initial approach that, when implemented using data provided by the government and public and private health institutions, aims to evaluate the correlation between socio-economic opportunities and the psycho-physical health of children, as demonstrated in the literature. Results: As a result, many aspects, such as the rate of air pollution or the illegal occupation of houses, were not taken into consideration. We therefore consider our COI proposal only a starting model that will have to be implemented once all the necessary information has been obtained. However, what can be deduced from this first descriptive study is how the opportunities in different neighborhoods are not the same for all children. The number of educational opportunities as well as the number of environmental opportunities differs between the various districts and is not homogeneous between different cities or within the same city. Conclusions: In conclusion, it is not simple to analyze in a scientific manner the child's health impact of living in different areas. The COI could be a useful and simple tool that can give us this information. Pediatricians could collaborate with institutions to implement intervention plans and to reduce existing differences, social and health inequalities. Future studies will have to implement this pilot study to create and validate an Italian model of COI to be used as a useful tool in children's assistance. [ABSTRACT FROM AUTHOR]

Background: Between 1 and 4% of children and adolescents suffer from obsessive-compulsive disorder (OCD) worldwide, but the majority of these young people do not have access to cognitive behavioral therapy (CBT) as a first-line treatment. CBT delivered via online videoconferencing (vCBT) offers a new way to provide young people with therapy, especially in the home environment where symptoms usually occur. Methods: In this study, we investigated the feasibility of a newly revised vCBT manual, symptom change during treatment, and effects on family life and social functioning. 20 patients with OCD, aged 12–18 years, were treated during 14 weekly sessions while using a multimodal sensor system that assessed their physiological and behavioral responses during therapy. Treatment was delivered in real time via an online videoconferencing platform. Measurements of feasibility, acceptance, and implementation were evaluated descriptively, and clinical measures were assessed with t tests. Results: The primary results showed that patients and parents perceived the manual-based vCBT as feasible and easy to understand. According to the therapists' ratings, all treatment modules and the content could be carried out in accordance with the manual. As a secondary outcome, OCD symptoms improved significantly during treatment (p <.001, d = 1.87), revealed by an average decrease of more than half in the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score. As the psychotherapy could be implemented directly in the patients' home environment, low barriers to participation were reported, and the majority of participants reported improvements in family life after treatment. Conclusions: In summary, the results of this feasibility study indicated a successful application of manual-based psychotherapy delivered via videoconferencing for pediatric OCD supported by a sensor system. This method should be further investigated in future randomized controlled trials with larger patient samples. Clinical trial registration: [www.ClinicalTrials.gov], identifier [NCT05291611], first submission: 2021-12-10. [ABSTRACT FROM AUTHOR]

Early exposure to socioeconomic distress is hypothesized to reinforce decision making that prioritizes immediate, relative to delayed, rewards (i.e., delay discounting); yet these relations have not been examined longitudinal across the vulnerable adolescent period. This study is one of the first to utilize objective and subjective measures to evaluate the relative effects of environmental disadvantage and the potential protective effects of perceived environmental support on delay discounting. A diverse (48.4% White; 46.7% female) sample of participants (N = 246) reported on their home addresses at baseline when they were, on average, 11.96 years old (SDage = 0.88); Youth then reported perceived environmental supports at baseline and delay discounting annually from ages 13 to 18. A socioeconomic distress index was derived from census tract rates of unemployment, income, educational attainment, and lone parenthood. Greater socioeconomic distress was associated with a greater propensity to discount delayed rewards at baseline. Findings also suggest greater perceived higher environmental support was associated with decreasing rates of delay discounting across adolescence for youth from highly socioeconomically distressed areas. These results highlight potential future avenues for preventative and intervention efforts to improve positive youth outcomes. [ABSTRACT FROM AUTHOR]

Play skills are a behavioral cusp as they provide the foundation for the development of other related skills in young children. Children with developmental disabilities often demonstrate significant delays in their play skills. When children do not engage in play at the same rates or in the same ways as their peers or siblings, their ability to learn and practice other skills such as communication and social interactions is negatively impacted. We used a concurrent, multiple probe design across participants to assess the efficacy of using a system of least prompts (SLP) intervention package to teach pretend play to three children with disabilities in contexts with their peers. The SLP intervention package was related to increases in target pretend play behaviors for all three children. Also, parents and teachers reported observed changes in play across both the classroom and the home environments. [ABSTRACT FROM AUTHOR]

Objective: Mitigation of household allergens is associated with the reduction of asthma exacerbations in those with allergic asthma and is recommended in recent asthma guidelines. However, we need to better understand patient knowledge of aeroallergens in their homes prior to integrating direct allergen measurement methods into standard asthma care. Methods: We conducted a mixed-methods sequential pilot study consisting of a survey and virtual interview with caregivers of children aged 3 to 15 with asthma diagnosis (any severity) about asthma control, household environment, mitigation knowledge and strategies, and knowledge of allergens and asthma. Results: A total of 21 participants responded and 13 completed the virtual interview. Less than half identified mice (43%), rats (29%), and cockroaches (43%) as sources of allergens on the online survey, and no individuals mentioned these in discussions. Only 23% were able to define the term "allergen," but 69% could list examples. There was a poor correlation between perceived asthma control (57% stated asthma control was good or excellent) compared to asthma that was classified as well controlled per Expert Panel Report 3 (EPR-3) guidelines (33% based on albuterol use and asthma symptoms). Finally, visual identification of mouse infestation was associated with active steps taken to mitigate mouse exposure (P = 0.007). Conclusion: Implementation of new Asthma Management Guidelines: Focused Updates 2020 by the National Institutes of Health will require additional aeroallergen education for individuals with asthma who do not recognize that cockroaches, rats, and mice can cause asthma symptoms, do not know the definition of an allergen, and do not correctly perceive asthma control status. Environmental assessment with education addressing these could hopefully decrease additional pharmaceutical needs. [ABSTRACT FROM AUTHOR]

Informed by models of resilience in military families, we explored factors theorized to be associated with social-emotional resilience and risk among young military-connected children. Our secondary analysis of cross-sectional data from 199 military-connected families (n = 346 parents) with at least one preschool-age child in the home (n = 199) led to the empirical identification of two distinct clusters: families with children demonstrating healthy social-emotional functioning and those showing indicators of less healthy social-emotional functioning when compared to the first group. We then identified factors associated with membership in each cluster to determine which deployment and parental well-being variables were salient for young child adjustment. Parent psychological symptoms, parenting, child behavior, and parent-child relationships were measured by parent report and observed interaction. Children with healthier social-emotional functioning were found to be residing with families experiencing less stress and distress. The importance of maternal trauma history is highlighted in our study, as elevated maternal symptoms across all three posttraumatic stress disorder symptom domains were associated with child social-emotional risk. Basic family demographic characteristics did not contribute significantly to the cluster distinctions, nor did military service factors such as active duty, reserve or veteran status, military rank or parent deployment history. These findings are important as the results deemphasize the importance of military service characteristics and highlight the importance of parent well-being when considering social-emotional risk and resilience of young children within military families. Highlights: Military-connected families with lower levels of stress were more likely to have preschoolers with positive social-emotional adjustment. Elevated maternal symptoms in all three posttraumatic stress disorder domains were associated with child behavioral risk. Family military service and demographic characteristics did not contribute significantly to social-emotional child adjustment. [ABSTRACT FROM AUTHOR]

For decades, language and literacy scholars working within a sociocultural framework have laboured to bring attention to the strengths of marginalized students in an effort to create more inclusive and equitable learning environments (e.g., Cummins, 2000 ; Dyson, 1997 ; González et al., 2005 ; Heath, 1983). While this work has moved the field forward in invaluable ways, it has not consistently engaged with processes of marginalization as a complex practice, which has produced gaps in our understanding of how we can best address it in research and practice to the benefit of all learners. Drawing on the notions of literacy socialization (Sterponi, 2012) and syncretic literacy (Duranti and Ochs, 1996 ; Gregory et al., 2013a), in this paper I conduct a close examination of the in- and out-of-school literacy socialization practices of Max Calfu, a seven-year-old Chilean-Canadian boy, over the course of a year-long ethnography that I conducted with his family at their home, at his Spanish-English bilingual public school, and in transit between home and school in a large Western Canadian city. At school, Max's Indigenous identity was regularly rendered invisible by the cultural capital his Chilean-national heritage held within the Spanish bilingual program (Calderón and Urrieta, 2019). Using thematic analysis (Saldaña, 2013), I demonstrate how Max incorporated the wolf figure into his literacy practices over the course of the research year, considering multiple scales of space and time, and in relation to key mediators. My analysis calls attention to the ways in which he drew on his syncretic literacy experiences to author his Indigenous identity in official and unofficial learning spaces. I conclude the paper by arguing that examining syncretism in children's literacy practices can lay the foundation for a more ethically, emotionally, and culturally engaged language education. [ABSTRACT FROM AUTHOR]

Aim: The supply of medical aids and training in their use are essential for home mechanically ventilated (HMV) children and their parents. Design: A qualitative interview study was performed to gain deeper insights into parents’ views and to derive sound recommendations for designing this form of care with the most common need for multiple medical aids (devices and accessories). Methods: Twelve problem-centred interviews were conducted with parents of children receiving HMV and subjected to qualitative content analysis. Results: Parents found ventilation-specific medical devices and accessories to be generally reliable, but not always well designed for children or well selected. Parents also identified challenges and problems regarding structural, procedural and personal aspects of the supply of medical aids. In particular, deficits in task performance and cooperation between stakeholders and involved healthcare institutions became apparent. When parents or home care nurses lacked competence in using the technology, unsafe situations easily arose. Conclusion: The study highlighted the need for further developments in the supply of ventilation-associated medical aids. Furthermore, the need for qualified professionals and for educational strategies to promote safety amongst parents as users of medical aids in home care became clear. [ABSTRACT FROM AUTHOR]

Background/Objectives: Understanding the neurocognitive profile of children with sickle cell disease in the Democratic Republic of Congo is essential, as this condition can significantly affect their development. Our study aims to assess these children's neurocognitive and developmental profiles and identify related factors. Methods: We conducted a descriptive cross-sectional study involving 287 children, aged 0 to 68 months, using the Mullen Scales of Early Learning and the Gensini Gavito Scale. We also screened for maternal depression using the Hopkins Symptoms Checklist-10. Results: More than half of the participants were boys, with an average age of 4 years. Remarkably, 95.8% (score T < x ¯ +2 SD) of children scored below average on the Mullen Scales. Significant associations were found between early neurocognitive development and factors like maternal depression, socioeconomic status, maternal education, age of weaning, and responses to the Ten-Questions Questionnaire (p < 0.005). Conclusion, children with sickle cell disease show below-average cognitive development, with maternal depression being a critical factor. Longitudinal studies are vital to understanding the long-term cognitive effects of sickle cell disease, particularly in the Democratic Republic of Congo, where targeted support is urgently needed. [ABSTRACT FROM AUTHOR]

Background/Objectives: Household insecticide use may impact the health of young children in urban communities, but little is known about its acute effects. This cross-sectional study aimed to investigate the symptoms that may have been related to residential insecticide exposure and its associated factors in young children in urban areas. Methods: The study included 375 primary caregivers of children aged 6 months to 5 years from the Bangkok Metropolitan Region, Thailand, who had used insecticides in their homes within the past 6 months. An interviewer-administered questionnaire collected data on caregiver and child demographics, household insecticide use and exposure, child behaviors, and the history of child symptoms following insecticide use. Results: The findings revealed that 9.6% of young children had experienced symptoms at some point during or after household insecticide use, with coughing (66.7%), skin rash/irritation (44.4%), and runny nose (25.0%) being the most common. The final logistic regression model using backward selection indicated that factors statistically significantly associated with symptoms included being a male child (OR = 3.38; 95% CI = 1.48–7.71), hand/object-to-mouth behaviors (OR = 2.69; 95% CI = 1.26–5.74), weekly use of insecticides (OR = 2.77; 95% CI = 1.22–6.26), use of insecticide chalk (OR = 3.64; 95% CI = 1.32–10.08), and use of mosquito repellent spray/lotion (OR = 2.51; 95% CI = 1.13–5.61). Additionally, the use of insecticide spray (OR = 2.72; 95% CI = 0.97–7.65), opening doors/windows for ventilation (OR = 0.46; 95% CI = 0.21–1.02), and consistently cleaning floors with a wet cloth after use (OR = 0.52; 95% CI = 0.24–1.11) were marginally associated. Conclusions: Residential exposure to household insecticides can lead to acute health effects, primarily respiratory symptoms, in young children in urban communities. Caregivers should be informed of these health risks to reduce children's exposure. [ABSTRACT FROM AUTHOR]

Background: The study aimed to investigate the efficacy of the indirect home-based program, including parent–child interaction therapy (PCIT), in reducing the severity and degree of stuttering in young children to be used as a treatment program for young children who stutter. Methods: A longitudinal multiple single-subject study was conducted on 16 Arabic-speaking Egyptian children aged 4–7 years who stutter. All parents and children were evaluated during the first clinic visit to assess stuttering and to start the clinic-based therapy. After six weeks, a follow-up was done. After three months of the home-based therapy program, a re-assessment of the degree and severity of stuttering was done using the Bloodstein classification of stuttering severity and Stuttering Severity Instrument-3 (SSI3). Results: Mean SSI3 pre-therapy was 17.5 and decreased to 11 post-therapy. Before therapy, most cases were moderate stuttering 68.8%, 25% were mild, and 6.3% were severe; after treatment, most cases became mild stuttering (75%), 12.5% became very mild, and 12.5% became moderate stuttering according to SSI3 scores, also mean Bloodstein pre-therapy was II and decreased to I post-therapy. Conclusion: An indirect home-based program, including PCIT, efficiently reduces the severity and degree of stuttering in young children and justifies its use as a treatment program for children who stutter. [ABSTRACT FROM AUTHOR]

This study investigated relationships among home reading practices, shared book reading (SBR) behaviors, and child literacy outcomes in young children with cochlear implants in Baltimore, Maryland. Parents (N =18) completed a home reading questionnaire and recorded themselves reading books with their children at home. Shared book reading sessions were coded for interactive reading behaviors. Children's early language skills and literacy skills were also assessed. We explored variability in these behaviors with regard to demographic characteristics and type of book; these exploratory analyses revealed that parents used more literacy teaching techniques when reading the wordless picture book and that parent interaction and engagement and literacy teaching techniques were more frequent with younger children than with older children. While many families frequently used interactive reading behaviors, our analysis did not find significant relationships between the parent behaviors and children's literacy scores. However, there was an interaction between the amount of reading and cochlear implant experience such that more cochlear implant experience was associated with better reading outcomes only for the group of children who received more reading time. In a sample of young children with cochlear implants, reading time, cochlear implant experience, and child language skills were better predictors of reading outcomes than parents' frequency of SBR behaviors alone. [ABSTRACT FROM AUTHOR]

The home environment is a significant factor that greatly influences the motor development of children. This study aims to examine the cultural adaptation validity and reliability of the Affordances in the Home Environment for Motor Development (AHEMD‐SR) for Turkish children aged 18–42 months. The study included 103 Turkish children (mean age = 29.3 ± 7.4 months; 57.3% female, 42.6% male). The majority of participants were from middle‐income families. The AHEMD‐SR was administered to parents, and test–retest reliability was evaluated with a subsample of 30 families. The Cronbach's alpha coefficient and Intraclass Correlation Coefficient (ICC) were calculated to assess reliability, while correlations with the Denver Developmental Screening Tool 2 (DDST‐2) were examined for convergent validity. The Cronbach's alpha coefficient of the AHEMD‐SR was 0.815, and the ICC for test–retest reliability was 0.889. The AHEMD‐SR total score correlated with DDST‐2's social development (r = 0.32), fine motor development (r = 0.33) and gross motor development (r = 0.33) domains (all p < 0.05). The Turkish version of the AHEMD‐SR was found to be a valid and reliable tool for assessing the home environment's impact on motor development in children aged 18–42 months. This questionnaire can provide valuable insights into how to enhance home environments to better support children's motor development in Turkey. [ABSTRACT FROM AUTHOR]

This study investigated the potential influences of administration context on the measurement of child skills. The Brief Observation of Social‐Communication Change (BOSCC) was administered at two time points to preschool‐aged children with autism in two contexts: (1) at school by trained research staff and (2) at home by the parent. Participants were of ages 3–5 years (M = 4.27 years) old with a confirmed diagnosis of Autism Spectrum Disorder. Of the 13 participants (nine male), eight were White, three Asian, one Black and one White/Black; all identified as non‐Hispanic. The social‐communication and Core total scores yield similar information in both contexts, but Restricted and Repetitive Behaviors and Other Abnormal Behavior subscales scores were not related. These results underscore the importance of purposeful selection of measures and their administration context. [ABSTRACT FROM AUTHOR]

OBJECTIVES: There is little understanding of the circumstances behind fatal pediatric opioid poisonings. Our objective was to characterize opioid fatalities according to child, family, and household factors. METHODS: We used data from the National Fatality Review-Case Reporting System to describe the circumstances behind the deaths of children 0 to 17 years of age who died of an opioid poisoning (ie, prescription opioid, heroin, illicit fentanyl) between 2004 and 2020. Decedents were stratified into age groups: 0-4, 5-9, 10-14, and 15-17 years. RESULTS: The majority (65.3%) of the 1696 fatal opioid poisonings occurred in the child's own home. Prescription opioids contributed to 91.8% of deaths, heroin contributed to 5.4%, and illicit fentanyl to 7.7%. Co-poisonings with nonopioid substances occurred in 43.2% of deaths. Among 0- to 4-year-olds, 33.9% died of homicide and 45.0% had a primary caregiver with a history of substance use/abuse. Among 10- to 14-year-olds and 15- to 17-year-olds, respectively, 42.0% and 72.8% of decedents had a history of substance use/abuse. In each age group, at least 25.0% of children were victims of previous child maltreatment. CONCLUSIONS: A history of maltreatment and substance use--whether on the part of the caregiver or the child--are common factors surrounding fatal pediatric opioid poisonings, the majority of which occur in the child's own home. Families with children of all ages would benefit from interventions focused on opioid prescribing, storage, disposal, and misuse. These findings also underscore the urgency of ensuring that access to naloxone becomes universal for families with a history of maltreatment and/or substance use. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Contextual factors that contribute to firearm injuries among children aged 0 to 10 are not well understood. METHODS: A retrospective review of the National Fatality Review-Case Reporting System was conducted for firearm deaths of children aged 0 to 10 from 2004 to 2020. Descriptive analyses characterized child and parent demographics, incident details, firearm characteristics, and firearm use. Cluster analysis identified key clustering of contextual variables to inform prevention efforts. RESULTS: Within the study timeframe, 1167 child firearm deaths were reported (Mage 5 4.9; 63.2% male; 39.4% urban). At the time of the incident, 52.4% of firearms were reported unlocked and 38.5% loaded. Firearm deaths occurred primarily at the child's home (69.0%) or a friend or relative's home (15.9%), with most involving a handgun (80.6%). Children were supervised in 74.6% of incidents, and 38.4% of child supervisors were impaired during the incident. Cluster analysis identified incident contextual factors clustering in distinct groups, including unsupervised firearm play, long gun discharge while cleaning, hunting, or target shooting, supervised discharge within the child's home, murder-suicide events, deaths occurring in the context of intimate partner violence, and community violence firearm deaths. CONCLUSIONS: Data highlight the importance of primary prevention through secure firearm storage to prevent child firearm deaths. Efforts focused on identifying and reducing intimate partner violence, addressing community violence (eg, community greening), and implementing policy that limit firearm access (eg, domestic violence restraining orders, background checks), may reduce child firearm deaths. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To describe sudden unexpected infant deaths (SUIDs) occurring in safe sleep environments and explore differences in selected characteristics. METHODS: We examined SUID from 22 jurisdictions from 2011 to 2020 and classified them as unexplained, no unsafe sleep factors (U-NUSF). Data were derived from the Sudden Unexpected Infant Death and Sudden Death in the Young Case Registry, a population-based Centers for Disease Control and Prevention surveillance system built on the National Center for Fatality Review and Prevention's child death review program. SUID classified as U-NUSF included infants who were (1) awake, under supervision, and witnessed to become unresponsive or (2) found unresponsive in a safe sleep environment after sleep (unwitnessed). We calculated frequencies and percentages for demographics, birth and environmental characteristics, medical history, and death investigation findings. RESULTS: Most of the 117 U-NUSF SUID occurred before 4 months of age. Witnessed deaths most commonly occurred at <1 month of age (28%), whereas unwitnessed deaths most commonly occurred at ages 2 to 3 months (44%) Among all U-NUSF, 69% occurred in the infant's home (62% witnessed, 77% unwitnessed). All unwitnessed deaths occurred in a crib; most witnessed deaths occurred while being held (54%) or in a car seat traveling (18%). Most infants (84%) had no history of abuse or neglect. Abnormal autopsy findings were reported in 46% of deaths (49% witnessed, 42% unwitnessed). CONCLUSIONS: Characterizing these deaths is key to advancing our knowledge of SUID etiology. Our study revealed a heterogeneous group of infants, suggesting physiologic, genetic, or environmental etiologies. [ABSTRACT FROM AUTHOR]

The unconsolidated motor and cognitive skills that are typical of the early childhood period place infants, toddlers, and preschoolers at risk for a variety of traumatic injuries. Such injuries may include mild traumatic brain injury or concussion. Knowledge regarding the risk, diagnosis, outcomes, and management of early childhood concussion is limited, especially compared with what is known about concussion in school-age children, adolescents, and adults. This state-of-the-art review aims to provide current knowledge on the epidemiology, physical signs, behavior, and clinical outcomes associated with early childhood concussion. Research on this condition has been challenged by the need to adapt methods to the unique physical, behavioral, and developmental characteristics of young children. We provide information on observable symptoms associated with concussion, recommended approaches to care, and suggestions for overcoming barriers to research in this area. Developmentally appropriate efforts are needed to improve our ability to identify, evaluate, and treat early childhood concussion. [ABSTRACT FROM AUTHOR]

Background: Limited evidence suggests inequality in the prevalence of physical activity and screen time for children of non‐English‐speaking backgrounds (NESB). However, factors associated with these behaviours are understudied. This study identified the prevalence and correlates of meeting guidelines (physical activity, screen time and combined) among children of English‐speaking backgrounds (ESB) and NESB. Methods: Participants were from the Mothers and their Children's Health Study, a sub‐study of the Australian Longitudinal Study on Women's Health (1973–1978 cohort). Mothers provided information on physical activity and screen time behaviours of up to three children (aged 2–12 years). Age‐specific Australian guidelines were used to classify children as meeting or not meeting physical activity and screen time guidelines. Those born in a non‐English‐speaking country or primarily speaking a non‐English language at home were classified as 'NESB'. Multivariable‐adjusted logistic regression analyses accounting for family‐level clustering were used for analysis. Results: Data were from 4143 children (mean age 7.3 ± 2.9 years, 6.7% NESB). Around 17% children of NESB met physical activity guidelines (vs. 25% ESB, p = 0.002), 63% met screen time guidelines (vs. 58% ESB, p = 0.150), and 9% met combined physical activity and screen time guidelines (vs. 15% ESB, p = 0.011). Increasing age was inversely associated with meeting physical activity guidelines among children of both backgrounds (OR [95%CI]: NESB 0.81 [0.69–0.95], ESB 0.85 [0.82–0.87]). Family‐level correlates (maternal education and physical activity level) were associated with meeting physical activity, screen time or combined guidelines among children of ESB only. A screen device in the child's bedroom was inversely associated with all outcomes among children of ESB. Children of NESB with a large yard at home had higher odds of meeting physical activity (4.14 [1.72–10.00]) and combined guidelines (4.48 [1.61–12.41]). Conclusions: Children of NESB were less likely to meet physical activity and combined guidelines. Interventions may need to be tailored based on ESB background, with children of NESB (particularly older children and those with limited outdoor space at home) being a higher priority for intervention. Future large‐scale studies examining a broader range of potential correlates, including cultural factors, are warranted. [ABSTRACT FROM AUTHOR]

Aim: Children up to the age of 10 are dependant primarily on their caregivers for oral care; COVID‐19 lockdowns may have disrupted this care. We therefore assessed whether the COVID‐19 lockdown affected routine parental oral care for their children. Methods: A short online survey regarding oral health behaviour and changes in the home setting during the COVID‐19 lockdown was emailed to parents (n = 782, response 15%) participating in an existing study 'Healthy Teeth All Aboard (HTAA)'. Results: During the lockdown, 29% of parents reported that they skipped their children's toothbrushing more often than before the lockdown, and 49% of the children were allowed to consume sugary snacks or drinks more often. These behaviours were not significantly associated with socio‐economic status, country of birth of the mother, work situation of the parents, school attendance patterns or HTAA participation status. Conclusion: The COVID‐19 lockdown affected the daily oral hygiene routines of children, potentially increasing caries risk. Clinical Relevance: Dental professionals should be aware of the potential impacts on oral health in children in the circumstance of a new lockdown. Parents should be made aware of the oral health consequences of a lockdown. [ABSTRACT FROM AUTHOR]

SYNOPSIS: Objective. Toddlers learn language as they participate in everyday routines in the home environment. The Routine Language Intervention encourages caregivers to infuse language in everyday routines to support toddlers' language development. Design. Researchers collaborated with a Spanish-speaking, immigrant community in New York City to develop an intervention that is grounded in the routines that mothers commonly engage in with their toddlers. Altogether, 51 mothers participated in 6 months of group workshops and home visits. To test the efficacy of the intervention, mothers were videorecorded interacting with their toddlers at home before and after participating in the intervention. A comparison group of 12 families drawn from the same community was also videorecorded in their homes. Results. Mothers who participated in the Routine Language Intervention increased their speech to toddlers, nearly doubling word tokens and word types, and used more types and tokens than mothers in the matched comparison group. Increases in maternal speech were seen for words referring to targeted daily routines (e.g., mealtime, grooming, play and literacy) and extended to other words (e.g., unrelated household objects). Conclusions. Routine Language offers a culturally sensitive, easy-to-implement intervention that builds on families' everyday routines and yields benefits for toddlers' early language exposure. [ABSTRACT FROM AUTHOR]

Objectives: To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high‐income countries. Methods: A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non‐dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high‐income countries. Studies specifically looking at food insecurity during the COVID‐19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle–Ottawa Scale (with modifications for cross‐sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. Results: Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross‐sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross‐sectional studies including 336 585 participants was equivocal, particularly in the sugar‐sweetened beverage (SSB) consumption post‐hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross‐sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross‐sectional studies, 138 102 participants). A single cross‐sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. Conclusions: This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self‐care in food insecure populations. [ABSTRACT FROM AUTHOR]

Background: The literature suggests that educators can use parent–educator communication to support parents with engaging their children in home learning activities (Epstein, 1995; Hoover-Dempsey & Sandler, 1997). Objective: This study examines the relations between parent–educator communication and preschoolers' numeracy, literacy, executive function, and vocabulary, and explores if the home numeracy environment (HNE) and the home literacy environment (HLE) was a better predictor of children's outcomes than parent–educator communication. Method: Data for this study came from a larger quasi-experimental study evaluating a state-funded preschool program (n = 558). Regression models were run controlling for child's age, sex, race/ethnicity, family income, group, parental education, and baseline skill scores. Results: Analyses revealed a significant relation only between parent–educator communication and numeracy skills (β = − 0.14, p = < 0.001). Unexpectedly, more frequent parent–educator communication in preschool were related to lower numeracy skills. Additionally, there was a statistically significant association between all three predictors- parent-educator communication (β = − 0.15, p = < 0.001), the HNE (β = 0.14, p =.016), and the HLE (β = − 0.18, p =.004)- and children's numeracy skills. Specifically, more frequent parent–educator communication and higher HLE scores in preschool predicted lower numeracy skills. Additionally, the higher quality of the HNE predicted greater numeracy skills in the spring of preschool. Conclusion: There may be increased communication when the children are performing lower on their numeracy skills than their peers and teachers and parents are working to remediate those challenges. [ABSTRACT FROM AUTHOR]

Objective: Given prior craniofacial research reporting higher risk for negative social interactions, this study aimed to explore experiences of stigma described by children with cleft lip and/or palate (CL/P). Design: Qualitative interviews were conducted with children in three sessions (totaling 90–180 min) using creative activities in their homes and/or and walking interviews in their neighborhood. Interview transcriptions were interpreted primarily with thematic analysis following theoretical frameworks of the stigmatization process and self-stigma concept. Setting: Participants were recruited through Operation Smile Colombia. Interviews took place at children's homes and neighborhoods within three Colombian regions (Boyacá, Bogotá and Cundinamarca). Participants: Children (N = 12) with CL/P aged between 6–12 years were interviewed. Results: Themes fit within the stigmatization process, starting with labeling and stereotyping, such as a range of mockery, and group separation by peers highlighting their not belonging and being socially 'other'. Status loss themes included negative appraisals of cleft-related differences and being perceived as 'ill' and 'imperfect'. Social exclusion themes reflected limited social interactions and loneliness. Self-stigma themes included shame about speaking with peers and anticipation of negative social interactions. Conclusions: The study results suggest that the process of stigmatization and self-stigma adversely affect social interactions for children with a cleft in multiple ways. Healthcare practitioners and policy makers can help address the potential consequences of stigma by implementing interventions at micro, meso and macro levels. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Specific home tasks and the use of splints seem to positively affect altered structures and functions, as well as the activities and participation, of children with unilateral cerebral palsy (UCP). However, how did families experience the implementation of these therapies? Objective: To describe the experiences as they were perceived by the families of children with UCP before, during, and after a specific task intervention in the home environment, either with or without upper limb splinting. Methods: A qualitative, descriptive, phenomenological study was conducted in a natural environment. Fourteen families caring for children with UCP who participated in a previous randomized controlled trial were included. Data from unstructured and semi-structured interviews were analyzed through a thematic analysis. Results: Fourteen families (17 parents, age 37–47 years) caring for children with UCP (14 children, ages 6–10 years, 64% female) were interviewed. The following three themes emerged: "The project itself", in which families explained that they enrolled because of their trust in therapists; "Results obtained", where the main improvement was the integration of the assisting hand in the body schema; and "Lights and shadows", where families showed what they learned as positive points and some negative aspects related to the assessments and splints. Conclusions: The perceptions of the parents after the specific task intervention in the home environment showed a greater integration of the most affected side. Nevertheless, although the support of a splint on the hand can have beneficial results in terms of performance, other drawbacks leading to the disuse of the splint were highlighted. [ABSTRACT FROM AUTHOR]

Context Increasing numbers of patients and caregivers are requesting transition to blenderized tube feeding. There is a lack of systematic reviews addressing the outcomes of blenderized tube feeding. Objective The aim was to evaluate the association of blenderized tube feeding on feeding tolerance in enterally fed pediatric patients. Data Sources A literature search for articles from 2012–2022 using PubMed, Medline, Embase, and CINAHL yielded 78 articles. Data Extraction A description and evaluation of the study's sample, purpose, and results were summarized for 9 studies using the Academy of Nutrition and Dietetics Evidence Analysis Library Worksheet. Data Analysis Nine studies were evaluated using the Evidence Analysis Library Quality Criteria checklist. Conclusions Studies demonstrated an improvement in vomiting (n = 7), gagging/retching and heartburn (n = 6), abdominal pain/upset and distension (n = 3), and diarrhea (n = 6) with blenderized tube feeding. The outcomes of blenderized tube feeding on gas (n = 5) and constipation (n = 9) are variable and remain unclear. Systematic Review Registration PROSPERO registration no. CRD42022369247. [ABSTRACT FROM AUTHOR]

This longitudinal study investigates whether the quality of family interactions at 3–5 years of age predicts narrative abilities in 7–9‐year‐old children from socioeconomically disadvantaged families. The sample consists of 67 children and their parents receiving social welfare. Family interactions were filmed during mealtime at home and coded using the Mealtime Interaction Coding System. Children's narrative abilities were measured based on their capacity to coherently elaborate and resolve stories from the Attachment Story Completion Task. Results revealed that children exposed to family interactions of higher quality make their narratives more accessible and understandable and include more appropriate expression of affects in their stories 4 years later, even after accounting for maternal education and verbal abilities. The results of this study highlight the importance of considering family interactions in the context of financial insecurity when studying socioemotional competence in childhood. [ABSTRACT FROM AUTHOR]

Effective treatment of challenging behaviors in young children with autism spectrum disorder requires identifying consequences that maintain the behavior under specific environmental circumstances. Assessment strategies help to identify environmental factors setting the occasion for the behaviors to continue to occur. Many studies have used antecedent–behavior–consequence (ABC) data collection strategies, but few have examined its ability to effectively identify the function. Research supports the use of the trial-based functional analysis (TBFA) but few studies examine its effectiveness in the home setting. The current study attempted to answer which assessments might work best in the home setting. Treatment was implemented for each participant based on the results of their assessments. All assessments identified the function of behavior as verified by function-based treatments, but the ABC assessment identified additional functions for three of the participants while the TBFA was more precise. Implications and limitations are reviewed, along with future directions for behavioral assessment in the home. [ABSTRACT FROM AUTHOR]

Education plays a central role in promoting social inclusion, respect and dignity and therefore contributes significantly to economic and social progress. The accessibility and quality of education are directly related to the development of any country. Therefore, ensuring equal access to quality education is crucial for sustainable economic growth, especially in developing countries. UNICEF's ranking of Pakistan as the country with the second highest number of school dropouts in the world stimulated this study to address the alarming problem of large numbers of out-of-school children in marginalized communities such as Pakistan. The study aims to examine the multiple factors that stimulate dropout rates or out of school, including socioeconomic status, geographical location, child-related characteristics, child labor, skills and attitudes. Using data from MICS Wave 6 in Pakistan, this study proposes recommendations for educators and policymakers aimed at promoting equal educational opportunity and inclusive growth around the world. [ABSTRACT FROM AUTHOR]

Prior research highlighted the effect of home environment on the language development of young children. Recent research has mainly discussed the moderating effect of personality traits like temperament. Nevertheless, the precise mechanism about the relationship between home environments to children's language development remains incompletely understood. This study explored how home environment impacts the language development of 2-year-old toddlers and the role of temperament and executive function in this relationship. We used the Chinese Child Adaptive Behavior Scale, the Temperament Scale for 1-3 years old of toddlers and the Home Environment Scale for Infants' and Toddlers' families to assess children's language development, temperament, and home environment. Simultaneously, the research used the Stroop-like day-night task and themultiple location search task to evaluate children's executive function. A total of 117 2-year-old children as well as their parents were involved in the study. The results revealed that home environment significantly predicts children's language ability with executive function as a mediating role. Temperament dimensions including extraversion, independence, reactivity, and social inhibition play a moderating role between home environment and executive function. The findings contributed to the improved implementation of home education tailored to children with diffent temperament traits, offering effective support for the cognitive and language development of young children. [ABSTRACT FROM AUTHOR]

Young children receiving outpatient cancer care are vulnerable to undermanaged pain. App‐based solutions that provide pain treatment advice to parents in real‐time and in all environments may improve access to quality pain care. We used a parent co‐design approach involving iterative rounds of user testing and software modification to develop a usable Pain Caregiver Resource (PainCaRe) real‐time pediatric cancer pain management app. Parents of children (2–11 years) with cancer completed three standardized modules using a PainCaRe prototype. App usability and acceptability were evaluated using the validated System Usability Scale and a thematic analysis of app testing sessions and interviews. Iterative testing sessions were conducted until data saturation. Interview themes were synthesized into action items that guided revisions to PainCaRe and additional testing rounds were conducted as necessary. Twenty‐two parents participated in three testing cycles. Overall, parents described PainCaRe as an acceptable and potentially clinically useful pain management tool. Mean system usability scores were in the acceptable scale range during each testing cycle. Usability issues identified and resolved included those related to software malfunction, complicated app navigation logic, lack of clarity on pain assessment questions, and the need for pain management advice specifically tailored to child developmental stage. Using co‐design methods, the PainCaRe cancer pain management app was successfully refined for its acceptability and utility to parents. Next steps will include a PainCaRe pilot study before evaluating the impact of the app on younger children's pain outcomes in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Deviant behaviours are often classified as errors in the education received by the individual within the family. Children act according to the model seen at home, being a mirror of the environment where they develop their personality. The imprint that the family leaves on them will have effects throughout their life, influencing their later lifestyle. In this paper I intended to study one of the family personalities analysed by David Field and to observe the influence it has in the child's life. I chose to analyse the chaotic family personality, because it is one of the factors that most often determines the appearance of problematic behaviour in a child. The objectives I forward are 1) Analysing the way in which the child from the chaotic family understands the concept of family and 2) The link between the relationship between family members and the child's relationship with society. We shall study how the child is affected by the chaotic interaction in the family, and we will analyse the effects that the family environment has on the child's behaviour by studying the literature. Through the paper, we want to identify how the problems of the chaotic family environment affect the child's behaviour and relationships in interactions with other children, the school environment and society. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is a significant public health crisis that is exposing children to associated morbidities and premature mortality. However, parents can positively influence physical activity trajectories and improve health outcomes by nurturing fundamental movement skills (FMS) in children. This is the first study to explore the determinants of family FMS practice via a systematic synthesis of qualitative evidence. Methods: Keyword searches were completed in SPORTDiscus, PubMed, Scopus, Web of Science, and Embase. Studies that offered perspectives relating to influences on the FMS of 2–6-year-old children in the family context via qualitative approaches, including visual methodologies that provided an important voice to children, were included. A thematic analysis was used to establish key themes. Results: The emergent themes included parent knowledge and beliefs, self-efficacy of parents to teach, and the home environment. Parents often undervalued FMS and lacked the self-efficacy to teach due to poor understanding, conflicting priorities, and multifaceted societal influences. Children preferred autonomous play and socialisation but were negatively influenced by technology and restrictive household rules. Conclusions: Greater knowledge exchange between stakeholders is necessary to empower parents and enhance FMS application at home. More community initiatives could facilitate greater access to outdoor spaces, facilities, and equipment, which may improve family engagement with FMS. [ABSTRACT FROM AUTHOR]

Purpose: Understanding which physical activity (PA) and sedentary behavior correlates cluster in children is important, particularly in the home, where children spend significant time. Therefore, this study aimed to assess clustering of physical and social activity-related factors at home, and whether these clusters are related to home-based sitting and PA in children. A secondary aim was to explore whether the clusters were associated with child, parent, and family characteristics. Methods: Altogether, 235 children (55 % girls, mean age = 10.2 [0.7] y) and their parents took part. Physical (eg, PA and electronic media equipment, house and garden size, layout) and social (eg, activity preferences, priorities, parental rules) home environmental factors were obtained via the Home- SPACE-II audit and self-report, respectively. Principal component analysis was used to identify clusters of physical and social environmental factors. Backward regression analysis and partial correlations were used to examine relationships between clusters, children's device-measured home-based activity behaviors, and background characteristics. Results: The findings show that physical and social environment activity-related factors at home cluster. The clusters were associated with several background characteristics, with socioeconomic factors appearing to be particularly influential. The clusters were also associated with homebased activity behaviors in the hypothesized directions. Conclusion: Interventions which target clusters of social and physical factors at home, especially among low-socioeconomic status families. are warranted. [ABSTRACT FROM AUTHOR]

Background: Parental psychosis (bipolar disorder and schizophrenia) are major risk factors for mental health problems in offspring. Although interventions that focus on parenting and the family environment have shown effectiveness in mitigating this risk, no systematic review has examined the impact of simply treating adult bipolar disorder or schizophrenia on their dependent children’s outcomes. Aims: To systematically review the effects (in randomized controlled trials) of adult-based interventions for bipolar disorder and schizophrenia, on offspring mental health and wellbeing. Method: Eligibility criteria included randomized controlled trials that examined the treatment of adults with bipolar disorder and schizophrenia that also included child mental health and wellbeing outcomes. PubMed, Scopus, PsycINFO, and Psych Articles databases were searched. Results: 168,317 studies were reviewed; however, zero studies that met the inclusion criteria could be found. Conclusions: The existing research aimed at treating adult bipolar disorder and schizophrenia has so far overlooked the potential advantages that these treatments could provide for their offspring. This is a missed opportunity to understand the mechanisms of intergenerational transmission. Researchers examining treatments for adults with bipolar disorder and schizophrenia should, where appropriate, consider including both adult and child mental health outcomes in their trials. [ABSTRACT FROM AUTHOR]

Purpose: Ocular trauma is a major cause of visual impairment; however, little is known about its burden in Saudi Arabia. Therefore, this study aimed to determine the epidemiological characteristics of ocular trauma in pediatric patients in Riyadh, Saudi Arabia. Patients and methods: Medical records of pediatric patients diagnosed with eye injuries between January 2016 and December 2020 were retrospectively reviewed. Demographic and injury characteristics were collected, and ocular trauma injuries were classified according to the Birmingham Eye Trauma Terminology. Results: A total of 855 injured patients were included in the study, of whom 525 (61.4%) were boys. Patient age ranged from one month to 18 years. Most ocular injuries occurred in children aged 5–9 years. The injuries were more prevalent in boys than in girls. Closed globe injuries accounted for 70% of cases, open globe injuries for 21%, and other injuries for 9%. Most ocular injuries occurred at home (n = 87, 42%), followed by school (n = 61, 30%). Conclusions: These results may inform the implementation and targeting of interventions to reduce or prevent eye injuries in children. Further, they highlight the importance of well-planned prevention programs to prevent eye injuries from occurring in children's daily lives. [ABSTRACT FROM AUTHOR]

Firearm injuries are the leading cause of death among children and adolescents in the US. Safe storage of firearms in the home is one of the most effective ways of preventing firearm injuries in children. This feasibility study was conducted in both the pediatric and general Emergency Departments of a large urban academic medical center in a community with high rates of firearm injuries in children. The objective was to pilot a survey seeking to describe sociodemographic characteristics, firearm specific risk factors, and firearm storage practices of households with children in the community. One hundred participants completed a survey containing items regarding participant demographics, household features, firearm ownership, firearm characteristics, and storage practices. Descriptive statistics were used to define sociodemographic characteristics of the enrolled population, comparing those with firearms to those without, and to describe firearms and storage practices of firearm owners in households with children. Of 100 participants, 30 lived in households with firearms and children. Most firearms in homes with children were stored locked and unloaded most of the time; however, 30% of participants with firearms and children in the home reported not consistently storing a firearm locked and unloaded. The most common reason given for not storing a firearm in the safest manner possible was that storing a firearm locked and unloaded would make it difficult to access quickly. Engaging families with children in discussions around firearm prevention during Emergency Department visits is feasible and may have implications for future efforts to promote safe firearm storage practices. [ABSTRACT FROM AUTHOR]

Real-time attention coordination in parent–toddler dyads is often studied in tightly controlled laboratory settings. These studies have demonstrated the importance of joint attention in scaffolding the development of attention and the types of dyadic behaviors that support early language learning. Little is known about how often these behaviors occur in toddlers' everyday lives. We brought wireless head-mounted eye trackers to families' homes to study the moment-to-moment patterns of toddlers' and parents' visual attention and manual activity in daily routines. Our sample consisted of English- and Spanish-speaking families who all reported being middle- or upper middle-class. Toddlers were 2 to 3 years old. Consistent with the findings from previous laboratory studies, we found variability in how frequently toddlers attended to named objects in two everyday activities—Object Play and Mealtime. We then tested whether parent–toddler joint attention in the seconds before a naming utterance increased toddler's attention on the named object. We found that joint attention accompanied by the attended object being held increased the child's attention to the labeled object during naming. We posit that in the rich, noisy world of toddlers' everyday lives, embodied attention plays a critical role in coordinating dyadic behaviors and creating informative naming moments. Our findings highlight the importance of studying toddlers' natural behavior in the real world. Public Significance Statement: This study used eye-tracking glasses to measure toddler and parent attention at home and to test whether findings from laboratory tasks matter in the real world. Toddlers' attention to an object while it is named by their parent is thought to be important for word learning. We found that toddlers' attention to a named object increases when they and their parent coordinate their attention to held objects, supporting previous lab-based work. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the relationship between socioenvironmental sugar promotion and geographical inequalities in the prevalence of dental caries amongst 5‐year‐olds living across small areas within England. Methods: Ecological data from the National Dental Epidemiology Programme (NDEP) 2018–2019, comprising information on the percentage of 5‐year‐olds with tooth decay (≥1 teeth that are decayed into dentine, missing due to decay, or filled), and untreated tooth decay (≥1 decayed but untreated teeth), in lower‐tier local authorities (LAs) of England. These were analysed for association with a newly developed Index of Sugar‐Promoting Environments Affecting Child Dental Health (ISPE‐ACDH). The index quantifies sugar‐promoting determinants within a child's environment and provides standardized scores for the index, and its component domains that is, neighbourhood‐, school‐ and family‐environment, with the highest scores representing the highest levels of sugar promotion in lower‐tier LAs (N = 317) of England. Linear regressions, including unadjusted models separately using index and each domain, and models adjusted for domains were built for each dental outcome. Results: Participants lived across 272 of 317 lower‐tier LAs measured within the index. The average percentage of children with tooth decay and untreated tooth decay was 22.5 (SD: 8.5) and 19.6 (SD: 8.3), respectively. The mean index score was (0.1 [SD: 1.01]). Mean domain scores were: neighbourhood (0.02 [SD: 1.03]), school (0.1 [SD: 1.0]), and family (0.1 [SD: 0.9]). Unadjusted linear regressions indicated that the LA‐level percentage of children with tooth decay increased by 5.04, 3.71, 4.78 and 5.24 with increased scores of the index, and neighbourhood, school and family domains, respectively. An additional model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.37, and by family domain it increased to 6.33. Furthermore, unadjusted models indicated that the LA‐level percentage of children with untreated tooth decay increased by 4.72, 3.42, 4.45 and 4.97 with increased scores of the index, and neighbourhood, school, and family domains, respectively. The model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.24 and by family domain rose to 6.47. School‐domain was not significantly associated with either outcome in adjusted models. Conclusions: This study reveals that socioenvironmental sugar promotion, particularly within neighbourhood‐ and family‐environments, may contribute to geographical inequalities in dental caries in children. Further research involving data on individual‐level dental outcomes and confounders is required. [ABSTRACT FROM AUTHOR]

This paper explores the cultural conceptualisation of children's social identity and status through memorialisation, based on the study of children's grave markers and plots in five South Australian cemeteries (from colonisation to the present), with an age range from infant (including stillborn) to 20 years. The idea of childness, the differing conception of being or being labelled a child, was used as a measure to identify the degree of variation in child identity realised by child-only and family grave markers, showing both change and continuity in the representation of children through family choices of form, style, wording, motif, spatial arrangement and grave furniture. Archaeological evidence of childness was observed through representations of smallness, innocence, domesticity, play, temporality and the distinct emotional nature of the parent-child relationship. Notably in the latter period of study, within the context of lower child mortality, revised understandings of child identity and status were observed representing the social re-evaluation of prenatally deceased and stillborn children. [ABSTRACT FROM AUTHOR]

Background: Mental health and health-related quality of life (HRQoL) in children and adolescents deteriorated during the COVID-19 pandemic. The aim of this population-based longitudinal study was to explore whether distinct mental health trajectories in youths can be identified over the course of the pandemic. Methods: Mental health problems (MHP), psychosomatic symptoms and HRQoL were assessed at five time points between May 2020 and October 2022 in 744 children and adolescents aged 7 to 20 years using established instruments. We used generalized mixture modeling to identify distinct mental health trajectories and fixed-effects regressions to analyse covariates of the identified profiles of change. Results: We found five distinct linear latent trajectory classes each for externalising MHP and psychosomatic symptoms and four trajectory classes for internalising MHP. For HRQoL, a single-class solution that indicates a common development process proved to be optimal. The largest groups remained almost stable at a low internalising and externalising symptom level (64 to 74%) and consistently showed moderate psychosomatic symptoms (79%), while 2 to 18% showed improvements across the pandemic. About 10% of the youths had consistently high internalising problems, while externalising problems deteriorated in 18% of youths. Class membership was significantly associated with initial HRQoL, parental and child burden, personal resources, family climate and social support. Conclusions: The mental health of most children and adolescents remained resilient throughout the pandemic. However, a sizeable number of youths had consistently poor or deteriorating mental health. Those children and adolescents need special attention in schools and mental health care. [ABSTRACT FROM AUTHOR]

The present study investigated the relation between continuous measures of two qualitatively different types of bilingual experience and outcome measures that varied in domain (verbal or nonverbal) and processing demands (degree of conflict). Participants were 195 English-speaking children, 7 years old, who were enrolled in French immersion programs. Children were assessed for their degree of "home bilingualism," reflecting language use patterns at home, and "school bilingualism," reflecting progress in learning French. None of the children spoke French at home. Participants completed verbal fluency, n-back, and global–local tasks, with conditions within tasks varying in degree of attentional processing required. Type of bilingual experience affected verbal and nonverbal tasks differently. Home bilingualism was positively associated with performance on attentionally demanding conditions of the n-back and global–local tasks, the two nonverbal tasks, whereas school bilingualism was positively associated with performance on English verbal fluency, the linguistic task. In both cases, results were modulated by the degree of bilingual experience. These results underline the importance of specifying the type and degree of bilingual experience and the details of the outcome tasks to understand the impact of bilingualism on children's development. Public Significance Statement: The possibility that bilingualism impacts children's cognitive development is controversial, but parents must make crucial decisions about their children's linguistic environments despite the absence of clear evidence. However, bilingualism can be achieved in different ways and the outcomes can be measured in different domains. The present study compares the effect of bilingualism achieved through heritage language use at home and language education in school on verbal and nonverbal task performance. The results show specific effects of each form of bilingualism on each type of outcome, underlining the complexity of these relations. [ABSTRACT FROM AUTHOR]

A small but growing body of research in pediatric feeding disorders asserts the importance of comprehensively measuring social significance of goals, procedures, and effects of intervention, and incorporating social validity into practice to inform treatment. This report sought to extend this literature by detailing procedures to measure and improve social validity during a clinical case of a 3.5‐year‐old during a home‐based intensive feeding program. A multiple baseline design demonstrated effectiveness of nonremoval and re‐presentation added to a treatment package. Repeated choice via direct child preference assessments informed demand fading and gradual progression across six feeding skill domains (medication, cup drinking, independence, texture, volume, variety) and arrangements of response effort (preference, skill) with layers of reinforcer parameters (quality, magnitude, rate, immediacy). Indices of happiness definitions were modified, and extinction bursts examined. Fostering a collaborative approach, caregivers provided detailed input on social validity measures pretreatment, at discharge, and long‐term follow‐up (6‐month, 1‐year), inclusive of both qualitative and quantitative responses, written and verbal communication, and permanent product data. Further implications for practitioners included detailing the process for caregiver training and generalization to family meals with siblings and community settings, and providing adaptable full‐text guidelines for free access/choice contexts. [ABSTRACT FROM AUTHOR]

Purpose: Emerging literature suggests caregiver self-efficacy is an important factor related to caregivers’ shared reading practices with their children. Reduced shared reading has been documented among families of caregiver(s) with language-based learning disabilities (LBLD). Yet, it remains unclear whether caregivers’ history of language and reading difficulties is associated with caregiver self-efficacy. The purpose of this study was to examine whether self-efficacy in language- and reading-related caregiver activities related to caregiver history of language and reading difficulties and shared reading practices. Method: One hundred seventy-six caregivers of children aged 18–60 months completed a custom self-efficacy in language- and reading-related caregiver activities questionnaire, as well as demographic, history of language and reading difficulties (used both as a continuous measure and to dichotomize caregivers with and without LBLD history), and shared reading measures in a one-time survey. Results: Caregivers with a history of LBLD reported an overall lower self-efficacy and a reduced amount of time reading with their children per week than caregivers without LBLD history. Examining caregiver history of language and reading difficulties continuously across the whole group, self-efficacy mediated the relationship between caregiver difficulties and shared reading practices, even when caregiver education was incorporated as an additional mediator in models. Conclusions: Findings indicate that self-efficacy and caregiver education mediate the relationship between caregiver history of language and reading difficulties and shared reading practices. Consideration of self-efficacy by clinicians and educators is warranted when promoting shared reading practices to caregivers of young children. There is a need for future research to examine relationships between self-efficacy and shared reading among caregivers with LBLD of culturally and linguistically diverse backgrounds. [ABSTRACT FROM AUTHOR]

We examined the consequences of the Coronavirus pandemic on the psychosocial, behavioral, and cognitive functions of Arab Israeli children aged 3–12 years. The findings of an online cross-sectional survey indicated that, as reported by the parents (N = 267), during the Coronavirus pandemic, most of the children expressed more behavioral and concentration problems. Almost 85% of the children felt more bored, and more than 50% were sadder, more reluctant, more frustrated, and felt lonely. Moreover, almost half of the children had sleep difficulties and tended to eat more than before. Boys and elementary school children were more vulnerable. The findings highlight the susceptibility of the children to the psychosocial consequences of Coronavirus and underline the need for interventions. [ABSTRACT FROM AUTHOR]