Search Results (195)

Background: Family-centered care (FCC) is a foundational principle in pediatric healthcare, yet its implementation in culturally specific contexts remains poorly understood. In Saudi Arabia, Islamic values, collective family structures, and gendered caregiving norms shape how mothers engage with pediatric intensive care in ways that existing Western-derived FCC models do not fully capture. The aim of this study was to explore Saudi mothers’ experiences of family-centered care during their children’s pediatric intensive care unit (PICU) admissions, focusing on perceived barriers, cultural negotiations, and evolving advocacy strategies. Methods: A qualitative descriptive study was conducted with 17 Saudi mothers whose children had been admitted to PICUs across major hospitals in Saudi Arabia within the preceding 12 months. Semi-structured interviews lasting 40–70 min were conducted in Arabic using a pilot-tested, 15-item guide. Data were analyzed through Braun and Clarke’s six-phase reflexive thematic analysis. Trustworthiness was strengthened through member checking, reflexive journaling, negative case analysis, and investigator triangulation. Reporting adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ). Result: Five interconnected themes emerged: (1) confronting crisis and uncertainty, (2) renegotiating maternal identity, (3) brokering culture within biomedicine, (4) forging trust with care teams, and (5) evolving into advocates. These themes trace a developmental arc from initial disorientation through progressive empowerment, shaped at every stage by culturally grounded resources and constraints. Mothers functioned as cultural brokers performing invisible labor that healthcare systems neither recognized nor supported. Conclusions: Saudi mothers in PICUs engage in sophisticated cultural mediation between family systems and biomedical institutions under conditions of acute stress. Findings underscore the need for structurally embedded cultural responsiveness in PICU policy, including continuous cultural assessment, care-team continuity, and family advocacy support. Full article

Background: Parents of children with disabilities often experience reduced quality of life (QoL), yet validated Arabic instruments remain limited. This study aimed to translate and validate the Arabic version of the Multicultural Quality of Life Index (MQLI-Ar). Methods: A cross-sectional study was conducted among 132 parents and caregivers in Saudi Arabia. The MQLI was translated using forward–backward translation and culturally adapted. Reliability and validity were assessed using Cronbach’s alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Results: The MQLI-Ar demonstrated high internal consistency (Cronbach’s alpha = 0.948). EFA supported a unidimensional structure explaining 68.3% of the variance. CFA indicated acceptable model fit (CFI = 0.934, TLI = 0.915, SRMR = 0.0397), although RMSEA was elevated. Factor loadings ranged from 0.642 to 0.919, confirming strong item–factor relationships. Conclusions: The MQLI-Ar is a reliable and valid tool for assessing QoL among Arabic-speaking caregivers of children with disabilities, supporting its use in research and clinical practice. Full article

Digital transformation has profoundly reshaped caregiving practices, yet its influence on family cohesion within disability contexts remains underexplored, particularly in Arab societies. This qualitative phenomenological study examines how digital technologies shape family cohesion among Jordanian caregivers of children with disabilities. In-depth, semi-structured interviews were conducted with 22 primary caregivers, and data were analyzed using reflexive thematic analysis. The findings reveal a central tension of being “between connectivity and care,” articulated through four interrelated themes: (1) a digital double-bind in which online support networks function as a vital “virtual village” while simultaneously contributing to intra-familial fragmentation; (2) the reconfiguration of care labor, whereby digital management emerges as an invisible and gendered form of caregiving work, often positioning mothers as primary digital coordinators; (3) the translation of traditional social capital (wasta) into digital spaces to navigate systemic resource constraints, producing new moral and emotional burdens; and (4) the strategic use of digital platforms to preserve cultural, religious, and familial identity in the face of stigma, thereby reinforcing internal cohesion. These findings suggest that digital technologies do not merely facilitate connection but actively reconfigure family dynamics through ongoing negotiation between support and strain. The study underscores the need for family-centered digital inclusion policies and support interventions that mitigate digital burdens while harnessing technology’s potential to strengthen culturally grounded resilience among families of children with disabilities. Full article

Background/Objectives: Receptive vocabulary is essential for children’s language, academic, and cognitive development. While cochlear implants (CIs) help children with severe to profound hearing loss develop spoken language, their vocabulary skills often fall behind their typical hearing (TH) peers, although early implantation and auditory-verbal therapy (AVT) can help narrow this gap. Children with CIs and other developmental difficulties face additional challenges, but can still progress, with outcomes depending on the disabilities’ type and severity. Limited research exists on Arabic-speaking children with CIs, where cultural factors may delay intervention, and outcomes vary widely. It remains unclear how well these children develop receptive vocabulary compared to hearing peers and which factors influence their progress. Methodology: A multicenter, cross-sectional study in six GCC hospitals compared 103 children with CIs to a control group of 94 children with TH. Children with CIs were divided into those with and without additional difficulties. Receptive vocabulary was evaluated utilizing the Peabody Picture Vocabulary Test, Fifth Edition. Results: Children with CIs in the GCC scored lower (mean 89.5; SD = 20.5) than the TH control group (mean 104; SD = 16.8). Children with CIs without additional difficulties (mean 97.7; SD = 18.8) scored similarly to TH, while children with CIs and additional difficulties scored significantly lower (mean 76.7; SD = 15). Age at switch-on and presence of additional difficulties significantly affected receptive vocabulary outcomes. Conclusions: Children with CI who have no additional disabilities can reach receptive vocabulary levels similar to typical hearing peers, while those with extra difficulties show very diverse outcomes and continue to face challenges. Full article

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and may persist into adulthood, characterized by inattention, impulsivity, and hyperactivity leading to functional impairment. The global prevalence in children and adolescents ranges from 5–7%, yet data from the Eastern Province of Saudi Arabia remain limited. This study determined the prevalence of hyperactive/impulsive and inattentive symptoms among children and adolescents aged 4–18 years and identified associated factors. A cross-sectional study was conducted across major cities using validated Arabic versions of the SNAP-IV and NICHQ Vanderbilt Assessment Scale distributed online. The survey assessed ADHD symptoms, oppositional defiant disorder, conduct disorder, anxiety/depression, functional impairment, and prenatal and perinatal risk factors, with DSM-based scoring and multivariable logistic regression to identify predictors. Among 920 participants (mean age 10.7 years; 52.9% boys), 12.7% met criteria for ADHD. The inattentive subtype was most common, followed by combined and hyperactive/impulsive types. Affected children and adolescents showed academic and interpersonal difficulties. Significant predictors included younger age, birth weight <1.5 kg, psychiatric history, previous ADHD diagnosis, and family history of psychiatric or neurological disorders. ADHD symptoms were relatively common and associated with functional impairment and identifiable developmental and familial risk factors. Full article

Due to high intraclass variability and subtle intercharacter differences, automatic Arabic handwriting recognition remains a challenging task, particularly for children’s handwriting. This study proposes a hybrid framework that combines class-conditional Wasserstein generative adversarial networks with gradient penalty (CWGAN-GP) for data augmentation and a convolutional neural network (CNN) enhanced with squeeze-and-excitation (SE) blocks for improved feature discrimination. Experiments were restricted to disconnected (isolated) characters from the Hijja dataset, which comprised 12,355 samples divided as follows: 80% for training (9884), 10% for validation (1236), and 10% for testing (1235). Training the CNN on real data alone yielded an accuracy of 93.47%, while incorporating CWGAN-GP-generated samples improved performance to 96.27%. Notably, the proposed SE-CNN trained with the CWGAN-GP-augmented data achieved the highest accuracy of 99.27%. This result demonstrates that the combination of advanced generative data augmentation and architectural refinement significantly enhances Arabic handwritten character recognition performance. Full article

Cyber-trauma has emerged as an important concern within online gaming environments, with growing implications for children’s mental health and well-being. Multiplayer games increasingly function as routine spaces for interaction, competition, and informal learning, which may expose young players to hostile behaviours such as harassment, hate speech, exclusion, and repeated targeting. Understanding the psychological consequences of these experiences and the protective role of family support is therefore essential. This study investigates the relationship between cyber-trauma victimisation (CV) and four mental health outcomes—depressive symptoms (DS), anxiety symptoms (AS), perceived stress (PS), and emotional distress (ED)—among Generation Alpha student gamers, while examining parental support as a moderating factor. Survey data were collected from 1223 students of diverse Arab nationalities enrolled in schools in Saudi Arabia, with Saudi nationals representing approximately 15% of the sample. The results indicate that CV is a strong and consistent predictor of all examined mental health outcomes. Higher levels of CV are significantly associated with increased depressive symptoms (β = 0.58), anxiety symptoms (β = 0.55), perceived stress (β = 0.52), and emotional distress (β = 0.60) (all p < 0.001). Parental support significantly moderates these relationships, weakening the association between cyber-trauma exposure and adverse psychological outcomes. These findings contribute to the growing literature on children’s digital well-being by demonstrating that online gaming environments can serve as meaningful psychosocial stressors for young players. The results further highlight the importance of family-centred protective mechanisms, suggesting that parental emotional support, guidance, and communication can play a critical role in buffering the mental health risks associated with hostile online interactions. Full article

Developmental Language Disorder (DLD) is a common neurodevelopmental condition that affects language acquisition in children. However, standardized diagnostic tools for Tunisian Arabic, a widely spoken yet underrepresented dialect, is still lacking. This study presents a multimodal biomedical informatics framework that integrates clinical assessments, speech recordings, and artificial intelligence (AI) for early DLD detection. Three linguistic tasks (the CLT Task, the Arabic Verb Evaluation Task, and the Nonword Repetition Task) were adapted for Tunisian Arabic, and spontaneous speech samples were collected from children with typical development and those with DLD. Statistical analyses revealed significant deficits in verb production, past-tense morphology, and phonological memory in the DLD group. For automated screening, we developed two systems: a Random Forest classifier based on structured clinical and linguistic features and a multimodal deep learning model using Wav2Vec2 acoustic embeddings. The best model achieved an F1 score of 0.85, demonstrating the feasibility of AI-assisted DLD screening. This work introduces the first standardized dataset and computational baseline for DLD in Tunisian Arabic, providing clinically relevant tools for early identification and supporting research on underrepresented Arabic dialects. This work also highlights future implications, including potential applications in early screening, the integration of acoustic markers, and the development of culturally adapted assessment tools for underrepresented languages. Full article

This study investigates the family language policies (FLPs) of two North Indian Muslim families residing in Saudi Arabia, focusing on how they navigate multilingualism to balance cultural heritage, religious practices, and sociolinguistic adaptation. Using Spolsky’s FLP framework and a qualitative case study approach, the research examines the dynamic roles of Urdu, Arabic, and English in these households. Semi-structured interviews were conducted with mothers and children to explore language ideologies, practices, and management strategies. The findings reveal that Urdu serves as a cornerstone of cultural identity, while Arabic is pivotal for religious education and social integration. English plays a supplementary role as a tool for academic and professional aspirations. Despite shared goals, the families adopt distinct approaches: one emphasizes heritage preservation and liturgical Arabic, while the other integrates Arabic more comprehensively alongside Urdu. These insights contribute to FLP scholarship by highlighting the intersection of language, faith, and identity in transnational families in non-western context, offering practical implications for educators and policymakers working with multilingual communities. Full article

This study aimed to identify young school students’ language learning strategies (LLSs) within their diverse socio-linguistic reality. The study was conducted in one elementary school in a peripheral city characterized by a heterogeneous population (Arabs and Jews) and immigrants from various countries who speak multiple languages. The principal of this school opted to introduce young children (Grades 1 and 2) to four languages: Hebrew, as a socially dominant language; Russian and Arabic, as the children’s home languages; and English, as a global language. We used photo elicitation and dialogical conversation to obtain reflections of 11 Arab and Jewish students (Grade 2). Each student was asked to describe the strategies they used to learn a novel language in the classroom and at home. Findings support the appropriateness of Oxford’s taxonomy to young language learners: all LLSs’ categories were reported. This study contributes to our understanding of children’s ability to use LLSs in early primary school. It highlights the leading role of language teachers who seem to mediate by modelling LLSs. Furthermore, it enriches the understanding of how 7–8-year-old learners can use diverse metacognitive LLSs and transfer them across languages. We also found one “child-specific” characteristics of the strategy related to parental involvement. Full article

Background: Childhood obesity is a growing public health concern globally and is associated with a wide spectrum of comorbidities, including sleep-disordered breathing (SDB). SDB remains under-recognized in pediatric population with obesity, particularly in Middle Eastern settings, despite its significant impact on cognitive, behavioral, and metabolic health. Objectives: To assess the prevalence of SDB among children with obesity aged 6–12 years attending King Faisal University polyclinics in Saudi Arabia and to identify key demographic and anthropometric predictors, with particular emphasis on the mediating role of neck circumference. Methods: A cross-sectional study was conducted involving 130 children with obesity aged 6–12 years. Data collection included sociodemographic characteristics, anthropometric measurements (BMI percentile, neck and waist circumference), and screening for SDB using the validated Arabic version of the Pediatric Sleep Questionnaire Sleep-Related Breathing Disorder (PSQ-SRBD) scale. Logistic regression and mediation analyses were performed to examine associations and pathways between obesity parameters and SDB risk. Results: Of the 130 participants, 37.7% screened positive for SDB risk. SDB prevalence was higher among males and older children. Neck circumference and BMI percentile were independently associated with SDB risk, with neck circumference mediating the relationship between BMI and SDB. The mediation model indicated that increased BMI contributes to SDB risk both directly and indirectly through increased neck circumference. Conclusions: SDB is highly prevalent among obese Saudi children, and neck circumference is a significant mediator of risk. Incorporating SDB screening and neck circumference measurements into routine pediatric obesity care can facilitate early detection and management. These findings support the need for integrated, multidisciplinary approaches to improve pediatric health outcomes. Full article

Background/Objectives: Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder characterized by social, communication, and behavioral challenges. complementary and alternative medicine (CAM) is widely used by parents worldwide, yet research exploring parents’ experiences, particularly in Arab countries, is limited. This study explored mothers’ perceptions and experiences of CAM use for children with ASD, information-seeking behaviors and challenges encountered. Methods: A qualitative study using semi-structured interviews was conducted among twenty mothers at Autism Academy of Jordan in 2024. Inclusion criteria were mothers with children diagnosed with ASD for at least six months and those who had used at least one CAM therapy. Interviews were conducted via Skype, transcribed verbatim, and analyzed using NVivo 12 with inductive thematic analysis. Results: Three major themes emerged in this qualitative study: (1) mothers’ experiences with CAM and perceptions of benefit; (2) sources of information and decision-making processes; and (3) main challenges in selecting and implementing CAM. Mothers reported using therapies such as honey, black seed, camel milk, Hujama, olive oil, supplements, and region-specific programs like Andalosiah. Faith, cultural beliefs, and the desire for natural, safe interventions strongly influenced CAM selection. Internet searches and social media groups were primary information sources. Challenges included financial, logistical, emotional burdens, and lack of trustworthy, Arabic-language information sources. Conclusions: Mothers in Arab countries navigate CAM use for their children with ASD through culturally and religiously informed practices. Interventions should focus on developing evidence-based guidance, culturally sensitive counseling, and accessible information to support families in safe, informed CAM use. Full article

Aim: This cross-sectional study aimed to evaluate and compare parents’ and children’s preferences for full-coverage restorative treatment options of primary molars, including stainless steel crowns (SSCs), zirconia crowns (ZCs), and BioFlx crowns. Additionally, the study evaluates the influence of providing a brief overview of the advantages and disadvantages of each full-coverage restorative treatment option on parental preference. Methods: The study was conducted at the pediatric dental clinics at King Abdulaziz University Faculty of Dentistry (KAUFD) in Jeddah, Saudi Arabia, from January to May 2024. Healthy Arabic-speaking children aged 6–12 years attending KAUFD for routine dental treatment, along with at least one parent who agreed to participate, were included. Three typodont models with a SSC, a ZC, and a BioFlx crown were prepared and cemented by an expert pediatric dentist. The participating children and their parents were simultaneously and independently shown the prepared typodont models and asked to indicate which treatment option they preferred most. Subsequently, a trained pediatric dentist presented a brief overview of the advantages and disadvantages of each treatment option to the parents. Then, parents were asked to re-evaluate their preferences. The threshold for significance was set at p < 0.05. Results: A total of 172 children and their parents were included. The most preferred full-coverage restorative treatment among children was SSC (39.0%), while among parents, ZC (60.5%) was the most preferred. After providing a brief overview, the most preferred option among parents was SSC (39.5%), with ZC and BioFlx crowns being equally preferred (30.2%). Significantly more children with no history of dental pain or discomfort (49.1%) (p = 0.023) or with a history of previous dental treatment involving SSC (40.2%) (p = 0.045) preferred SSC. The ZC was significantly more preferred by parents of female children (70.65%) (p = 0.027) and by parents of children with a history of dental treatment (60.6%) (p = 0.018). Conclusions: The study revealed that parental demands and expectations often differ from those of their children, leading to notable differences between children’s and parents’ preferences. After a brief overview, parental preference shifted from ZC to SSC, highlighting the importance of effective communication and education when making treatment decisions for pediatric patients. Full article

Background/Objectives: Research about the effects of schizophrenia, along with caregiver burden, exists extensively in Western countries. However, research on Middle Eastern societies, especially Saudi Arabia, is limited. We assessed the burden experienced by caregivers of individuals with schizophrenia and identified the associated factors contributing to it. Methods: The current cross-sectional study was conducted in Jeddah, Western Saudi Arabia, from December 2024 to March 2025. We used a validated Arabic data collection tool comprising 22 items that assessed five domains of caregiver burden. The associations between background characteristics and individual domains were determined by the Mann–Whitney U test and the Kruskal–Wallis test. We applied binomial regression analysis to find the factors associated with caregiver burden. Results: Of the 330 participants studied, no burden was observed in 17.9%. The remaining had mild (25.8%), moderate (34.8%), and severe (21.5%) burdens. Among the domains, emotional strain showed the highest mean (11.52 ± 4.32), followed closely by time and social limitations (11.29 ± 5.07) and health and financial impacts (11.08 ± 5.08). The caregiver burden was significantly higher among the adult children caring for their parents (p = 0.034) and lower among the participants working in the government sector (p = 0.022). Conclusions: The findings suggest a policy-relevant support program that includes workplace flexibility and financial help to manage their overall caregiving load and improve their health. Future research should explore the effectiveness of support strategies tailored to caregivers in different sociocultural contexts to enhance both caregiver and patient outcomes. Full article

Recognizing handwritten Arabic characters written by children via scanned or camera-captured images is a challenging task due to variations in writing style, stroke irregularity, and diacritical marks. Although deep learning has advanced this field, building reliable systems remains challenging. This study introduces a stacking ensemble framework for sensor-acquired handwriting data, enhanced with a dynamic confidence-thresholding mechanism designed to improve prediction reliability. The framework integrates three high-performing convolutional neural networks (ConvNeXtBase, DenseNet201, and VGG16) through a fully connected meta-learner. A key feature is the use of an optimized threshold that filters out uncertain predictions by maximizing the macro ${\mathrm{F}}_1$ score on validation data. The framework is evaluated on two benchmark datasets for children’s Arabic handwriting: Hijja and Dhad. The results demonstrate state-of-the-art performance, with an accuracy of $95.13\%$ and ${\mathrm{F}}_1$ score of $94.62\%$ on Hijja and an accuracy of $96.14\%$ and ${\mathrm{F}}_1$ score of $95.59\%$ on Dhad. Compared to existing methods, the proposed approach achieves more than a $3\%$ improvement in Hijja accuracy while maintaining robust performance across diverse character classes. These findings highlight the effectiveness of confidence-based stacking ensembles in enhancing reliability for Arabic handwriting recognition and suggest strong potential for automated educational assessment tools and intelligent tutoring systems. Full article