Search Results (211)

Background/Objectives: Juvenile idiopathic arthritis (JIA) and inflammatory bowel disease (IBD) are chronic autoimmune conditions that impact the physical and psychological well-being of pediatric patients. While previous studies have shown a high prevalence of mental health challenges among youth with chronic conditions, the prevalence of mental health issues in Canadian pediatric patients with JIA and IBD remains unclear. We aimed to estimate the prevalence of documented mental health disorders and related medication use of youth with JIA or IBD at a tertiary care centre. Methods: We conducted a retrospective chart review of youths aged 12–17 diagnosed with JIA or IBD at McMaster Children’s Hospital (MCH) to understand the prevalence of generalized anxiety disorder (GAD), separation anxiety disorder, social anxiety disorder (SAD), obsessive–compulsive disorders (OCD), eating disorders, major depressive disorder (MDD), adolescent adjustment disorder, suicide attempt/suicide ideation, self-harm behaviour, substance use disorder, and attention deficit disorders (ADD). Results: We reviewed 429 patient charts, including 303 patients with IBD and 126 with JIA. Our findings identified 90 IBD patients and 20 JIA patients who had one or more documented mental health conditions. Proportionately, there was a higher prevalence of mental health conditions among IBD patients (30%) compared to JIA patients (16%). The most frequently observed conditions in both IBD and JIA patients were GAD (63%, 50%), ADD (33%, 35%), and MDD (29%, 15%). Conclusions: These findings highlight the critical need for early mental health screening and integrated care approaches that address both medical and psychosocial needs in adolescents with chronic illnesses. Future research should incorporate prospective study designs, include diverse geographic and demographic populations, and explore targeted interventions to improve mental and physical health outcomes in this vulnerable group. Full article

Background: Indigenous peoples in Canada endure lasting effects of colonialism including racism, marginalization, and social, political, and geographic inequities resulting in disproportionate rates of disease and inequitable healthcare. Indigenous infants and children in Canada experience a high incidence of birth complications and illnesses, and families are often left to navigate the care of their child with limited resources. Accordingly, improved, culturally responsive and safe healthcare is needed to enhance child outcomes and optimize family well-being. Purpose and Methods: A qualitative study was conducted by our research team including family members of Indigenous children with serious illnesses, a Cultural Advisor, researchers, and pediatric clinicians. In one component of the study, we explored pediatric healthcare providers’ (HCPs) experiences of caring for Indigenous families of children with serious illness. A purposive sample of 19 pediatric healthcare providers took part in semi-structured qualitative interviews or one focus group. The data were analyzed thematically to identify common experiences and priorities for improved supportive healthcare. Findings: Five themes were identified representing insights from pediatric HCPs, with a focus on barriers to effective healthcare at the interpersonal, institutional, and system levels for seriously ill Indigenous children and their families. Ideas for enhancing the social and cultural responsiveness and safety of supportive healthcare were identified. Implications and Conclusions: The findings offer valuable insights and strategies for HCPs to support holistic, comprehensive, and culturally safe and responsive healthcare. Full article

Drawing on data from a three-year longitudinal study of 56 Chinese–Canadian families with early elementary school-aged children, this study explores Chinese immigrant parents’ lived-through emotional experiences of heritage language maintenance (HLM). Informed by Vygotsky’s concept of perezhivanie, thematic analysis of annual interview data reveals the mixed and refracted nature of parental emotions involved in Chinese language preservation and bilingual child-rearing. These emotional experiences were profoundly shaped by the intersection of environmental, personal, and situational factors and were deeply entangled with parents’ perceptions of and attitudes toward their children’s heritage language learning and use at home. The emotional work involved significantly influenced the parents’ language and literacy planning and HLM practices. By foregrounding the emotional dimensions of heritage language education, this study offers important implications for educational stakeholders seeking to support immigrant parents both emotionally and practically in raising bilingual children in the host country. Full article

Background/Objectives: Canadian guidelines for diagnosing fetal alcohol spectrum disorder (FASD) strongly recommend using direct measures to assess brain domains whenever possible. Executive functioning, one of the brain domains assessed, can be measured using direct and indirect measures; however, research has found discrepancies between these two forms of assessment and has not examined this relationship using ratings from the newest version of one of the most commonly used indirect measure of executive functioning, the second version of the Behavior Rating Inventory of Executive Functioning (BRIEF2). Academic achievement may also help explain discrepancies between these forms of assessment, especially in indirect executive functioning skills at school, because many of the items on the BRIEF2 Teacher Form are related to school skills. This study aimed to examine the relationship between direct measures of executive functioning, indirect measures of executive functioning, and academic achievement. Methods: Charts of 74 children who completed an FASD diagnostic assessment in Canada were included in this study (61% males; 58% with FASD; M_age = 11.77). Direct and indirect measures of executive functioning across settings and academic achievement were assessed. Results: Few correlations between corresponding BRIEF2 and direct measures of executive functioning were significantly associated. There were several significant correlations between academic achievement and (a) educator ratings on the BRIEF2 and (b) direct measures of executive functioning. None of the caregiver ratings on the BRIEF2 were significantly associated with academic achievement. Conclusions: The results suggest that academic performance is related to BRIEF2 ratings of executive functioning skills at school and direct measures of executive functioning. Aside from a few exceptions, direct and indirect measures of the same executive functioning skill were not correlated. Full article

Objective: To comprehensively evaluate the interaction between diet quality and multivitamin intake during pregnancy on offspring neurodevelopment. Methods: This analysis was grounded in mother-child dyads from the 3D Cohort Study in Quebec, Canada. Among the 2366 participants initially enrolled in the 3D study, 1535 women successfully completed the 3-day food record during 20–24 weeks of gestation. A Canadian adaptation of the Healthy Eating Index (HEI-C) 2010 was used to quantify diet quality. The total HEI-C score was dichotomized into low and high diet quality by median split. Cognitive and motor development in childhood were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Language abilities were measured using the toddler short-form version of the MacArthur–Bates Communicative Development Inventories (MCDI) questionnaire, administered in either English or French. After excluding participants with missing covariate data, cognitive, motor, and language development scores at 2 years of age were available for 1066, 1040, and 981 children, respectively. Multiple linear regression models were employed to calculate adjusted effect estimates. The interaction on an additive scale was assessed by incorporating a product term into the linear regression model. Results: Statistically significant interactions were detected between diet quality and multivitamin intake in relation to the cognitive and language development outcomes of the offspring (interaction p-values were 0.018 and 0.023, respectively). The lowest cognitive and language scores were observed in the group of women who neither took multivitamins nor maintained a high-quality diet. Among women not taking multivitamins, a high-quality diet was associated with improved offspring cognitive and language scores (mean difference [95% CI] = 4.2 [0.1, 8.2], p = 0.04; and 11.3 [3.1, 19.5], p = 0.01, respectively). However, among women taking multivitamins, no such associations were identified. Conversely, in participants with a low-quality diet, multivitamin intake was associated with a 3.0-point increase in cognitive composite scores (95% CI: 0.3, 5.8, p = 0.03), but this was not the case for those with a high-quality diet. No statistically significant interactions were observed between maternal diet quality and multivitamin intake for motor development outcomes. Conclusions: Adequate nutritional supply during pregnancy, achieved either through a high-quality diet or multivitamin supplementation, is fundamental for the neurodevelopment of children. Full article

Background: Children, including the estimated 7% with food allergy, spend most of their waking hours in school. Variations in school-based food allergy (FA) practices exist. We aimed to examine differences in FA management practices across schools in Canada and the United States (US). Methods: Parents of children with Immunoglobulin E (IgE)-mediated FA were recruited through social media to complete a survey evaluating the schools’ stock epinephrine, epinephrine storage locations, school type, and location. Data were described, analyzed using logistic and linear regressions, and then reported as odds ratios (ORs) and standardized coefficients (b), respectively, with corresponding 95% confidence intervals (95%CIs) and p < 0.05. This study was approved by the University of Manitoba Health Research Ethics Board. Results: Overall, 177 participants (14% [26/177] Canada, 86% [151/177] US) were included. Children were, on average, 4.92 ± 3.12 years and were commonly but not mutually exclusively allergic to tree nuts (50% Canada; 40% US) and peanuts (33% Canada; 29% US). Compared to US parents, Canadian parents were more likely to report epinephrine self-carriage by their children (OR = 4.58; 95%CI = 1.67–12.59). Parents with children age > 5 years were more likely to report epinephrine self-carriage by their children (OR = 3.70; 95%CI = 1.38–9.93) but less likely to report that their children’s school had an allergen-friendly zone (OR = 0.25; 95%CI = 0.06–0.99). Compared to US parents, Canadian parents were more likely to report their child’s school had anaphylaxis management policies (OR = 8.98; 95%CI = 1.11–72.42). Conclusions: Significant in-school FA management differences exist between countries. These findings stress the need for consistent policies and practices to ensure effective care. Full article

Background/Objectives: The majority of Canadian children bring a home-packed lunch to school, and previous research suggests lunches are of poor nutritional quality. This pilot study aimed to test the feasibility, acceptability, and preliminary impact of an eHealth family-based intervention designed to improve the nutritional quality of home-packed lunches. Methods: In this 12-week intervention, families (n = 20 parents with children aged 4–8 years) received a toolkit which included a cookbook on tips for preparing healthy lunches and 15 tested lunch box-friendly recipes, a lunch box, text messages, and an online cooking class. Feasibility was assessed via documentation of intervention delivery and participant retention rates. Acceptability was assessed via post-intervention surveys and semi-structured interviews in a sub-sample of parents (n = 9). Preliminary impact was assessed using 3-day lunch food records. Descriptive statistics were used to assess feasibility and acceptability, and Wilcoxon signed-rank tests were used to evaluate changes in the nutritional content of packed lunches. Results: Findings indicated a high retention rate (85%), and the majority (94%) of participants reported that the intervention was helpful and that they would recommend it to another parent. Qualitative interviews suggest parents found the recipes practical and diverse, the lunch box and the cooking class helpful, and some reported increased confidence and greater awareness of the foods being packed. No changes in the nutritional content of packed lunches were observed (n = 10 children). Conclusions: In summary, a home-packed lunchbox intervention is feasible and well accepted by families, but further refinements are needed to optimize its impact before a full-scale trial. Full article

Background/Objectives: Canada’s 2019 Food Guide (CFG) encourages the increased consumption of plant-based foods as dietary protein sources. However, the nutritional implications of replacing animal-based proteins with plant-based alternatives in children’s diets remain unclear. This study aimed to examine the association between protein food sources and nutrient intake in Canadian children aged 9–18 years. Methods: We analyzed data from 2324 children from the 2015 Canadian Community Health Survey (CCHS), using the Public-Use Microdata File (PUMF) containing 24 h dietary recalls. Participants were categorized into four groups based on the proportion of protein from plant sources: Group 1 (0–24.9%), Group 2 (25–49.9%), Group 3 (50–74.9%), and Group 4 (75–100%). Nutrient intakes were compared and assessed against the Recommended Dietary Allowances (RDAs) and Adequate Intake (AI). Results: Groups 1 and 3 had less favorable macronutrient profiles than Group 2. A 3:1 animal-to-plant protein ratio (Group 2) aligned most closely with dietary recommendations. Groups 1 and 2 exceeded RDAs for protein, iron, vitamin B12, thiamine, riboflavin, niacin, vitamin B6, and zinc by over 146% (about four SDs above the mean requirement), suggesting a low risk of inadequacy, although saturated fat intake was high. The intakes of vitamin D and folate were below 66% of the RDA, while calcium and magnesium were below 100% in some subgroups, with probabilities of inadequacy of 0.93 and 0.31, respectively. Group 4 (2.71%) was too small for reliable analysis. Conclusions: An approximate 3:1 ratio of animal-to-plant protein sources may represent an optimal balance for supporting nutrient intake and improving macronutrient profiles in the diets of Canadian children. Full article

Background/Objectives: Despite evidence on the association between marketing unhealthy foods to children (M2K) and negative health outcomes, M2K remains widespread in Canada. To support mandatory restrictions, Health Canada has prioritized a monitoring strategy to assess the current state of M2K, identify gaps, and establish a baseline for future policy evaluation. This study aimed to support this initiative by updating the University of Toronto (UofT) Food Classification List and evaluating the proportion of foods and beverages in the Canadian grocery and restaurant food supply that would be permitted or restricted from M2K under Health Canada’s proposed nutrient profile model. Methods: Grocery items from the UofT Food Label Information Price 2020 (n = 24,949) and restaurant menu items from Menu-Food Label Information Price 2020 (n = 14,286) databases were evaluated using Health Canada’s M2K nutrient profile model, which assesses foods solely based on thresholds for added sodium, sugars, and saturated fat. The proportion of items permitted for or restricted from M2K was determined overall and by food and menu categories for grocery and restaurant items, respectively. Results: The updated UofT List contained n = 24,494 grocery items and n = 14,286 menu items. Overall, 83% (n = 32,664/39,235) of foods and beverages in the 2020 Canadian food supply would be restricted from M2K. Among grocery items, 23% (n = 5630) would be permitted and 77% (n = 19,202) would be restricted from M2K. Among restaurant items, only 6% (n = 837) would be permitted and 94% (n = 13,442) restricted. Conclusions: The updated UofT List supports Health Canada’s monitoring strategy and highlights the large proportion of unhealthy products in the Canadian food supply that are currently still permitted for M2K. While Health Canada’s M2K nutrient profile model is stringent, gaps remain that could allow continued M2K exposure under the current proposed policy. Ongoing monitoring and policy refinement are essential to effectively protect children from M2K and its harmful effects. Full article

Background: Motor competence is a key determinant of children’s physical, cognitive, and social development, and it is influenced by various biological and environmental factors. Among these, relative age and the presence of siblings have been proposed as potential contributors, yet their impact remains underexplored, especially in school-aged populations. Objective: This study investigates the influence of relative age and the effects of the presence of siblings on the motor competence of children and adolescents. Methods: The motor competence level of 747 students, 381 from primary school (mean age = 8.81 ± 1.8 years) and 366 from secondary school (mean age = 13.52 ± 1.22 years), was measured by the means of the Canadian Agility and Movement Skill Assessment. Participants were queried about their birth date and whether they had any older siblings. Results: Overall, motor competence exhibited an upward trend with chronological age, reaching its peak among children aged 14 years old. Analysis revealed a significant impact of relative age effects on motor competence among primary children, with considerably higher scores in the first semester (p = 0.017). Conversely, no clear trend was observed for secondary children. Having siblings did not significantly affect motor competence proficiency. Multiple regression analysis further confirmed that relative age did not contribute to this lack of association (quarter of birth: p = 0.003; β = −0.144; siblings: p = 0.697; β = −0.019). Conclusions: These findings suggest that physical education teachers should be aware of the influence of relative age not only when assessing motor competence but also when designing and implementing their teaching practice in primary school settings. In contrast, the effect of relative age appears to be less significant in secondary education, where it may be less relevant for both evaluation and teaching practice. Further research should explore longitudinal designs and consider additional psychosocial and environmental variables to better understand how these factors influence motor competence development over time. Full article

There is abundant evidence that, following community transition or deinstitutionalization, persons with intellectual and developmental disabilities experience improvements in quality of life and well-being. However, very little research in this area has been conducted in the Canadian context. In this qualitative study, individual in-depth interviewing was used to explore the perspectives of eight Canadian mothers of adults with intellectual and developmental disabilities regarding their children’s residences and access to services after community transition. Within an interpretive description framework, narrative data collected during semi-structured interviews with participating mothers were analyzed using thematic analysis. Three main themes portraying a combination of positive and negative maternal perspectives emerged from the data: (1) quality of care, (2) quality of life, and (3) health status and behavior. The study findings bring attention to the importance of offering individualized community living options that are person- and family-centered to all persons with intellectual and developmental disabilities. Full article

Inclusive education demands that children worldwide have access to education alongside their peers in their neighborhood schools and within regular classrooms. Understanding experiences that contribute to pre-service teachers’ self-efficacy is important as it influences their readiness to enact inclusive strategies effectively. This study involved 69 pre-service teachers from Canadian faculties of education in mixed-methods research using Group Concept Mapping. The analysis identified five clusters of experiences; a repeated measures ANOVA revealed that ‘Applying Knowledge’ and ‘Collaborating with Colleagues’ comprised the most important experiences for contributing to pre-service teachers’ self-efficacy for inclusive practices, while ‘Community Support’ and ‘Experiences with Diverse Student Needs’ were significantly more important than ‘Professional Development’. By aligning these clusters with Bandura’s sources of self-efficacy, this study highlights the importance of mastery experiences and supportive interactions. These findings suggest that teacher education programs that focus on and enhance practical experiences and interpersonal supports will connect to and better prepare pre-service teachers for inclusive education. Full article

Background: Neurodevelopmental disorders (NDDs) and mental health disorders (MH) present significant challenges to Canadian Children. While there is increased awareness, the NDD/MH service needs and barriers to service for immigrant children in Canada are unclear. Therefore, the present study explores NDD and MH problems and management among Canadian children compared to immigrant children. Method: An online survey was administered to eligible participants using AskingCanadians. A total of 682 parents (Mean age = 31.8, SD = 7.4), 41.3% of whom were immigrants, completed the survey. Participants were asked to complete questionnaires related to mental health in general, child MH and NDD service needs, social support and use and barriers to accessing services. Results: Results showed that immigrant participants reported significant underuse of child mental health services (1.5 times less use) despite a higher reported child need. Similarly, a higher frequency of children born to Canadian parents reported accessing NDD/MH assessment referrals compared to immigrant families. Parents of children referred for NDD/MH assessment also reported a higher prevalence of mood disorders and anxiety disorders. Furthermore, parents of children presenting with NDD/MH concerns overall reported a significantly higher impact of barriers to their child’s education compared to parents whose children did not present with NDD/MH concerns. This effect was driven by Canadian parents of children with NDD/MH reporting increased barriers. Conclusions: These findings highlight the importance of considering cultural background in clinical approaches to MDD/MH services. There is a need to increase awareness and reduce stigma regarding service access. Furthermore, the findings reiterate the ongoing challenges families of children with NDD/MH challenges face in accessing support. Full article

Background: The harmonious development of gross motor skills (GMSs) is vital for children, fostering their physical, cognitive, and socio-emotional growth. This study aimed to achieve three primary objectives: (1) to establish standardized reference values for all GMS tests conducted; (2) to examine the impact of overweight and obesity on factors influencing the development of GMSs and cardiorespiratory fitness (CRF); and (3) to investigate the relationship between GMSs and CRF levels and body image dissatisfaction among Canadian children from the province of Québec. Methods: The study encompassed 3144 children aged 6 to 12 years (1535 boys and 1609 girls) recruited from 24 elementary schools situated in five urban areas. Anthropometric measurements included body mass, body height, and body mass index (BMI). Physical performance was assessed using a maximal aerobic power test and 12 GMS tests, which comprised two segmental speed tests, four agility tests, two static balance tests, one simple reaction time test, and three coordination tests. Body perception and body image dissatisfaction were evaluated using a silhouette scale featuring two sets of nine drawings depicting a spectrum of body shapes ranging from very thin to obese. Results: Standardized normative values were established for each GMS test. GMSs demonstrated continuous improvement throughout childhood, albeit with a deceleration in progress during later developmental stages. At comparable age, boys generally outperformed girls on tests demanding greater strength, speed, or endurance, whereas girls exhibited superior performance in balance and hand–foot coordination tasks (p ≤ 0.05). However, segmental speed remained equivalent between sexes (p > 0.05). GMS and CRF were significantly influenced by obesity status. Children with a normal BMI demonstrated superior performance compared to their overweight or obese counterparts, particularly in tests requiring body mass displacement (p ≤ 0.05). Conversely, socioeconomic status exhibited no significant impact on body perception in boys (p = 0.106), but it was a notable factor among 6–8-year-old girls from lower socioeconomic backgrounds (p = 0.045). Conclusions: Obesity status is linked to diminished GMS performance, especially in tasks involving body mass movement. These findings underscore the importance of early intervention strategies to encourage an active lifestyle and promote a healthy body composition in children. Full article