Search Results (243)

Background/Objectives: Children with severe physical and communication disabilities face many challenges. They have very limited opportunities for upright, hands-free, self-initiated mobility. Current findings in neuroscience and theories on child development suggest that self-initiated mobility can have positive cascading effects on various developmental areas, including language and communication. This study was conducted to examine the current use of hands-free support walkers with children who have severe physical and communication disabilities and use augmentative and alternative communication and to identify the benefits and problems perceived by their parents and professionals from different disciplines. Methods: Online surveys were utilized to collect information from 127 participants, including 31 parents and 96 professionals or paraprofessionals. Results: The participants reported that these children could perform various motor activities in the hands-free support walkers to achieve different goals. Benefits identified by both parents and professionals included providing a way to exercise and stay active, improving motor control, enhancing independence, and bringing enjoyment. Professionals also observed positive impacts on communication, vocalization, use of eye contact, and problem solving. Conclusions: Results suggest that children with severe physical and communication disabilities can benefit from the upright, hands-free, self-initiated mobility provided by hands-free support walkers. Clinical implications and needs for future research are discussed. Full article

Introduction: It is widely acknowledged that good quality relationships between social workers and children are essential to children’s non-formal inclusion in child protection processes. However, research exploring the perspective of children has shown this relationship to be highly complex, particularly when children are taken into care. Methods: This paper combines insights from two qualitative participatory studies conducted in Italy, both developed out of a collaboration between university, professional social work associations, and the Italian association of care leavers. The two projects explored, respectively, the perspectives of social workers on the one hand and of children in care and care leavers on the other regarding their relationship. Outcomes: The data reveal the complexity of the relationship between children and social workers, showing how both share a mirrored perception of it. Social workers recognise children’s negative feelings toward them and see them as inevitable, especially in cases of tense family dynamics. A relationship marked by hostile attitudes, anger, and distrust not only fuels social workers’ emotional struggles but also makes it harder to engage children effectively. While hostile attitudes and mistrust are often seen as obstacles to positive engagement, we advocate for recognising them not as barriers to be overcome but as realities to be acknowledged and addressed openly. This approach can create space for both children and practitioners to explore alternative forms of agency, fostering more meaningful participation. Full article

Background: In Japan, new challenges are emerging, such as declining birth rates, an increase in age at childbirth, postpartum depression, and child abuse. Methods: This study examines the factors influencing maternal consultation behavior at public institutions using some of the data from the Japan COVID-19 and Society Internet Survey (JACSIS). A total of 6227 women (1380 pregnant and 4847 postpartum) were analyzed through logistic regression. Results: The results showed different factors influencing consultations between pregnant women and postpartum women. Among pregnant women, different trends were observed between primigravidae and multigravidae, indicating that primigravidae aged ≥40 years and multigravidae with multiple childbirths tend to seek consultations more frequently. In postpartum women, psychological distress (K6), adverse childhood experiences (ACEs), and social support networks significantly influenced consultation behavior. Postpartum women with extensive support networks (≥3 confidants) exhibited higher consultation rates. In contrast, those with elevated Edinburgh Postnatal Depression Scale (EPDS) and Mother-to-Infant Bonding Scale (MIBS-J) scores were less likely to seek help, potentially due to mental health stigma. Conclusions: This study showed that pregnant and postpartum women facing physical, mental, family, or relationship issues are seeking consultations and receiving thorough support. On the other hand, since some pregnant and postpartum women refrained from seeking consultation, it is necessary to further consider support measures that make it easier for all pregnant and postpartum women to seek advice in the future. Full article

Background: Eosinophilic esophagitis is a chronic immune-mediated disease with increasing prevalence. In pediatric populations, it often coexists with IgE-mediated food sensitization. This dual diagnosis presents unique therapeutic challenges, including on the one hand both temporary and lifelong dietary restrictions, and on the other hand, therapeutic interventions with a potential impact on quality of life (QoL). Objectives: This study prospectively evaluated the prevalence of IgE-mediated food sensitization and allergy in children with EoE attending a tertiary center in Flanders, Belgium. Additionally, it prospectively documented dietary habits and restrictions in these children, with or without concomitant IgE-mediated food allergies, and assessed the impact of dietary management on quality of life compared to pharmacological treatment. Methods: We consecutively followed 30 children with biopsy-confirmed pediatric EoE (PedEoE) attending a tertiary referral center for at least 12 months. Patient demographics, allergy testing, dietary history, and treatment modalities were recorded. Symptom score and PedEoE QoL were assessed using validated Pediatric Eosinophilic Esophagitis Symptom Score (PEESS 2.0) and Pediatric Quality of Life Inventory (PedsQL 3.0) questionnaires. Statistical analysis was performed using the Mann–Whitney U test and Kruskal–Wallis test with Dunn’s test as a post hoc test. Results: Among 30 children with EoE (60% male, median age 8 years), 60 PedEoE QoL (PedsQL) and 39 symptom (PEESS) questionnaires were collected at one or more time points over a median follow-up of 14.5 months. IgE sensitization to common dietary triggers was observed in multiple patients, with varying clinical reactivity. Symptom scores tended to be higher in children without histological remission, though differences were not statistically significant (median PEESS 23.75 vs. 17.50, p = 0.1934). Grouped by degree of dietary restriction, QoL scores showed significant differences (child p = 0.0102; parent p = 0.0203), with children in the 1–2 food elimination group reporting better QoL compared to the 0 food elimination and >6 food elimination groups. No clear statistically significant differences were observed between the 1–2 food elimination group and the 3–4 or 5–6 food elimination groups. Conclusions: IgE sensitization is prevalent among pediatric EoE patients and has significant clinical implications for disease management. Treatment choice can influence not only disease control but also the QoL of both patients and their families. Full article

This paper describes the development and testing of a classroom and complementary home-based intervention to build preschoolers’ spatial orientation skills, focusing on exploring implementation feasibility and initial child learning outcomes. Spatial orientation, one type of spatial thinking, involves understanding the relationship between spatial positions, using maps and models to represent and navigate through space, and using spatial vocabulary. Evidence continues to accumulate that gaining spatial skills helps overall mathematics achievement and that learning resources are needed in this field. This mixed-methods study is the third in a series of investigations that leverage a design-based implementation research approach to develop preschool resources to support spatial orientation with both hands-on and technology-based experiences. Through a quasi-experimental comparison study, treatment teachers implemented eight weeks of hands-on activities, read-aloud stories, and digital activities (including an augmented reality app) and a sample of families also engaged in complementary home-based activities. The findings suggest that the resources help teachers feasibly implement spatial lessons, and preschoolers improve their learning of spatial concepts with the use of the classroom and home-based intervention. Full article

Background: Hand, foot, and mouth disease (HFMD) is a frequently self-limited viral infectious disease that affects children and has no specific antiviral treatment option. There has been increasing interest in bee products in recent years, and propolis has come to the fore due to its impressive therapeutic and protective effects. Although previous studies have shown the inhibitory effect of propolis against enteroviruses (EVs), there are no clinical data regarding its use in combatting HFMD. This prospective multicenter randomized clinical study aimed to evaluate the effect of administering propolis to children with HFMD. Methods: This study analyzed 183 children with HFMD. All children were assessed for eligibility and diagnosed with HFMD by a child health and disease specialist after presenting with symptoms of either fever, enanthem, or exanthems that had begun within the last 48 h. The patients were randomly assigned to the group receiving Anatolian propolis (n = 87) or that receiving no supplement—the control group (n = 96)—in addition to receiving symptomatic therapy as decided by the physician. The duration of the patient’s complaints, the distribution of the lesions on their body, and their fever status were recorded on admission. Parents were asked to rate the severity of their child’s restlessness, inappetence, and sleeplessness on a scale of 0–10 at their initial, second (at 48th hour), and third (after 5–7 days) visits to the hospital. The primary data analysis methods included the Kolmogorov–Smirnov test for normality and non-parametric tests such as the Kruskal–Wallis and Mann–Whitney U tests, which were used for group comparisons. Results: The median age of the patients was 28 months (range: 12–112), and the male-to-female ratio was 1:1. Most patients (62.8%) had no history of a household contact with HFMD. Intraoral lesions were present in 92.3% of patients, and 47.5% received the propolis treatment while 53.5% were in the control group. There was a significant difference between the groups in terms of their complaint scores during their second (p = 0.028) and third (p < 0.001) visits to the hospital. In addition, the mean duration of the illness in the propolis group (7.45 days) was significantly lower than that in the control group (8.58 days) (p < 0.001). No adverse effects were observed. Conclusions: Propolis has been shown to facilitate symptomatic relief and reduce the duration of the disease in children with HFMD. To better assess the efficacy of this product, which can be used safely in children, future studies supported by virological analyses are required. Full article

The article explores the concept of family language policy in relation to heritage languages and child agency in the context of Latvian as a heritage language. Its aim is to find out what role Latvian may have in relation to other languages within the core families in the diaspora, as well as in communication with their extended families in Latvia. For this, we investigate which language beliefs and attitudes underlie those language practices and examine children’s engagement in family language management. Our research is based on 20 in-depth interviews collected in 2023. Respondents were recruited through the distance online learning program “Latvian as a foreign language teacher” created for the Latvian diaspora and through Saturday (community) schools. The main research questions are as follows: What role does Latvian have in relation to other languages in Latvian diasporic families, and how do language practices reflect beliefs and attitudes of the parents? Which languages and which communication channels are used by diasporic families in communication with their (extended) families in Latvia? What impact do children have on family language policies? Our data show a huge diversity in family language practices, switching between two and more languages depending on communicative situations, the age of children, their language proficiency, and the communication channels. Family members flexibly use their languages to participate in family life and to achieve interactional goals, not always focusing just on particular language use. Heritage language transmission correlates with family language planning and consequent language use. On the other hand, language is tightly tied to the relationships and emotions of family members. Full article

This study aimed to explore the factors influencing food hygiene behaviours among child caregivers in Chikwawa district, Malawi. This research focused on three specific hygiene behaviours: keeping utensils on an elevated surface, using soap to clean kitchen utensils, and washing hands with soap at critical times. These practises are known to contribute to the reduction in diarrhoeal disease. To understand these behaviours, this study utilised multilevel binary logistic models to examine variations at both the household and village levels. The findings reveal that educational background, age group, occupation, self-confidence, intervention, self-will, and perception were the most significant factors influencing food hygiene behaviours. Notably, there were significant variations at the village level (p < 0.00001), while no significant variations were observed at the household level (p > 0.1). Additionally, caregivers from areas where interventions were implemented showed a positive response to these interventions. Full article

Research on pediatric hand exoskeletons remains limited compared to that on devices for adults. This paper presents the design and experimental validation of a customizable pediatric finger module, part of a hand exoskeleton tailored to individual anatomical features. The module aims to assist finger flexion in children with mild spasticity during activities of daily living. A patient-specific design methodology was applied to the case of a 12-year-old child. The finger module integrates compliant dorsal structures and cable-driven transmission with rigid anchoring elements to balance flexibility and structural stability. Different geometries and thickness values were tested to optimize comfort and quantify mechanical performance. Additive manufacturing was adopted to enable rapid prototyping and easy replacement of parts. Tensile and bending tests were conducted to determine stiffness and cable travel. Results support the feasibility of the proposed finger module, offering empirical data for selection and sizing of the actuation system and paving the way for the advancement of new modular pediatric devices. Full article

Introduction: The aim of this study is to explore variables relating to teacher–student relationships, and their association with the detection of child maltreatment in secondary schools (12–18 age range), given that child and adolescent abuse is under revealed and underreported, and teachers play an important role in identifying and detecting it. Method: 662 teachers from secondary schools from different autonomous communities in Spain answered a self-administrated questionnaire. Results: This study revealed that while theoretical knowledge of the issue goes hand-in-hand with a higher self-reported ability to recognize cases among students, the same does not hold true of the teachers’ real detection capacity. Nonetheless, a relationship of trust with students and addressing child maltreatment in the classroom contributes to a better real detection capacity by teachers, relating this information to the possible existence of a teacher–student alliance. Discussion: We propose a trust-constructed relationship between both agents, named the teacher–student alliance. Prospective: These results point to the need for further research into the association and characteristics of teacher–student alliances on the identification in schools of cases of child maltreatment. Full article

Cultural norms, beliefs, and practices influence parental expectations, children’s responses, and the acceptance of behaviour management techniques (BMTs) in paediatric dentistry. Despite this, the existing guidelines often adopt a standardized approach, overlooking critical cultural differences. This scoping review maps the links between culture and behaviour management strategies in paediatric dental settings. A scoping review following PRISMA guidelines was conducted across PubMed, Cochrane Library, Web of Science, Google Scholar, and hand-searched sources from the inception of the databases to 31 January 2025. A total of 671 studies were identified, with 15 meeting the inclusion criteria. Data on the key findings were inductively analyzed to assess cultural influences on parental acceptance, child behavior, and communication. The findings show that non-invasive BMTs such as TellShow–Do and positive reinforcement were the most accepted across cultures, while passive and active restraints were least accepted, especially in Western populations. Parental preferences varied; Jordanian parents were more accepting of passive restraint than German parents, while general anaesthesia was preferred in Bahrain. Cultural norms shaped communication styles—Latino families emphasized warm interpersonal interactions, whereas Pakistani families exhibited limited parental involvement due to language barriers. Black and Hispanic Medicaid-enrolled mothers in the U.S. reported lower satisfaction with pain management, highlighting disparities in culturally competent care. In conclusion, cultural factors significantly influence paediatric behaviour management in dental clinics. Integrating cultural competence into practice can enhance communication, improve patient compliance, and promote equitable care. Further research is needed, particularly in Africa and South America, to inform globally inclusive behaviour management guidelines. Full article

This study examined age-related changes in qualitative paper-cutting performance of typically developing children aged 5 to 10 years. Using the Hands-On! observation tool, we analysed 178 (85 boys; Mage 8.06 years, SD ± 1.58) children’s performance on the DCDDaily paper cutting task. Paper cutting involves several intra-task components, such as grip type and cutting movements, each comprising multiple observable actions that reflect a child’s qualitative performance (e.g., small or large cutting movements). We assessed the differences in the occurrence of these actions within each intra-task component across age groups, along with task duration and mistakes. Our findings revealed significant age-related differences in the qualitative performance of multiple actions within the intra-task components. Three distinct developmental patterns emerged: progression, variability in progression, and stability. Notably, these qualitative differences were observed even when quantitative measures, such as duration and mistakes, showed ceiling effects, highlighting the ability of qualitative assessments to capture nuanced developmental changes. This study provides valuable insights into the development of paper-cutting skills, emphasising the importance of incorporating qualitative analysis into motor skill assessments. Future research should explore the qualitative performance of children with both typical and atypical motor development to further understand the complex interplay of factors influencing fine motor skill performance. Full article

Background/Objectives: Cerebral palsy (CP) is the most common childhood motor disorder, with unilateral cerebral palsy (UCP) presenting with asymmetrical motor function that can cause decreased upper limb function. Constraint-Induced Movement Therapy (CIMT) is an evidence-based intervention that addresses upper limb functional limitations, but further study on combining interventions with CIMT is warranted. Combining CIMT with virtual reality (VR) is hypothesized to enhance engagement and therapeutic outcomes. This study compared the effectiveness of CIMT alone versus CIMT combined with VR (CIMT + VR) in improving upper limb function and occupational performance in children with UCP. Methods: A blinded, randomized, controlled trial included children aged 5–13 years with Manual Ability Classification System (MACS) levels I–III. The participants were randomized into CIMT or CIMT + VR groups and completed a standardized 10-day camp protocol (60 h). Pre-intervention and post-intervention assessments included the Assisting Hand Assessment (AHA) and the Canadian Occupational Performance Measure (COPM). Secondary measures included acceptability ratings of VR devices and fidelity. Results: Thirty-two participants, with a mean age of 9 years and 3 months (3 years 1 month), MACS I = 4, II = 20, and III = 8, completed this study. CIMT and CIMT + VR led to significant improvements in upper limb function, with no statistically significant differences between the groups in bilateral hand use and occupational performance. Conclusions: These findings reinforce the efficacy of CIMT while highlighting the potential of VR to enhance engagement when the child prefers to interact with the technology, underscoring the importance of individualized approaches that consider a child’s preferences and responsiveness to different intervention modalities. Full article

Background/Objectives: Research considering objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary behaviors (SB) and health outcomes among urban children has produced equivocal findings. Therefore, this study was designed (i) to compare MVPA and SB of urban and non-urban children and (ii) to analyze associations between the risk of overweight and MVPA of children by their degree of urbanization. Methods: The sample comprised 389 children (195 girls) aged 6 to 10 years. Measurements for height and weight were taken, followed by the calculation of body mass index (BMI). A motion sensor was employed to gather data on MVPA and SB for 7 days. Urban regions were characterized as areas with a population density exceeding 500 inhabitants per square kilometer or having a total population greater than 50,000. ANOVAs, partial correlations, and logistic regression analysis were used, controlling for potential confounders. Results: After controlling for wearing time and sex, urban children were significantly less active (lower MVPA) than non-urban peers [i.e., urban: 48 min/day vs. 51 min/day (non-urban)]. On the other hand, urban children spent significantly more time on SB than their non-urban counterparts on the weekend and during all assessed days. MVPA was significantly associated with the risk of being overweight at the weekend for both urban and non-urban children. Inspection of the final regression model indicated that urban children who engaged in sedentary behavior for extended periods were at a higher risk of being categorized as overweight. Conclusions: Findings revealed the association between MVPA and the risk of overweight on weekdays was just significant for urban children. The location where a child lives significantly influences their weight status, and therefore, community-based programs [at schools (PE and recess) and after-school (organized sports)] should be developed that encourage active lifestyles tailored to urban environments. Full article

Background/Objectives: South Asian children living in Canada have a higher prevalence of cardiovascular disease risk factors compared to their non-South Asian counterparts, and poor dietary habits may contribute to this health disparity. Methods: This study uses a pre–post intervention design to examine the impact of a family-focused, “hands-on” cooking workshop on improving three cooking and dietary strategies: (1) using healthy cooking techniques, (2) practicing portion control, and (3) making healthy substitutions. We recruited 70 South Asian parent–child dyads (n = 140) across four elementary schools in Surrey, British Columbia. The 90 min workshop includes a didactic segment on healthy food preparation and dietary strategies, followed by an interactive cooking session where participants make a healthier version of a traditional Punjabi dish. Results: Among the three dietary strategies measured, both children and parents increased their frequency of using healthy cooking techniques (child p = 0.02; parent p < 0.001) and practicing portion control (child p < 0.001; parent p = 0.02). No changes were reported by either group for making healthy substitutions. Conclusions: Findings suggest that educational approaches that engage the family as a unit and encourage active participation are associated with improvements in cooking and dietary strategies in the South Asian community. Full article