Search Results (2,761)

Language delay is a fairly frequent phenomenon in young children, with associated negative outcomes across the academic, social, and emotional areas of their lives. This qualitative study was designed to deeply examine mothers’ experiences and the ways in which they promote the development of their children with language delay. Twenty mothers of children with language delay (aged four to nine), who were recruited through advertisements posted by language preschool/school teachers, participated in semi-structured interviews. Thematic analysis revealed themes relating to the challenges of raising a child with language delay, along with how mothers create a safe emotional environment for their child’s development, find opportunities and encourage social interactions, utilize their day-to-day routines to promote language and learning, and actively engage with their children’s educational framework. These results highlight how mothers serve as the “architects” of their children’s development. Despite the difficulties they encounter, such as high stress levels, mental health challenges, isolation, and guilt, and the far-reaching implications of their children’s language delay on their day-to-day living, mothers shape the home environment to promote their children’s academic, social, and emotional development. The study thus indicates that mothers intuitively promote their children’s development and that practitioners and others can support mothers’ own initiatives along with providing guidance. Full article

Family-implemented interventions are evidence-based practices used to support a range of developmental outcomes, including social communication. Social communication is a broad construct that encompasses a variety of skills, from foundational abilities such as joint attention (i.e., two people attending to the same object or event) to more advanced behaviors like triadic interactions (i.e., responding to or initiating conversation that involves reciprocal interactions). In a previous study, we examined the effects of a brief, parent-implemented Naturalistic Developmental Behavioral Intervention (NDBI), delivered over telepractice with video feedback coaching. The intervention resulted in increased strategy use by all mothers and the frequency of communication for three young children. In the current study, we conducted a secondary analysis of those data to explore whether the communication-focused intervention produced a collateral effect on activity-engaged triadic interactions (i.e., mother–child–mother or child–mother–child exchanges while simultaneously engaging in a joint activity). Although a functional relation was not established, critical theoretical implications are posed. These findings highlight the need for future research to break apart complex skills into subskills to detect any subtle changes in child outcomes. Limitations and directions for future research are discussed. Full article

Background and Objectives: The effect of growth hormone (GH) on body composition is well recognized, and recombinant human GH (rGH) therapy may improve lean mass and related parameters. The aim of this study was to analyze changes in body composition parameters and lipid profile under rGH treatment in children diagnosed with short stature and to explore potential influencing factors. Materials and Methods: A secondary data analysis was conducted in the Endocrinology Department of the Mures County Hospital, Romania, approved by the local Ethics Committee. All children diagnosed with short stature and receiving rGH treatment were eligible for inclusion if they had four body composition analyses at least 6 months apart. Analyzed variables included age, gender, environment, mean rGH dose, height and body mass index (BMI) SDS, body composition parameters assessed by bioimpedance, and family-related variables. Statistical analysis was performed using SPSS v.25 with a level of significance α = 0.05. Results: There was no statistically significant trend in body composition parameters taken during serial measurements, except for the sarcopenic index and height (p < 0.001). Environment, pubertal development, and family-related variables other than maternal BMI had no significant influence on body composition or lipid profile. Gender differences in body composition revealed that the change in muscle mass (p = 0.009) and skeletal muscle mass (p = 0.013) was statistically significantly higher for boys, and body fat (p = 0.013) for girls. In linear regression analysis, mother’s BMI emerged as a significant predictor for changes in high-density lipoprotein cholesterol (HDL-C) levels (p = 0.032, β = −0.691) during rGH therapy. Body composition changes did not differ by treatment indication. Conclusions: Gender may be associated with treatment-related changes in body composition during pediatric rGH therapy, while maternal BMI may predict HDL-C variation. rGH treatment appears to improve the sarcopenic index and has minimal and variable effects on the lipid profile. Full article

From an interbehavioral and contingential perspective, family dialogues about sexuality are understood as patterns of verbal interaction regulated by social, gender, and caregiving contingencies rather than as individual attitudes or intentions. Background: This study analyzes the functional conditions under which family dialogues about sexuality occur between mothers and their adolescent sons and daughters, considering caregiving roles and gender norms that regulate these interactions. The research aimed to identify the functional relations between communicative practices and the social contingencies that maintain or inhibit them. Methods: A qualitative approach grounded in interbehavioral psychology was employed, using semistructured interviews with 40 mothers of students from a public middle school in Puebla, Mexico. Data were analyzed through contingency analysis, distinguishing micro- and macrocontingential systems related to family sexual education. Results: Results show that, although patterns of avoidance and discourse displacement toward schools or peers persist, families exhibit increasing openness toward comprehensive sexuality education and recognize its preventive value against violence, adolescent pregnancy, and misinformation. Functional delegation and adolescent mediation of dialogue were identified, along with emerging inclusive macrocontingencies linked to the acceptance of diverse families and LGBTIQ+ themes. Conclusions: It is concluded that households function as self-regulated interbehavioral systems in which historical and gender contingencies restrict sexual dialogue, yet gradual functional changes toward respect, inclusion, and shared educational responsibility are observed. Full article

Background: Children of mothers exposed to adverse childhood experiences (ACEs) may be at increased risk of sleep disruptions, such as night waking, due to potential suboptimal caregiving or living conditions. Mothers’ ACEs are also associated with maternal depressive symptoms, which in turn are associated with children’s screen time and sleep disruptions, revealing relevant, but unexplored, mediation pathways. This Canadian study investigated if mothers’ ACEs were associated with their 5-year-old children’s sleep disruptions (1) directly and (2) indirectly through independent or serial mediation via maternal depressive symptoms and/or children’s screen time. Methods: Data (n = 622; maternal mean age 32.3 years, 88.4% white) came from the longitudinal APrON Study. ACEs were measured 1 year postpartum. Mother’s depressive symptoms were measured across prenatal and postnatal timepoints. Children’s evening screen time (i.e., number of days in a week children engaged in one hour of screen time before bedtime) and sleep disruptions (number of days in a week their child wakes up multiple times) were measured at 5 years postpartum using adapted scales (52.9% male). PROCESS was used to assess for mediation. Results: Mothers’ ACEs had an indirect effect on their children’s sleep disruptions through mothers’ mean depressive symptoms (effect = 0.018, 95% CI [0.006, 0.034]), but not through children’s screen time. No other effects (i.e., direct, total) were observed. Conclusions: Although replication studies are warranted, this novel study reveals that the effects of maternal ACEs on children’s sleep disruptions may operate indirectly with effects potentiated through maternal depressive symptoms, thus serving as a target for intervention. Full article

Background/Objectives: Greater than 50% of surviving very preterm infants are affected by postnatal growth failure and are at high risk of associated development of bronchopulmonary dysplasia (BPD). Given the influence of enteral feeding on growth failure, we aimed to determine the impact of type, volume, and time of introduction of enteral feeds on mitigating the risk of postnatal growth failure and BPD risk. Methods: This was a retrospective chart review of mothers’ own milk (MOM), pooled pasteurized donor human milk (PDHM) feeding, postnatal growth, and BPD severity in preterm infants <33 weeks of gestation admitted to the Children’s Hospital of Richmond at VCU neonatal intensive care unit between 2021 and 2024. Statistical analysis included linear regression with moderation analysis using the Hayes Process model, chi-square tests, linear and multinomial logistic regression, with p-value < 0.05 considered significant. Results: After controlling for the percentage of MOM received at 34 weeks corrected gestational age (cGA), greater severity of BPD was associated with lower infant weight and growth failure, p < 0.001. Early introduction of MOM (3 days of life) and greater volume of MOM showed better linear growth and decreased risk of severe BPD, respectively (p < 0.001). Conclusions: Provision of MOM to preterm infants within 3 days of life was associated with a moderation of the relationship between gestational age and growth velocity, with improved growth velocity trajectory. Preterm infants who received a greater volume of MOM through 34 weeks cGA experienced less severe BPD compared to those fed higher volumes of PDHM. As the incidence of growth failure paralleled the incidence of BPD severity, identification of key MOM components becomes important to address and augment the value of PDHM in the management of preterm infants. Full article

Intergenerational trauma significantly affects the health and mental health of African American families, particularly women whose lives are shaped by systemic inequities and historical oppression. This scoping review examines how trauma and resilience are transmitted across generations in African American communities, with a focus on dyads such as mother–child and mother–daughter relationships and a conceptual grandmother–mother–daughter triad. The review aims to identify mechanisms of trauma transmission and resilience and to inform culturally responsive, multigenerational interventions. Peer-reviewed studies published between 2012 and 2025 were identified that included African American caregivers and children and addressed biological, psychological, social, cultural, and resilience dimensions of intergenerational processes. Data were synthesized using a dimensional conceptual analysis approach. Findings indicate that intergenerational trauma is perpetuated through chronic stress and discrimination, maternal mental health challenges, family structure and caregiving strain, and cultural narratives about strength and self-reliance. At the same time, resilience is transmitted through sensitive caregiving, spirituality and faith, social and kin support, racial socialization, and economic survival strategies that draw on cultural and historical knowledge. These results underscore the importance of addressing intergenerational trauma holistically by integrating dyadic evidence within a broader conceptual triadic framework. Culturally responsive, multigenerational interventions that leverage family and community strengths and make space for emotional vulnerability are essential for interrupting cycles of trauma and fostering healing within African American families. 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: Traumatic dental injuries (TDI) in children are a common but often underestimated emergency. Parental knowledge and timely response are crucial for successful treatment. This study aimed to evaluate parental knowledge, experiences, and awareness regarding dental trauma management and the use of protective mouthguards. Methods: A cross-sectional study was conducted using a self-administered questionnaire among 333 parents in dental clinics in Split and Zagreb, Croatia. The questionnaire assessed sociodemographic data, parental knowledge of TDIs, and prior experience with dental trauma. Statistical analysis included chi-square test (p < 0.05). Results: The overall level of parental knowledge regarding traumatic dental injuries was generally low (7.6 out of 15 points). Almost all parents correctly identified the age when children have primary or permanent teeth. However, less than half knew that an avulsed primary tooth should not be replanted, while about three-quarters recognized that professional help should be sought within 30 min after trauma. Overall, 43.5% of parents reported that their child had experienced dental trauma, most often affecting primary teeth (60.7%), particularly the maxillary central incisor (76.6%). Mothers demonstrated significantly higher knowledge than fathers (p = 0.025), and prior experience or information about dental trauma significantly improved awareness (p < 0.001). Although 54.3% of respondents were unaware of the purpose of dental shields, 82.3% considered them necessary during contact sports, yet only 12.9% reported that their child actually uses them. Conclusions: Within the limitations of this clinic-based study, the findings indicate gaps in parental knowledge regarding the appropriate management of dental trauma. Strengthening parents’ understanding of emergency response and preventive measures may support timelier and appropriate care and contribute to improved outcomes for children experiencing traumatic dental injuries. Full article

Background/Objectives: We aimed to assess the risks and benefits of early, intermediate, and late vesicoamniotic shunting (VAS) for lower urinary tract obstruction (LUTO) treated at a single center. Methods: A retrospective analysis of 104 fetuses with LUTO that underwent VAS was carried out. The investigation covered the time between the first VAS and postnatal hospital discharge. The cases were analyzed in three groups: Group I fetuses underwent their first intervention ≤ 16 + 0 weeks; Group II fetuses underwent intervention between 16 + 1 and 24 + 0 weeks; and Group III fetuses underwent intervention > 24 + 0 weeks of gestation. Maternal morbidity, pre- and postnatal complications, fetal and neonatal mortality, and urological and renal outcomes were assessed. Results: All mothers tolerated the procedures well. Mean gestational age at delivery was 35.4 weeks of gestation. In total, 78 of 104 children were born alive (75%). Postnatal survival was 72 of 78 (92.3%). Overall survival was 72 of 104 (69.2%). Overall, 61.2% of children survived from Group I; 69% of children survived from Group II; and 100% of Group III children survived from the first VAS to postnatal hospital discharge. A total of 41 of 72 survivors (56.9%) were discharged with normal renal function. For 80%, normal renal function was highest after early VAS ≤ 16 + 0 weeks of gestation (Group I), whereas 31% of Group II and 61% of Group III survived with normal renal function. Postnatal pulmonary hypoplasia occurred in 13.3% of the cases of Group I, 40% of Group II, and 23.1% of Group III. Conclusions: The findings of this retrospective study confirm that VAS ≤ 16 + 0 weeks of gestation is the best chance for preserved renal function after birth. However, when LUTO is treated later in gestation, fetuses can also benefit from VAS. Pre-interventional sonography may aid in selecting those with the highest chances for a better renal outcome. Full article

Inclusive education is at the forefront of transnational policy agendas. Yet, normative, deficit-oriented disability discourses and institutional gaps continue to shape how inclusion is enacted in schools, often displacing extensive and unacknowledged labour onto families, especially mothers. Drawing on feminist theories of invisible work, this article critically examines the everyday labour performed by mothers of disabled children as they navigate inclusive education systems in Alberta, Canada. Situated within a broader collective case study, this analysis asks: What forms of invisible work do mothers undertake in pursuit of inclusion within education systems labelled as inclusive? Semi-structured interviews were conducted with nine mothers of disabled children. Reflexive thematic analysis illuminated four intersecting dimensions of invisible work: (1) working within the system, (2) working to fit the system, (3) crafting system workarounds, and (4) working above and beyond the system. These forms of work reveal how inclusive education systems rely on mothers to bridge the gap between policy rhetoric and lived experiences. Findings illuminate how mothers’ invisible work simultaneously sustains, negotiates, and resists systemic ableism, highlighting the need to recognize and redistribute this work and reimagine inclusion as a shared structural responsibility rather than an individual, maternal pursuit. Full article

Background/Objectives: Within Paediatric Palliative Care (PPC), motherhood in the context of severe cognitive impairment is shaped by unique emotional, relational, and identity-related challenges. Traditional understandings of maternal identity are strained when verbal communication and typical developmental milestones are absent. Although caregiving in PPC has been widely studied, the subjective and symbolic dimensions of motherhood in this setting have received far less attention. This study sought to explore how mothers construct, interpret, and make sense of their maternal identity while caring for a child with severe cognitive impairment in a PPC context, and to underscore the clinical relevance of these identity-related processes. Methods: A qualitative study was conducted involving nine mothers of children receiving paediatric palliative care services at a regional centre in Italy. Participants engaged in three online focus groups, totalling 270 min. Reflexive thematic analysis was employed to interpret the transcribed data, using ATLAS.ti software, version 25.0.1 ATLAS.ti Scientific Software Development GmbH, Berlin, Germany, for support. Member reflections were incorporated to validate the findings. Results: Three interconnected themes emerged from the reflexive thematic analysis. First, mothers described the development of a fusion-like, enmeshed mother–child relationship, characterised by embodied attunement, specialised interpretive expertise, and lifelong care dependency. Second, mothers detailed the construction of their maternal role, shaped by emotional labour, identity negotiation, sacrifice, loneliness, and peer support, alongside the construction of the child’s role, in which children were perceived as unique, symbolically meaningful beings whose social presence and limited reciprocity shaped maternal identity. Third, mothers articulated a search for meaning that sustained them throughout the caregiving journey, reframing their experience within a broader existential and relational perspective. Conclusions: Maternal caregiving in PPC encompasses distinct emotional, relational, and symbolic dimensions that extend beyond conventional understandings of motherhood. Grasping these identity-related dynamics has direct clinical relevance: it enables more attuned communication, strengthens the therapeutic alliance, and supports personalised, meaning-oriented care. These insights highlight the need for tailored interventions and further qualitative research to inform health care professionals and interdisciplinary practice. Full article

Objective: This study aims to investigate the dietary assessment and trends of preschoolers aged 3 to 5 years in Korea from 2012 to 2021 and to provide basic data for early childhood dietary education and policy development. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2012 to 2021 were analyzed for 2510 children in the 3–5 age group. Dietary intake was assessed using a 24 h recall. Intakes of food groups, dishes, and nutrients were calculated, and trends across years were tested using generalized linear models adjusted for gender, age, household income, energy intake, mother’s age, and mother’s education. Results: Over the tenyear period, intakes of carbohydrates, phosphorus, iron, sodium, potassium, carotene, thiamine, niacin, and vitamin C, as well as the carbohydrate energy ratio, showed significant declines. Meanwhile, protein, fat, retinol, and riboflavin increased, as did the protein and fat energy ratios. Fruit intake decreased by approximately 42 g among food group intakes. Analysis of foods contributing to total food intake revealed that milk, white rice, apples, and eggs consistently accounted for a high proportion of total intake in all survey years. Average calcium intake was approximately 100 mg below the estimated average requirement. Conclusions: The results of this study showed that preschoolers exhibit insufficient intake of certain nutrients, such as calcium, and a decrease in fruit intake. Interventions are needed to establish regular meal patterns, promote plant food intake such as fruit, and improve calcium intake. These results provide valuable evidence for designing dietary education programs and dietary guidelines tailored to early childhood. Full article

Background and Objectives: Current evidence remains insufficient to determine whether the impact of autism spectrum disorder (ASD) on dental health is primarily mediated through oral hygiene and dietary habits or through direct effects of the disorder itself. This study examined the theoretical pathways through which ASD severity and toothbrushing-related and dietary-choice-related factors influence dental health in autistic children and adolescents. Materials and Methods: A cross-sectional study was conducted with 399 mothers reporting on their autistic children (aged 2–18 years, mean = 7.8). The exclusion criterion was being older than 18 years. Data included parent-reported data about ASD severity, dental health status, willingness to brush teeth, and dietary quality (assessed using the Diet Quality Inventory). Structural Equation Modeling (SEM) was used to analyze the direct and indirect effects of ASD severity on dental health, with probit regression coefficients estimated using the WLSMV method. Results: Parent-reported variables of ASD severity, diet quality, and toothbrushing willingness together explained 37% of the variance in dental health. The direct effect of ASD severity on dental health was 0.199 (p = 0.039). The indirect effect via toothbrushing was 0.137 (p = 0.006), and via diet quality, it was 0.070 (p = 0.020). The total indirect effect of ASD on dental health was 0.207 (p = 0.026), which was approximately as strong as the direct effect. The associations among the studied variables were statistically equivalent across sex and age groups. Conclusions: Parent-reported ASD severity shows significant association with dental health outcomes, both directly and indirectly, with toothbrushing behavior emerging as the primary mediator. Interventions that promote regular brushing (and, to a lesser extent, healthier eating) may help to reduce the dental health disparities associated with autism. Full article

Background: There is a high prevalence of the double burden of malnutrition (DBM) in children and adolescents in South Asia. This research aims to explore which sociodemographic factors are attributed to DBM in urban Bangladesh, a South Asian country. Methods: We conducted secondary analyses of data obtained from the national survey of childhood obesity among school-age children in Bangladesh (2012–2013). The sample includes 4140 children (aged 5–9 years) and adolescents (10–19 years) randomly recruited from the city corporation (urban) areas in all administrative divisions. At the population level, DBM was defined as the coexistence of underweight and overweight/obesity among children and adolescents. At the household level, DBM was defined as maternal underweight co-occurring with child overweight/obesity within the same mother-child dyad. A multivariable logistic regression model was fitted to estimate odds ratios and 95% confidence intervals. A rapid policy review was conducted to understand the implication of the results obtained from the analysis. Results: The prevalence of DBM at the population level was 45.2% (95% CI: 42.5–45.5%), ranging between 40.0% and 47.6% across seven divisions (p < 0.001). At the household level, DBM prevalence was 16.6% (95% CI: 14.7–18.7%), ranging between 14.0% and 19.0% across seven divisions (p = 0.015). At the population level, DBM odds were 56% higher among younger children (5–9 years) than adolescents (10–19 years) (OR: 1.56; 95% CI: 1.37–1.78), and this association was found in four divisions. At the household level (mother-child pairs), DBM odds were 64% higher in younger children than adolescents (OR: 1.64; 95% CI:1.38–1.95); and higher in children living at a lower-middle socioeconomic status (SES) and middle SES, than upper SES. The policy review revealed that Bangladesh has made substantial commitments to improve nutrition; however, reference to DBM is absent from policy documents. Conclusions: The prevalence of DBM is high among children in urban areas in Bangladesh, disproportionately affecting younger children and households with low SES. In the current policy space, Bangladesh should revise national nutrition frameworks to recognize DBM as a public health priority and implement region-sensitive strategies for preventing and reducing malnutrition among school-aged children. Full article