Search Results (4,729)

Selective mutism (SM) is an anxiety disorder that prevents speech in certain situations. Increasingly, it is reported that a proportion of those with SM may also be autistic and that physical freezing may be an important feature of SM. Information on speech and freezing behavior in children with a diagnosis of autism only (n = 20), SM only (n = 61), both autism and SM (n = 19), or neither diagnosis (n = 131) was collected via a self-selected cross-sectional online parent survey with an embedded child survey completed by a small subsection of the children (total n = 27: autism only n = 1, SM only n = 13, both autism and SM n = 3, neither diagnosis n = 10). Throat and body freezing were reported by children with SM, whether they were also autistic or not. The most common reasons given by the children that increased their difficulty in speaking were pressure to talk, worries about how they would be perceived, and fear of making mistakes. The Selective Mutism Questionnaire (SMQ) gave the lowest median score for children with both autism and SM, with median scores increasing in the order SM only, autism only, and neither diagnosis. Children who reported more freezing tended to have lower SMQ scores. Full article

The sensory system plays a critical role in development, as it enables the processing and integration of internal and external stimuli. Dysfunctions in this system lead to sensory processing disorders (SPDs), which affect approximately 5–13% of children aged 4–6 years, impacting not only sensory responsiveness but also social interaction, emotional regulation, motor coordination, learning, attention, communication, and sleep. Although SPDs have been extensively investigated from molecular to behavioral levels, their underlying neurobiological mechanisms remain debated, and reliable biomarkers are still lacking. Moreover, due to overlapping behavioral manifestations, SPDs are frequently misdiagnosed as attention deficit hyperactivity disorder (ADHD), leading to challenges in accurate diagnosis and treatment planning. This narrative review aims to synthesize current evidence on the neurofunctional and molecular underpinnings of SPDs in relation to ADHD, providing an integrated perspective on their converging and diverging pathways. By comparing neuroimaging and neurophysiological findings across the two conditions, we seek to deepen understanding of their shared mechanisms, clarify diagnostic boundaries, and inform the development of targeted, evidence-based interventions to address a critical gap in the field. Full article

Background/Objectives: Youth with type 1 diabetes (T1DM) face unique challenges in balancing dietary choices, physical health outcomes, and social–emotional well-being in school settings. This cross-sectional exploratory pilot study examined the associations of diet with physical health and teacher-reported social–emotional functioning in students with T1DM. Methods: Students with T1DM (mean age = 13.42; 47 female, 50 male; 50% White, Non-Hispanic, 50% minority) self-reported their nutritional habits using the KBlock Dietary Screener for Children when school was in session. Teacher-rated school-related behaviors were assessed through the Behavior Assessment Scale for Children-2nd Edition (BASC-2). Canonical correlation analysis was conducted to determine whether the variable sets (diet with physical health and school-related behavioral health) shared a significant multivariate relationship. Results: Youth with lower glycemic loads and consuming more sugar, dairy, and meat/poultry/fish but fewer legumes, fruit, and less saturated fat exhibited fewer externalizing symptoms and higher BMI. Diet uniquely accounted for modest variance in combined social–emotional and physical health, controlling for demographics and T1DM duration. Findings support increasing the availability of whole, nutrient-rich foods, integrating comprehensive nutrition education into curricula, and ensuring access for all students, regardless of socioeconomic status. Conclusions: Comprehensive dietary assessments and school-based randomized control trials are needed to enact more evidence-based dietary recommendations or interventions for youth, aiming for a balanced approach that addresses both mental and physical health outcomes. 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

Many children with cancer referred to physical therapy (PT) do not attend the service. We conducted a pilot study, comprising a cross-sectional survey and interviews with parents of children with acute lymphoblastic leukemia. The survey explored parents’ (1) views on PT service delivery for their child, (2) perspectives on barriers and facilitators, (3) preferred timing to introduce PT, and (4) views on virtual services. Questions were designed based on the Theoretical Domains Framework, and responses were mapped onto the Capability, Opportunity, Motivation–Behavior Change Model. Twenty parents participated in the survey. Although all parents would consider their child accessing PT if deficits were present, access depended on a convenient location (70%) and availability of virtual delivery (45%). While half of the parents preferred PT treatment to be introduced during the maintenance phase of chemotherapy, findings also support earlier introduction during the consolidation phase when services are framed as part of standard care. While most parents perceived that it would be manageable to support home-based PT, barriers included a lack of child’s motivation without therapist support. Seven parents participated in semi-structured interviews. They identified time constraints, distance, and costs as common barriers. Most parents responded positively to hybrid PT models and connections with community locations to mitigate these challenges. Full article

Background/Objectives: The effects of online physical activity (PA) interventions on executive function (EF) and Attention-Deficit Hyperactivity Disorder (ADHD) symptoms are promising; nonetheless, their benefits for Latinx youth remain unclear. Methods: This study explores levels of adherence, cognitive and behavioral outcomes and acceptability of an online PA intervention, Zing Performance, among a Latinx youth sample; only a few of the participants completed their condition (n = 6). Results: There was wide variability in adherence levels at mid-treatment (n = 5) and high-level adherence at post-treatment (n = 2). A Mann–Whitney test yielded a statistically significant (p = 0.004) improvement in the treatment group’s inattention symptoms at mid-treatment (n = 5), compared to the Waitlist Control; (WLC; n = 6). EF and hyperactivity/impulsivity were not significantly different. Further, pre-, mid- and post-participant trajectory data revealed that one participant benefited significantly from treatment, one participant demonstrated little to no response to treatment, and most of the WLC participants remained in the severity ranges throughout the 12 weeks. The parents of the two children who completed treatment reported high levels of acceptability informally and on the quantitative measure. Conclusions: Exploratory findings support further investigation of Zing among Latinx families with cultural consideration to study procedures. The lessons learned from this study are valuable for future research procedures and interventions with this marginalized population. Full article

Pediatric obesity is an increasingly prevalent, chronic, and multifactorial disease. Achieving successful and sustained weight reduction with current interventions remains challenging due to significant heterogeneity in treatment response. This review summarizes current evidence describing variability in outcomes across lifestyle, pharmacologic, and metabolic/bariatric surgery interventions in children and adolescents, and examines key biological, metabolic, behavioral, environmental, and psychosocial factors that influence response. In adults, recent findings on energy balance obesity phenotypes (characterized by abnormal satiation, abnormal postprandial satiety, abnormal hedonic eating, and reduced energy expenditure) have demonstrated promise in predicting weight loss outcomes and guiding tailored interventions. However, data on obesity phenotyping within children and adolescents remain limited. Addressing this gap is essential for advancing precision medicine approaches in pediatric obesity, with the potential to improve treatment selection, enhance effectiveness, and optimize long-term clinical outcomes. Full article

Background/Objectives: Many elementary school-aged children (i.e., 5 to 12 years old) experience sleep difficulties that negatively impact their daytime functioning. Despite this high prevalence, sleep education is rarely included in school curricula and evidence-based interventions are limited. To better understand this gap, a needs assessment was conducted to inform the development of a sleep education program. Method: Semi-structured virtual interviews were conducted with 14 elementary school teachers in Nova Scotia, Canada. Participants were asked 20 questions about their students’ sleep and its impact, teachers’ needs and practices in sleep education, what a sleep education program would look like, and how it could be delivered. During the interview, participants watched the online ABCs of SLEEPING storybook as a potential foundation for developing a sleep education program, and interview themes were analyzed using deductive thematic analysis. Results: All teachers identified poor sleep as an issue impacting students’ behavior and learning, and reported that they had a lack of resources to teach sleep education. Teachers believed the storybook could be used with their students and integrated into the curriculum. Recommended modifications include making the storybook available for families, adding interactive activities and student discussions, providing teacher resources, and tailoring the content to be suitable for both lower and upper elementary school-aged students. Most teachers indicated that the storybook could be adapted for upper elementary students with more age-appropriate vocabulary and visuals. Conclusions: The findings from this needs assessment will inform the development of an elementary school sleep education program using the ABCs of SLEEPING storybook as the foundation of the program, while noting limitations such as sample diversity. Full article

Background/Objectives: Low back pain (LBP) is increasingly prevalent among children and adolescents and represents a growing public health concern due to its potential persistence into adulthood. Screen-based sedentary behavior has substantially increased in pediatric populations. However, evidence regarding its association with LBP remains inconsistent, and the existence of a dose–response relationship is not well established. Methods: A systematic review and meta-analysis of observational studies was conducted in accordance with PRISMA guidelines. Studies examining the association between screen-based sedentary behavior and LBP in children and adolescents aged 6–18 years were included. Random-effects meta-analyses were used to pool continuous exposure estimates, and a multivariate random-effects dose–response meta-analysis was performed to assess changes in LBP risk across increasing levels of daily screen time. Results: A total of 30 studies were included. The pairwise meta-analysis of continuous exposure showed no statistically significant association between screen time and LBP, with OR = 1.02 (95% CI 0.65 to 1.59). In contrast, the dose–response meta-analysis demonstrated a significant positive association, with a 26% (95% CI 8% to 48%) increase in the odds of LBP for each additional hour of daily screen time. High between-study heterogeneity was observed, and most studies relied on self-reported measures of screen exposure and LBP, which may have introduced recall and misclassification bias and warrants cautious interpretation of the findings. Conclusions: Higher levels of screen-based sedentary behavior were associated with an increased risk of LBP in children and adolescents when examined using a dose–response approach, whereas pairwise meta-analyses did not identify a significant association. Nevertheless, substantial between-study heterogeneity and high risk of bias limit causal inference and require cautious interpretation. Full article

Although pre-service teachers play a crucial role in promoting safe mobility among children, there are no validated instruments to assess their civic competencies, knowledge, and behaviors in road safety education. Existing questionnaires primarily target the general population or college students, and thus it remains unclear whether future teachers are adequately prepared to deliver road safety education. This study aims to design and validate a tool to assess pre-service teachers’ behavior in situations related to traffic safety and their knowledge of road safety education.. The designed tool is a questionnaire made up of 32 items distributed across five dimensions. The questionnaire’s content was validated through the judgment of eight experts, who ensured the relevance and adequacy of its items. The confirmatory factor analysis of data obtained from a pilot sample was used to examine the questionnaire’s structure, and reliability was assessed using Cronbach’s alpha coefficient. After analyzing the responses of 388 participants, the results suggest that the questionnaire’s overall structure is adequate and satisfactory reliability coefficients were obtained. The confirmatory factor analysis supported the proposed four-factor structure, indicating good model fit. These findings suggest that a valid and reliable diagnostic tool can identify the road safety training needs of future teachers and inform curriculum design and targeted educational interventions to enhance road safety competencies in schools. Full article

Pragmatic language is a core component of school-based social participation, yet children with Autism Spectrum Disorder (ASD) and Social Communication Disorder (SCD) frequently experience persistent difficulties in using language appropriately across everyday learning contexts. This study investigated the effectiveness of a culturally adapted, school-based immersive Virtual Reality (VR) learning program designed to enhance pragmatic language and social communication skills among Thai primary school children. Eleven participants aged 7–12 years completed a three-week, ten-session VR program that simulated authentic classroom, playground, and canteen interactions aligned with Thai sociocultural norms. Outcomes were measured using the Social Communication Questionnaire (SCQ) and the Pragmatic Behavior Observation Checklist (PBOC). While SCQ scores showed a small, non-significant reduction (p = 0.092), PBOC results demonstrated significant improvements in three foundational pragmatic domains: Initiation and Responsiveness (p = 0.032), Turn-Taking and Conversational Flow (p = 0.037), and Politeness and Register (p = 0.010). Other domains showed no significant changes. These findings suggest that immersive, culturally relevant VR environments can support early gains in core pragmatic language behaviors within educational settings, although broader social communication outcomes may require longer or more intensive learning experiences. Full article

Over 10% of US children and adolescents have attention-deficit hyperactivity disorder (ADHD), with a similar prevalence among youth athletes. While ADHD may confer certain athletic performance advantages such as heightened quickness, decision-making and periods of hyperfocus, it also poses some challenges including reduced concentration, frustration, and possible increased injury risk. Pharmacologic treatments, including stimulant-based medications, can improve attentiveness and athletic performance but could alter nutritional behaviors such as appetite suppression. This paper reviews the current literature on nutritional strategies to provide practical sports nutrition guidelines for children and adolescent athletes with ADHD. Evidence suggests that optimizing energy intake, emphasizing complex carbohydrates, improving fat quality intake, and consuming adequate amounts of micronutrients may support both athletic performance and ADHD symptom management. In contrast, excessive added sugars and saturated fats are associated with poorer outcomes and manifestation of ADHD symptoms. Although no research examining nutritional interventions in youth athletes with ADHD have been performed, applying established sports nutrition principles for youth athletes with ADHD offers a promising approach to enhance performance, reduce injury risk, and support the long-term health of the athlete. 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

The present study proposes to identify information from health, educational and sports science studies that used Bronfenbrenner’s theory of human development to verify the complex relationship between factors associated with physical activity (PA) and sedentary behavior (SB) in children and adolescents. The scoping review will be developed across seven databases (PubMed, Scopus, SPORTDiscus, Web of Science, PsycINFO, ERIC, and Scielo). The inclusion criteria were formulated based on the PCC (Population, Concept, Context) framework: (a) children and adolescents (5–17 years); (b) studies on PA and/or SB that used Bronfenbrenner’s theory; (c) any context. Only peer-reviewed journal articles published in English, Spanish, or Portuguese will be included; grey literature will not be included. Finally, two reviewers will screen studies using Rayyan. A standardized charting form will be used to extract data on study characteristics and the factors mapped considering Bronfenbrenner’s theory components. This study is expected to show how Bronfenbrenner’s theory has been applied to explain PA and SB in children and adolescents, as well as to map the methodological tools used in this area, identifying gaps and providing a clear framework for future research on the complex and multilevel determinants of PA and SB in children and adolescents. Full article

Background/Objectives: The first step in learning an alphabetic writing system is to establish letter–sound associations. This process is more difficult for children with dyslexia (DYS) than for typically developing (TD) children. Cerebral mechanisms underlying these associations are not fully understood and are expected to change during the training course. This study aimed to identify the neurophysiological correlates and developmental changes of visual letter processing in children with DYS compared to TD children, using event-related potentials (ERPs) during a letter/non-letter classification task. Methods: A total of 71 Russian-speaking children aged 7–11 years participated in the study, including 38 with dyslexia and 33 TD children. The participants were divided into younger (7–8 y.o.) and older (9–11 y.o.) subgroups. EEG recordings were taken while participants classified letters and non-letter characters. We analyzed ERP components (N/P150, N170, P260, P300, N320, and P600) in left-hemisphere regions of interest related to reading: the ventral occipito-temporal cortex (VWFA ROI) and the inferior frontal cortex (frontal ROI). Results: Behavioral differences, specifically lower accuracy in children with dyslexia, were observed only in the younger subgroup. ERP analysis indicated that both groups displayed common stimulus effects, such as a larger N170 for letters in younger children. However, their developmental trajectories diverged. The DYS group showed an age-related increase in the amplitude of early components (N/P150 in VWFA ROI), which contrasts with the typical decrease observed in TD children. In contrast, the late P600 component in the frontal ROI revealed an age-related decrease in the DYS group, along with overall reduced amplitudes compared to their TD peers. Additionally, the N320 component differentiated stimuli exclusively in the DYS group. Conclusions: The data obtained in this study confirmed that the mechanisms of letter recognition in children with dyslexia differ in some ways from those of their TD peers. This atypical developmental pattern involves a failure to efficiently specialize early visual processing, as evidenced by the increasing N/P150. Additionally, there is a progressive reduction in the cognitive resources available for higher-order reanalysis and control, indicated by the decreasing frontal P600. This disruption in neural specialization and automation ultimately hinders the development of fluent reading. Full article