Search Results (343)

This paper proposes a structured design framework and system architecture for a non-intrusive spatial system aimed at supporting child behavior in everyday domestic environments. Rooted in ethical considerations, our approach defines four core behavior-guided design strategies: routine recovery, emotion-responsive adjustment, behavioral transition induction, and external linkage. Each strategy is meticulously translated into a detailed system logic that outlines input conditions, trigger thresholds, and feedback outputs, designed for implementability with ambient sensing technologies. Through a comparative conceptual analysis of three sensing configurations—low-resolution LiDARs, mmWave radars, and environmental sensors—we evaluate their suitability based on technical feasibility, spatial integration, operationalized privacy metrics, and ethical alignment. Supported by preliminary technical observations from lab-based sensor tests, low-resolution LiDAR emerges as the most balanced option for its ability to offer sufficient behavioral insight while enabling edge-based local processing, robustly protecting privacy, and maintaining compatibility with compact residential settings. Based on this, we present a working three-layered system architecture emphasizing edge processing and minimal-intrusion feedback mechanisms. While this paper primarily focuses on the framework and design aspects, we also outline a concrete pilot implementation plan tailored for small-scale home environments, detailing future empirical validation steps for system effectiveness and user acceptance. This structured design logic and pilot framework lays a crucial foundation for future applications in diverse residential and care contexts, facilitating longitudinal observation of behavioral patterns and iterative refinement through lived feedback. Ultimately, this work contributes to the broader discourse on how technology can ethically and developmentally support children’s autonomy and well-being, moving beyond surveillance to enable subtle, ambient, and socially responsible spatial interactions attuned to children’s everyday lives. Full article

Childhood obesity is a complex and multifactorial disease influenced by various factors including behavioral, physical, and psychological conditions. This cross-sectional study aimed to evaluate the impact of maternal and child stress and food addiction on the nutritional status of children with obesity. Children aged 6 to 12 years were divided into Control Group (n = 42) and Obesity Group (n = 68) according to BMI-Z score. Mothers were allocated to their children’s respective groups. Anthropometric measures, body composition, stress levels, and food addiction were evaluated in both children and mothers. Children with obesity exhibited a significantly higher prevalence of food addiction compared to controls (22.1% vs. 2.6%, p = 0.006), while mothers in the control group showed higher stress levels (68.6% vs. 46.3%, p = 0.039). Positive correlations were observed between mother–child pairs for weight (r = 0.433, p < 0.01) and waist circumference (r = 0.461, p < 0.01). In children, food addiction was a significant predictor of BMI-Z scores (adjusted R square = 0.186); however, maternal BMI and stress were more important predictors (adjusted R square = 0.468). These findings highlight the influence of maternal physical and psychological health on childhood BMI-Z scores. Effective interventions should target both mother and child to improve overall health outcomes. Full article

Background/Objectives. Social and Emotional Education (SEE) interventions during early childhood have shown considerable promise in enhancing children’s emotion understanding, social competence, and behavioural adjustments. However, few studies have examined their long-term impact, especially across the preschool-to-primary school transition. This study evaluated the effectiveness of a manualized SEE program, Timmy’s Trip to Planet Earth, in promoting emotional, behavioural, and social functioning over time. Methods. A quasi-experimental longitudinal design was adopted with pre- and post-test assessments conducted approximately 18 months apart. Participants were 89 typically developing children (aged 59–71 months), assigned to an experimental group (n = 45) or a waiting-list group (n = 44). The program combined teacher training, classroom-based lessons, home activities, and teachers’ ongoing implementation support. The effectiveness of the program was measured via the Test of Emotion Comprehension (TEC), the Strengths and Difficulties Questionnaire (SDQ), and the Social Competence and Behavior Evaluation (SCBE-30). Results. Significant Time × Group interactions were observed for the TEC External and Mental components, indicating greater improvements in emotion recognition and mental state understanding in the intervention group. The SDQ revealed significant reductions in conduct problems and increased prosocial behaviours. In the SCBE-30, a significant interaction effect was found for social competence, with the intervention group showing greater improvement over time compared to the control group. Conclusions. The findings suggest that SEE programs can produce meaningful and lasting improvements in children’s emotional and social skills across key educational transitions. Teacher training and family involvement likely played a critical role in supporting the program’s sustained impact. Full article

Background/Objective: A growing body of international research continues to show evidence of worsening youth mental health since the beginning of the COVID-19 global pandemic, yet very little research in this area has included young children under 6 years. Given the potential impact of early life stress during this critical period of development, it is crucial to better understand the effects on this age group. The objective of this study was to better understand the impact of the COVID-19 pandemic on the emotional health of very young children. Methods: This study utilized retrospective chart review of primary care records to compare the prevalence of markers of stress in two cohorts of children under the age of 6 years, comparing children presenting for care prior to the pandemic (1 April 2019–31 March 2020; control period) with those presenting for care during the first year of the pandemic (1 April 2020–31 March 2021; study period) in a large pediatric primary care clinic in Washington, DC, USA. Based on power calculations, charts of 200 patients from each cohort were reviewed and prevalence of stress markers were summarized using counts and percentages and compared between groups using chi-squared tests. Multivariable logistic regression models were also conducted for each domain adjusting for age, gender, and insurance type. Results: Overall, sleep difficulties were significantly more prevalent during the pandemic period compared to the control period (14% vs. 6.5%, p = 0.013). In addition, signs of stress presented differently across age groups. For example, during the pandemic period toddlers (13–35 months) were 13 times more likely (OR = 13, 95% CI [2.82, 60.4], p < 0.001) and preschool-aged children (36–71 months) were 18.5 times more likely (OR = 18.5, 95% CI [4.0, 86], p < 0.001) than infants to present with behavior problems, indicating substantially higher risk of externalizing symptoms in older children compared to infants. Toddlers were less likely than infants to present with mood changes (e.g., fussiness or crying) (OR = 0.15, 95% CI [0.03, 0.65], p = 0.011). In addition, toddlers (OR = 0.55, 95% CI [0.31, 0.97], p = 0.038) and preschool-aged children (OR = 0.15, 95% CI [0.06, 0.4], p < 0.001) were also less likely to present with feeding difficulties compared to infants. Conclusions: One of the very few studies of young children under 6 years (including infants) during the COVID-19 pandemic, this study found that even very young children experienced stress during the pandemic. Signs of emotional stress were identified in a primary care office during routine care, highlighting an important opportunity for early intervention and/or prevention, such as counseling and resources for caregivers, in settings where young children are already presenting for routine care. Full article

Approximately 18% of U.S. children experience cognitive and behavioral challenges, with both genetic and environmental contributors. We examined if household insecticides, particularly those used in and around the home and on pets, are associated with neurodevelopmental changes. Data were from children aged 24–60 months in the CHARGE study with the following classifications: autism spectrum disorder (ASD, n = 810), developmental delay (DD, n = 192), and typical development (TD, n = 531). Exposure to indoor, outdoor, and pet insecticides was reported for the period from three months pre-conception to the second birthday. Cognitive and adaptive functioning were assessed using the Mullen Scales of Early Learning and Vineland Adaptive Behavior Scales. Linear regression was used to evaluate associations by diagnostic group, adjusting for confounders. Flea/tick soaps, shampoos, and powders used during year two were significantly associated with lower cognitive and adaptive scores in children with ASD after FDR correction. Flea/tick skin treatments in early pregnancy were associated with reduced scores in the DD group, though not significant after correction, especially when used with high frequency. No associations were observed in TD children. These findings underscore the need to examine early-life exposure to non-agricultural insecticides as modifiable risk factors for neurodevelopment. Full article

Background/Objectives: Childhood/youth are ideally the best periods to teach healthy behaviors; unfortunately, children/adolescents are frequently characterized by unhealthy lifestyles and reduced well-being. Lifestyle improvement early in life may play a fundamental role in determining present health, preventing many chronic diseases, and fostering well-being. Having a clear picture of the lifestyle characteristics of a group can help institutions and schools define effective educational and intervention strategies. This observational study aims to examine whether information collected from children and adolescents about their lifestyles and perceptions of well-being could help identify particular groups that deserve specific interventions, implemented by the school, to improve their overall health. Methods: After administering a simple lifestyle/well-being questionnaire to 225 children/adolescents at an Italian school complex, we investigated the relationships between lifestyles and perceptions of well-being by constructing statistical indicators through nonlinear principal component analysis. Then, we defined lifestyle typologies based on lifestyle indicators and studied the distribution of the well-being indicator across such typologies, also adjusting for sex and age effects. Results: The study shows that lifestyle worsens with age (p < 0.001) and influences overall well-being perception. We identified four lifestyle typologies by combining two indicators of sedentary behavior and sleep, and of quality of nutrition and the volume of physical activity. The healthier the lifestyle, the better the overall well-being perception is (represented by the indicator that includes the perceived quality of health, sleep, and academic performance) (p = 0.005). Conclusions: Tailored educational/intervention strategies that consider specific groups’ characteristics, rather than general counseling, might be more effective at improving health/well-being. Full article

Background: Food addiction (FA) is an emerging construct that mirrors the behavioral and neurobiological characteristics of substance use disorders. Despite growing interest, its association with specific psychiatric disorders among bariatric patients remains understudied. Objective: Our aim was to examine the prevalence and strength of associations between FA and seven major psychiatric disorders in individuals who underwent bariatric surgery. Methods: In a sample of 100 post-bariatric patients referred for psychiatric evaluation, FA was assessed using the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Logistic regression models were used to estimate adjusted odds ratios (aORs) for the association between FA and each psychiatric disorder, controlling for sex, age, body mass index (BMI), employment status, the number of children, clinical comorbidities, physical activity, family psychiatric history, and region of residence. Results: FA was present in 51% of the sample. Descriptive analyses revealed a significantly higher prevalence of major depressive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, agoraphobia, obsessive–compulsive disorder, and bulimia nervosa among individuals with FA. Multivariate models showed robust associations between FA and bulimia nervosa (aOR = 19.42, p < 0.05), generalized anxiety disorder (aOR = 2.88, p < 0.05), obsessive–compulsive disorder (aOR = 6.64, p < 0.05), agoraphobia (aOR = 3.14, p < 0.05), social anxiety disorder (aOR = 4.28, p < 0.05) and major depressive disorder (aOR = 2.79, p < 0.05). Conclusions: FA is strongly associated with a range of psychiatric comorbidities in post-bariatric patients, reinforcing the need for comprehensive mental health screening in this population. These findings underscore the potential role of FA as a clinical marker for stratified risk assessment, supporting more personalized approaches to mental health monitoring and intervention following bariatric surgery. Full article

This study proposes a novel method to assess urban park accessibility by incorporating perceived utility based on both park area and distance. Departing from conventional models that treat accessibility as a function of geometric proximity alone, we define park utility as a distance-discounted benefit of park area, thereby allowing for a more behaviorally grounded measure. A customized discounting function is introduced, where larger park sizes proportionally reduce perceived travel cost, and walking speed adjustments are applied based on demographic user profiles (children, adults, and older adults). The methodology was implemented using a Python-based v.3.12.9 geospatial workflow with network-based distance calculations between 18,614 census block groups and all urban parks in Seoul. Population-weighted utility scores were computed by integrating park size, distance, and age-specific mobility adjustments. The results reveal significant intra-urban disparities, with a citywide deficit of 4,066,046 m in population-weighted distance, particularly in areas with large populations but insufficient proximity to high-utility parks. Simulation analyses of 30 candidate sites demonstrate that strategic park placement can yield substantial utility improvements (maximum gain: 493,436 m), while indiscriminate expansion may not. These findings offer spatial decision support for optimizing limited public resources in urban green infrastructure planning and underscore the need to consider both park scale and user-specific walking behavior in evaluating accessibility. Full article

Background/Objectives: This study aimed to examine the association between leukocyte telomere length (TL) measured at ages 4 and 8 and emotional and behavioral problems at age 8. We also explored whether changes in leukocyte TL between ages 4 and 8 were associated with outcomes. Methods: Data were obtained from a population-based birth cohort and included 647 children with TL at age 4 and emotional and behavioral assessments at age 8, 673 with TL and outcomes at age 8, and 315 with TL measured at both ages. TL was determined using quantitative PCR on blood samples and converted into z-scores for analysis. Emotional and behavioral problems—including internalizing, externalizing, and total difficulties—were assessed using the Strengths and Difficulties Questionnaire. Regression models were conducted using zero-inflated and negative binomial, adjusting for sociodemographic and lifestyle covariates. Results: No statistically significant associations were observed between leukocyte TL at ages 4 or 8, or TL changes over this period, and emotional and behavioral outcomes at age 8. Conclusions: Although no significant associations were found, further longitudinal research is warranted to clarify the role of TL as a potential psychobiomarker of emotional and behavioral disorders in childhood. Full article

Background/Objectives: Early childhood is a critical window of development, which is influenced by early life exposures including breastfeeding. Observational and preclinical studies have linked human milk oligosaccharides (HMOs) with neurocognitive development. However, less attention has focused on behavioral outcomes including temperament and eating behaviors. Herein, we investigated the associations between HMO consumption and child temperament and child eating behaviors through four years of age. Methods: Participants were drawn from the STRONG Kids 2 cohort. Human milk was collected at 6 weeks postpartum, and HMO relative abundances were determined by HPLC-MS. Using validated questionnaires, child temperament was assessed at 3, 18, and 48 months of age, and child eating behaviors were measured at 12, 18, 24, 36, and 48 months of age. After adjusting for covariates, multiple linear regressions were carried out to assess the relationship between HMOs and the outcome measures. Results: The HMO profile of mothers showed two distinct clusters explained by maternal secretor status. Significant associations between HMO and surgency were only found in the full cohort and secretors, while more associations between HMO and negative affectivity were observed in non-secretors. A significant number of associations was observed between HMOs and child eating behaviors in full cohort, secretors, and non-secretors. HMO diversity, total fucosylation, and total sialylation were positively associated with food responsiveness, while neutral HMOs presented negative associations. However, these associations with food responsiveness were not observed in non-secretors. Conclusions: HMO profiles were associated with behavioral outcomes in the children, with variations by child age and maternal secretor status, highlighting the potential role of HMOs within the broader context of maternal and postnatal influences. Full article

Background/Objectives: Parental emotion socialization is a key influence on children’s emotional regulation and psychosocial development. This study examined how supportive and non-supportive parental responses to children’s negative emotions are associated with internalizing and externalizing problems and social competence among Greek children aged 6–12 years. Methods: A non-experimental, cross-sectional correlational study using convenience sampling was conducted with 100 Greek parents who completed the Coping with Children’s Negative Emotions Scale and the Child Behavior Checklist. Correlation and multiple regression analyses were used to examine associations between parenting responses and child outcomes, controlling for child age, child gender, and parent gender. Results: Minimization/devaluation responses were significantly associated with higher internalizing problems (β = 0.396, p = 0.009), externalizing problems (β = 0.264, p = 0.048), and total problems (β = 0.320, p = 0.012). Punitive responses significantly predicted externalizing (β = 0.383, p = 0.003) and total problems (β = 0.304, p = 0.004). Supportive strategies (e.g., emotion-focused and problem-focused responses) did not significantly predict lower problem scores but were positively correlated with social competence (e.g., problem-focused response: ρ = 0.25, p = 0.017). Parent gender predicted minimization/devaluation responses, with mothers scoring higher than fathers (β = 0.308, p = 0.006). Conclusions: Non-supportive parental responses—especially punitive and dismissive behaviors—are robustly associated with increased behavioral and emotional difficulties in children. While supportive strategies may contribute to social competence, their benefits appear diminished in the presence of negative parenting practices. These findings highlight the importance of culturally sensitive interventions tailored to Greek family dynamics. Despite limitations such as the use of self-report measures and a non-representative sample, this study contributes valuable insights into emotion socialization and child adjustment in a specific cultural context. Full article

Problem behaviors and the risk of learning disorders in early childhood carry significant implications for children’s future development. Understanding the relationship between parenting stress and these developmental outcomes may inform the design of effective interventions to promote healthy child development. The present longitudinal study investigated the association between parenting stress and preschoolers’ risk of learning disorders, specifically focusing on the mediating role of problem behaviors. Data were collected at two time points, approximately 6 months apart, from 284 preschool-aged children and their parents (mean age of children at Time 1 = 56.64 months; 53.17% of them were girls). Parents completed standardized assessments of parenting stress, children’s problem behaviors, and the risk of learning disorders. An autoregressive cross-lagged panel model within a half-longitudinal framework was employed to test the hypothesized mediation model. Results revealed that parenting stress had a direct effect on both children’s problem behaviors and their risk of learning disorders. Moreover, children’s problem behaviors partially mediated the longitudinal association between parenting stress and learning disorder risk. Specifically, the indirect effect size was statistically significant (β = 0.022, p = 0.025), indicating that increased parenting stress contributed to approximately a 2.2% increase in the risk of learning disorders through elevated problem behaviors. Theoretically, these findings underscore the critical role of child behavioral adjustment as a mechanism through which parenting stress may influence developmental risk. The results highlight the potential benefits of reducing parenting stress and addressing children’s behavioral difficulties to prevent early learning problems. However, the study relied exclusively on parent-reported data, which may introduce shared method variance and reporting bias; future research should incorporate multiple informants and objective behavioral assessments. Full article

Parental school involvement (PSI) is a multidimensional construct that significantly influences children’s academic adjustment and overall development. However, inconsistencies persist in its definition and measurement, with researchers operationalizing PSI through a varied of parental activities. This study aimed to (1) identify PSI instruments and their theoretical models and (2) evaluate their psychometric properties. Following PRISMA guidelines (PROSPERO ID CRD42023451091, registered August 2023), this systematic review examined six databases (Web of Science, ERIC, MEDLINE, Psychology and Behavioral Sciences Collection, PsycArticles, and PsycInfo), analyzing quantitative studies from 2000 to 2024. Inclusion criteria encompassed instruments designed for parents, teachers, or children aged 6–15 and published in peer-reviewed journals in English, Portuguese, Spanish, or French. From an initial pool of 490 records, 38 studies were included, yielding 43 instruments: 23 for parents, 15 for children, and 5 for teachers. Seven instruments followed Epstein’s model, while nine followed the Hoover-Dempsey and Sandler framework, underscoring the prominence of these theoretical approaches. The study quality, assessed with MMAT, was generally moderate to high. Despite an exhaustive search effort, it is possible that some relevant instruments were not identified. Nevertheless, this review advances the understanding of PSI operationalization, promotes more consistent and replicable assessments, enhances alignment between instruments and study objectives, and strengths the validity of findings derived from these tools. Full article

Background: While the mHealth and school-based scale-up intervention for salt reduction (EduSaltS) effectively reduced salt intake and blood pressure among adults living with participating schoolchildren, the sustainability of these effects remains uncertain. This study aimed to evaluate whether these effects persisted one year post intervention. Methods: A one-year follow-up of a cluster randomized controlled trial was conducted, involving 524 children and their 524 adult family members from 20 primary schools. At 24 months, 509 children (97.1%) and 486 adults (92.7%) completed the assessment. Mixed linear models were used to analyze the difference in changes in salt intake between the intervention and control groups at 24 months, compared to baseline and 12 months, as measured by consecutive 24 h urinary sodium excretions. Secondary outcomes included the differences in changes in blood pressure and salt-related knowledge, attitudes, and practices (KAP) scores. Results: The adjusted mean difference in changes in salt intake between groups was −0.34 g/24 h (95% CI: −0.94 to 0.26, p = 0.265) for children and −0.72 g/24 h (95% CI: −1.48 to 0.05, p = 0.065) for adults at 24 months versus baseline. The corresponding differences from 12 to 24 months were −0.09 g/24 h (95% CI: −0.69 to 0.51, p = 0.775) for children and 0.29 g/24 h (95% CI: −0.50 to 1.08, p = 0.468) for adults. The adjusted difference in changes in adult blood pressure showed a slight, nonsignificant rebound at 24 months. The intervention group maintained significantly higher KAP scores than the control group at both 12 and 24 months. Conclusions: The effects of EduSaltS on reducing salt intake and blood pressure in adults diminished slightly one year after the intervention ended. However, sustained improvements in salt-related KAP were observed in both children and adults. Ongoing support is vital to sustain long-term salt-reduction behaviors. Full article

Background: This study aimed to investigate the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on quality of life and behavioral problems in children diagnosed with leukemia and β-thalassemia major, with a focus on post-transplant diagnosis-specific differences in psychosocial adjustment. Method: This study included 112 children (63 children with acute leukemia, 49 children with β-thalassemia major) aged 6–18 years, along with a control group of 30 healthy children within the same age range. The Pediatric Quality of Life Inventory (PedsQL) and the Child Behavior Checklist for Ages 6–18 (CBCL) were administered. Participants were categorized into five groups, and the outcomes were compared accordingly. Results: The emotional functioning subscale scores of the PedsQL were significantly lower in children with leukemia and those who had undergone HSCT for leukemia, when compared to children with thalassemia (p < 0.05). The social functioning subscale scores were also significantly lower in children with leukemia who underwent HSCT compared to those with thalassemia (p < 0.05). The CBCL internalizing scores were higher in children with leukemia and post-HSCT leukemia patients than in their healthy peers (p < 0.05). Over time, both diagnostic groups showed improvements, with total PedsQL scores increasing and total CBCL scores decreasing after HSCT. Conclusions: This study demonstrates that quality of life improved and behavioral problems diminished over time following HSCT. However, the psychosocial impact of HSCT varied depending on the underlying disease, with children diagnosed with leukemia being slightly more adversely affected. These findings suggest that interventions aimed at improving quality of life and addressing behavioral issues should be tailored to the specific diagnosis. Full article