Search Results (2,055)

Objective: Irritability and reactive aggression are transdiagnostic features that are predictive of adverse long-term outcomes. This investigation examined whether intranasal oxytocin administration impacts the interaction between irritability and reactive aggression, and whether these effects can be detected at a neural level via a facial expression processing task during functional MRI (fMRI). Methods: In this study, 40 children and adolescents with severe irritability and psychiatric diagnoses of disruptive mood and behavioral disorders were assigned to either intranasal oxytocin or placebo administration over a 3-week period in a randomized, double-blind trial (ClinicalTrials, NCT02824627). Clinical measures and fMRI during a facial expression processing task were collected pre- and post-intervention. Brain regions sensitive to oxytocin administration were determined using whole-brain statistical analyses, with post hoc analyses to determine whether changes in the neural activity mediated the relationship between changes in irritability and reactive aggression across the intervention period. Results: Youth who received intranasal oxytocin administration exhibited significant decreases in irritability and reactive aggression compared to their counterparts in the placebo group. Further, oxytocin administration was associated with significant increases in neural activity in the right superior prefrontal cortex, which fully mediated the relationship between improvements in irritability and improvements in reactive aggression. Conclusions: Intranasal oxytocin significantly reduced irritability and reactive aggression in youth, as well as neural activity in the prefrontal cortex, such that increases in the cortical activity fully mediated the relationship between changes in irritability and reactive aggression. Taken together, these findings may reflect oxytocin-related enhancements in emotional regulation in youth with severe irritability, a potential therapeutic mechanism for mitigating reactive aggression. Full article

Despite extensive research on early childhood education (ECE) quality at the preschool level, toddler settings remain comparatively understudied, particularly in Chile and Latin America. Research suggests that quality ECE strengthens child development, while low-quality services can be harmful. ECE quality comprises structural features like ratios and classroom resources, and process features related to interactions within classrooms. This study examines how process and structural quality indicators are related in nurseries serving disadvantaged backgrounds. Data were collected from 51 Chilean urban classrooms serving children aged 12–24 months. Classrooms were evaluated using the Classroom Assessment Scoring System (CLASS) for toddlers, questionnaires, and checklists. Latent Profile Analysis identified process quality patterns, while multinomial regression examined associations with structural quality indicators. The results revealed low-to-moderate process quality across classrooms (M = 4.78 for Emotional and Behavioral Support; M = 2.35 for Engaged Support for Learning), with three distinct quality clusters emerging. Marginally significant differences were found between high- and low-performing clusters regarding classroom space (p = 0.06), number of toys (p = 0.08), and staff educational credentials (p = 0.01–0.07). No significant differences emerged for group sizes or adult-to-child ratios, which are heavily regulated in Chile. These findings underscore the need to strengthen quality assurance mechanisms ensuring all children access quality ECE. Full article

Family empowerment is a key component of effective family-centered practices in healthcare, mental health, and educational services. The Family Empowerment Scale (FES) is the most commonly used instrument to evaluate empowerment in families raising children with emotional, behavioral, or developmental disorders. Despite its importance, the FES for diverse populations, especially Latinx parents, has rarely been evaluated using innovative psychometric approaches. In this study, we evaluated key dimensions and psychometric evidence of the Family Empowerment Scale (FES) for 96 Latinx parents of children with intellectual and developmental disabilities (IDD) in the United States using an exploratory graph analysis (EGA). The EGA identified a five-dimensional structure, and EGA models outperformed the original CFA 3-factor models for both parents of children with autism and other disabilities. This study identified distinct, meaningful dimensions of empowerment that reflect both shared and unique empowerment experiences across two Latinx parent groups. These insights can inform the design of culturally responsive interventions, instruments, and policies that more precisely capture and boost empowerment in Latinx families. This study contributes to closing a gap in the literature by elevating the voices and experiences of Latinx families by laying the groundwork for more equitable support systems in special education and disability services. Full article

This article examines training itineraries for early childhood education professionals in Portugal, focusing on promoting social and human development through music and the arts for infants. The training models discussed are categorized as short-term and long-term, encompassing both theory and practice through a transdisciplinary approach. Based on initiatives promoted by the Companhia de Música Teatral (CMT) and the Education and Human Development Group of the Centre for the Study of Sociology and Musical Aesthetics (CESEM) at NOVA University Lisbon, the article highlights projects such as: (i) Opus Tutti and GermInArte, developed between 2011 and 2018; (ii) the Postgraduate Course Music in Childhood: Intervention and Research, offered at the University since 2020/21, which integrates art, health, and education, promoting collaborative work between professionals; and (iii) Mil Pássaros (Thousand Birds), developed since 2020, which exemplifies the integration of environmental education and artistic practices. The theoretical basis of these training programs combines neuroscientific and educational evidence, emphasizing the importance of the first years of life for integral development. Studies, such as those by Heckman, reinforce the impact of early investment in children’s development. Edwin Gordon’s Music Learning Theory and Malloch and Trevarthen’s concept of ‘communicative musicality’ structure the design of these courses, recognizing music as a catalyst for cognitive, emotional, and social skills. The transformative role of music and the arts in educational and social contexts is emphasized, in line with the Sustainable Development Goals of the 2030 Agenda, by proposing approaches that articulate creation, intervention, and research to promote human development from childhood onwards. Full article

Art therapy serves as a crucial intervention modality for children with autism spectrum disorder (ASD), demonstrating unique value in emotional expression, sensory integration, and social communication. However, current practice presents critical challenges, including the disconnect between design expertise and clinical needs, unclear mechanisms of environmental factors’ impact on therapeutic outcomes, and insufficient evidence-based support for technology integration. Purpose: This study aimed to construct an evidence-based theoretical framework for art therapy environment design for children with autism, clarifying the relationship between environmental design elements and therapeutic effectiveness. Methodology: Based on the Web of Science database, this study employed a dual-track approach comprising bibliometric analysis and micro-qualitative content analysis to systematically examine the knowledge structure and developmental trends. Research hotspots were identified through keyword co-occurrence network analysis using CiteSpace, while 24 representative design cases were analyzed to gain insights into design concepts, emerging technologies, and implementation principles. Key Findings: Through keyword network visualization analysis, this study identified ten primary research clusters that were systematically categorized into four core design elements: sensory feedback design, behavioral guidance design, emotional resonance design, and therapeutic support design. A responsive therapeutic environment conceptual framework was proposed, encompassing four interconnected components based on the ABC model from positive psychology: emotional, sensory, environmental, and behavioral dimensions. Evidence-based design principles were established emphasizing child-centeredness, the promotion of multisensory expression, the achievement of dynamic feedback, and appropriate technology integration. Research Contribution: This research establishes theoretical connections between environmental design elements and art therapy effectiveness, providing a systematic design guidance framework for interdisciplinary teams, including environmental designers, clinical practitioners, technology developers, and healthcare administrators. The framework positions technology as a therapeutic mediator rather than a driver, ensuring technological integration supports rather than interferes with children’s natural creative impulses. This contributes to creating more effective environmental spaces for art therapy activities for children with autism while aligning with SDG3 goals for promoting mental health and reducing inequalities in therapeutic access. Full article

Phubbing, a relatively new phenomenon in the field of digital risks, refers to the act of ignoring someone in favor of focusing on a smartphone during face-to-face interactions. Parental phubbing, a specific form of this behavior, is a prevalent negative parenting practice that can affect parent–child relationships and child development. However, the impact of parental phubbing on the emotional and behavioral development of preschool children remains unclear. This study aims to explore the relationship between parental phubbing and preschoolers’ behavioral problems, as well as test whether parents’ mindful attention awareness (MAA) acts as a mediator between them. Method: A questionnaire was administered to 138 Italian parents (mean age = 38.5, SD = 6.2) of 138 kindergarten preschoolers (mean age = 3.9, SD = 1.03). Questionnaires included the Generic Scale of Phubbing (GSP), the Mindful Attention Awareness Scale (MAAS), and the Strengths and Difficulties Questionnaire (SDQ). Results: Analyses revealed a significant negative correlation between the MAAS and SDQ total scores, a positive correlation between the GSP total score and the SDQ total score, and a negative correlation between the GSP total score and the MAAS total score. The mediation analysis did not show a direct effect of GSP on SDQ, suggesting that parental phubbing did not directly predict children’s behavioral difficulties. Nevertheless, the indirect effect measured by bootstrapping was significant, indicating that parental MAA fully mediated the relationship between parental phubbing and preschoolers’ problematic behaviors. Conclusions: Although further research is needed, parental mindfulness may influence phubbing behaviors in parents providing valuable insights for early interventions aimed at reducing problem behaviors in young children. Full article

Participation in organized sport is widely encouraged for youth development, yet positive outcomes are not guaranteed. Parents play a pivotal role in shaping young athletes’ experiences, requiring emotional support, interpersonal skills, and self-regulation. This study examines the meanings parents attribute to their children’s sports participation and how young athletes construct their experiences under parental and coaching influences. An interpretive phenomenological methodology involved semi-structured interviews with coaches, focus groups with parents, and open-ended questionnaires to young athletes. Seventeen players (M = 11.2 years, SD = 0.59), nineteen parents (M = 47.6 years, SD = 3.61), and two coaches from the same football club volunteered to participate in the study. Participants were selected through purposive sampling to ensure a homogeneous experience. The findings reveal that parental involvement balances support and pressure, while trust-building between parents and coaches significantly impacts the athletes’ experiences. The evolving role of technology and the importance of social dynamics within teams also emerged as critical factors. Intrinsic motivation, fostering emotional bonding through the sport, and adopting a developmental rather than purely competitive framework were emphasized factors identified as supporting positive youth sport experiences. These findings offer insights into how interconnected relationships among parents, coaches, and athletes influence children’s sports engagement and development. Full article

Background and Objectives: Although survival after congenital cardiac malformations (CCM) has improved, little is known about Romanian children’s own perceptions of health-related quality of life (HRQoL) or their emotional burden. We compared HRQoL, depressive symptoms, and anxiety across lesion severity strata and explored clinical predictors of impaired HRQoL. Methods: In this cross-sectional study (1 May 2023–30 April 2025), 72 children (mean age 7.9 ± 3.0 years, 52.8% male) attending a tertiary cardiology clinic completed the Romanian-validated Pediatric Quality of Life Inventory (PedsQL), Children’s Depression Inventory (CDI) and the Screen for Child Anxiety-Related Emotional Disorders questionnaire (SCARED-C, child version). Lesions were classified as mild (n = 22), moderate (n = 34), or severe (n = 16). Left-ventricular ejection fraction (LVEF) and unplanned cardiac hospitalisations over the preceding 12 months were extracted from electronic records. Results: Mean PedsQL total scores declined stepwise by severity (mild 80.9 ± 7.3; moderate 71.2 ± 8.4; severe 63.1 ± 5.4; p < 0.001). CDI and SCARED-C scores rose correspondingly (CDI: 9.5 ± 3.0, 13.6 ± 4.0, 18.0 ± 2.7; anxiety: 15.2 ± 3.3, 17.2 ± 3.8, 24.0 ± 3.4; both p < 0.001). PedsQL correlated positively with LVEF (r = 0.51, p < 0.001) and negatively with hospitalisations (r = −0.39, p = 0.001), depression (r = −0.44, p < 0.001), and anxiety (r = −0.47, p < 0.001). In multivariable analysis, anatomical severity remained the sole independent predictor of lower HRQoL (β = −8.4 points per severity tier, p < 0.001; model R² = 0.45). Children with ≥ 1 hospitalisation (n = 42) reported poorer HRQoL (69.6 ± 8.0 vs. 76.1 ± 11.1; p = 0.005) and higher depressive scores (p < 0.001). Conclusions: HRQoL and internalising symptoms in Romanian children with CCM worsen with increasing anatomical complexity and recent hospital utilisation. The severity tier outweighed functional markers as the main determinant of HRQoL, suggesting that psychosocial screening and support should be scaled to lesion complexity. Integrating the routine use of the Romanian-validated PedsQL, CDI, and SCARED-C questionnaire into cardiology follow-up may help identify vulnerable patients early and guide targeted interventions. Full article

Racket sports are very popular not only in professional sports but also among recreational players. As a result, their impact on the field of education has grown significantly in recent years. Table tennis (TT) offers significant advantages in terms of skill acquisition and health improvement. Nevertheless, its application within physical education (PE) curricula remains undetermined. The aim of this systematic review was to analyze the use of TT as educational content in the subject of PE in primary school. The PRISMA 2020 methodology was used to conduct the systematic review. Six databases (ERIC, Pubmed, ScienceDirect, Scopus, Sport Discus, and Web of Science) were used during the search process. The search cutoff date was December 31, 2024. After applying the eligibility criteria, 3595 articles were found. Only seven studies were selected for the final analysis and the data included 1526 students from primary school. The results indicate that TT is rarely used in primary education during PE classes. Research indicates interest among teachers and students in playing it during PE. Furthermore, due to the benefits, motivation, and interest this sport generates, educational experiences have been developed, such as roundtable discussions, table top tennis, balloon TT, and TT triathlon. A lack of materials, facilities, and teacher training for teaching this sport is notable. The teaching experiences analyzed in this review confirm that TT is a highly versatile and interesting sport as a subject matter in school PE. The use of TT allows for innovative, comprehensive, and inclusive PE, thanks to the sport’s multiple possibilities. Given its adaptability and low entry barrier, TT could serve as an effective tool for increasing children’s physical activity levels, improving motor skills, and fostering social–emotional development. However further research is needed to quantify its impact on health outcomes such as cardiovascular fitness or obesity prevention. Full article

Background/Objectives: Early experiences can significantly influence brain development, particularly when they occur during specific time windows known as sensitive or critical periods. Therefore, the early promotion of neurodevelopmental functions is crucial in children at risk for neurodevelopmental disabilities, such as those with cerebral palsy. This article introduces AMIRA (A Multidimensional and Integrated Rehabilitation Approach), a rehabilitative framework designed for infants at risk of neurodevelopmental disabilities. Methods: AMIRA is intended to guide clinical–rehabilitation reasoning rather than prescribe a rigid sequence of predetermined activities for the child. The theoretical foundation and structure of AMIRA are presented by formalizing its criteria, objectives, tools, and intervention procedures. The framework comprises four distinct sections, each supported by adaptive strategies to facilitate access to materials and to promote play-based interactions among the child, their environment, and communication partners. Particular attention is given to optimizing both micro- and macro-environments for children with, or at risk of, co-occurring visual impairment. Each rehabilitative section includes three progressive phases: an initial observation phase, a facilitation phase to support the child’s engagement, and an active experimentation phase that gradually introduces more challenging tasks. Results: The intervention pathways in AMIRA are organized according to six core developmental domains: behavioral–emotional self-regulation, visual function, postural–motor skills, praxis, interaction and communication, and cognitive function. These are outlined in structured charts that serve as flexible guidelines rather than prescriptive protocols. Each chart presents activities of increasing complexity aligned with typical developmental milestones up to 24 months of age. For each specific ability, the corresponding habilitation goals, contextual recommendations (including environmental setup, objects, and tools), and suggested activities are provided. Conclusions: This study presents a detailed intervention approach, offering both a practical framework and a structured set of activities for use in rehabilitative settings. Further studies will explore the efficacy of the proposed standardized approach. Full article

Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. Full article

Background/Objectives: Art therapy is a psychotherapeutic technique that involves the creation of tangible visual arts and represents a coping strategy to support children with cancer. Evaluating the effects of such activities on children with cancer is essential for providing evidence of the value that creativity holds within healthcare systems. A dedicated tool for assessing the creative process is the Arts Observational Scale (ArtsObS), focusing on mood and emotional states as key indicators of psychosocial well-being. This study aims to validate a translated version of the ArtsObS in the Italian language. Methods: The translation process followed recommendations for translation and cultural adaptation. The distribution properties of the scores, internal consistency, sensitivity to change, reliability, and convergent validity were assessed through observations conducted by two different evaluators. Results: The ArtsObS in its Italian adaptation is proven to be an adequate tool for capturing changes following an intervention, with good internal consistency and low sensitivity to differences between operators. The analysis supports the reliability of the ArtsObS across different observers. Conclusions: The Italian ArtsObS is a valid and reliable instrument for evaluating the impact of art therapy on pediatric patients’ mood and emotional states. It provides a standardized tool for clinical and research settings to assess creative interventions in pediatric oncology. Full article

This study explores the potential of craft-based activities in the context of special education, focusing on a papier mâché sculpting workshop implemented at the Special Kindergarten of Komotini, Greece, as part of the Horizon Europe Craeft project. The initiative aimed to assess how such creative activities could enhance the learning experience of children with intellectual and motor impairments, foster socialization, and develop fine motor skills. With reference to literature in art therapy, craft education, and inclusive pedagogy, the study applied a mixed-methods approach combining observation, visual analysis, and a survey. The findings indicate that, despite varied levels of participation based on individual needs, all students engaged meaningfully with the materials and activities. School professionals observed increased student engagement, emotional comfort, and communication, while also identifying the activity as well adapted and replicable in similar contexts. The results highlight the value of crafts in special education, not only as a sensory and cognitive stimulus but also as a means of fostering inclusion and self-expression. The study concludes with a call for further research into the role of tactile materials and hand gestures in relation to specific impairments. Full article

Background: Nemaline myopathy is a rare congenital neuromuscular disease associated with progressive weakness and frequent respiratory complications. In emergency situations, families often serve as the first and only responders. The aim of this study is to explore how parents in Spain care for children with nemaline myopathy during emergency situations, focusing on the clinical responses performed at home and the organizational challenges encountered when interacting with healthcare systems. Methods: A qualitative phenomenological study was conducted with 17 parents from 10 families belonging to the Asociación Yo Nemalínica. Semi-structured interviews were performed via video calls, transcribed verbatim, and analyzed using Giorgi’s descriptive method and ATLAS.ti software (version 24). Methodological rigor was ensured through triangulation, reflexivity, and member validation. Results: Four themes were identified. First, families were described as acting under extreme pressure and in isolation during acute home emergencies, often providing cardiopulmonary resuscitation and respiratory support without professional backup. Second, families managed ambiguous signs of deterioration using clinical judgment and home monitoring tools, often preventing fatal outcomes. Third, parents frequently assumed guiding roles in emergency departments due to a lack of clinician familiarity with the disease, leading to delays or errors. Finally, the transition to the Pediatric Intensive Care Unit was marked by emotional distress and rapid decision-making, with families often participating in critical choices about invasive procedures. These findings underscore the complex, multidisciplinary nature of caregiving. Conclusions: Parents play an active clinical role during emergencies and episodes of deterioration. Their lived experience should be formally integrated into emergency protocols and the continuity of care strategies to improve safety and 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