Search Results (1,453)

Background: Mothers of children with autism spectrum disorder (ASD) face numerous challenges in meeting their children’s needs. This study aimed to assess parent-reported child behavioural and emotional outcomes and the levels of anxiety, depression, and stress among mothers of children with ASD. It also explored the correlations between parent-reported child behavioural and emotional outcomes and maternal mental health, as well as potential factors associated with these outcomes. Methods: A cross-sectional study was conducted between 30 December 2022 and 23 March 2023. An online questionnaire was distributed through autism associations across Saudi Arabia. The survey included (1) demographic data; (2) the Autism Family Experience Questionnaire (AFEQ) for children’s behavioural and emotional outcomes; and (3) the Depression, Anxiety, and Stress Scale-21 (DASS-21). Statistical analyses were performed using Jamovi software. Results: The study included 218 mothers of children with ASD. Extremely severe anxiety was reported by 41.3% of mothers, while 30.7% had normal stress and 30.7% had normal depression scores. The mean AFEQ symptom score was 37.4 ± 5.02. Univariate analysis revealed significant associations between parent-reported child behavioural and emotional outcomes and maternal mental health. In the multivariate analysis, higher family income (5000–10,000 SAR, p < 0.001; >10,000 SAR, p = 0.009) was associated with more favourable outcomes, while having more than one child with ASD was associated with less favourable outcomes (p = 0.015). Anxiety was positively associated with having two (p = 0.003) or three children (p = 0.029), while depression was negatively associated with having more than three children (p = 0.001). Conclusions: Higher family income was associated with more favourable parent-reported child behavioural and emotional outcomes, whereas having more than one child with ASD was associated with less favourable outcomes and higher maternal anxiety. Full article

This study examined parents’ and grandparents’ perspectives on intergenerational interactions within an innovative school–family partnership in early childhood education (ECE). Drawing on sociocultural concepts of learning and a ‘more-than-parents’ approach to intergenerational learning (IGL), this research project adopted a two-way partnership perspective, encouraging children and their family members to explore and reconstruct local cultural heritage sites together by utilising their lived experiences and cultural resources. A qualitative case study approach was employed, with data derived from an online open-ended questionnaire completed by 20 adult participants (i.e., 14 parents and six grandparents). Inductive thematic analysis revealed five core themes: (a) acknowledging children as capable agents; (b) identifying children’s learning; (c) adults as learners; (d) shared activities as a space for fostering family connection; and (e) challenges and suggestions for future implementation. The findings demonstrate that the shared exploration of cultural heritage can enhance mutual learning and foster vivid intergenerational communication, thereby strengthening family relationships. By observing the active role of young learners in intergenerational activities, participants acknowledged capabilities that they had previously overlooked in their children and/or grandchildren. However, challenges relating to time constraints, available resources and practical issues suggest that schools need to provide families with tailored information about such initiatives. Overall, this study emphasises the pivotal role of early childhood education in fostering IGL through reciprocal school–family partnerships. Full article

Background/Objectives: Several studies have reported a high prevalence of overweight and obesity among children and adults, with relevant implications for long-term health. Digital platforms and social media may support nutrition education when their content is developed and supervised by health professionals. This study evaluated whether dietary habits, lifestyle indicators, body mass index-related measures, and Mediterranean diet adherence differed between baseline and 210-day assessments among participants in a family- and school-mediated multimedia educational program aimed at promoting healthier lifestyles and greater adherence to the Mediterranean diet. Methods: This was an uncontrolled repeated cross-sectional before-and-after evaluation based on online surveys administered at baseline and after 210 days to respondent samples from the same project population. The multimedia educational program was delivered through a dedicated website and social media channels. The analysis included 329 children/adolescents at both assessment waves and 119 and 122 adult female respondents at baseline and 210 days, respectively. Since only 11 adult males responded, analyses of adults were restricted to women. Additionally, Mediterranean diet adherence was assessed using a modified KIDMED-derived score in children/adolescents and the PREDIMED score in adults. Data from the two assessment waves were compared at the group level, rather than as paired longitudinal observations. Results: Among children/adolescents, higher physical activity, lower screen time, and more favorable dietary indicators were observed at 210 days than at baseline. Moreover, daily fruit intake, daily vegetable intake, regular fish consumption, and the modified KIDMED score were higher at 210 days. Good adherence to the Mediterranean diet increased from 46.8% at baseline to 61.4% at 210 days. Among adult female respondents, the median body mass index was lower at 210 days than at baseline, and favorable differences were observed for vegetable, fish/seafood, legume, and nut intake. The median PREDIMED score increased from 7.0 [6.0–8.0] at baseline to 9.0 [7.0–10.0] at 210 days, and good Mediterranean diet adherence increased from 10.9% to 35.2%. Conclusions: Among children/adolescents, physical activity, screen time, and dietary indicators showed more favorable distributions in the 210-day respondent group than in the baseline respondent group. Daily fruit intake, daily vegetable intake, regular fish consumption, and the modified KIDMED-derived score were higher at 210 days, and good Mediterranean diet adherence was more frequent at 210 days than at baseline (61.4% vs. 46.8%). Among adult female respondents, the median body mass index was lower in the 210-day respondent group than in the baseline respondent group, and more favorable distributions were observed for vegetable, fish/seafood, legume, and nut intake. The median PREDIMED score was higher at 210 days than at baseline: 9.0 [7.0–10.0] versus 7.0 [6.0–8.0], respectively. Good Mediterranean diet adherence was also more frequent at 210 days (35.2% vs. 10.9%). Full article

Background/Objectives: Celiac disease (CD) is a chronic immune-mediated disorder triggered by gluten ingestion in genetically predisposed individuals with higher prevalence among first-degree relatives. Despite its hereditary risk, little is known about how parents with at least one child with CD perceive this risk in unaffected children. This study examined parental perceptions and dietary practices regarding CD prevention in unaffected children. Methods: A cross-sectional mixed-methods study was conducted in Greek parents using an online questionnaire for the quantitative component and semi-structured interviews for the qualitative. Quantitative data were analyzed using descriptive statistics and multivariable logistic regression analysis, while qualitative data were analyzed using framework analysis. Results: Although parents demonstrated high awareness of genetic risk, this was not translated into preventive dietary modifications. Belief in the role of diet as a preventive CD strategy emerged as the only significant predictor of dietary change. Diet was widely recognized as important for overall health or as a therapeutic regimen for children living with CD; however, it was not perceived as a preventive strategy for CD. Reported family barriers to adopting a healthy diet included financial constraints and limited guidance, whereas advice from healthcare professionals emerged as a key facilitator of dietary change. Conclusions: Although parents recognize the genetic risk of CD, they rarely implement dietary changes as CD preventive behavior for their unaffected children. These findings highlight the potential value of clearer dietary guidance and targeted professional support for families with children with CD and unaffected siblings. Full article

The home and preschool settings serve as important contexts for children’s early language and literacy development. There is limited research on parent–preschooler shared reading and children’s comprehension of information texts that vary in their format, structure, or mode of presentation. Comparing different types of information texts can help identify which features are associated with particular forms of parental scaffolding and children’s understanding, be used to guide parents, and perhaps find ways to promote children’s comprehension of these important text types. As such, this exploratory quantitative study examined shared reading of non-rhyming, rhyming, and magazine information texts and children’s listening comprehension, taking into consideration parental education, children’s age and gender, frequency of reading information texts at home, and total parents’ words in the interaction. The participants were 63 children (28 boys and 35 girls) and one of their parents (55 mothers and 8 fathers). On average, the children were 5 years, 11 months old (SD = 10.18 months). Data were collected in January–February of 2021 during the COVID-19 lockdowns. Parent–child dyads participated in three recorded online meetings, sharing two texts during each meeting and six texts in total: two non-rhyming information texts, two rhyming information texts, and two information magazine texts. Following each text, children answered two literal and two inferential comprehension questions. Negative binomial regression with generalized estimating equations revealed that overall, parents tended to ask more open questions and included significantly more elaborations and references to illustrations when reading the non-rhyming information texts. Children answered significantly more literal than inferential questions for both the non-rhyming and magazine texts compared with the rhyming texts. Various parent and child characteristics predicted parent talk and children’s comprehension. Results highlight how adult, child, and text characteristics can relate to the shared-reading discourse and children’s understanding. Future studies should be conducted to replicate and extend these findings. Full article

Purpose: Childhood apraxia of speech (CAS) is a motor speech disorder characterized by deficits in speech planning and programming. However, current diagnostic frameworks have been developed primarily from studies of English-speaking children, raising questions regarding their applicability to other languages. This study examined the common and diagnostic speech characteristics of Hebrew-speaking children with CAS as perceived by Israeli speech–language pathologists (SLPs). Method: Two hundred Israeli SLPs with experience diagnosing and/or treating children with CAS completed an online questionnaire. Participants rated 26 speech characteristics on 7-point scales reflecting their perceived frequency and diagnostic specificity in Hebrew-speaking children with CAS. Descriptive analyses included mean ratings and the percentage of clinicians endorsing each characteristic. Results: Increased difficulty with multisyllabic words (M = 6.37) and inconsistent errors (M = 6.32) received the highest frequency ratings and were endorsed by 87.0% and 84.0% of clinicians, respectively, as common characteristics of CAS. Inconsistent errors received the highest diagnostic specificity rating (M = 6.12), followed by groping movements (M = 5.73) and difficulty sequencing syllables (M = 5.48). Prosodic features, including lexical stress errors (M = 3.72) and equal stress patterns (M = 3.73), received ratings at or below the midpoint of the scale and were endorsed by fewer than 20% of clinicians as common characteristics of CAS. Breathy voice (M = 3.11) and consistent hypernasality (M = 2.79), two control characteristics not typically associated with CAS, received the lowest ratings. Conclusions: Israeli SLPs identified syllable sequencing difficulties and inconsistency as the most salient and diagnostically informative characteristics of CAS in Hebrew-speaking children. In contrast, prosodic features, particularly lexical stress errors, were perceived as less common and less central to diagnosis than suggested by English-based diagnostic frameworks. These findings suggest that the clinical manifestation of CAS may be influenced by language-specific phonological and prosodic properties and underscore the need for direct investigation of CAS characteristics in Hebrew-speaking children. Full article

Background: The prevalence of autism spectrum disorder (ASD) is increasing globally and in Saudi Arabia (SA), although many cases remain undiagnosed. Caregivers of children with ASD are confronted by challenges, especially mothers as primary caregivers, who have higher levels of stress and burden of care due to autism symptoms and difficulties of children, which negatively affects their quality of life (QoL). Objective: The primary outcome of this study was to assess primary caregivers’ quality of life and their perceptions of child-related difficulties associated with autism spectrum disorder (ASD) using the Quality of Life in Autism (QoLA) questionnaire. The secondary outcome was to examine the correlation between these two QoLA domains and identify the factors independently associated with each outcome Material and Methods: A convenience sample (247) of Saudi primary caregivers, primarily mothers, was taken from autism primary schools in Tabuk, Riyadh, Qassim, Hail, Jazan & Najran cities in SA by distributing an online questionnaire, which was composed of three parts, was used for data collection; Part I included demographic and clinical data of primary caregivers. Part II: The child’s personal characteristics. Part III: QoLA Questionnaire that measures the crucial aspects of living with autistic children and is composed of two parts (A and B). Data analysis was performed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA), version 23. Results: More than half of the caregivers (50.2%) had a moderate level of QoL. Regarding caregivers’ perceptions of child-related difficulties, 70.9% reported high levels of difficulties, and 7.2% reported low difficulties. Quality of life was significantly associated with maternal age, educational level, number of children. The study’s univariate regression and multivariate regression analysis revealed that, QoL score had a significant negative association with maternal ages, university school and secondary school, working, and those who had medical diseases. In contrast, QoL level had a significant positive association with mothers who received training, had another person helped in caring for the child and who had enough income. Conclusions: Mothers of autistic children had poorer QOL and perceived more difficulties in caring for their children. Thus, educating sessions for mothers about dealing with their autistic children, psychological and financial support services are needed, which in turn improve their QoL. Full article

Background/Objectives: Dental caries remains one of the most prevalent chronic diseases in childhood, influenced by a combination of hygiene, dietary, and access-related behaviours that are largely shaped by parental involvement. This study aimed to evaluate oral hygiene habits, dietary risk factors, access to dental services, awareness of caries prevention, and the impact of oral health on the child, in relation to parent-reported dental caries in Romanian children and adolescents. Methods: A cross-sectional study was conducted using a structured online questionnaire completed by parents or legal guardians of 508 children and adolescents aged under 18 years. Associations between categorical variables and reported caries were assessed using chi-square tests and Cramér’s V. Ordinal variables were compared using the Mann–Whitney U test. A multivariable logistic regression identified independent predictors of reported caries, with robustness examined through sensitivity analyses. Results: Parent-reported caries was present in 61.2% of children. The strongest associations with caries were the absence of parental supervision during brushing (Cramér’s V = 0.364), the age at which children began brushing unsupervised (V = 0.354), and the reason for the last dental visit (V = 0.426). In the multivariable model, older age, absence of brushing supervision, sweets before bedtime, less frequent dental visits, and rural residence were independent predictors (all p < 0.05; Nagelkerke R² = 0.361). All six assessed dimensions of oral-health impact on the child were significantly associated with caries, with physical discomfort showing the largest effect (V = 0.349). Conclusions: Parent-reported caries risk in this population clustered around a small number of modifiable behaviours rather than any single dominant factor, while reported caries was associated with a substantial burden on children’s daily functioning. These findings point to sustained parental supervision and routine, non-symptomatic dental care as priority targets for future prevention efforts, although intervention studies are needed to confirm their effectiveness. Full article

Behavioural management strategies used in paediatric dentistry have neurobiological effects. This scoping review aimed to map the existing literature on the neurobiological effects of non-invasive behavioural management strategies used in paediatric dentistry. The study protocol was registered on the Open Science Framework (registration number: OSF.IO/9EZVT). A search was conducted on PubMed, Web of Science, Scopus, Google Scholar, and African Journals Online (AJOL) for studies published up to May 2025. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies were included if they assessed non-invasive behavioural strategies in children aged 0–17 years undergoing dental procedures and reported at least one neurobiological or physiological outcome. The data were summarised descriptively, and key findings were thematically synthesised to identify trends in behavioural strategy types and neurobiological outcomes measured. Out of 1720 records retrieved, 35 studies met the inclusion criteria. These included randomised and non-randomised controlled trials and observational studies conducted in 13 countries on five continents involving 2919 children. The behaviour management strategies identified were 18 in number, with distraction (n = 19) and tell–show–do (n = 17) being the most frequently applied. The neurobiological outcomes assessed included anxiety (n = 36), pain perception (n = 8), fear (n = 7), and stress response (n = 1). Their physiological regulation was assessed using heart rate (n = 26), oxygen saturation (n = 10), blood pressure (n = 8), pulse rate (n = 6), cortisol (n = 4), respiratory rate (n = 1), and oxytocin (n = 1). Behavioural assessment tools used were classified into Child-Reported Anxiety and Fear Instruments (n = 23), Pain Perception Instruments (n = 9), Clinician/Observer-Rated Behavioural and Anxiety Scales (n = 18), and Parental and Proxy Reports (n = 2). This review underscores the emerging evidence that non-invasive behavioural strategies may be linked to neurobiology in paediatric dentistry. More studies are needed in new countries to be able to map the possible impact of context and culture on study findings. Full article

Short-form video platforms have become embedded in adolescents’ everyday lives, and rural left-behind children may be particularly vulnerable to problematic use in the context of prolonged parental absence. This cross-sectional study examined associations between family, peer, and school adversity and short video addiction (SVA), as well as whether these associations differed between left-behind children (LBC) and non-left-behind children (NLBC). Guided by selected components of the I-PACE model and ecological systems theory, we surveyed 1839 rural Chinese secondary school students, including 876 LBC and 963 NLBC. Bullying victimization, academic stress, parental rejection, stress, anxiety, social anxiety, online social support (OSS), and SVA were measured. Partial least squares structural equation modelling and multi-group analysis were used. LBC reported higher mean levels of bullying victimization, academic stress, stress, anxiety, social anxiety, and SVA than NLBC, although the corresponding effect sizes were small. Among LBC, significant indirect associations linked bullying victimization and academic stress with SVA through social anxiety, both independently and serially through OSS; academic stress was also indirectly associated with SVA through OSS alone. Among NLBC, significant indirect associations involving general stress and social anxiety linked adversity with SVA, whereas OSS alone was involved only in the academic stress–SVA association. No between-group path difference remained significant after Bonferroni or false discovery rate correction. The findings identify social anxiety and academic stress as relevant prevention targets but do not establish causal pathways or robust structural differences between LBC and NLBC. Full article

Despite growing evidence of the serious impact of intimate partner violence (IPV) on children, research on intervention practices in the psychosocial sector remains limited. This study investigates professionals’ perspectives on children exposed to IPV and how they address this issue in their practice. Using a sequential mixed-methods design, an online survey (N = 129) was followed by semi-structured interviews (n = 13). The findings reveal major limitations in interventions targeting children exposed to IPV, which help explain a significant gap between professionals’ perspectives—where children are recognized as victims of IPV and its substantial impact—and what is implemented in practice. In this context, children exposed to IPV often appear secondary both to children victims of other forms of abuse and to adult victims of IPV. Overall, these results underscore the need for specialized training and the development of targeted interventions to better address the specific needs of these children. Full article

Background/Objectives: Haematopoietic stem cell transplantation (HSCT) causes substantial morbidity in children and young people (CYP). Although prehabilitation benefits adults with cancer, its role in paediatric HSCT remains underexplored. This study aimed to describe current pre-transplant assessment and supportive care practices across paediatric HSCT centres, explore healthcare professional perspectives on prehabilitation implementation, and integrate patient and public involvement (PPI) to inform future intervention design. Methods: A cross-sectional survey was administered to healthcare professionals across 16 paediatric HSCT centres in the UK and the Republic of Ireland, alongside semi-structured PPI discussions conducted with eight children, young people, and caregivers with direct experience of paediatric HSCT. Survey data were analysed descriptively, free-text responses by qualitative content analysis, and PPI by reflexive thematic analysis. Results: Forty-nine eligible responses were received from healthcare professionals. Formal prehabilitation services were reported by 27 (55.1%) respondents, with substantial within-centre variation. Nutritional advice was the most consistently delivered component, 36 (72%), whilst physical activity interventions were the least consistently provided, 13 (26%). Workforce limitations were identified as the dominant barrier by 37 (95%) respondents. PPI findings described provision as reactive and inconsistent, with families expressing preference for flexible, hybrid, and family-centred delivery models. Conclusions: Prehabilitation provision in paediatric HSCT is variable, often informal, and limited by workforce capacity. CYP and caregivers expressed a desire for prehabilitation, particularly through flexible, hybrid (face-to-face and online), and family-centred approaches. Future research should prioritise co-design and feasibility testing of safe, individually tailored programmes that can be integrated into paediatric HSCT pathways. Full article

Background/Objectives: Children now spend a substantial part of daily life in digital environments, and their digital, media, and information literacies shape their online safety, social-emotional development, and mental health, making these competencies a concern for child public health and preventive paediatric care. This study applies a Synthetic Knowledge Synthesis (SKS) to map how digital, media, and information literacies (hereafter digital literacies) among children have evolved, comparing neurotypical and neurodivergent children. SKS is a semi-automated approach that combines descriptive bibliometrics, keyword co-occurrence mapping, and qualitative content analysis to map an entire research field or topic. Methods: We treat digital literacies as relevant to children’s health, well-being, and safe online participation, and we analyse Scopus-indexed literature from 1996 to 2025 using descriptive bibliometrics, keyword co-occurrence mapping, and qualitative content analysis. Results: The mapping shows strong growth in general digital-literacy scholarship alongside a small but persistent body of work on a “double digital divide” affecting children with autism spectrum disorder (ASD), ADHD, and dyslexia. The two bodies of work differ in emphasis: the general literature foregrounds social integration and critical agency, while research on neurodivergent children foregrounds inclusive pedagogy, implicit learning, and multimodal expression. It also shifts from general digital-safety awareness toward protective mediations for vulnerabilities such as social-emotional decoding differences and impulsivity, which bear on children’s online safety and mental health. Because bibliometric mapping reveals where research is concentrated rather than what works in practice, the synthesis points to evidence gaps rather than proven methods. Conclusions: On this basis, we argue for an integrated public-health and socio-educational framework that complements universal literacy standards with adaptive, assistive safety nets, so that all children can take part in digital life safely and on equal terms. Full article

Purpose: The purpose of the current study was to evaluate adults’ retrospective recollection regarding childhood cursive writing requirements and their view of their current reading–writing abilities, efficiency, speed, confidence, accuracy, and the perceived ease in and value of learning to read and write print and cursive. Method: An online survey, consisting of 24 questions, was administered to adults. A total of 190 participants without any history of speech, language, or reading disorders were included in the current analysis. Results: Of the 190 respondents, 70.53% were required and 29.47% were not required to learn cursive. Mann–Whitney U test revealed no significant differences between the two groups in the ratings for reading print, writing print, or communication. All participants reported poorer ability and ease, higher stress levels, and lower perceived value of learning to read and write cursive compared to print. Participants’ beliefs regarding their reading efficiency, speed, accuracy, or confidence levels did not differ based on whether they recalled having a childhood cursive requirement. Some of the participants (56.25%) with cursive requirements found it beneficial and worth the effort. Conclusions: Overall, adult perspectives provide little subjective justification for requiring young children to learn cursive to enhance reading and writing skills. Full article

Households have been reported to account for more than a third of food waste (FW) generated in the most developed and high-income countries. Despite this, there remains a limited understanding of the behavioural and sociodemographic factors driving household food waste (HFW) generation in most countries, including the Republic of Ireland (ROI). This study therefore examined how behavioural practices and sociodemographic characteristics independently and interactively influence HFW generation in the ROI. Data from a national online survey (n = 966 households; 3163 individuals) were analysed using hierarchical quantile regression. Households with children (Mixed households) reported the highest HFW (1177 g/household/week), and single-adult households recorded the highest per capita median waste (females = 596.0 g/cap/week and males = 496.5 g/cap/week). Behavioural factors were stronger predictors than sociodemographic characteristics. Reliance on date labels was the strongest predictor of HFW, associated with an additional 239 g/week. Each additional weekly shopping trip was associated with 140 g/week more waste, whereas using a shopping list was associated with 42 g/week less waste. Some effects were moderated by sociodemographic factors: reliance on date labels was more strongly associated with waste among adults aged 18–24, and shopping frequency more strongly associated with waste in middle-income households. The findings point to the value of reforming date labelling, supporting more planned shopping, and encouraging the active reuse of leftovers, with attention to differences across household groups. The findings also have direct implications for Ireland’s obligations under SDG 12.3 and the EU Waste Framework Directive. Full article