Search Results (265)

Background: High quality pediatric sleep is shaped by multiple factors, including duration, restoration, and continuity. Multiple socio-ecological factors that are typically enforced by caregivers (e.g., bedtime routines) also determine the likelihood of attaining optimal pediatric sleep health. Consistent with the extant sleep literature on pre-pubertal children, this qualitative study targeted caregivers to identify factors influencing children’s sleep quality. Methods: Participants were recruited from Project G-SPACE, a US-based study exploring the influence of greenspace on sleep and mental health among elementary school-aged children. A racial, ethnic, and socio-economically diverse sample of caregivers (n = 21) participated in virtual semi-structured interviews about their perceptions of determinants of child sleep quality and behavior. Template-style thematic analysis was employed to synthesize the interviews. Results: Caregivers report that busy days for their children, especially characterized by high levels of physical activity, facilitate sleep continuity and good sleep quality. Sibling dynamics can be disruptive, resulting in poor sleep quality. To promote sleep health, parents employ rules regarding screentime, food/drink, and bed/wake time schedules, though the latter seems to be more flexible when children are not in school (e.g., weekends). Conclusions: Caregivers demonstrated great variability regarding implementing strategies to enhance their children’s sleep quality, suggesting that parents may be unsure of how to optimize the strategies they employ, which are most effective, or how to manage resistance from their children. Clinicians should discuss how to address these practical challenges with caregivers. Future research investigating the developmentally unique differences in determinants of sleep quality among elementary school-aged children is prudent. Full article

Chrononutrition, which emphasizes the timing, frequency, and regularity of eating in alignment with circadian rhythms, has emerged as an important yet understudied determinant of obesity, particularly in children and adolescents. We aimed to compare chrononutrition and physical fitness between elementary and intermediate schoolgirls and to examine their associations with obesity. Methods: This cross-sectional study included 457 schoolgirls aged 10–14 years from elementary and intermediate schools. Chrononutrition behaviors were evaluated. Anthropometric measurements and physical fitness, including handgrip strength, standing long jump, and 20 m shuttle run, were assessed. Fasting blood glucose and lipid profile were determined using capillary blood samples. Results: Compared with intermediate students, elementary school students demonstrated more favorable meal-related behaviors, longer overnight fasting durations, and better dietary intake (p < 0.05), along with higher VO₂ max and higher standing long jump performance. Conversely, intermediate students exhibited greater absolute handgrip strength. A higher number of meals/day (aOR = 0.68, p = 0.039) and a longer interval between the last meal and bedtime (aOR = 0.78, p = 0.013) were inversely associated with obesity. Furthermore, higher HGS/BMI was associated with lower odds of obesity (aOR = 0.01, p < 0.001), while HDL cholesterol was inversely associated with obesity (aOR = 0.91, p < 0.001). Conclusions: Chrononutrition behaviors and physical fitness varied across school stages and were associated with obesity among school-aged girls. Higher meal frequency, a longer interval between the last meal and bedtime, and greater handgrip strength relative to body mass index (HGS/BMI) were associated with lower odds of obesity. Non-obese students also demonstrated higher VO₂ max. These findings suggest that chrononutrition behaviors and physical fitness may contribute to obesity prevention, underscoring the importance of early nutrition and physical activity interventions. Full article

Background/Objectives: Children develop the ability to construct meaning from language long before they learn to read. These foundational language processes support learning across academic contexts and form the basis for later reading and writing. However, many students, particularly those with Developmental Language Disorder (DLD), enter school with weaknesses in oral academic language that limit their ability to understand and express increasingly complex classroom discourse. Despite the central role of narrative and expository language in early instruction, explicit and systematic intervention targeting both discourse genres remains uncommon in the early grades. The purpose of this randomized controlled trial was to examine the immediate and maintained effects of a structured, small-group oral language intervention targeting both narrative and expository discourse for early elementary-age students with and without DLD. Methods: Participants (N = 80) were kindergarten through second-grade students identified as having DLD or significantly weak narrative language performance and were randomly assigned to an intervention condition or business-as-usual control. Narrative outcomes were collected for all participants at pretest, posttest, and a two-month follow-up, and expository outcomes were collected at posttest. Results: Results indicated statistically significant intervention effects for narrative language at posttest, with gains maintained at follow-up. Treatment effects were not moderated by language status, and subgroup analyses demonstrated large effects for students with DLD. Regression analyses indicated a non-significant intervention effect on expository outcomes. Conclusions: Findings provide experimental evidence that explicit, contextualized narrative and expository language instruction delivered in brief small-group sessions can produce meaningful and durable improvements in narrative language for young children, including those with DLD. Full article

Background/Objectives: Sleep problems and physical activity are key lifestyle behaviors associated with children’s socioemotional development. However, their relative contribution to emotional regulation and emotional instability during middle childhood remains insufficiently clarified. This study aimed to examine the associations between sleep problems, habitual physical activity, and emotional regulation in elementary school children, while controlling for sociodemographic and lifestyle confounding variables. Methods: A cross-sectional study was conducted with 386 elementary school children (mean age = 11.15 ± 0.66 years; 45.6% boys) from southern Spain. Emotional regulation was assessed using the Emotion Regulation Checklist (ERC), sleep problems were measured with the Children’s Sleep Habits Questionnaire (CSHQ), and habitual physical activity was evaluated using the Physical Activity Questionnaire for Children (PAQ-C). Age, sex, socioeconomic status, and daily screen time were included as covariates. Pearson correlations and multiple linear regression analyses were performed. Results: Sleep problems were strongly associated with lower adaptive emotional regulation and higher emotional lability. In adjusted regression models, sleep problems emerged as the most robust independent predictor of both emotional regulation and lability. Although habitual physical activity was significantly associated with emotional outcomes at the bivariate level, its predictive strength decreased after adjustment for covariates and did not independently predict adaptive emotional regulation. Conclusions: Sleep problems appear to play a central role in children’s emotional functioning during middle childhood. Interventions aimed at promoting socioemotional well-being may benefit from prioritizing sleep health alongside physical activity within a comprehensive 24 h movement behavior framework. Full article

(1) Background: Eating disorder risk factors in children are early maturation, body dissatisfaction, dieting, stress and physical inactivity. The COVID-19 pandemic has further exacerbated these factors due to isolation, online classes and reduced physical activity, all of which have increased children’s risk of developing eating disorders. The aim of the research was to examine the frequency of eating disorders among school-aged children in the Republic of Serbia during the COVID-19 pandemic, as well as the association of these disorders with socio-demographic characteristics, lifestyle habits, and levels of depression, anxiety and stress. (2) Methods: The research was conducted as a descriptive cross-sectional study on a sample of students from the fifth grade of elementary school to the fourth year of secondary school. The research was conducted from May to August in 2023. using the EAT-26 questionnaire. Before the research, the approval of the ethics committee of the Jagodina Health Center (No. 1238/28.04.2023.) was obtained, where the research was conducted. (3) Results: The results show that 5.8% of students exhibited eating disorder symptoms during the COVID-19 pandemic (EAT-26 ≥ 20). Statistically significant differences were observed in girls with an eating disorder, who had a significantly lower body weight compared to the others (p < 0.05). Students with symptoms of depression, anxiety and stress showed eating disorders significantly more often. Also, elementary school students and boys with an eating disorder visited a nutritionist and played sports more often. (4) Conclusions: Research has shown that during the COVID-19 pandemic, a smaller percentage of students showed symptoms of eating disorders, with girls being more sensitive. Disorders were significantly associated with the presence of depression, anxiety and stress. The obtained results indicate the importance of monitoring children’s psychological and nutritional health, as well as the need for preventive and intervention measures in crisis conditions. Full article

Background: Dental caries and poor oral hygiene remain major public health problems among school-aged children, particularly in low- and middle-income countries. Teachers play a strategic role in delivering sustainable school-based oral health education; however, their effectiveness depends on appropriate pedagogical training. Objective: This study aimed to evaluate the effectiveness of a multimedia-assisted microteaching intervention for elementary school teachers in improving students’ oral health knowledge, attitudes, practices, and oral hygiene status. Methods: A mixed-methods sequential explanatory design was employed. Quantitative data were collected from 582 students and their teachers across three groups: multimedia-enhanced microteaching, multimedia-only training, and a control group. Outcomes were assessed using Knowledge–Attitude–Practice (KAP) questionnaires, the Oral Hygiene Index–Simplified (OHI-S), and the Decayed, Missing, and Filled Teeth (DMFT) index before and after a two-month implementation period. Non-parametric statistical tests were applied. Qualitative data were obtained through focus group discussions with teachers and were analyzed thematically. Results: Students in the multimedia-enhanced microteaching group demonstrated greater improvements in KAP scores and OHI-S values compared with the multimedia-only and control groups (p < 0.05). Qualitative findings indicated increased teacher confidence, improved classroom engagement, and better integration of oral health education into daily lessons. Changes in DMFT values were interpreted descriptively due to the short follow-up period. Conclusions: Multimedia-assisted microteaching appears to be a promising approach for strengthening teacher-led oral health education and improving short-term behavioral and hygiene outcomes among elementary school children. Further longitudinal studies are needed to assess long-term clinical effects. 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

Crescendo is a music-based social and emotional learning (SEL) programme designed for primary/elementary school children living in disadvantaged communities. It is a community-led, orchestra-delivered, and evidence-informed initiative aimed at improving children’s musical and SEL outcomes through sustained engagement. Children growing up in socioeconomically disadvantaged areas often experience challenges with SEL and limited access to orchestral music education. However, emerging research suggests a relationship between music participation and SEL development. This study evaluated the initial impact of Crescendo on 559 children aged 5–6 in their first year of participation (Year 1 of 7). A quasi-experimental, rolling cohort design compared pupils in four participating Crescendo schools with pupils in four matched control schools not receiving the programme. Outcome measures included music skills (beat, pitch, and reaction to music) and SEL (behavioural self-regulation). The findings indicated significant positive effects of the programme across all outcome domains, with moderate effects observed in self-regulation (Cohen’s d = 0.29) and reaction to music (Cohen’s d = 0.21) compared to control schools. These results suggest that collaboration between orchestral musicians and educators can positively influence young children’s musical and SEL development in resource-constrained settings. The findings also underscore the importance of clearly defined programme models to support replication and scalability. Full article

Background/Objective: Mexico has experienced an increase in the prevalence of overweight and obesity among schoolchildren, predisposing them to type 2 diabetes mellitus. In addition, rapid eating has been increasingly implicated in the dysregulation of appetite control, greater energy intake, and adverse metabolic outcomes in children. Prior evidence indicates that a faster eating pace is associated with excess adiposity and lipid metabolism. This study aimed to compare cardiovascular risk factors (waist circumference, waist-to-height ratio, body mass index (BMI), and lipid profile) among school-aged Mexican children according to self-reported eating speed. Design: Cross-sectional observational study. Setting: Public elementary schools in Mexico. Participants: Ninety school-aged children (52.2% female) aged 6–12 years old. Eating speed was assessed using an adapted and validated self-administered questionnaire. Intervention: No intervention was applied; participants were classified into slow-, normal-, or fast-eating groups according to their usual eating speed as reported in the instrument, which includes questions regarding self-perception and family perception. Main Outcome Measure: The primary outcomes included anthropometric parameters (BMI, waist circumference, and waist-to-height ratio), blood pressure (systolic and diastolic), and biochemical markers of lipid metabolism (triglycerides, total cholesterol, and HDL cholesterol). Analysis: Descriptive statistics were computed, and comparisons across eating speed groups were performed using one-way ANOVA for continuous variables and chi-square tests for categorical data. Statistical significance was set at p < 0.05. Results: Among the 90 children evaluated, 17.7% were classified as fast eaters. Although gender differences in eating speed were not statistically significant (χ²= 4.607, p = 0.100), a higher proportion of boys were classified as fast eaters. Children in the fast-eating group exhibited significantly higher BMI (1.4 kg/m²), waist circumference (4 cm greater), and modest elevations in triglyceride and total cholesterol levels, alongside lower HDL cholesterol, relative to their slow-eating peers (all p < 0.05). Among all variables, only diastolic blood pressure differed significantly across groups (F = 3.92, p = 0.022), with fast eaters showing the highest values. Nevertheless BMI, waist circumference, triglyceride levels, and total cholesterol were not statistically significant in the logistic regression, and HDL cholesterol demonstrated an association close to 95% [0.051 (0.011–0.226)] to a protective factor against cardiometabolic events, estimating an effect size of 1.64 using Cohen’s d, which is considered a large effect, when compared to their slower-eating peers. Conclusions and Implications: Faster eating speed was consistently associated with unfavorable anthropometric and lipid profile indicators, aligning with previous evidence linking rapid eating to early cardiometabolic alterations. These findings emphasize the relevance of including eating behavior assessments in pediatric cardiovascular risk screenings and prevention strategies. Full article

This study examined the psychometric properties of the Pre-Literacy Test, developed to measure the literacy readiness skills of children who have completed preschool education. Using a quantitative, multistage design, the study was conducted with a total of 5966 children aged 6–7 who were about to enter elementary school in the 2024–2025 academic year (N₁ = 1911; N₂ = 1644; N₃ = 2411). Exploratory Factor Analysis revealed a three-factor structure—Reading Skills, Writing Skills (Dictation), and Writing Skills (Copying)—which explained 82.38% of the total variance. Confirmatory Factor Analysis demonstrated that this structure showed an acceptable model fit (CFI = 0.997, TLI = 0.997, SRMR = 0.030, RMSEA = 0.111). The internal consistency coefficients (α = 0.891–0.962; ω = 0.912–0.983) and convergent validity values (AVE = 0.867–0.949) of the PLT were found to be high. Discriminant validity was confirmed according to the Fornell–Larcker criterion, and measurement invariance across gender was supported through Multigroup Confirmatory Factor Analysis. Item analyses indicated that most test items were of moderate difficulty (mean difficulty = 0.409) and high discrimination (mean discrimination = 0.516). In conclusion, the PLT was determined to be a psychometrically robust, valid, and reliable instrument for assessing basic literacy skills prior to elementary school entry. These findings suggest that the test can be confidently used in early literacy research and school readiness assessments. Full article

Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) in children is a developmental disorder that has been rapidly increasing worldwide. Its core symptoms, which include inattention, impulsivity, and hyperactivity, are often accompanied by emotional and behavioral problems such as depression and aggression. These factors can significantly impair a child’s development and functioning, making effective therapeutic intervention essential. This non-randomized controlled trial with parallel-group design examined the intervention effects of a 10-week school group sandplay therapy (SGST) program on internalizing and externalizing problems in children at risk for ADHD. Methods: This non-randomized controlled trial involved 101 fifth- and sixth-grade students (ages 11–12) from an elementary school in a mixed urban–rural area. Participants were divided into a control group (n = 47) and an intervention group (n = 54). The intervention group participated in a 10-session SGST program held once a week, while the control group received no intervention. The Korean Youth Self-Report (K-YSR) was used to evaluate the effects of the intervention, and a Repeated Measures ANOVA (RM-ANOVA) was conducted to analyze the program’s effectiveness. Results: The results revealed significant interaction effects between group and time in the SGST intervention group for several K-YSR subscales. The intervention group showed statistically significant differences in the areas of anxiety/depression (p < 0.04; η² = 0.043), somatic symptoms (p < 0.04; η² = 0.040), social immaturity (p < 0.01; η² = 0.061), and rule-breaking behavior (p < 0.04; η² = 0.044). Conclusions: SGST was found to be associated with improving not only internalizing problems like anxiety/depression, somatic symptoms in children at risk for ADHD but also externalizing problem like rule-breaking behavior and social problem like social immaturity. These findings demonstrate that school sand play therapy can be used as a non-pharmaceutical intervention for school-age children at risk of ADHD, and suggest that it can also be useful in an educational context. Full article

Background: Prior research has established a positive relationship between emotional self-efficacy and life satisfaction in elementary school-age children. However, less is known about the direct impact of positive leisure experience on subjective well-being and the potential mediating role of emotional self-efficacy. Objectives: This study examined whether emotional self-efficacy mediates the association between overall leisure enjoyment and life satisfaction among elementary schoolchildren. It was hypothesized that both direct and indirect effects are statistically significant. Methods: A quantitative, cross-sectional design was used with 100 fifth- and sixth-grade students from a U.S.–Mexico border community. Participants completed the Children’s Assessment of Participation and Enjoyment (CAPE), the emotional subscale of the Self-Efficacy Questionnaire for Children (SEQ-C), and the Student Life Satisfaction Scale (SLSS). Mediation analysis was conducted in R with bootstrapping (500 simulations). Results: Overall leisure enjoyment was positively associated with life satisfaction (β = 0.54, 95% CI [0.23, 0.90], p = 0.004). The direct effect remained significant after accounting for emotional self-efficacy (β = 0.41, 95% CI [0.15, 0.73], p = 0.004). The indirect effect through emotional self-efficacy was also significant (β = 0.13, 95% CI [0.03, 0.29], p = 0.016), accounting for approximately 25% of the total effect. Conclusions: Emotional self-efficacy partially mediated the relationship between overall leisure enjoyment and life satisfaction, suggesting that positive leisure experience enhances children’s emotional coping confidence and subjective well-being. These findings underscore the importance of promoting accessible and enjoyable leisure opportunities within marginalized communities that simultaneously foster children’s emotional self-efficacy and well-being. Full article

Background: Parents’ dietary strategies shape children’s eating habits. This study investigated socio-demographic determinants of maternal feeding practices among school-aged children in the Pomeranian province of Poland. Using a cross-sectional survey conducted in July 2025, we compared feeding strategies based on family structure, maternal employment, and number of children, and identified distinct parenting profiles through cluster analysis. Methods: A cross-sectional survey was conducted in July 2025 among 719 mothers of elementary school children in Pomeranian Voivodeship, using a convenience sampling design. An abbreviated version of the Comprehensive Feeding Practices Questionnaire (CFPQ) with 16 items across eight subscales was used. ANOVA compared feeding strategies between groups, Spearman correlations examined associations, and k-means cluster analysis identified maternal parenting profiles. Results: Encouragement and modeling were the most frequent strategies, while monitoring was least common. Mothers raising children with a partner and those employed used monitoring, modeling, and encouragement more often. Single or non-working mothers relied more on food as a reward and for emotion regulation. Mothers of only children applied control and monitoring less intensively than mothers with multiple children. All strategies were positively correlated. Cluster analysis identified three parenting profiles: intensely directive, moderate, and emotional-supportive. Conclusions: Maternal feeding strategies vary with socio-demographic factors. Educational interventions promoting healthy eating should be tailored to family structure and mothers’ employment status. Full article

Background: Dental caries, periodontal disease, and malocclusion are common childhood oral diseases strongly influenced by lifestyle factors, including sleep, exercise, and media use. In Korea, the prevalence of dental caries among elementary school children is approximately 20–25%, periodontal disease 1–2%, and malocclusion 12–18%. Sleep is a key determinant of child health; insufficient sleep is linked to weakened immunity, higher systemic inflammation, and greater susceptibility to cariogenic bacteria, suggesting a potential pathway to poor oral health. This study aimed to analyze the combined effects of sleep duration, exercise frequency, and media use on oral health indicators in Korean elementary school students. Methods: We analyzed Student Health Examination data from the Ministry of Education (2021–2023) for 93,220 children aged 6–12 years. Oral health indicators included dental caries prevalence (DCP), required rate of improved oral hygiene (RRIOH), periodontal disease prevalence (PDP), and malocclusion prevalence (MP). Sleep duration was categorized as short (<8 h) or adequate (≥8 h). Exercise (≥3 times/week) and media use (>2 h/day) were assessed as lifestyle factors. Associations were examined using the Rao-Scott χ² test and logistic regression. Results: Short sleep was significantly associated with a higher prevalence of all oral health indicators, with particularly strong associations for DCP and PDP. Low exercise frequency and excessive media use were also linked to increased DCP and RRIOH. These lifestyle factors were closely interrelated with sleep duration. Conclusions: Short sleep, infrequent exercise, and high media use form a lifestyle pattern associated with poor oral health in children. Improving sleep and lifestyle habits should be emphasized as a preventive strategy in pediatric dentistry. Full article

Guided by self-determination theory (SDT), this study aimed to examine the impact of All Stars Moving Together (ASMT), an 8-week school–university service learning program, on elementary children’s physical activity (PA), school-time behavior, and motivation. A concurrent theory-based mixed-methods study with 21 fourth graders from an under-resourced community (age 9–10) wore Moki PA trackers to capture step count and minutes of moderate-to-vigorous PA (MVPA) during school-time. Linear and generalized mixed-effects models examined school-day type on PA and benchmarks for meeting school-based PA (3000 steps; 20 min of MVPA). Self-efficacy and enjoyment were assessed using pictorial scales, and the focus groups explored program experiences thematically using the SDT framework. School day type showed significant main effects for steps (F (5, 642) = 170, p < 0.001) and MVPA (F (5, 581) = 105, p < 0.001), where school days with ASMT added an average of 2000–2400 steps and 10–12 min of MVPA compared to school days with no PA. Enjoyment of PA significantly increased (p = 0.006, d = 0.75). Thematic analysis revealed relatedness (support from peers, college students), competence (self-efficacy, positive feelings, perceived motor competence improvements), and autonomy through preferences and self-regulation of PA. ASMT significantly increased school-time PA and children’s enjoyment while fostering competence and relatedness among elementary children. Full article