Search Results (127)

Background: The psychosocial needs of families involving a child with a life-limiting or life-threatening condition are well recognized. However, evidence-based interventions that address the needs of the entire family remain scarce, even though family health can be maintained and supported if interventions encompass each individual family member, as well as the family as a unit. The aim was to evaluate the family talk intervention (FTI), regarding family communication, and psychosocial health, for families involving a child with a life-limiting or life-threatening condition. Methods: This pre-post study without a control group involved families of children with a life-limiting or life-threatening condition receiving FTI at a pediatric hospital and a hospice in Sweden. The study is registered at clinicaltrials.gov (ID NCT05020158, date of registration: 23 August 2021). FTI is a family-based intervention with the goal of facilitating family communication about illness-related topics, e.g., prognosis, support parenting, and making all children’s needs visible. In total, 105 participants from 29 families were included. Surveys measuring self-assessed family communication and satisfaction, anxiety, resilience, parenting skills, and children’s mental problems were answered at three time points: baseline (before intervention), at the end of the intervention, and six months later. Changes over time were analyzed using linear mixed-effects models. Results: Significant improvements were reported in family communication, family satisfaction, parenting skills, and levels of anxiety over time. Children’s mental health problems were reduced over time regarding emotional symptoms, conduct problems, peer relationship difficulties, and hyperactivity. No changes were found regarding resilience. Conclusion: The results suggest that FTI contributes to improved family communication and psychosocial health for families involving a child with a life-limiting or life-threatening condition. This highlights the value of a systemic approach that actively involves all family members. Full article

Objective: From a family perspective, this study aimed to examine the effects of a 12-week digital platform-based parent–child exercise intervention on children’s behavioral level (physical activity), psychological level (physical exercise attitude), and mental health. Methods: This study included 218 students aged 10–11 years who underwent a 12-week standardized parent–child exercise intervention. The intervention group completed two structured parent–child tasks per week through a digital platform (Ding Talk App) while maintaining regular physical education classes; the control group only maintained their regular physical education classes. Assessments were conducted using the Physical Activity Rating Scale, Exercise Attitude Scale, and mental health scales (The Spence Children’s Anxiety Scale (SCAS) and The Patient Health Questionnaire-9 (PHQ-9)) at four stages: pre-intervention (T1), mid-intervention (T2), post-intervention (T3), and a 2-month follow-up period (T4). The intervention effects and effect sizes (ηp²) were examined using Repeated Measures Analysis of Variance. Results: At the behavioral level, a significant group × time interaction was found for physical activity volume (F = 17.651, p = 0.04, ηp² = 0.138), indicating the presence of a moderate effect. At the psychological level, significant interactions were observed across exercise attitude dimensions (behavioral attitude: F = 3.699, p = 0.002, ηp² = 0.033; perceived behavioral control: F = 4.189, p = 0.006, ηp² = 0.037; subjective norm: F = 4.616, p < 0.001, ηp² = 0.040) and mental health measures (depression: F = 4.009, p = 0.026, ηp² = 0.044; anxiety: F = 3.1, p = 0.016, ηp² = 0.020), though no significant effect was found for behavioral intention (F = 1.346, p = 0.259, ηp² = 0.012), with all significant effects being relatively weak. Conclusions: The home–school collaborative, digital platform-based parent–child exercise intervention demonstrated positive effects on children’s physical activity volume, exercise attitudes, and mental health, offering a feasible and promising strategy to support more integrated child health promotion initiatives. Full article

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

People with Down Syndrome often experience more barriers to achieving a good quality of life compared to people without disabilities. A lot of the existing research has focused on the views of parents and professionals, rather than directly including the voices and perspectives of people with Down Syndrome themselves. We wanted to find out how this might be done. At the 2024 World Down Syndrome Conference, over 140 adults with Down Syndrome came together at a one-day Forum to talk about their lives—aspects that are going well and what could be better. The goal was to hear directly from them. This article explains how the Forum was run so that others with Down Syndrome can use a similar process. We describe how Artificial Intelligence (AI) was used to assist the authors in organising and sharing the information from participants, such as grouping what people said into different themes and helping to create plain language reports. This process worked. Eight key themes were found that could help people to have a good life, such as having good relationships with family and friends; having a job; making personal choices; and being respected and included. The list was longer than previously reported in other studies. The Forum gave valuable insights and helped us think of new ideas for supporting people with Down Syndrome to speak up for themselves. Used thoughtfully, AI (Artificial Intelligence) could be a helpful tool in the future to help these people share their experiences and needs. More research is needed to understand how people with Down Syndrome can be more involved in making changes through advocacy projects where they take an active role. Full article

Early parent–child interactions are crucial for children’s social–emotional development. Mental state talk (MST)—language referring to thoughts, feelings, and intentions—is a key contributor. MST may be reduced in hearing parents of deaf or hard-of-hearing (DHH) children, who face unique communication challenges. Yet, existing research on MST in hearing parents of DHH children and on MST use by DHH children themselves is limited and fragmented, often focusing on MST quantity in a single context. Few studies have examined MST quality, variation across contexts, or its relationship with children’s social–emotional functioning. This study addresses these gaps by investigating MST quantity and quality across two activities and its associations with children’s MST and social–emotional development. Forty-eight hearing parent–DHH child dyads (ages 2–5) participated. MST was studied during storybook reading and free play. Children completed tasks on emotion understanding and theory of mind; parents reported on MS vocabulary and family characteristics. The results showed that parents adjusted MST complexity based on children’s age but not audiological characteristics. MST varied by activity, with different contexts eliciting distinct types of MST. Parental and child MST were associated, though not linked to children’s task performance. Findings highlight the importance of diverse interaction contexts and suggest a need for longitudinal research on MST’s developmental impact. Full article

Background/Objectives: Qualitative child-centered research on pediatric obesity treatment and body image remains limited. This study aimed to explore children’s and adolescents’ experiences with hospital-based obesity treatment and how these experiences relate to body image. Methods: A full-day workshop including three main participatory tasks was conducted in two groups of children (9–13 years) and adolescents (14–18 years), focusing on their experiences with obesity treatment and body image. Data were audiotaped, transcribed verbatim, and analyzed using reflexive thematic analysis. Results: Four main themes emerged, reflecting different aspects of participants’ experiences. The first theme, Talk with me and not my parents, encompassed participants’ desire for greater agency, as children described lacking information and feeling excluded from consultations. The second theme, Experiences of communication with healthcare professionals (HCPs) about obesity, concerned participants’ perceptions of trust, support, and non-judgmental communication, with some adolescents expressing a need for additional psychological support. The third theme, Internalization of lifestyle advice, indicated that healthy diet was viewed as the primary focus of obesity treatment, while physical activity received less attention. The final theme, Perceptions of the body, conveyed mixed experiences with weighing and most participants perceived weight loss as success in treatment and weight gain as failure. The participants shared experiences of weight-based bullying, perceived stigma, and challenges with maintaining a positive body image in a society with stereotypical thin and muscular body ideals. Conclusions: Body image was influenced by HCPs’ emphasis on health and body size, and by their own internalized perceptions, influenced by societal ideals and experiences of stigma. Full article

Background/Objectives: Time spent with parents and educators encompasses a large portion of a child’s waking hours, with the home and early childhood education and care serving as two of the first settings in which children develop social and cognitive abilities. While previous studies have used social and cognitive tests to examine antecedents of child behavior, we extend such studies to take into account the congruence and incongruence of parents’ and teachers’ views on those antecedents. We examine the importance of parent-teacher alignment on the perceptions of a child’s personality and abilities in early development. Methods: Parents and teachers of 2968 German Kindergarten-aged (4–5 years old) children were surveyed using the National Educational Panel Study (NEPS). Parents and teachers independently rated 10 child behavioral traits, with higher scores indicating more prosocial behavior. Educators also rated children on five developmental abilities (social abilities, ability to concentrate, language abilities, general knowledgeability, and mathematical reasoning) compared to the student’s peers. While previous work has often examined how parental investments in children or teachers’ views of children might be related to development, we provide a new take by examining parents and teachers in conjunction with each other. Research that has looked at both parents and teachers has tended to examine alignment, or lack thereof, on child behaviors and personality traits. We analyzed child developmental abilities using OLS regression models, measures of parent–teacher divergences in ratings of child behavior, and demographic controls. Results: Greater differences in parent and teacher perceptions of desire for knowledge were negatively associated with all five developmental abilities. Differences in parent and teacher perceptions on talkativeness, confidence, good-naturedness, and understanding were negatively associated with at least one developmental outcome. By contrast, differences in perceptions of children’s neatness were positively associated with all five developmental abilities. Conclusions: Using both parent and teacher perceptions of child behaviors and abilities is a unique approach to understanding the relevance of parent and educator perceptions to a child’s development. Our findings indicate the need for collaboration across young children’s home and school or care settings. Establishing congruence in perceptions and the kinds of relationships that can lead to such congruence can help children with behavioral issues receive support in both home and educational settings and encourage mutual respect and partnership between parents and educators. Full article

Background/Objectives: Parental weight stigma and bias can shape how parents talk about weight and health with their children, yet their interplay in Romania is unexplored. We examined how parents’ experienced stigma, internalized bias, and explicit antifat attitudes relate to weight- and health-focused conversations with 5–17-year-olds, and whether these links vary by child weight status. Methods: In a cross-sectional survey of 414 Romanian parents, we assessed stigma (teasing/unfair treatment), internalized bias (WBIS-M), antifat attitudes (AFA, UMBFAT), and frequency of health (healthy eating/PA) versus weight-focused talks and comments. BMI-derived child weight status was classified via WHO percentiles. Multivariate regressions and mediation analyses tested predictors and indirect effects. Results: Nearly 80% of parents discussed weight at least sometimes; higher child BMI percentile and parental internalized bias independently predicted more weight conversations (β = 0.44 and β = 0.25, both p < 0.001). Internalized bias mediated the effect of experienced stigma on weight talk (indirect effect = 0.105, 95% CI [0.047, 0.172]). Explicit antifat attitudes drove comments about others’ weight (β = 0.17, p = 0.002). Health-focused talks were unrelated to stigma or bias but were more frequent among parents with higher education, better self-rated health, and lower BMI. Conclusions: Parents’ internalized weight bias—shaped by stigma—fuels weight-focused conversations, especially when children have higher BMI, while antifat attitudes underlie negative comments about others. Interventions should reduce parental internalized bias and train supportive, health-centered communication to curb weight stigma transmission. Full article

Gendered social protection interventions such as Let’s Talk are now appreciated as a significant component of family-based HIV prevention services. The intervention deliberately focuses on bridging the caregiver–adolescent relational and communication divides in the context of HIV prevention. This qualitative study used interviews to explore the caregivers’ parenting experiences after attending the Let’s Talk programme in Soweto, South Africa. Simple random sampling was used to select four Community-Based Organisations (CBOs). Twelve caregivers were purposively sampled from the four CBOs. Data analysis was accomplished through thematic analysis. The findings indicate that Let’s Talk had positive transformative effects on the caregivers’ parenting experiences and relational dynamics with adolescents. The improved parenting experiences were characterised by better communication, mutual respect and observed behaviour improvements by adolescents. In conclusion, caregivers’ reports of improved parenting experiences provide empirical evidence of acceptability to participants, effective implementation, and Let’s Talk’s efficacy in facilitating desired outcomes. Full article

This study investigates the impact of family engagement on student reading achievement in the United Arab Emirates (UAE) using counterfactual explainable artificial intelligence (CXAI) analysis. Drawing data from 24,600 students in the UAE PISA dataset, the analysis employed Gradient Boosting, SHAP (SHapley Additive exPlanations), and counterfactual simulations to model and interpret the influence of ten parental involvement variables. The results identified time spent talking with parents, frequency of family meals, and encouragement to achieve good marks as the strongest predictors of reading performance. Counterfactual analysis revealed that increasing the time spent talking with parents and frequency of family meals from their minimum (1) to maximum (5) levels, while holding other variables constant at their medians, could increase the predicted reading score from the baseline of 358.93 to as high as 448.68, marking an improvement of nearly 90 points. These findings emphasize the educational value of culturally compatible parental behaviors. The study also contributes to methodological advancement by integrating interpretable machine learning with prescriptive insights, demonstrating the potential of XAI for educational policy and intervention design. Implications for educators, policymakers, and families highlight the importance of promoting high-impact family practices to support literacy development. The approach offers a replicable model for leveraging AI to understand and enhance student learning outcomes across diverse contexts. Full article

Parental attention and care is essential for children and adolescents who are unable to take care of their own oral health. There have been studies on the characteristics of mothers and the oral conditions of children in Korea, but there are very few previous studies that report on the oral health status of children according to the employment status of mothers. The aim of this study was to investigate the relationship between maternal employment and educational status and children’s oral health. Using data from the 10th Panel Study on Korean Children (PSKC), we analyzed the association between maternal employment and education status and the occurrence of dental caries among 1175 nine-year-old Korean children. The relationship was examined through cross-tabulation and logistic regression analysis. After adjusting for the mother’s age, parental style, parental relationship, family talk time, family meal time, leisure time, area of residence, and household income, the study found that children with working and studying mothers were 1.159 times more likely to have dental caries than children with non-working and non-studying mothers. The relationship between maternal employment and educational status and children’s oral health was confirmed. Based on the results of this study, it is expected that systematic follow-up studies will be needed to better understand the association and causal relationship between dental caries and oral disease in children according to whether mothers are employed or educated. Full article

This theoretical paper expands upon previous research and proposes a guide for promoting mathematical talk and play through shared book reading (SBR), with a focus on the home environment. Building on a previously developed classroom-based model, this article describes a design-based research approach to extend the guide to including diverse literary genres—such as narrative, informational, multicultural, and math-specific books in a home setting. Parent–child shared book-reading in authentic contexts can provide a rich platform for “math talk”, where references are made to mathematical words, concepts, and content, and may support children’s mathematical skills. SBR with quality children’s literature can play a promising role in motivating and engaging children’s interest and pleasure in both reading and mathematics. However, few studies have explored this with diverse literary genres in the home setting, as the main focus has been in the classroom and using books specifically written to teach math content such as counting or sorting books. The proposed guide provides direction and practical examples for fostering parent–child math talk and play activities that can be used to extend concepts covered during the SBR. The potential application of the SBR guide, and how it can encourage parent–child talk to support a full range of mathematical concepts, encourage home-preschool collaboration, promote effective SBR techniques, and facilitate parent–child conversations about math in new and confident ways is discussed. Full article

Background: Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers, yet vaccination rates remain suboptimal, particularly in Florida. Social influence, including family and peer support, may shape parental decisions to vaccinate their children. In this study, we examined the role of social networks (online and offline) in parental intention to vaccinate their 11- to 12-year-old children against HPV. Methods: We conducted a cross-sectional survey among 746 parents in Florida as part of the Text & Talk trial (2022–2023). Among other questions, parents reported on their intention to vaccinate, perceived social norms, and support received from up to three reported confidants. We performed logistic regression and multivariable analyses to assess the relationship between network support, social norms, and vaccination intent. Results: Seventy percent of parents intended to vaccinate their children. Greater support from the first reported confidant was significantly associated with higher vaccination intention (OR = 1.30, p < 0.0001). Perceived norms among friends (p = 0.01) and higher overall network support (p < 0.0001) were also predictive of intent. The higher the percentage of reported family members, the higher the support received for the vaccine (p = 0.04). Conclusions: Social support, particularly from close confidants and peers, plays a critical role in shaping parental HPV vaccination decisions while accounting for perceived social norms. Public health interventions can leverage peer networks alongside family support to enhance HPV vaccine uptake. Full article

Background/Objectives: The high sensitivity of paediatric nurses directly influences the quality of nursing care provided to patients. The purpose of this study is to present the most frequent issues faced by paediatric nurses in their everyday work and their responses to difficult situations at work, define the actions applied when a difficult situation occurs, and assess the level of stress and other factors influencing the level of stress experienced by paediatric nurses. Methods: This study was conducted using an original survey form and a standardised psychological questionnaire based on the Perceived Stress Scale (PSS-10) for paediatric nurses. Results: The study involved 416 paediatric nurses and indicated a medium level of stress among the nurses. The median stress level, calculated as the sum of answers to questions based on the PSS-10, was 18 (16.0 ÷ 20.0), and the mean was 17.9 (min–max = 1–30). The median Sten score was 6 (5.0 ÷ 7.0), and the mean Sten score was 5.94 (min–max = 2–9). Nurses aged 21–30 years, who live in a city, have a Bachelor of Science in Nursing or a Master of Science in Nursing, and work ≥ 61 h a week and 161–250 h a month experience a higher level of stress. Factors such as choosing which child to help first, spending a great deal of time filling out medical documentation, obtaining a sick child’s consent to perform nursing procedures which the child does not understand, involving the minor in decision-making, impolite or offensive behaviour from a sick child or their parents, ineffective nursing and treatment methods, providing care against the opinion/views of a sick child or their parents, difficulties in or a lack of understanding of the situation of a sick child and their family, performing nursing procedures that can cause the child pain, and the inability to fulfil a sick child’s request increase the level of stress experienced by paediatric nurses. When a difficult situation occurs at work occurs, the nurses usually meet and talk about the situation with someone close (72.4%) or engage in other activities to avoid thinking about the situation (66.6%). They consult a psychologist/psychotherapist very rarely (9.6%) and a psychiatrist extremely rarely (4.6%). Conclusions: Polish paediatric nurses were found to experience a medium level of stress. Since paediatric nurses are exposed to stress, providing them with psychological care is important. The level of perceived stress is dependent on the nurse’s age, place of residence, and education, as well as weekly and monthly working durations. Paediatric nurses experience many difficult situations in their everyday work that influence their stress levels. Management should pay special attention to difficult workplace situations faced by paediatric nurses and implement regular actions to reduce the levels of stress experienced. Full article

Parents are primary “supporters” for helping their children cope with feelings of anxiety, a significant concern for many young children. The current study examined parents’ perceptions of an anxiety management manual. Parents reviewed an anxiety coping manual for elementary school-aged children. This manual explained how anxiety influences the body and emotions, as well as presenting cognitive-behavioral anxiety management strategies. The strategies included breathing, imagery (superhero to fight worries and imagine your favorite place), relaxation, talking to supportive others, and using distraction. Convenience samples of 15 parents completed virtual interviews and 6 completed in-person interviews to determine their perceptions of the manual and of worry for today’s children. Qualitative analyses were performed to determine themes in the data. Results indicated that parents would use the manual and key themes, which were (1) learning new strategies for helping their child, (2) discussing children’s worries, and (3) sharing why the worry strategies would be useful (e.g., for emotion regulation). Parents felt that today’s children are worrying more about serious things like school performance and family stressors. Future research needs to examine parent implementation of the strategies over time to determine if the use of anxiety management strategies is related to lower levels of worry for young children, if the strategies reduce anxiety-related stress, and if prevention minimizes the impact of anxiety on emotional functioning. Full article