Search Results (151)

Background/Objectives: Excess consumption of energy-dense foods (EDF; ultra-processed snacks, sweets, and sugar-sweetened beverages) among preschool-aged children is a public health concern, particularly in low-income families. Caregiver parenting style, psychological stress, and food-parenting practices (FPP) may shape children’s EDF consumption, yet little is known about how these factors operate in real time. This exploratory pilot study examined (1) associations between baseline characteristics and EDF feeding episodes across 1 week and (2) whether caregivers’ momentary stress during EDF episodes related to FPP used. Methods: In total, 22 caregivers of Head Start children (ages 3–5) completed baseline measures and 7 days of ecological momentary assessment (up to seven prompts/day). At each prompt, caregivers reported child EDF consumption in the past hour; if confirmed, they reported FPP used and rated momentary stress. Aim 1 used Poisson regression to model caregiver-level EDF episode counts. Aim 2 tested momentary stress–practice associations during EDF episodes using GEE, with within-person and between-person stress modeled separately. Results: Authoritarian parenting was associated with a higher weekly rate of EDF episodes (RR = 1.43, 95% CI 1.23–1.66, p < 0.001); authoritative parenting trended lower (RR = 0.90, p = 0.065). Higher baseline stress was associated with more EDF episodes (RR = 1.25, p = 0.001). Momentarily, elevated stress above a caregiver’s own average increased odds of using food as a reward (OR = 1.08 per +10 points, p = 0.011), while higher average momentary stress was associated with co-eating (OR = 1.59, p = 0.042). Domain-level FPP composites showed no association with momentary stress. Conclusions: Authoritarian parenting and higher caregiver stress were associated with increased EDF feeding, and momentary stress was linked to reward-based feeding during those episodes. These hypothesis-generating findings suggest potential behavioral targets for just-in-time adaptive intervention, pending replication in adequately powered studies. Full article

Background/Objectives: Prior research suggests that it is possible to improve health outcomes in children with adverse childhood experiences (ACEs) through multi-component interventions that promote protective factors. We designed the Families Implementing Resilient Systems Together (FIRST) study to address the gaps in research on the potential effectiveness of screening for specific ACEs through pediatric practice. Methods: As part of our clinical quality improvement efforts to improve patient care for children impacted by ACEs, we trained a random sample of pediatricians on strategies to promote protective factors and encouraged them to make referrals to community health workers (CHWs) and parenting education resources. This manuscript describes our clinic data on practice changes associated with the FIRST physician training, and our data collection plan for our research study. Results: Physician training resulted in attitudinal shifts and measurable behavioral changes. Trained providers made referrals to CHWs for approximately 5–10% of well-child care visits. The majority (84%) of referrals were for multiple risk factors, most commonly ACEs and socioeconomic concerns. The most common ACEs were parental divorce/separation, parent–child verbal abuse, and caregiver mental health problems. Conclusions: FIRST training improves counseling, education and referrals for children exposed to ACEs. Our research study will evaluate the impact of the FIRST intervention and address important questions about associations between specific ACEs, protective factors, and biomarkers of toxic stress. Full article

This study examines how religious and spiritual identities relate to depression and anxiety at baseline and longitudinally. Using data from the Family Foundations of Youth Development Project, which sampled parent–child dyads from the Western United States, we investigated how mental health relates to the conjunction of spirituality and religiosity (S/R), the lack of either, or one separate from the other. At baseline, children identifying as “Spiritual but not Religious” (SBNR) reported the highest levels of anxiety and depression, whereas children who identified as “Religious and Spiritual” (RAS) exhibited the lowest levels of depression. The difference between RAS identity and the SBNR identity was significant across all baseline scales, with SBNR individuals demonstrating greater pathology. Among parents, the “religious but not spiritual (RBNS) group” was more depressed than the RAS group, and both RBNS and SBNR parents were more anxious than the “not religious, nor spiritual” (NRNS) parents. Longitudinally, SBNR children uniquely showed significant decreases in their depression levels, and no increases in their anxiety levels, likely reflecting a ceiling effect given their initially high symptoms. Regarding adults, all groups except RBNS decreased in depressive symptoms over time. It is important to note that this study does not investigate the effects of spiritual or religious identity shift: i.e., conversion or deconversion. This study highlights the nuanced relationship between psychological well-being and S/R. It examines participants from the Western United States, in predominantly white, highly homogenous areas, with a large presence of members from the Church of Jesus Christ of Latter-day Saints, and is not generalizable to world populations. It offers possible interpretations, intending to alleviate suffering and encourage flourishing by identifying risk and protective factors. Full article

We examined how sociodemographic, parental, and temporal factors are associated with parent-reported reasons for seeking consultation in a child and adolescent psychotherapeutic clinic. Data were derived from a large retrospective sample of more than 3000 cases collected between 2011 and 2023. Multivariable binary logistic regression analyses assessed the independent effects of age, gender, living arrangements, migration background, parental education, parental age at childbirth, parental separation or bereavement, and pandemic-related periods. School-aged children and adolescents were more likely than younger children to present with learning difficulties, depression, anxiety, mobbing and media addiction. Female patients showed lower odds of consultations related to learning difficulties, aggression, behavioral addiction, attention deficit/hyperactivity, but higher odds of depression, psychosomatic symptoms, anxiety, eating disorders and sleeping disorders. Parental separation increased the likelihood of consultations related to problematic social behavior within the family, delinquency and trauma and grief. Consultations for attention deficit/hyperactivity concerns were more frequent in the post-pandemic period compared to pre-pandemic. The findings highlight that sociodemographic, familial, and temporal factors are systematically associated with distinct patterns of parent-reported help-seeking patterns in child and adolescent psychotherapeutic care. Full article

Though separate research has found that early experiences, parental beliefs, and cognitive skills all influence science learning, science remains an underexamined domain compared to math and reading, despite its policy and societal implications. We integrate and expand on previous research by examining culturally relevant variables in different subgroups of Asian American kindergartners (N = 894). Guided by the Opportunity-Propensity Model of Achievement, we conducted a multi-group path analysis with science scores as the outcome, and propensity (self-regulation, social skills, and prior knowledge), opportunity (e.g., parent and child reading, TV-watching routine), and antecedent variables (e.g., poverty, SES, number of siblings and close grandparents, parental expectations, primary language at home, immigrant status) as predictors. We expected that propensity and opportunity variables would mediate the effects of antecedent variables. We conducted a multi-group path analysis, in which we examined differences between subgroups (China, India, Vietnam, Other East, Other Southeast, Other). Although we did not find heterogeneity in science achievement among subgroups, we found various direct and indirect effects at the subgroup level. Findings suggest that Asian American children may generally benefit from enhanced self-regulatory skills and prior knowledge, though some subgroups may benefit specifically from having fewer TV-watching rules and non-structured activities. We also recommend further disaggregation and reporting of data to better support learners. Full article

Background/Objectives: The mediating role of the diverse range of screen-based sedentary behaviors (SBs) remains understudied, particularly at younger ages. The present study examined the direct and indirect effects of parental BMI and education on ultra-processed food (UPF) consumption among preschoolers, testing the potential mediating role of screen time. Methods: The cross-sectional study sample comprised 919 kindergarten children (484 boys, 52.7%), with ages ranging from 2.2 to 6.8 years (mean: 4.7 ± 1.0 years). Screen-based sedentary behaviors (television viewing, smartphone use, tablet use, computer use, and playing electronic games) were measured by proxy-report fulfilled by parents, separately for weekdays and weekends. UPF consumption (drinks/yogurts, packaged/fast foods, and sweet/salty snacks) was assessed via 24 h recall scales. Path analysis mediation models tested direct effects of maternal/paternal BMI and education on UPF intake, and indirect effects through screen time, controlling for child age and sex. Results: Lower parental education and higher parental BMI were associated with increased mobile device use and UPF consumption (r = 0.10–0.28). Screen-based sedentary behaviors mediated the association between maternal BMI and UPF pathways (15–90% of total effects), particularly for sweet and salty snacks (50–90%). Parental education effects were also mediated by screen time (9–23% indirect effects), with paternal education showing stronger protection against packaged/fast foods. Conclusions: Mobile devices and watching television partially mediate intergenerational transmission of obesogenic dietary patterns from parental BMI/education to preschoolers’ UPF consumption. Findings of the current study support family-centered interventions targeting screen-time limits and UPF exposure, mainly at the weekends, to prevent early obesity trajectories. Full article

Background/Objectives: Mindfulness-based interventions show promise for treating childhood ADHD, yet the mechanisms through which they produce effects remain unclear. This study provides the first direct comparison of treatment mechanisms between a mindfulness-based family intervention (MYmind) and methylphenidate. Methods: Data were drawn from a preregistered trial combining randomized and preference arms, comparing MYmind (2-month parallel parent–child mindfulness training) with 4-month methylphenidate in children aged 8–18 with ADHD (N = 120 children, 224 parents). Families were assessed at baseline, 2, 4 and 10 months. Multilevel mediation analyses tested whether treatment effects on ADHD symptoms were transmitted through 111 treatment-to-mediator-to-outcome pathways across three mechanism categories: child emotion regulation and coping (all children); adolescent self-regulation and mindfulness (ages 11+); and parent-level mechanisms, including mindful parenting, parental mindfulness, parenting style and self-compassion. Results: Direct treatment effects favored methylphenidate for ADHD symptom reduction at 4 months, with mindfulness catching up by 10 months. MYmind produced significantly greater improvements than methylphenidate in adolescent healthy self-regulation, parental self-compassion, mindful parenting and over-reactive parenting. Treatment did not differentially affect the remaining mechanisms. Across model sets, observed emotion regulation, maladaptive coping, parental self-compassion and mindful parenting each predicted ADHD outcomes. Across 111 pathways tested in 18 models, numerous significant individual pathways were consistent with theoretical predictions, yet no complete mediation chains reached statistical significance. Conclusions: MYmind engages distinct psychological and family-level processes compared to methylphenidate that are separately associated with ADHD symptom improvement. The absence of significant mediation effects likely reflects power limitations. These findings support mindfulness-based family intervention as a viable alternative to medication and highlight the need for larger-scale mechanism research. Full article

Adverse childhood experiences (ACEs) prompt parentification, which is related to providing regular caregiving as adults. This study examines the association between the number and types of ACEs and caregiving as adults, and to whom caregiving is extended. Analyses were based on 90,666 adults from 13 states in the U.S. in 2020–2024 and involved binomial and multinomial logistic regression, adjusted for selected covariates. Approximately 21% of participants provided regular care and 66% had ≥1 ACEs. Each of 11 ACEs considered was positively associated with providing regular care. As the number of types of ACEs increased, the odds of providing regular care increased. The strongest ACE predictor of providing regular care was living with a parent or adult who was depressed, mentally ill, or suicidal, and the weakest was when the parents were divorced, separated, or an unmarried couple. Among those receiving regular care, if the caregiver had more ACEs versus less, they were significantly less likely to care for a parent or grandparent but more likely to care for a spouse, child, sibling, or friend or non-relative. Full article

This study illustrates the application of Acceptance and Commitment Therapy (ACT) for a 12-year-old boy with separation anxiety and his mother. Over 23 sessions, ACT strategies promoted psychological flexibility, values-based parenting, and adaptive behaviors. The intervention reduced the child’s experiential avoidance, anxiety, and depressive symptoms, while increasing value-oriented actions, while the mother showed improved psychological flexibility and life satisfaction. The results were sustained at a three-month follow-up. This case study highlights the potential of ACT in treating childhood separation anxiety by simultaneously involving parents, demonstrating its feasibility and efficacy. The findings provide guidance for adapting ACT for families and child populations. Full article

Background/Objectives: Physical inactivity is associated with increased cardiometabolic disease risk and poor cognition in children and their parents. Family-based physical activity offers an opportunity for children and their parents to engage in physical activity concurrently. The present study examined the effect of an acute bout of family-based tag rugby on risk factors for cardiometabolic disease and cognition in families. Additionally, this study qualitatively explored families’ perceptions of enjoyment and factors affecting implementation with considerations for socioeconomic status. Methods: Sixteen families (27 children, 20 parents) participated in an exercise (45 min family-based tag rugby) and resting control trial (45 min seated rest), separated by seven days. Postprandial gylcaemia, insulinaemia, lipaemia and cognitive function were measured following exercise/rest. Families also participated in whole-family focus groups and separate parent and child interviews. Results: In parents, postprandial plasma insulin concentrations were lower on the exercise trial than the rested control trial at 30 min (p = 0.004) and 120 min following the consumption of a standardised lunch (p = 0.011). In children, a significant trial*time interaction for inverse efficiency scores on the Sternberg paradigm (three-item) was exhibited (p = 0.016). In parents, a significant trial*time interaction for inverse efficiency score on the Stroop congruent test was exhibited (trial*time interaction; p = 0.012), whereby inverse efficiency scores improved immediately post-exercise, compared with the rested control trial (p = 0.016). Qualitatively, families from all socioeconomic backgrounds agreed that tag rugby is an inclusive, enjoyable mode of physical activity that families want to participate in together, which can be adapted to overcome the barriers associated with the cost of and access to local facilities. Conclusions: An acute bout of tag rugby improved postprandial insulin concentrations in parents and cognitive function in children and their parents. Tag rugby was deemed an appropriate exercise modality for families from a range of socioeconomic backgrounds. Full article

Background/Objectives: This study presents a brief report on the preliminary psychometric properties of a first Polish version of the Parental Assistance with Child Emotion Regulation (PACER) Questionnaire. The PACER measures ten emotion regulation (ER) strategies parents use to assist their children in their ER. We aimed to examine PACER’s internal consistency reliability, convergent, divergent and discriminant validity. Methods: The sample included 74 Polish-speaking parents aged from 27 to 50, recruited in 2025. Along with the PACER, we used a robust set of psychometric tools for measuring parental burnout, anxiety and depression symptoms, somatic complaints, well-being, and beliefs about emotions. Results: All PACER subscale scores demonstrated good-to-excellent internal consistency reliability (i.e., Cronbach’s alpha of ≥0.83). Encouraging adaptive strategies (e.g., reappraisal) in one’s children was associated with better outcomes (e.g., lower parental burnout and psychopathology symptoms), whereas maladaptive strategies (e.g., avoidance) were associated with worse outcomes. We also demonstrated that PACER strategy scores were statistically separable from maladaptive beliefs about emotions, indicating good discriminant validity. Conclusions: Overall, the Polish PACER demonstrated promising psychometric properties and strong clinical relevance. These findings can help to inform interventions targeted at improving parents’ capacity to help their children regulate emotions, which in turn may help to prevent parental burnout. Full article

Background/Objectives: Orthopaedic surgery is often recommended for children with cerebral palsy (CP) across all Gross Motor Function Classification System (GMFCS) levels. Despite this, little is known about the experience of parents during their child’s surgery and recovery. Methods: This topic was explored using a mixed-methods research design. Using an interpretive description methodology, in-depth interviews with parents of children with CP who had undergone orthopaedic surgery were completed by a physical therapist within an interdisciplinary clinical context in an acute care orthopaedic surgery clinic. Transcripts were reviewed by inductive thematic analysis. Resulting themes were used to inform the development of a self-administered survey, which was distributed to a separate cluster sample of parents. Results: From interviews with six parents, four themes were identified: (1) preparing and being prepared, (2) feeling known and recognized, (3) knowing and advocating for your child, and (4) feeling stressed and coping. The results of surveys completed by 25 parents were analyzed using descriptive statistics. When asked whether their child’s surgery was a stressful experience, 80% (20/25) agreed. However, 60% (15/25) indicated that the surgery was not a negative experience. Forty-four percent (11/25) felt their child’s recovery was longer than expected. Survey responses to questions related to the qualitative themes were similar across GMFCS levels and surgical procedures. Conclusions: The findings identify the importance of recognizing the needs of parents and suggest opportunities for collaboration between the healthcare team and families in caring for children across the spectrum of functional mobility and orthopaedic procedures. Full article

Background/Objectives: Maternal vitamin supplementation (including folic acid, vitamin D, and multivitamin supplements) during pregnancy may lower the likelihood of neurodevelopmental disorders in offspring. This study examines the associations between maternal vitamin suppletion during pregnancy and morphological patterns in offsprings’ brain structure and traits of Autism Spectrum Disorder (ASD) and Attention-Deficit Hyperactivity Disorder (ADHD) in a large population-based study of child development. Methods: The study cohort included a total of 3937 children (aged 9–11) participating in the Generation R cohort in Rotterdam, the Netherlands. Maternal vitamin D and folateserum levels, multivitamin supplement use, and overall dietary quality (as assessed by the Food Frequency Questionnaire, FFQ) during pregnancy were used as predictors. T1 structural MRI scans were acquired and segmented using Freesurfer to assess brain morphometry. Cortical and subcortical brain volumes of children were separated into four independent components and used as mediators. ADHD and ASD traits, as measured by parent-completed questionnaires (Child Behavior CheckList and Social Responsiveness Scale, respectively) were used as outcome variables. Results: Results show that (1) maternal vitamin D, multivitamin supplementation, and better diet quality were associated with fewer ADHD or ASD traits in the offspring; (2) vitamin D and diet quality were associated with larger-volume childhood brain components; (3) larger-volume brain components were associated with fewer ADHD and ASD traits; (4) part of the association between dietary factors in pregnancy and offspring ADHD and ASD traits was mediated through the brain volumes of the children. Conclusions: Though all observed effect sizes were small, further population-based research should be performed to further delineate the effects of gestational multivitamin and vitamin D exposure and investigate whether this may be an avenue for preventive interventions. Full article

The absence of parental presence has a direct impact on the emotional stability and social routines of children, especially during extended periods of separation from their family environment, as in the case of daycare centers, hospitals, or when they remain alone at home. At the same time, the technology currently available to provide emotional support in these contexts remains limited. In response to the growing need for emotional support and companionship in child care, this project proposes the development of a multi-platform software architecture based on artificial intelligence (AI), designed to be integrated into humanoid robots that assist children between the ages of 6 and 14. The system enables daily verbal and non-verbal interactions intended to foster a sense of presence and personalized connection through conversations, games, and empathetic gestures. Built on the Robot Operating System (ROS), the software incorporates modular components for voice command processing, real-time facial expression generation, and joint movement control. These modules allow the robot to hold natural conversations, display dynamic facial expressions on its LCD (Liquid Crystal Display) screen, and synchronize gestures with spoken responses. Additionally, a graphical interface enhances the coherence between dialogue and movement, thereby improving the quality of human–robot interaction. Initial evaluations conducted in controlled environments assessed the system’s fluency, responsiveness, and expressive behavior. Subsequently, it was implemented in a pediatric hospital in Guayaquil, Ecuador, where it accompanied children during their recovery. It was observed that this type of artificial intelligence-based software, can significantly enhance the experience of children, opening promising opportunities for its application in clinical, educational, recreational, and other child-centered settings. Full article

Background/Objectives: Depression and anxiety in children pose a significant public health concern, with long-term implications for well-being. Over 10% of children and adolescents are affected by emotional disorders such as depression and anxiety. African American youth face disproportionate exposure to mental health risk factors, including poverty, adverse childhood events, community violence, and racial discrimination, which elevate their vulnerability to these disorders. A particularly at-risk subgroup includes African American children in kinship care arrangements (e.g., grandparents raising grandchildren), who may face additional factors such as family disruption and separation from birth parents. Methods: This mixed-methods sequential study examined how caregiver stress and birth mother–child relationship quality relate to depression and anxiety symptoms in African American children in kinship care. Phase I included survey data from 58 caregivers of children aged 5 to 12; Phase II involved interviews with 16 of these caregivers. Results: Results indicated that lower caregiver stress was associated with reduced child depression and anxiety symptoms. Furthermore, findings suggest that a high quality of the birth mother–child relationship serves as a promotive factor, particularly for depressive symptoms. Qualitative findings highlighted two themes: (1) the weight of kinship care, marked by factors such as ongoing grief and financial strain; and (2) birth parent relationships, defined by a mix of connection, conflict, and loss that affects children’s mental health. Conclusions: These findings underscore the need for greater understanding of the strengths and resources within kinship families that support positive mental health outcomes and highlight the importance of targeted interventions to reduce caregiver stress and foster supportive parent–child relationships. Full article