Search Results (1,971)

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders among children and is associated with significant behavioral, academic, and social challenges. Caregiver-focused behavioral interventions have gained increasing attention as effective non-pharmacological approaches for improving child outcomes and enhancing parental management skills. Thus, this study aimed to evaluate the potential effectiveness of behavior change wheel (BCW)-based nursing intervention in improving maternal behavioral management practices, as well as child outcomes involving ADHD symptoms among preschool children aged 3–6 years with attention-deficit/hyperactivity disorder. Methods: A one-group pretest–posttest quasi-experimental design was conducted among 55 mothers and their children diagnosed with ADHD at Thawat Center and King Abdullah Center for Disability Services in Jeddah, Saudi Arabia. The study did not include a control group. Participants were recruited using a convenience sampling technique. Data were collected using a sociodemographic questionnaire, ADHD Rating Scale IV—Preschool Version, the BCW Intervention Compliance Questionnaire, and the Parental Knowledge and Attitude Questionnaire. The intervention was implemented over eight weeks and included educational sessions, behavioral skills training, motivational enhancement, role-play activities, and follow-up reinforcement. Results: The preliminary findings from the one-group pre/posttest quasi-experimental study revealed statistically significant improvements in children’s inattentive and hyperactivity symptoms following the intervention (p < 0.001). Mothers also demonstrated significant improvements in perceived knowledge, attitudes, and compliance with BCW components after program implementation (p < 0.001). The proportion of mothers with satisfactory perceived knowledge increased from 21.8% pre-intervention to 94.5% post-intervention, while positive attitudes increased from 23.6% to 98.2%. In addition, compliance with BCW components improved from 30.9% before the intervention to 94.5% after implementation. Conclusions: The BCW-based nursing intervention was associated with pre–post improvement in maternal caregiving outcomes and reduced ADHD symptoms among preschool children. These preliminary findings from the one-group pretest–posttest quasi-experimental study suggest the potential value of theory-informed, caregiver-focused nursing interventions in pediatric and community healthcare settings. However, due to the one-group pretest–posttest design without a control group, causal inferences cannot be made. Further controlled studies are needed to confirm these associations and establish causal inferences. Full article

Background: The early development of sociocognitive skills is linked to, and serves as a precursor for, the development of communication, language, and socialisation. Some of the most prevalent neurodevelopmental disorders, such as autism, are characterised by difficulties in communication and social interaction. Identifying delays in these skills could enable us to detect an earlier warning sign. Method: The original version of the Early Social Cognition Inventory (ESCI), a 21-item parent-reported questionnaire, was translated and culturally and linguistically adapted for use in Spain. Participants: The sample included 113 children from nursery schools and 19 children from an early intervention centre, aged between 18 and 60 months, from 10 early childhood centres in Valencia (Spain). Parents completed the ESCI and the Social Reactivity Scale, Preschool Second Edition (SRS-2 P). The children were assessed using additional tests, including the Early Sociocognitive Battery (ESB) and the Peabody Picture Vocabulary Test III (PPVT). Results: Internal consistency (α = 0.78, p < 0.001) and the correlation between criterion measures (p < 0.001) indicate that the ESCI measures sociocognitive development. Furthermore, the results regarding diagnostic ability, assessed using the AUC (area under the curve) values from the ROC analysis, are promising (AUC = 0.94; p < 0.001 for Autism Spectrum Disorders), although further research is needed given the sample size. Conclusions: The results of the ESCI pilot study indicate that it is a suitable tool for assessing early sociocognitive development in Spain, although further research with larger samples and longitudinal studies is required. Full article

Background: Vaccinations are highly effective in preventing infectious diseases, which otherwise present a serious challenge to the health of individuals and public health. To identify potential gaps in vaccination coverage, we examined childhood vaccination levels in Frankfurt am Main (FFM) and the Rhein Neckar district (including Heidelberg city, RNHD) prior to, during and following the COVID-19 pandemic. Moreover, we explored various factors that appear to contribute to lower vaccination levels in specific communities in either or both locations. The results are intended to guide strategies for designing and improving vaccination services for specific groups in local health settings. Methods: A retrospective analysis was conducted to examine the vaccination rates of children in Frankfurt am Main and the Rhein Neckar district (including Heidelberg city) by using anonymized data from school entry examinations spanning the years 2017 to 2024. Data pre-processing, analysis, and visualization were performed using R (5.4.2). Frequencies and percentages were calculated for sociodemographic and vaccination rates (the completeness of the vaccination schedule recommended by STIKO for children). Multivariate logistic regression was performed to determine factors with a significant impact on vaccination uptake. Results: Multinomial logistic regression with ‘measles-only’ (Measles) as the reference category revealed distinct predictor patterns across vaccination levels. In both regions, children who completed preventive medical check-ups had higher odds of completing the schedule of vaccination plus at least one additional vaccine (ScheduledPlus) versus, measles-only vaccination. In RNHD, children from Eastern European language families and low- and medium-social-status backgrounds showed higher odds of completing the scheduled vaccinations without the recently introduced rotavirus vaccination (ScheduledNotRota), versus measles-only vaccination. In FFM, strong interaction effects were observed between medical examination completion and migration background, with children from non-German birthplaces showing dramatically reduced odds of complete vaccination when preventive care was incomplete. Discussion: The proportion of children with a complete vaccination status remained stable over the study period in both locations, with no evidence of post-pandemic decline. Nevertheless, this stability masks important heterogeneity in vaccine coverage patterns across sociodemographic groups. Systematic identification and modeling of interactions between nationality, parental employment, and healthcare utilization tell a compelling “double jeopardy” story that the effects of these risk factors are not additive but synergistic. Regular medical check-ups remain an important factor in ensuring high vaccination coverage among children until they start school and underscore the justification for such established preventive care programs. A nuanced understanding, however, is crucial for moving beyond simplistic, one-size-fits-all public health messaging. Full article

Background: Animal-assisted therapy (AAT) is a targeted intervention that supports participants’ development by involving animals in the therapeutic process. This study aimed to investigate the effectiveness of AAT with preschool and primary school children, including children with special educational needs (SEN). Methods: A total of 201 children (114 experimental, 87 control; including children with and without special educational needs) participated in the study. Behavioural functioning was assessed using the parent-rated Conners questionnaire and the Strengths and Difficulties Questionnaire (SDQ). Data were analysed using the Wilcoxon test and repeated measures ANOVA. Results: Mixed-design repeated measures ANOVA showed no significant Group × Time interaction for the primary behavioural outcomes, indicating that behavioural changes over time did not differ significantly between the intervention and control groups. Within-group analyses showed improvements in parent-reported oppositional behaviour, cognitive problems/inattention, hyperactivity, and conduct problems in the intervention group; however, similar improvements were also observed for some outcomes in the control group. Conclusions: Although behavioural improvements were observed over time, the intervention did not result in significantly greater improvements than those observed in the control group. Dog-assisted AAT may provide a supportive therapeutic environment that facilitates engagement and behavioural practice; however, further adequately powered randomised controlled trials are needed to determine its effectiveness. Full article

This paper presents the design and pedagogical rationale of an AI-powered avatar developed to mediate Cypriot woven heritage for preschool education. The study is conceptual and design-oriented, focusing on how visual motifs from Cypriot traditional weaving can be reinterpreted through an LLM-based conversational system grounded in retrieval-augmented generation (RAG). The system, named Sophia, transforms textile patterns from the fythiotiko tradition into dialogic narrative prompts that support storytelling, visual exploration, and creative expression in early childhood contexts. The proposed framework is intended to illustrate how artificial intelligence can support the reinterpretation of cultural artifacts as pedagogical resources when embedded within guided-play and museum-based learning approaches. It integrates visual analysis, dialogic storytelling, and artmaking into a structured learning sequence that moves from observation to interpretation and creative transformation. Rather than claiming empirical outcomes, the study positions AI-supported storytelling as a design hypothesis for culturally responsive early childhood education. It argues that AI systems can function as mediational tools between material heritage and children’s imaginative engagement, provided they are developed with pedagogical intentionality, cultural sensitivity, and ethical oversight. The paper concludes by outlining design principles for implementing AI-driven storytelling systems in museums and classroom contexts and identifies the need for future empirical validation in real educational settings. Full article

Background: Early childhood oral health remains a major public health concern in Thailand despite the implementation of preventive oral health programs. Understanding the factors influencing oral health care system effectiveness is essential for improving oral health outcomes among preschool children. This study aimed to assess oral health care system factors and identify determinants associated with the effectiveness of oral health care services for preschool children in child development centres under local administrative organizations in Ubon Ratchathani Province, Thailand. Methods: A cross-sectional analytical study was conducted among 270 stakeholders involved in the preschool oral health care system, including administrators, teachers, health professionals, village health volunteers, and parent representatives. Data were collected using a structured questionnaire developed based on the Input–Process–Output framework. Oral health outcome data were obtained from routine dental examination records of 498 preschool children. Descriptive statistics, Pearson’s correlation analysis, and multiple linear regression were used to analyse the data. Results: Overall oral health care system effectiveness was rated at a high level (mean = 4.01, SD = 0.44). Service delivery processes showed the highest mean score (mean = 4.19, SD = 0.39), while monitoring and evaluation activities demonstrated the lowest performance. The prevalence of dental caries among preschool children was 57.83%. Multiple linear regression analysis identified service delivery processes (β = 0.239, p < 0.001) and home visits by public health and dental personnel (β = 0.165, p = 0.006) as significant predictors of oral health care system effectiveness. The final model explained 11.1% of the variance in system effectiveness (R² = 0.111, p < 0.001). Conclusions: The effectiveness of oral health care systems for preschool children was primarily influenced by the quality of service delivery processes and community-based outreach activities. These findings indicate that strengthening service implementation and home-visit programs may enhance oral health system effectiveness in child development centres operating within decentralized local government settings. Full article

Executive functions (EFs) are foundational for early learning and school readiness. Interventions that couple motor engagement with explicit cognitive demands may offer an efficient approach to support EFs during preschool years. This exploratory randomized controlled trial examined the preliminary effects of an 8-week Playful Physical Activities (PPA) program on EF and school readiness. Preschool children were randomized to (i) PPA, a structured program integrating executive challenges (response inhibition, working memory, and planning) into movement games, or (ii) an active control receiving the regular physical education curriculum (3 sessions/week, 60 min/session, 8 weeks). Outcomes were assessed before and after the intervention and included Go/No-Go error rate, BVMT-R immediate and delayed recall, RCFT copy score, and school readiness domains (mathematical, linguistic, and social competence). Group × Time effects were tested using mixed ANOVA and summarized with partial eta squared (η²p). Between-group post-test differences were quantified using Hedges’ g. PPA was associated with greater pre-to-post improvements relative to control in attentional control/inhibition (Go/No-Go errors: η²p = 0.134; g = −1.78) and visuospatial organization/planning (RCFT copy: η²p = 0.307; g = 1.36). Visuospatial memory outcomes showed very large interaction effects (BVMT-R immediate η²p = 0.937, g = 5.14; delayed η²p = 0.854, g = 4.10), but these values are exploratory and should not be emphasized as the primary evidence for cognitive improvement because the BVMT-R was used as a non-normed raw-score index outside its validated age range in this preschool sample. School readiness indicators showed favorable changes across mathematical, linguistic, and social competence (η²p = 0.514, 0.385, and 0.337; g = 1.95, 2.05, and 1.31, respectively). Overall, these preliminary findings suggest that cognitively enriched movement may support EF-related performance and school-readiness indicators, but they should not be interpreted as definitive proof of efficacy. Larger prospectively registered trials with balanced groups, age-appropriate outcome measures, and stronger fidelity documentation are needed before firm recommendations can be made. Full article

Playground safety for preschool and early elementary school children has become an increasingly important issue for families and local communities. In semi-open playground environments, direct supervision by caregivers is often difficult, while conventional positioning approaches may be costly, infrastructure-dependent, or unreliable due to frequent signal obstructions. This study presents an integrated low-cost monitoring system that combines commercial BLE beacons, a single smart device installed in the playground, a push-notification server, and a caregiver smartphone application to detect children’s entrance and exit events and visualize their playground usage logs. Rather than proposing a new localization algorithm, the main contribution of this work is the practical system integration and field validation of BLE-based entrance/exit detection in semi-open playground settings. The smart device continuously scans beacon RSSI values, applies Kalman-filter-based smoothing and threshold-based state transitions, and transmits detected events to the server, where daily, weekly, and monthly statistics are generated and visualized for caregivers. Field experiments conducted at five real playgrounds showed that the proposed system achieved over 99% entrance/exit detection accuracy with an average response time of less than 7 s. These results demonstrate that reliable playground entry/exit monitoring can be implemented at low cost, with simple infrastructure and practical deployment in residential environments. Full article

Background/Objectives: Early childhood is an important period when growth and adiposity patterns emerge and may persist into later childhood. Children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) face elevated obesity risk. We characterized BMI-for-age z-score (BMIz) trajectories from 24 to 60 months and their child-, caregiver-, and household-level correlates. Methods: This was a secondary analysis of the WIC Infant and Toddler Feeding Practices Study-2 (ITFPS-2) public-use dataset. We analyzed 5,583 BMIz observations from 2,247 dyads; adjusted models used 4,314 observations from 1,738 children. Linear mixed-effects models tested individual, interpersonal, and household predictors. Restriction and pressure-to-eat were lagged, time-varying exposures. Results: Mean BMIz was elevated at all waves (0.46 to 0.56). Obesity prevalence rose from 15.4% to 18.5%. Unconditionally, BMIz was stable from 24 to 48 months and rose by 60 months. Adjusted models linked higher BMIz to higher birth weight, Hispanic or Latino ethnicity, birth complications, maternal overweight or obesity, paternal overweight, prenatal smoking, adolescent maternal age, and lower maternal education. Male sex was associated with lower BMIz. Prior-wave restriction was associated with higher, and pressure to eat with modestly lower, subsequent BMIz. Household indicators showed no independent association. Conclusions: Caregiver and perinatal characteristics and feeding practices were the most consistent modifiable correlates of late-preschool BMIz. These observational, complete-case findings warrant caution. The 48–60-month window may be a promising period to target for WIC-based obesity prevention. Full article

Background/Objectives: Postural stability is considered a key component of motor development during early childhood; however, its specific association with different components of physical fitness in preschool children remains insufficiently explored. This study aimed to evaluate the association between postural stability and physical fitness components in preschool children. Methods: A cross-sectional study was conducted in 134 preschool children. Physical fitness was assessed through lower-limb muscular strength (standing long jump), speed/agility (4 × 10 m shuttle run), cardiorespiratory fitness (20 m shuttle run), and flexibility (sit-and-reach test). Object-control skills and postural stability were evaluated using selected tasks from the Movement Assessment Battery for Children-2. Composite indices were created for object-control skills and postural stability. Multiple linear regression analyses were performed adjusting for age, sex, body mass index (BMI), and object-control skills. Additional analyses included ANCOVA by postural stability tertiles and sensitivity analyses using HC3 robust standard errors, exclusion of influential observations, and bootstrap resampling. Results: Greater postural stability was independently associated with better lower-limb muscular strength (B = 9.49; 95% CI: 4.39–14.60; p ≤ 0.001) and cardiorespiratory fitness (B = 0.27; 95% CI: 0.06–0.49; p = 0.014). An association with speed/agility was observed in the primary model but lost statistical significance in sensitivity analyses. No significant association was found with flexibility. ANCOVA analyses confirmed significant differences across postural stability tertiles for lower-limb muscular strength (p = 0.033) and cardiorespiratory fitness (p = 0.011). Sensitivity analyses supported the robustness of the associations for lower-limb muscular strength and cardiorespiratory fitness. Conclusions: Greater postural stability was consistently associated with better lower-limb muscular strength and cardiorespiratory fitness in preschool children. These findings suggest that postural stability is associated with selected components of physical fitness during early childhood. Longitudinal and intervention studies are needed to clarify the direction and potential implications of these associations. Full article

Th paper describes a low-cost solution forsignificantly increasing the efficiency of color perception testing for visual screening. The target areas are school and preschool children, people taking medical exams, testing in occupational medicine, and military recruitment. The research involved two stages: developing a virtual application for rapid and objective assisted testing of chromatic vision, and effectively testing about 30 subjects, of different social and age categories, for visual screening. We proved not the low cost, but also the high effectiveness of the method. This creates potential for a better way to prevent visual impairments, especially in children. Full article

Background/Objectives: The systematic review aims to highlight the effects of school-based physical activity and nutritional supplementation programs in obese children from preschool to high school, based on randomized controlled trials. Methods: The search strategy was designed based on the PICOS framework. Then, a systematic review of relevant articles was conducted across six databases (Cochrane Library, PubMed, ProQuest, SCOPUS, Web of Sciences and SPORTDiscus) to identify articles that included children from preschool to high school who engaged in physical activity at school and received nutritional supplementation. All the included studies were assessed using the RoB-2 checklist. Results: Of the 234 studies reviewed, six met the inclusion criteria for this systematic review (publication years: 2023–2025). The results revealed highly heterogeneous interventions and mixed outcomes, often influenced by factors such as supplement type, dosage and participant gender. This limited and inconsistent body of evidence underscores a significant gap in the literature concerning the combined effects of school-based exercise and nutritional supplementation in obese youth. Conclusions: Limited evidence suggests mixed results with multi-micronutrient supplementation showing some benefits in boys from resource-limited settings, while several interventions demonstrated no effects. Energy-dense supplementation proved counterproductive. Gender-stratified approaches are recommended, but cautious implementation is warranted given methodological limitations and inconsistent findings. Full article

Background: As a traditional Chinese exercise, Wushu has been shown to effectively promote balance and postural stability in various populations. Preschoolers’ capacity for balance control, including static, dynamic, and dual-task balance, is linked to the later development of stability skills in adulthood. However, studies of Wushu intervention focusing on balance ability and the related physical fitness in preschool children are limited. Objectives: This study investigated the effects of a 10-week Wushu program on static, dynamic dual-task balance and physical fitness in children 5–6 years old. Methods: Seventy-three participants were randomly divided into an intervention (INT, n = 39) and a control (CON, n = 34) group. The INT group participated in a 10-week Wushu program that included three 30 min sessions per week, while the CON group engaged in unstructured free play with purposely designed materials. The three key primary outcomes were dominant-leg stance for static balance, the balance beam walk for dynamic balance, and the center of pressure (CoP) path length obtained via a force platform during dual-task balance testing, in which the participants were instructed to count numbers backward. The five derived primary outcomes were non-dominant-leg stance, CoP ML path length, CoP AP path length, CoP sway velocity, and CoP sway area. Secondary outcomes were physical fitness indicators, including sit and reach, grip strength, standing long jump (SLJ), countermovement jump (CMJ), 15 m zigzag run, double-leg continuous jump, height and body weight. The analysis of the outcomes was conducted using analysis of covariance (ANCOVA) and Pearson correlation. Results: At baseline, the CON and INT groups did not differ significantly. The INT demonstrated significant enhancements in comparison with CON in the dominant and non-dominant-leg stance (p = 0.017 and p = 0.005, respectively), the balance beam walk, SLJ, 15 m zigzag run and double-leg continuous jump (all p < 0.05), along with the mediolateral CoP path length (p = 0.012). A strong correlation was found between the balance beam walk and the double-leg continuous jump (r = 0.55, p = 0.001), and between the balance beam walk and the 15 m zigzag run (r = 0.43, p = 0.015). Conclusions: The present study demonstrates that a 10-week Wushu program significantly enhances preschool children’s static balance, dynamic balance, and mediolateral postural control during dual-task condition. The improvements in dynamic balance are correlated with lower-limb coordination and jumping agility. Full article

Long-term analyses of year changes in preschoolers’ cognitive and affective development are limited. This field-based study examined yearly trends in a multimedia-assisted, theme-based English and Chinese program in South Korean daycare centers (2022–2024). Participants included 112, 120, and 124 children aged 3–5 annually. Changes were analyzed for cognitive (vocabulary/sentence comprehension and expression) and affective (learning interest, confidence, and motivation) domains. Group differences based on duration of enrollment (three years vs. less than three years) were examined among five-year-old children. Significant cognitive gains occurred for both languages across all three years. Affective development was significant for both languages in 2022 and 2023; however, in 2024, significant positive changes persisted for English across all subdomains, while for Chinese, only confidence improved. Correlation patterns varied by year and language; notably, English motivation was significantly associated with selected cognitive domains in the third year. Furthermore, group comparisons indicated that children enrolled for three years demonstrated better performance in both English and Chinese than those enrolled for less than three years, with statistically significant differences particularly evident in sentence expression. These findings underscore the value of developmentally appropriate and engaging learning contexts that foster both the cognitive and affective dimensions of early learning. Full article

Emotional and behavioral problems (EBPs) experienced by children have become an important global health issue requiring immediate attention. Previous studies have shown that parental neuroticism is associated with EBPs in children. However, the mechanisms underlying this association have yet to be fully elucidated. This study examined the relationship between parental neuroticism and preschoolers’ EBPs, focusing on the mediating role of parental emotional distress (e.g., anxiety, depression, and somatization). In addition, to gain a deeper understanding of children’s emotional and behavioral difficulties, this study constructed a comprehensive network of preschoolers’ EBPs to investigate the interconnections among individual symptoms. A total of 1216 Chinese families (M_{children age} = 4.46 years; 47.6% girls) participated in this study, completing the Chinese Big Five Personality Inventory, Brief Symptom Inventory, and Strengths and Difficulties Questionnaire. Data analysis was conducted using structural equation modeling (SEM) and network analysis. The results showed that parental neuroticism was positively associated with children’s EBPs, and this relationship was partially mediated by parental emotional distress. “Constantly fidgeting or squirming”, “stealing from home, kindergarten, or other places”, “often unhappy‚ depressed or tearful”, and “many fears‚ easily scared” emerged as the most central symptoms in the network of EBPs. These findings hold significant implications for enhancing well-being among parents and their preschool children, suggesting that parents should prevent the spread of negative emotions such as anxiety and depression. Timely, targeted interventions focusing on central symptoms of EBPs are essential for promoting children’s mental well-being. Full article