Search Results (170)

Animal-assisted interventions (AAIs) for children with developmental disabilities (DD) have traditionally focused on dogs and horses, with less research on cat-centered AAIs. However, many potential AAI participants prefer, or only have access to, cats. The current Randomized Control Trial (RCT) study evaluated a novel Cat-Assisted Training (CAT) intervention designed to promote healthy behaviors in children, while also strengthening child–cat bonds. Participants included 36 children with DD (ages 8–17 years) and their family cats. Participating pairs were randomly assigned to either the CAT intervention (experimental) group or the waitlist control group. Feasibility was supported by 100% session attendance, a 94.4% post-intervention retention rate, and an 81% average homework completion rate. Participants in the CAT group reported increases in health-promoting activities, such as walking with their cat (p = 0.008), and demonstrated a significant increase in cat care responsibility (p = 0.039). Cats showed an immediate increase in sociability toward their child (p = 0.036), and a higher rate of secure attachment to their child partner at the one-year follow-up compared to baseline (p = 0.031). Overall, this initial study suggests that the CAT intervention represents a promising AAI model, providing empirical support that cats can be active and successful AAI partners for children with DD. Full article

Currently, there is a lack of sufficient research regarding spirituality in the lives of young people in youth care contexts. In this study, youth care refers to various forms of either voluntary or mandatory support and care for young people (children and teenagers) and their educators for growing-up problems, parenting problems, and psychological, psychosocial, and behavioral problems or intellectual disabilities. The available research is not systematically gathered in an overview. Against this background, this article presents a systematic literature review based on the following main research question: What insights can be distilled from scholarly peer-reviewed journal articles published from January 2000–July 2025 regarding spiritual formation in youth care? The results of the review study were based on 41 journal articles. Half of these articles thematize the foster care context. The other articles are spread over other youth care contexts, including psychiatric care, child and youth welfare, residential care, social work, and services for unaccompanied minors. Most of the articles presented empirical research. Three major themes can be defined that connect most articles: (a) the discussion of religion and spirituality as naturally present in the lives of children and the need or right to recognize that dimension and to facilitate continuity in it; (b) the question or the hypothesis that religion and spirituality can promote well-being, including the finding that this does not always appear unambiguous, up to and including attention to the harmful effects of religion and spirituality; and (c) the question of whether and how religion and spirituality can be used more instrumentally in youth care services to provide the best possible care to young people. The article discusses these findings, and recommendations for youth care professionals and follow-up research are presented. Full article

Co-design is a term commonly used to describe involving people with lived experience in program, policy, and research design and its outcomes. However, the implementation of co-design is inconsistent due to a lack of an agreed-upon definition, framework, and set of principles for application. In this paper, the co-authors, as practising policy advocates and co-designers, aim to develop a set of guiding principles for genuine co-design with children and young people with disability in Australia. The paper first synthesises the existing Australian evidence from youth and disability scholarship, best practice approaches, and case studies of co-design projects recently undertaken where the co-authors are based at Children and Young People with Disability Australia, and then validates this evidence base through collaborative autoethnographic reflections of the co-authors’ collective experience in a co-design team. Drawing together themes and insights from this process, we propose four relationally driven guiding principles for genuine co-design that can be applied in Australian as well as international settings: 1. personalised: building trust and safety over time; 2. holistic: embedding co-design across the project lifespan; 3. reflexive: considering and sharing power; and 4. inclusive: prioritising accessibility and diversity. We end with final critical reflections on addressing power relations and ableist structures in genuine co-design with children and young people with disability. Full article

Background: Transgender and gender expansive (TGE) people experience high rates of interpersonal victimization, which has been linked to high rates of post-traumatic stress disorder (PTSD, a highly disabling and under-studied mental illness among TGE people). This systematic review identifies, classifies, critically appraises, and synthesizes the peer-reviewed literature describing the association between interpersonal victimization and post-traumatic stress among TGE people. This review collates what is known about the associations between victimization and PTSD among TGE people and makes recommendations to guide future research and intervention development. Methods: Searches were conducted across five databases (PubMed, Embase, Web of Science, PsycInfo, and CINAHL) following PRISMA guidelines. Inclusion criteria were: English language; peer-reviewed original research; articles describing the association between victimization and PTSD among TGE youth or adults; reporting TGE-specific data. Exclusion criteria were: reviews, commentaries without original data, dissertations or theses, conference abstracts, animal studies, studies without TGE-specific findings, and case studies. Quality appraisal was completed for all studies, which included a discussion of bias. Data extraction was completed by two independent authors, and conflicts were resolved by a third. Data were stratified by gender identity, race or ethnicity, and type of violence for further synthesis. Results: 25 studies were evaluated for design, measure quality, and key findings. Findings were highly consistent across studies: multiple forms of interpersonal violence (e.g., childhood maltreatment, sexual violence, intimate partner violence, and transgender-specific victimization) were significantly associated with PTSD symptom severity or diagnosis across diverse identities and geographic contexts. All studies examining childhood sexual abuse reported significant associations with PTSD outcomes, highlighting early life as a critical period of vulnerability. Samples were disproportionately White and adult, with limited examination of intersectional experiences shaped by race, ethnicity, and socioeconomic status. Discussion: Interpersonal violence-related PTSD among TGE populations reflects a pervasive and systemic pattern of trauma rooted in structural discrimination rather than isolated individual risk. Addressing this inequity requires multilevel prevention and intervention strategies. Future research should prioritize longitudinal designs, culturally responsive measurement tools, and intersectional analyses to inform prevention, clinical care, and policy responses. The majority of studies were cross-sectional designs, so causality cannot be inferred. Additionally, the samples were disproportionately White and adult, which may bias the magnitude of associations reported and limit generalizability to racially and ethnically diverse TGE populations. Although many studies reported race and ethnicity descriptively, none disaggregated violence-related PTSD outcomes by racial or ethnic group within TGE samples, representing a critical limitation for intersectional analysis. Full article

Background/Objectives: Seasonal influenza vaccination is pivotal for protecting high-risk populations, including those with chronic health conditions (CHCs), from severe complications and outcomes. This study aims to describe the sociodemographic characteristics of unvaccinated children (6 months–17 years old) with CHCs, the reasons why vaccine hesitant parents chose not to vaccinate their children, and the factors associated with seasonal influenza non-vaccination among these children. Methods: This cross-sectional analysis used a sub-sample from the 2023 Childhood COVID-19 Immunization Coverage Survey, which captured data between April and July 2023. Parent and child characteristics were explored, using frequencies and proportions. Weighted unadjusted, partially adjusted (with child age and sex at birth), and fully adjusted multivariable quasi-Poisson models were designed to identify socio-demographic factors associated with seasonal influenza non-vaccination. Results: A total of 649/1187 (55%) children with CHCs were unvaccinated against influenza during the 2022–2023 influenza season. Vaccine hesitant parents with unvaccinated children expressed concerns with vaccine effectiveness (39.1%) and safety (27.5%), as did parents who refused vaccination for their child (56.1% and 35.8%, respectively). Unvaccinated parents (RR: 4.549, 99% CI: 4.480, 4.619) and parents with low household income (RR: 1.428, 99% CI: 1.400, 1.456) were more likely to have unvaccinated children, whereas children who received an annual influenza vaccine (RR: 0.097, 99% CI: 0.094, 0.100) and did not have a disability (RR: 0.913, 99% CI: 0.904, 0.922) had a lower likelihood of non-vaccination. Conclusions: These findings highlight the need for renewed messaging and educational resources targeting vaccine hesitancy and misinformation prevalent among parents with vulnerable youth. Full article

Background/Objectives: This cross-sectional study aimed to quantify hope levels in adolescents with chronic musculoskeletal pain (CMP) and examine patient-reported outcomes associated with hope. Methods: This was an exploratory, cross-sectional, secondary analysis of baseline data from a prospective, single-center longitudinal study of 60 youth presenting for an initial evaluation at a pediatric subspecialty pain clinic. Subjects were English-speaking 12–17-year-olds with a diagnosis of CMP, primarily female and non-Hispanic White, with diffuse pain, median pain duration of 2 years, and moderate to severe physical dysfunction. Subjects completed surveys measuring hope (Children’s Hope Scale [CHS]) and patient-reported mental, physical, and overall health. Associations between hope scores (total and each subscale) and patient-reported outcomes were evaluated using Spearman rank correlations. Results: The median CHS score was 20.0 (IQR: 16.5–25.0), indicating slight hope. Patient hope was negatively correlated with depression (r = −0.61), anxiety (r = −0.49), psychological distress (r = −0.52), functional disability (r = −0.43), and pain interference (r = −0.37), but not pain intensity. Adolescents’ hope was positively correlated with resilience (r = 0.74) and overall health (r = 0.55; all p < 0.01). Conclusions: Hope is correlated with various patient-reported health measures in youth with CMP. Although causal inferences are not possible due to the cross-sectional nature of this study, the results suggest that hope may be an important coping mechanism in pediatric chronic pain. Future efforts to incorporate existing resilience coaching programs into usual care may improve hope and health-related quality of life in youth with CMP. Full article

Children with special educational needs and disabilities (SEND) and those defined as ‘neurodiverse’ are significantly over-represented in the English and Welsh youth (juvenile) justice system (YJS). Evidence points to a number of significant challenges in neurodiverse children’s lives before entering the justice system that increase the likelihood of criminalisation. Then, once in the youth justice system, they encounter further challenges that are both harmful and arguably inconsistent with their human rights. This paper discusses research showing that neurodiverse children often have their rights compromised both prior to and throughout their involvement with the youth justice system. The concluding section of the paper will focus on best practices and recent developments in England and Wales that seek to close the rights gap for this group of children. It is hoped that, by considering both the advances and challenges in England and Wales, the paper will provide a useful case study for international jurisdictions seeking to close this gap for neurodiverse children in youth justice systems. Full article

Background/Objectives: Health-related quality of life (HRQoL) is a critical indicator of developmental progress, educational engagement, and psychosocial resilience. By identifying both shared and context-specific differences in HRQoL, we aim to contribute to a more nuanced understanding of well-being that can inform the development of assessment approaches and future research tailored to the diverse contexts in which children with disabilities live and learn. Thus, the purpose of this study is to explore HRQoL and its putative influencing factors among youth with multiple disabilities across two distinct cultural settings, the United States and Iceland. Methods: Participants (N = 26; Icelandic = 50%; Mage = 16.34 ± 2.33 years) completed height, weight, the Test of Perceived Physical Competence (TPPC), Supine-to-Stand (STS), Rapid Assessment of Physical Activity (RAPA), and VISIONS QL. We conducted five, 2 group × 2 sex ANOVA and several independent samples t-tests within groups by sex for our variables of interest. Results: There was a significant difference between Icelandic boys and girls for BMI (p = 0.087, d = 0.65) and STS (p = 0.027, d = 1.04). Conversely, a significant difference was found in the American group between boys and girls for RAPA (p = 0.092, d = 0.81) and TPPC (p = 0.068, d = 0.92). Conclusions: Preliminary findings suggest that patterns in objective and self-reported health indicators may vary by context. These results highlight the importance of considering both measured performance and self-perceived health when examining HRQoL among adolescents with multiple disabilities, while underscoring the need for further research in larger samples to clarify these relationships. Full article

Background: Youth with disabilities remain among the most overlooked groups in global sexual and reproductive health and rights (SRHR) discourses, including in sub-Saharan Africa. Yet, their SRHR needs are often ignored. This reflexive article aims to illuminate and recenter the experiences and perspectives of youth with disabilities living in Gulu City and Gulu District, Northern Uganda, exploring what matters to them regarding SRHR and their broader life aspirations. Methods: We adopted a qualitative, reflexive and participatory approach. Data were collected among six Ugandan young co-researchers with different disabilities (physical, visual, hearing, and albinism), who interacted with two Ugandan research assistants and a Canadian researcher involved in a larger SRHR research project. They engaged in in-person and virtual WhatsApp and Microsoft Teams exchanges over weeks, with the support of three Ugandan Sign Language interpreters. We thematically analyzed data, informed by the Intersectionality-based Policy Analysis and Structural Health Vulnerabilities and Agency frameworks. Results: Our analysis revealed four main findings: (1) the persistent feeling of social discrimination, stigma, and exclusion, including from parents, (2) inaccessible SRHR information and services, and knowledge gaps, (3) gender- and disability-based violence, and (4) youth with disabilities’ aspirations for SRHR and in life. Conclusions: The voices of youth with disabilities in Gulu underscore the value of disability equity-focused research. They reminded us that they are intelligent, capable, and thoughtful citizens with agency whose SRHR and broader well-being must be acknowledged and respected. Their perspectives carry critical implications for SRHR programming, policy, and research. Full article

Young caregivers, defined as individuals under 25 years of age who provide unpaid care to a family member(s) with illness, disability, or age-related needs, remain significantly underrecognized in Canada despite their valuable contributions to the healthcare system. Limited awareness, fragmented services, and adult-centred caregiving infrastructures leave them vulnerable to social isolation, disrupted education, and poor mental health. Unlike the United Kingdom and Australia, Canada lacks a coordinated national strategy to identify and support young caregivers. This qualitative study examines caregiving organizations across multiple Canadian provinces, exploring current practices, barriers, and future visions for supporting young caregivers. Group interviews were conducted with 18 service providers from caregiving organizations in Alberta, BC and Nova Scotia. Four themes emerged through analysis: (1) The Landscape of Existing Caregiving Organizations, (2) Barriers and Challenges to Supporting Young Caregivers, (3) Navigating a Pandemic, and (4) a Journey and Vision Worth Supporting. Organizations reported a strong interest in expanding support for young caregivers with a vision for cross-sector collaboration and school-based outreach. However, challenges such as inadequate funding and a lack of formal recognition limits their capacity in building youth programs. Findings from the study highlight the need for systemic reform, including early intervention models, sustainable funding, and formal recognition of young caregivers within policy frameworks. Addressing these gaps will not only uplift young caregivers, but also strengthen Canada’s broader caregiving and healthcare ecosystem. Full article

Children and adolescents with disabilities experience disproportionate challenges in achieving recommended levels of physical activity (PA) and adequate sleep, two core determinants of health and functional well-being. This systematic review examined associations between meeting PA guidelines and sleep duration among youth with disabilities. Following PRISMA guidelines, MEDLINE, PsycARTICLES, and SPORTDiscus were searched through Spring 2024 for studies assessing PA and sleep in children and adolescents (<18 years) with disabilities using subjective or objective measures. Data were extracted from 28 studies (N = 138,016) and synthesized using qualitative methods and regression-based quantitative analyses to examine the effects of diagnosis category and PA guideline adherence on sleep duration. The diagnosis type was associated with sleep duration, with youth with autism spectrum disorder (ASD) exhibiting shorter sleep than those with physical disabilities. Meeting PA guidelines (≥60 min/day) was associated with longer sleep duration among youth with ASD, but not consistently across other diagnostic groups. Qualitative findings further indicated diagnosis-specific variability, with PA positively associated with sleep outcomes in ASD, attention deficit/hyperactivity disorder, and epilepsy, and mixed associations observed for cerebral palsy and intellectual disability. These findings suggest that PA may support sleep health in specific disability groups. Given persistently low PA participation among youth with disabilities, integrating accessible, diagnosis-specific PA opportunities within school, community, and clinical settings may represent a feasible strategy to improve sleep and overall health. Full article

Inclusive education is at the forefront of transnational policy agendas. Yet, normative, deficit-oriented disability discourses and institutional gaps continue to shape how inclusion is enacted in schools, often displacing extensive and unacknowledged labour onto families, especially mothers. Drawing on feminist theories of invisible work, this article critically examines the everyday labour performed by mothers of disabled children as they navigate inclusive education systems in Alberta, Canada. Situated within a broader collective case study, this analysis asks: What forms of invisible work do mothers undertake in pursuit of inclusion within education systems labelled as inclusive? Semi-structured interviews were conducted with nine mothers of disabled children. Reflexive thematic analysis illuminated four intersecting dimensions of invisible work: (1) working within the system, (2) working to fit the system, (3) crafting system workarounds, and (4) working above and beyond the system. These forms of work reveal how inclusive education systems rely on mothers to bridge the gap between policy rhetoric and lived experiences. Findings illuminate how mothers’ invisible work simultaneously sustains, negotiates, and resists systemic ableism, highlighting the need to recognize and redistribute this work and reimagine inclusion as a shared structural responsibility rather than an individual, maternal pursuit. Full article

The current study explores the social experiences of adolescent and transition-age youths with intellectual disabilities (IDs) and the support mechanisms available to these groups in Saudi Arabia. This study adopts a qualitative methodology with a semi-structured interview constituting the data collection method involving 13 parents with children aged between 11 and 19 years, a critical adolescent period and transition to early adulthood. The results suggest that family, caregivers, community, friendships, and healthcare providers play important roles that impact the quality of life for these groups. The main challenges identified include health-related issues, employment challenges, educational barriers, insufficient services, inadequate community participation, and limited social relationships, with special emphasis on obstacles linked to transition during the 18 to 19-year period when youths must navigate transfers from pediatric to adult services and changes associated with legal rights. This study highlights several reasons it is important to increase awareness and education, while also continuing to improve support systems aimed at dealing with both transition challenges and adolescent needs. The results further illustrate that although support from family provides the foundation for care, systemic changes are needed to promote social inclusion and reduce stigma during critical development periods. The current study contributes to the limited research related to IDs in the context of the Middle East, with special reference to Saudi Arabia. Finally, the discussion highlights several insights that are culturally specific for the development of policy and provision of services associated with the transition from adolescence to early adulthood. Full article

Background/Objective: The COVID-19 pandemic led to a widespread transition to online learning. Yet, it is unclear how this shift in learning format impacted school attendance in adolescents with chronic pain, a group that struggles with school absenteeism. This study compared school attendance and format (e.g., in-person, online) in patients with chronic pain attending an Intensive Interdisciplinary Pain Treatment Program (IIPT) before the pandemic to an age- and gender-matched sample of youth attending the program after the pandemic. Methods: Participants were 226 school aged adolescents (13–18 years; M age = 15.89, SD = 1.46) enrolled in an IIPT before and after the COVID-19 pandemic. Patients admitted before March 2020 (pre-pandemic group; n = 113) were compared to an age- and gender-matched group of patients who were admitted to the IIPT from November 2021 to November 2023 (post-pandemic group = 113). Upon admission to the program, participants completed validated measures of internalizing symptoms and functional disability. They also completed structured questions related to pain and school history. Results: Significantly more patients in the post-pandemic group were attending school through online and home-schooling options (p < 0.01). Youth who attended the IIPT after the pandemic missed fewer school days (p < 0.05) than those who attended before the pandemic. The groups did not differ in functional disability or internalizing symptoms. However, participants in the post-pandemic group who attended online school missed more school days (p < 0.01) and experienced greater functional disability (p < 0.05) than those who attended in person. Conclusions: The findings highlight how the COVID-19 pandemic may lead to sustained changes in the way adolescents with chronic pain attend school, with implications for increased functional disability and school dropout among this vulnerable population. Full article

This study evaluates South Africa’s progress toward achieving SDG 4.5 by examining disparities in educational access and outcomes for vulnerable groups, including girls, children with disabilities, rural populations, and low-income households. The study recognises multidimensional inequalities and develops strategies that promote inclusive and equitable education. The quantitative approach was employed by constructing a composite Educational Equity Index (EEI) using seven indicators: gender parity in primary and lower secondary completion, location-based attainment among adults, gender parity in adult lower secondary education, disability parity in primary completion, gender parity among the poorest quintile, and wealth parity in youth literacy. These indicators were standardised and aggregated to develop the EEI. The study developed a multivariate regression model to identify the most influential parity factors affecting youth literacy outcomes. Data from UNESCO, the World Bank, and national education statistics were sourced. The findings revealed persistent inequities across gender, disability, geography, and economic status, with particularly pronounced disparities in adult participation, rural attainment, and youth literacy among poorer households. While parity in youth literacy and primary education completion has been largely achieved, inequities persist in secondary education completion and adult education. The findings further revealed that upper secondary completion had a strong positive impact on equity outcomes, whereas disparities in adult participation significantly hindered progress. This study conducted a comprehensive, data-driven examination of educational equity in South Africa. By presenting a novel index approach customised to SDG 4.5, it provided fresh insights into multidimensional inequalities and offered actionable evidence for targeted policy interventions. The study contributes to scholarship on inclusive education while highlighting practical pathways for South Africa to accelerate progress toward equity in line with global education commitments. Full article