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In pediatric settings, the concept of hope is frequently positioned as a fundamental aspect of care and at odds with the possibility and proximity of death. This arguably fosters silence about death and dying in childhood despite evidence indicating the benefits of open communication at the end of life. In this paper, we describe the unspeakable nature of death and dying in childhood, including its conceptual and clinical causes and dimensions, its persistence, and the associated challenges for children and youth facing critical illnesses, their families, and society. We explore how the tension between hope and death can be reframed and apply our analysis to the context of medical assistance in dying for mature minors in Canada. Considering the lack of related literature, this paper offers initial reflections to form a framework for the unspeakable nature of death and dying in childhood and to advance the crucial need for research. [ABSTRACT FROM AUTHOR]

Background: In 2016–17 an important consensus was established regarding the use of the diagnostic label 'developmental language disorder' (DLD) to describe children with a persistent language problem having a functional impact on communication or learning and in the absence of any other biomedical condition. Despite this consensus, past research has revealed ongoing uncertainty regarding when to use the DLD label among speech–language pathologists (SLPs). Aims: In response to this uncertainty, a survey of SLPs was conducted aimed at investigating which types of clinical language profiles, and specific assessment results, were viewed as warranting the diagnostic label DLD. Methods & Procedures: SLPs were presented with 10 childhood language profiles and assessment results. Participants reviewed each case and described if they felt a diagnosis of DLD was warranted, which presented symptoms were consistent/inconsistent with DLD and if further information/testing was desired. Additionally, participants provided details regarding their personal diagnostic processes. Outcomes & Results: Results indicated a general consensus among SLPs as to when the DLD label should be applied. However, free‐text responses demonstrated considerable variation between clinicians regarding symptoms of importance, points of contention/confusion in language profiles and minimal assessment results viewed as necessary in the diagnostic process. Conclusions & Implications: This detailed look at the assessment/diagnostic process for DLD provides valuable insight into how to build further practice consistency in the provision of the diagnostic label DLD, especially in cases of complex language profiles and assessment results. WHAT THIS PAPER ADDS: What is already known on this subject: The label DLD should be used as a diagnostic label to describe children with persistent language problems having a functional impact on communication or learning and in the absence of any biomedical condition. However, in current clinical practice, actual use of the label is inconsistent and SLPs face a number of challenges in diagnosing DLD. What this paper adds to the existing knowledge: This investigation provides clarity regarding which complexities in paediatric language profiles are most challenging for SLPs when determining if a child does/does not have DLD. Additionally, details regarding current assessment beliefs and practices are explored. What are the practical and clinical implications of this work?: By providing a detailed look at the diagnostic processes of practising SLPs, valuable insight is provided into how to build further practice consistency and confidence in the provision of the diagnostic label DLD, especially in cases of complex language profiles and assessment results. [ABSTRACT FROM AUTHOR]

Aim: This paper highlights a new role of Advanced Practice Nurse/Nurse Practitioner as the clinical planning lead in the development of a unique model of care and service delivery for children living with health complexity, in the context of a LEADS leadership framework and related capabilities. Background: The LEADS in a Caring Environment Framework is an effective tool for leadership development and systems change. An experienced Advanced Practice Nurse/Nurse Practitioner hired into a leadership role contributes to system change for a complex population across a large geographic area. Sources of evidence: World Health Organization, Canadian Nurses Association and other websites, academic databases (PubMed and CINAHL) and relevant books were explored, and the expertise and knowledge of the authors and the redevelopment project team were utilized. Discussion: The Advanced Practice Nurse/Nurse Practitioner (first author) shares and reflects on her own lived experience as a leader in the planning for programmes and services at the new centre utilizing the five LEADS domains and related capabilities. Conclusion: The utilization of the LEADS in a Caring Environment Capabilities Framework showcases the strengths and skills of an Advanced Practice Nurse/Nurse Practitioner shifting from direct clinical care to successfully leading system‐level change. By incorporating the LEADS framework into practice, in any setting or role, Advanced Practice Nurse/Nurse Practitioners can both evaluate and develop their leadership skills while positively effecting system transformation. Implications for nursing practice: The LEADS framework fosters ongoing professional development and can be used to measure the added value of Advanced Practice Nurses within an organization. Implications for nursing policy: Advanced Practice Nurses improve outcomes within the health care system. Leaders must consider this evidence in health workforce planning, ensuring that Advanced Practice Nursing roles become fully integrated and are supported in the context of national and regional health systems. [ABSTRACT FROM AUTHOR]

Asthma often starts before six years of age. However, there remains uncertainty as to when and how a preschool-age child with symptoms suggestive of asthma can be diagnosed with this condition. This delays treatment and contributes to both short- and long-term morbidity. Members of the Canadian Thoracic Society Asthma Clinical Assembly partnered with the Canadian Paediatric Society to develop a joint working group with the mandate to develop a position paper on the diagnosis and management of asthma in preschoolers. In the absence of lung function tests, the diagnosis of asthma should be considered in children one to five years of age with frequent (≥8 days/month) asthma-like symptoms or recurrent (≥2) exacerbations (episodes with asthma-like signs). The diagnosis requires the objective document of signs or convincing parent-reported symptoms of airflow obstruction (improvement in these signs or symptoms with asthma therapy), and no clinical suspicion of an alternative diagnosis. The characteristic feature of airflow obstruction is wheezing, commonly accompanied by difficulty breathing and cough. Reversibility with asthma medications is defined as direct observation of improvement with short-acting ß2-agonists (SABA) (with or without oral corticosteroids) by a trained health care practitioner during an acute exacerbation (preferred method). However, in children with no wheezing (or other signs of airflow obstruction) on presentation, reversibility may be determined by convincing parental report of a symptomatic response to a three-month therapeutic trial of a medium dose of inhaled corticosteroids with as-needed SABA (alternative method), or as-needed SABA alone (weaker alternative method). The authors provide key messages regarding in whom to consider the diagnosis, terms to be abandoned, when to refer to an asthma specialist and the initial management strategy. Finally, dissemination plans and priority areas for research are identified. [ABSTRACT FROM AUTHOR]

Training staff and volunteers is an important aspect of successful program implementation. This paper follows Part A of an evaluation of the Special Olympics Canada (SOC) Coaching Young Athletes Training course. Consistent with Kirkpatrick's four-level model of training evaluation, Part A evaluated program leaders' reactions to (level 1) and immediate learning from (level 2) the training. This Part B paper covers "on the job" behavior (level 3). In-depth semi-structured interviews were conducted with youth program leaders (n = 11) from eight provinces. Overall, participants felt that more training related to working with children with autism and promoting positive athlete behavior was needed. The findings also lead us to suggest that program leaders need to develop a more fulsome understanding of how to foster skill mastery, including how to practice the same skill in many and varied ways. [ABSTRACT FROM AUTHOR]

Serious games (i.e., digital games designed for educational purposes) can foster positive learning attitudes and are increasingly used as educational tools. Foodbot Factory is a serious game application (app) that helps children learn about healthy eating based on Canada's Food Guide principles and has demonstrated to increase nutrition knowledge among this group. This paper describes the process followed to expand Foodbot Factory's educational content and integrate immersive technologies and innovative features into the app. The revision process, which was guided by the Obesity-Related Behavioral Intervention Trials model, included the following phases: first, an interdisciplinary team of nutrition scientists, education experts, and computer scientists analyzed data from the original pilot study, recently published literature, and feedback from stakeholders to define areas to improve Foodbot Factory. The five original Foodbot Factory modules were evaluated by the team during weekly meetings, where the educational content, interactive features, and other elements that required updates (e.g., aesthetics and accessibility) were identified. Second, prototypes were created and refined until a final version of Foodbot Factory was approved. Nineteen children tested the updated Foodbot Factory and found it "easy to use" (89%) and "fun" (95%). The new version of Foodbot Factory contains 19 learning objectives, including 13 original and six new objectives. Interactive engagement features in the updated Foodbot Factory included augmented reality incorporated into two learning modules; new mini-games were created, including a memory game; an overhaul of the aesthetics; (e.g., new food images); and accessibility features were included to support users with cognitive and vision disabilities. [ABSTRACT FROM AUTHOR]

Background: Parents seek support on behalf of their transgender and gender nonconforming (TGNC) children. Previous qualitative studies explore the types of support parents seek inside and outside of healthcare settings. Healthcare providers often remain unprepared to effectively provide gender-affirming services to TGNC children and their accompanying parents and may benefit from learning about the support seeking experiences of parents with TGNC children. Aims: This paper summarized qualitative research studies that address the topic of parents seeking support on behalf of their TGNC children. We produced this report for healthcare providers to review to enhance gender-affirming services for parents and TGNC children. Methods: This paper outlines a qualitative metasummary of studies from the United States or Canada with data collected from parents of TGNC children. Data collection included the steps of journal runs, database searches, reference checks, and area scans. Data analysis involved the steps of extracting, editing, grouping, abstracting, and calculating the intensity and frequency effect sizes for finding statements from qualitative research study articles. Results: The results of this metasummary yielded two primary themes, six subthemes, and 24 total findings. The first primary theme of seeking guidance had three subthemes: educational resources, community networks, and advocacy efforts. The second primary theme of seeking healthcare had three subthemes: healthcare providers, mental healthcare, and general healthcare. Discussion: These findings provide information healthcare providers can use to inform their practice. These findings also highlight the importance of providers working collaboratively with parents when serving TGNC children. This article concludes with practical tips for providers. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. Methods: Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. Results: Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. Conclusion: There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth. [ABSTRACT FROM AUTHOR]

• Many mental health disorders first emerge during early childhood or adolescence. • Wait times for children's mental health services have been an international and widespread problem. • Long wait times prolong the emotional distress of children and/or adolescents and their caregivers which can exacerbate mental health difficulties. • The majority of research in this area has been conducted in the United Kingdom and Canada and focus on one waitlist strategy. • Common strategies include alternative service delivery models, increasing system capacity, and improving intake and assessment processes. Background: Although many mental health disorders first emerge during early childhood or adolescence, there is a significant gap between demand and availability of mental health resources, leading to long waitlists for services. Objective: The objective of this scoping review was to identify and characterize the research literature related to the range of waitlist management strategies that have been implemented in outpatient child and adolescent mental health care. Methods: Electronic databases reviewed included: Medline (Ovid), Embase (Ovid), PubMed, PsychINFO, SCOPUS, CINAHL, and ISI Web of Science. Grey literature databases included: OpenGrey, Conference Papers Index, and Proquest Digital Dissertations. Articles were screened by two reviewers in two steps: first by title and abstract, then full text level. Data were extracted using an a-priori developed data extraction framework, which was piloted and modified iteratively. Results: A total of 119 papers related to waitlist interventions in child and adolescent mental health were reviewed. Of these 119 papers, 11% were reviews, summary, or theoretical papers; 8% used a randomized control trial design and 2.5% were trial protocols. Most studies used less rigorous designs, such as uncontrolled before-and- after designs. The large majority focused on just one waitlist strategy each. The most commonly used approaches included: prioritization/triage and initial assessment; brief consultation and advice or brief therapy approaches; group-based models; interim services; increasing capacity; and strategies to decrease non-attendance. Most studies were conducted in the United Kingdom or Canada. Discussion: While mental health systems are complex, most studies examining waitlist initiatives explored the implementation of single initiatives. It is unlikely that a single waitlist strategy can be effective in managing wait times for children's mental health. Rather, consistent and systemic approaches to address wait times that consider the impact of the reduction approach on the patient, the program, and the community are needed. [ABSTRACT FROM AUTHOR]

With an increasing number of children diagnosed with Autism-Spectrum-Disorder in Canada, this paper focuses on how their mothers, as Asian immigrant women, experience the process of diagnosis and learn to parent their children. By taking two Asian (Korean and Chinese) mothers' critical personal narratives as major data sources, this paper aims to explore the diagnosis process of Autism-Spectrum-Disorder through a sociocultural lens on the intersectionality of (im)migrants and their cultural competence, and argues that their identity (re)construction and learning for parenting take place at the intersectionality of race, gender, class, and disability. This paper highlights possible implications for everyone involved in this 'medical' process, in the context of Canadian or other similar multicultural societies. Asian immigrant mothers usually have to deal with children with Autism-Spectrum-Disorder (ASD) and they have bitter experience of mistreatment tied to race, gender and class. This study reveals how Asian immigrant mothers struggled in their integration to Canadian society as well as their experiences of denial into Canada's medical system. The stories of these two women shed lights on the social and cultural aspects of immigrant mothers' learning strategies, including how they utilize accessible resources and networks for their children's treatment and diagnosis. This paper suggests that policymakers need to consider the social and cultural aspects of diagnosis in immigrant families to better fit their needs and provide them appropriate medical and social support. [ABSTRACT FROM AUTHOR]

Background & Aims: Given that standardized language measures alone are inadequate for identifying functionally defined developmental language disorder (fDLD), this study investigated whether non‐linguistic cognitive abilities (procedural learning, motor functions, executive attention, processing speed) can increase the prediction accuracy of fDLD in children in linguistically diverse settings. Methods & Procedures: We examined non‐linguistic cognitive abilities in mono‐ and bilingual school‐aged children (ages 8–12) with and without fDLD. Typically developing (TD) children (14 monolinguals, 12 bilinguals) and children with fDLD (28 monolinguals, 12 bilinguals) completed tasks measuring motor functions, procedural learning, executive attention and processing speed. Children were assigned as fDLD based on parental or professional concerns regarding children's daily language functioning. If no concerns were present, children were assigned as TD. Standardized English scores, non‐verbal IQ scores and years of maternal education were also obtained. Likelihood ratios were used to examine how well each measure separated the fDLD versus TD groups. A binary logistic regression was used to test whether combined measures enhanced the prediction of identifying fDLD status. Outcomes & Results: A combination of linguistic and non‐linguistic measures provided the best distinction between fDLD and TD for both mono‐ and bilingual groups. For monolingual children, the combined measures include English language scores, functional motor abilities and processing speed, whereas for bilinguals, the combined measures include English language scores and procedural learning. Conclusions & Implications: A combination of non‐linguistic and linguistic measures significantly improved the distinction between fDLD and TD for both mono‐ and bilingual groups. This study supports the possibility of using non‐linguistic cognitive measures to identify fDLD in linguistically diverse settings. What this paper adds: What is already known on the subject: Given that standardized English language measures may fail to identify functional language disorder, we examined whether supplementing English language measures with non‐linguistic cognitive tasks could resolve the problem. Our study is based on the hypothesis that non‐linguistic cognitive abilities contribute to language processing and learning. This is further supported by previous findings that children with language disorder exhibit non‐linguistic cognitive deficits. What this paper adds to existing knowledge: The results indicated that a combination of linguistic and non‐linguistic cognitive abilities increased the prediction of functional language disorder in both mono‐ and bilingual children. What are the potential or actual clinical implications of this work?: This study supports the possibility of using non‐linguistic cognitive measures to identify the risk of language disorder in linguistically diverse settings. [ABSTRACT FROM AUTHOR]

The majority of refugees are children and youth and their integration and life-course transitions are a research priority. This paper examines the timing of refugee children and youths' entrance into the labour market and family formation (marriage/common law union and parenthood). It does so by examining how admission category, knowledge of a host country's official languages, and age at arrival shape their transition to adulthood. Using data from the Canadian Longitudinal Immigration Database and Heckman selection estimation, the paper finds minimal variation in refugee children and youths' entry into the labour market compared to children of other immigrant streams. It also finds that refugee children and youth start forming families at a younger age than children of economic class immigrants, but at an older age than family class children. The analysis also shows limited effects of knowledge of official language prior to arrival while age at arrival has a robust impact on their adulthood transitions. These findings shed light on the unique patterns of life-course transition among refugee children and youth and contribute to a better conceptualization of their experiences relative to children and youth of other immigrants. [ABSTRACT FROM AUTHOR]

Background: The involvement of speech and language therapists (SLTs) within paediatric palliative care (PPC) settings has been recognized within the extant literature. However, there is little understanding of SLT's specific roles and practices when working with this vulnerable cohort of children and their families. As part of a larger body of work to develop consensus‐based recommendations for SLTs working in PPC, it is important to investigate demographic and caseload characteristics. Aims: This exploratory study aimed to gather previously undocumented international demographic data pertaining to SLT service provision, caseload and training in PPC. Additionally, it sought to ascertain the current treatment and assessment approaches of SLTs, and if variations exist in beliefs and practices. Methods & Procedures: An anonymous cross‐sectional survey was designed and reported according to the Checklist for Reporting Results of Internet E‐Surveys (CHERRIES). The online survey consisted of 40 items spanning four domains: (1) demographic information, (2) caseload information, (3) service provision and (4) training and education. SLTs from Australia, Canada, New Zealand, the UK, Ireland and the United States were recruited using a purposive snowball sampling approach. Descriptive analysis of closed‐ended survey responses and content analysis of open‐ended responses are presented. Outcomes & Results: A total of 52 respondents completed the survey. SLTs worked in a variety of PPC settings, with patients of varying age and disease groups. Over 50% of participants reported working in PPC for ≤ 4 years. Genetic disorders (34%), oncology (27%) and neurological conditions (21%) made up a significant portion of respondents' caseloads. Reported treatments and assessment approaches used by SLTs are not unique to a PPC population. Barriers and enablers for practice were identified. A portion of participants did not feel trained and prepared to assess (19.2%) or treat (15.4%) PPC clients. Conclusions & Implications: This study confirms that SLTs internationally have a role in the management of communication and swallowing impairments in a PPC context. However, whether current training and resources adequately support SLTs in this role remains questionable. This paper helps to provide SLTs, administrators, professional associations and tertiary institutions with foundational data to help inform workforce planning, advocacy efforts and training priorities. What this paper addsWhat is already known on the subjectThe published multidisciplinary literature has identified that SLTs have a role in PPC. However, there has been no targeted research investigating the professional characteristics of clinicians in this context, nor any detailed information regarding associated clinician beliefs or management approaches.What this paper adds to existing knowledgeThis study is a snapshot of attributes, practice patterns and beliefs of SLTs who work with a PPC population. It highlights SLT perspectives of education and training, as well as meta‐perceptions of themselves within the multidisciplinary team.What are the potential or actual clinical implications of this work?Data presented in this paper will help to enable SLTs, organizations and associations to augment service provision and determine future professional development priorities within the field of PPC. [ABSTRACT FROM AUTHOR]

This paper draws on studies carried out in Canada (2016-2018) and the UK (2009-18) which explored the experiences of boys and men with Duchenne muscular dystrophy (DMD). Life expectancy with DMD has increased significantly and generations of men lead lives that many did not expect them to be leading. This paper searches our data to see if boys and men with DMD are supported to manage the precariousness of a life shorter than the 'norm'. Our studies had focuses on transition to adulthood, gender, social care, interactions in rehabilitation clinics, and managing conversations about death. The paper discusses how respondents framed DMD within time and the life-course. Our analysis suggests that ableist assumptions about time make the management of a challenging disease such as DMD even more challenging. We found little evidence of boys and men being helped to think through how to plan for a life expectancy that kept shifting. [ABSTRACT FROM AUTHOR]

Background: In this paper we assess the quality of six deliberative stakeholder consultations regarding the implementation of a precision diagnostic for life-threatening pediatric brain tumors. Decision makers who base policy recommendations on the outputs of consultative exercises can presuppose that all deliberants are well informed of the policy issue, that participation in the deliberative process was fair, and that overcoming implementation barriers will necessarily result in practice change. Additional evidence is therefore needed to substantiate the informational quality of the deliberation, measure the equality of participation and study the effects on stakeholder reasoning to appropriately guide uptake of proposed recommendation(s). Methods: Using the DeVries framework for assessing the deliberative quality, we analyzed data from 44 post-consultation evaluation surveys completed by pediatric oncology and palliative care teams at two tertiary pediatric healthcare centers in Canada. We also conducted turn-taking and word-contribution analyses from the text transcriptions of each deliberation to assess equality of participation using descriptive statistics. Results: Deliberants agreed the quality of the deliberative process was fair (median ratings ranging from 9–10 out of 10) and the opportunities to receive expert information and discuss with others about the implementation of a new LDT were helpful (9.5 out of 10). While the session improved understanding of the implementation barriers and opportunities, it had marginal effects on deliberants' reasoning about whether LDTs would change their own clinical practice (3–10 out of 10). Participation was proportionate in at least four of the six deliberations, where no deliberant took more than 20% of total turns and contributed equal to, or less than 20% of total words. Conclusion: The quality assessment we performed demonstrates high informational value and perceived fairness of two deliberative stakeholder consultations involving pediatric palliative care and oncology teams in Canada. Quality assessments can reveal how the process of deliberation unfolds, whether deliberative outputs are the result of equitable participation among deliberants and what, if any, stakeholder voices may be missing. Such assessments should be routinely reported as a condition of methodological rigor and trustworthiness of deliberative stakeholder engagement research. [ABSTRACT FROM AUTHOR]

Limited academic literature has explored the responsibilities of Provincial and Territorial Child and Youth Advocates in Canada. This paper analyses the responsibilities that constitute the role of Canadian Provincial and Territorial Child and Youth Advocates, as well as the forces that impact and shape these responsibilities. A total of 17 participants, including current and former members of the Canadian Council of Child and Youth Advocates (CCCYA) as well as their staff members are included in the study. Findings reveal that individual advocacy, systemic advocacy, investigations into critical injuries and child deaths, as well as educational outreach, constitute the primary responsibilities of the CCCYA. Additionally, at the provincial and territorial level, it is important for advocates to navigate the historical, cultural and political factors that inform discourses surrounding childhood as these factors impact the way advocacy is understood and carried out within these organisations. [ABSTRACT FROM AUTHOR]

Child homicides are rare occurrences, but when they occur, they often cause significant outrage. This paper examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases. Focusing on 533 cases of child homicide between 1985 and 2012 in Ontario, Canada, characteristics of intrafamilial and extrafamilial cases, biological and step/foster parents, and maternal and paternal perpetrators are compared. Results show that characteristics of the child homicide vary depending on the degree of intimacy between victims and perpetrators, including: perpetrator and victim age, weapon use, suicide following the offence, sexual violence and use of excessive force. These findings provide support for developmental victimology and a routine activities theoretical perspective. Suggestions for future research and policy implications are also discussed. 'Examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases' Key Practitioner Messages: Younger children are at a greater risk of homicide from family members, while older children are at a greater risk of homicide from individuals outside the family.Developmental victimology and routine activities theory can contribute to a better understanding of the dynamics between victims and perpetrators in child homicide.Collaboration should take place between researchers, child death review committees, mental health services, social services and policymakers to improve child homicide prevention and intervention initiatives. [ABSTRACT FROM AUTHOR]

Background: Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0–17 years) and present, explain, substantiate, and discuss the final Consensus Statement. Methods: The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada's Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan. Results: Evidence from the literature reviews provided substantial support for the importance of family on children's movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in this pursuit. Conclusion: Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders. [ABSTRACT FROM AUTHOR]

The Government of Canada identifies numeracy as a foundational skill for work, learning, and life. Libraries have historically been champions of literacy; however, the role of libraries in developing numeracy skills is understudied. Specifically, there is a critical gap in studying numeracy programs offered by public libraries. This exploratory study examines the state of numeracy programming at five major urban public libraries in Canada (Calgary Public Library, Edmonton Public Library, Bibliothèques de Montréal, Ottawa Public Library, and Toronto Public Library) to understand the types and varieties of numeracy programs that they offer. The frequency of programs, the intended age range, and the program content are the main foci of this paper. The researchers examined 1166 program listings by scraping programming information from the five libraries' websites. The data was collected for the second week of December 2015 and relied on programming descriptions from libraries' websites. Results showed that a total of 65 programs (5.6% of total programs) covered numeracy related skills. Overall, the options to learn about numeracy concepts were very limited at all of the libraries in the sample. Calgary offered the highest number of children-focused numeracy programs, while Toronto offered the greatest number of adult-focused numeracy programs. "Math/mathematics" was the most common term used to describe numeracy-related programs. This exploratory study underscores the need for greater investigation of numeracy programming in public libraries. [ABSTRACT FROM AUTHOR]

Background: Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. Methods: A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. Conclusions: Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children. [ABSTRACT FROM AUTHOR]

The overall purpose of this study was to explore the lived experiences of sandwich generation (SG) women and the influence multigenerational caregiving had on their health behaviors. The specific purpose of this paper was to examine the roles of SG women, whom are individuals providing care to both their aging parents/in-laws and children (Sinha, Spotlight on Canadians: Results from the General Social Survey: Portrait of caregivers, 2012. Statistics Canada catalogue no. 89-652-X - No. 001, Social and Aboriginal Statistics Division, Ottawa, Ontario, 2013). This study was qualitative in nature and utilized the theoretical orientation of phenomenology. Nine SG women completed a background questionnaire and a semi-structured one-on-one interview. After critically analyzing the data, four salient themes emerged, however, this paper only focused on the theme the role of the caregiver. Five subthemes were developed from this theme: (1) Physical care; (2) 'Sounding board': Emotional aspects of caregiving; (3) Never enough time in the day; (4) Am I a caregiver to my children?; and (5) Transitions and variations in caregiving. These findings provide an in-depth understanding of the role of SG women and the complexities that occur when faced with caregiving. This study hopes to provide more knowledge to support government legislation, sandwich generation caregivers, and healthcare providers. [ABSTRACT FROM AUTHOR]

Although other nation-states have denounced multiculturalism, Canada continues to declare it is a fundamental characteristic of its national identity. However, there is no consensus about how multiculturalism should be defined or how it is implemented in Canada. This paper draws on an analysis of interviews conducted with members of the second-generation Sri Lankan Tamil diasporic community in Toronto, as well as online comments posted in response to articles on protests staged by this community about the end of the Sri Lankan ethnic conflict. This paper argues that there are cleavages among Canadians with respect to how multiculturalism is understood. The diverging perspectives of the multicultural discourse in Canada illustrate that while the diaspora sees multiculturalism as a means to maintain their dual identities and engage in homeland politics, non-Sri Lankan Tamil Canadians conceptualize this form of activism in homeland politics as being disloyal to Canada, thereby questioning their Canadian identities. [ABSTRACT FROM PUBLISHER]

Background: Children with chronic medical conditions often experience limited opportunities for social experiences due to frequent hospitalizations and medical appointments. Computer technology can provide valuable opportunities for social inclusion through online communities. However, moderation has been shown to be an important component of safe and successful use. This paper explores the potential of a social media platform technology, Upopolis, to promote social connection and health‐related management for children with chronic medical conditions, as well as the role of the coordinators who support children's use. Methods: This study conducted qualitative in‐depth, semi‐structured telephone interviews with hospital‐based child life specialists across Canada who acted as coordinators for Upopolis. Thematic analysis was employed on verbatim interview transcripts. Results: Seven Upopolis coordinators (n = 7 female) from across Canada participated in six telephone interviews. Four themes were identified: First, Upopolis offered opportunities for connection (social and emotional) through receiving and giving support to others in similar situations. Second, Upopolis was considered safe and reliable for younger children (under 12) within the broader social media landscape. Third, Upopolis was a helpful resource for children to learn about medical diagnoses and procedures, as well as for expressing their experiences and reducing isolation. Fourth, participants identified that time, misuse of technology, and technical problems were challenges to the successful coordination of Upopolis. Conclusions: Children with chronic medical conditions were reported to use Upopolis to develop a greater social community. Specialized websites such as Upopolis have the potential to offer a safe online social networking opportunity where children can discuss what is happening to them, compared with other mainstream social media platforms. Given the increase in technology use in health and high usage of social media among children generally, these data can potentially inform the development and implementation of other specialist health‐related online platforms for children with chronic medical conditions. [ABSTRACT FROM AUTHOR]

Adequate calcium intake and supply of vitamin D during childhood play important roles in ensuring adequate bone mass gain to achieve optimal peak bone mass. The Healthy Immigrant Children study employed a mixed-method cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3–13 years who had been in Canada for less than 5 years. This paper presents bone mineral content and vitamin D status data along with qualitative data that deepen the understanding of newcomer bone health status. A significantly higher percentage of refugee children (72.3%) had insufficient (<50 nmol/L) or deficient (<30 nmol/L) serum vitamin D compared with immigrants (53.2%). Vitamin D deficiency was most common among ethnic minority girls. Newcomer children with higher intakes of vitamin D, younger newcomer children, and those from western Europe or the United States had higher serum vitamin D levels. Immigrants had significantly higher mean total body bone mineral content compared with refugees. Total body fat, serum vitamin D, calcium intake, height, height by calcium intake, total body fat by calcium intake, and total body fat by height predicted total body bone mineral content levels. Vitamin D deficiency among newcomer children may be related to lack of knowledge regarding children's vitamin D requirements in the Canadian environment, dietary habits established in country of origin, low income that limits healthy dietary choices, and lifestyle habits that limit exposure to sunlight. Results suggest a need to screen newcomer children and pregnant women for vitamin D deficiency and support early intervention. [ABSTRACT FROM AUTHOR]

Objectives/background: This paper outlines the current state of Canadian training, clinical services, research, and advocacy initiatives related to non-respiratory sleep disorders, with a specific focus on insomnia, the most common sleep problem in children.Methods: Information for this narrative review was collected from peer-reviewed publications, web-resources, and personal communications and experiences.Results: It is estimated that approximately one-third of Canadian children and youth present with insomnia, and that this is impacting their physical and mental health, as well as learning in school. Training in pediatric sleep is limited and highly inconsistent within and across disciplines. While there are some publicly and privately funded pediatric sleep services available, these are mostly focused on respiratory sleep problems and are not equally accessible across the country.Conclusions: Pediatric assessment and treatment services for non-respiratory sleep disorders needs to be more integrated into the Canadian health care system. [ABSTRACT FROM AUTHOR]

The Child and Youth Resilience Measure (CYRM) is one of the most popular measures of resilience. In this paper, we investigate the CYRM using Rasch analysis to explore and improve its psychometric properties, leading to a more robust measure of resilience.Cross-sectional data were obtained from a questionnaire administered to n = 408 individuals in Canada aged 11-19 who were participating in the Pathways to Resilience study. Rasch analysis was applied to these data, resulting in the production of a 17-item, 2-subscale CYRM-R, consisting of intra/interpersonal and caregiver resilience subscales. The subscales demonstrated good fit to the Rasch model by satisfying requirements of unidimensionality, good fit statistics and internal reliability, and a lack of item bias and problematic local dependency. The person separation indices also indicated that the subscales had good ability to differentiate between individuals of varying levels of resilience. In sum, the CYRM-R is a 2-subscale, 17-item Rasch-validated measure of resilience with robust psychometric properties. This revised measure is recommended for researchers and practitioners who are interested in measuring resilience across diverse cultures and contexts. [ABSTRACT FROM AUTHOR]

Introduction: Effective home management of childhood asthma by caregivers requires education along with a written asthma action plan (AAP), which should outline clear instructions for treatment during exacerbations. However, a large number of asthma exacerbations continue to be managed in the emergency department (ED) and in hospitals, particularly in Canada. The objective of this study was to assess caregiver management of acute asthma at home following the 2015 Global Initiative for Asthma (GINA) guidelines and to identify factors that may be associated with deviations from these guidelines.Methods: 122 caregivers of children, aged 3-17 years, with physician diagnosed asthma, completed a paper-based questionnaire. Correct caregiver management (defined according to the GINA guidelines) of acute asthma as well as their use of an AAP were assessed.Results: Out of all caregivers, 74.6% incorrectly treated their child's asthma exacerbation in a home setting. Among those who used an AAP, we observed significantly more ED visits (0.9 ± 1.2 versus 0.5 ± 0.9, p = 0.04) and hospitalizations (0.2 ± 0.4 versus 0.0 ± 0.0, p = 0.02) when compared to non-AAP users in the past 1 year.Conclusions: Caregivers of children with asthma in Canada may still lack skills for proper home management of asthma exacerbations. We found a higher number of ED visits and hospitalizations in those using an AAP compared to those who did not use an AAP. These data suggest that current AAPs may not be sufficient for home asthma management. [ABSTRACT FROM AUTHOR]

To reflect on the role of risk-taking and risky play in child development and consider recommendations for the injury prevention field, a symposium was held prior to the November 2013 Canadian Injury Prevention and Safety Promotion Conference. Delegates heard from Canadian and international researchers, practitioners and play safety experts on child development, play space design and playground safety, provision of recreation, and legal and societal perceptions of risk and hazard. The presenters provided multidisciplinary evidence and perspectives indicating the potential negative effect on children's development of approaches to injury prevention that prioritise safety and limit children's opportunities for risky play. Delegates considered the state of the field of injury prevention and whether alternative approaches were warranted. Each presenter prepared a discussion paper to provide the opportunity for dialogue beyond attendees at the symposium. The resulting discussion papers provide a unique opportunity to consider and learn from multiple perspectives in order to develop a path forward. [ABSTRACT FROM AUTHOR]

Recent research and theorizing has characterized contemporary mothering as medicalized, intensive and risky. The rate of diagnosis of children's mental health issues has grown rapidly, particularly since the 90s. This paper examines the construction of mothering in regard to children's behaviours and mental health through an exploratory and qualitative content analysis of the portrayal of advice to mothers in Chatelaine Magazine, the premier women's magazine published in Canada. The time periods chosen for comparison were 1945-1956 and 1990-2010. The first period was selected because it was a time of dramatic changes that occurred in family, occupational and domestic life for women immediately after World War II. The second represents the modern period. The findings of the paper suggest that mothering was intensive, medicalized and risky in both periods although the conceptualizations of problems differed. [ABSTRACT FROM AUTHOR]

Substantial historical research indicates that during World War II Canadian schools were considered optimal sites for fostering nationalistic sentiments in teachers and learners. Policymakers directed educators and students to collect scrap metals, purchase war savings certificates, salute the flag, and undertake marching drills. These wide-reaching directives give the impression that schools were considerably reshaped during the war. Nevertheless, since much of the literature has used official information sources, such as curriculum documents and government missives, it is unclear to what extent teachers implemented such directives. No Canadian scholarship has tapped the memories of former teachers to determine their compliance in promoting nationalistic sentiments and activities. Nor have existing histories categorised activities by geographic area (such as rural versus urban; coastal versus inland) or school level (elementary versus secondary). Thus, the “unity of purpose and experience” implied by some of the literature may be overemphasised. This paper challenges the suggestion that throughout Canada all children and teachers in schools fervently engaged in nationalistic behaviour during World War II. To supplement government perspectives found in newspapers, magazines, curricular documents, and other Department of Education sources, I interviewed two dozen teachers who taught in 40 schools throughout British Columbia between 1939 and 1945. Despite policymakers’ intentions, there were many factors influencing schools’ abilities to support the war effort. These included a community’s geographic proximity or access to centres of larger war-related activity, such as munitions factories or collection stations; the values and social circumstances of families and communities; and teachers’ individual preferences, often reflecting their career stage. [ABSTRACT FROM AUTHOR]

This paper critically examines the professional learning needs called for by educators working to support transgender, non-binary, and gender-creative (trans) youth and makes recommendations for practice. Interviews were conducted with 26 educators (preschool to secondary) who have worked directly with trans students (any child whose behaviour does not match stereotypes for their sex category assigned at birth, or who identifies with a gender different from their sex category assigned at birth). We examine two new concepts related to professional learning and educator preparation that emerged from theorising the data and related literature: pedagogies of exposure and culture of conversation. The limits and possibilities offered by these approaches are critically examined through the research base on teacher learning. Recommendations are made for teacher preparation, professional development and related practices to better create and sustain learning environments that affirm gender diversity. [ABSTRACT FROM AUTHOR]

This paper troubles seductive discourses of Canadian multiculturalism and the centrality of whiteness to national belonging, highlighting how migrant children understand and navigate assimilation. Evolving out of childhood migration stories shared by 12 interviewees in the documentary Twelve, the article addresses the ways ‘childist’ logics are used to separate childhood from the realities of race and racism. In working towards anti‐racist praxis, we address how storytelling challenges adult–child power hierarchies, exposing how childhood continues to be framed as a time of innocence, disconnected from the violence, danger and pain involved in migrating to Anglophone Canada. [ABSTRACT FROM AUTHOR]

Introduction: The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. Methods: A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Results: Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Discussion: Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Conclusion: Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families. [ABSTRACT FROM AUTHOR]

Delivered as one of the keynote addresses at the International Standing Committee on the History of Education (ISCHE) Conference held in Chicago in August 2016, this paper offers a broad review of how the body and embodiment have been incorporated into histories of education. Based on this historiography, I extend three “inspiring provocations” intended to set the stage for new questions, new theorising, and new methods regarding the body in the field. By asking new questions of the past, drawing on innovative theoretical and methodological frameworks, I argue, historians can continue to give proper empirical standing to the body and embodiment in our histories of education. I conclude with a central question: What are the important questions in the history of education that the body might help us to answer? [ABSTRACT FROM PUBLISHER]

Healthy eating campaigns that promote unprocessed foods to children using character licensing and fun appeals hope to offset the aggressive marketing of highly processed, unhealthy foods to children. Such campaigns are equally premised on the assumption that fruits, vegetables, and other whole foods are not desirable enough in the current food environment and must be marketed as child friendly to be appealing. This paper examines how children in Canada classify foods and whether they think of whole, unprocessed foods as ‘for them.’ Children aged 7–12 (n = 183) completed a survey asking them to classify various foods (fruit, vegetables, milk, eggs, beef, whole grains) as for ‘kids’, ‘adults’ or ‘both’. Most children classified these foods as for both adults and kids, suggesting that promotional initiatives to convince children that whole foods are uniquely children’s fare may not be necessary. Given the questionable efficacy of marketing whole foods as fun and ‘for kids,’ alongside the ethical stakes of commercializing childhood, we recommend that public health initiatives reject attempts to market whole foods as kids’ foods. Instead a key opportunity exists to emphasize the message that good food is for everyone – which is the most conducive to a building a healthy food environment and positive food habits across a lifetime. [ABSTRACT FROM PUBLISHER]

The Canadian Government has announced that over 50,000 refugees from the Middle East will be resettled in Canada by 2018. More than one-third of these refugees are expected to be children. The Canadian Paediatric Society has called for the Canadian government to prepare for the influx of these children. This should include addressing developmental, behavioural, and mental health needs. The focus of this paper is the role of paediatricians and family physicians in caring for the developmental health of refugee children, as a means of supporting their developmental and learning potential. The authors suggest the use of EMPOWER (Education, Migration, Parents and Family, Outlook, Words, Experience of Trauma and Resources), a mnemonic checklist they developed for assessing developmental risk factors in refugee children. EMPOWER can be used along with online web resources such as Caring For Kids New to Canada in providing evidence-informed care to these children. [ABSTRACT FROM AUTHOR]

There is a need to identify barriers to participation as well as recruitment strategies to engage minority parents of young children in health-oriented research. This paper offers insights on strategies and challenges in recruiting black immigrant mothers living in Ottawa (Canada) for a community-based health-oriented research project among 6-to-12-year-old children. We recruited 259 mother-child dyads. Most participants were recruited by team members during community events, fairs, religious gatherings, etc. Other successful strategies included referral from participants, community partners, and through research team members' networks. Mass media strategies were mostly ineffective. Instant and meaningful incentives, developing community partnerships, building and ensuring study legitimacy and trust, placing convenience of participants ahead of that of research team members, doing community outreach, and taking contact information on the spot, as well as using word-of-mouth were essential to recruiting. This study clearly indicates the importance of adopting multiple recruitment strategies. [ABSTRACT FROM AUTHOR]

The role of Canadian Child Advocates has been under-researched by academics and civil society alike, and the following paper addresses this knowledge deficit with findings from a graduate study (Bendo, 2016) reviewing their legislative and professional roles through a sociology of childhood lens. The aim was to investigate the Canadian Council of Child and Youth Advocates (cccya), and data was derived through a discourse analysis of legal, policy and media documents, and in-depth interviews with five current and former Advocates. This exploratory, qualitative study employed a critical ethnographic methodology, and findings indicate that child advocacy is a complex phenomenon with ample opportunities, although numerous barriers exist hindering the work and affecting the quality of outcomes. The study's main argument suggests the role of the Advocates is not well understood by Canada's children, youth or the public at large, and may be hampered by a continued lack of cross-national, multisystemic implementation of the United Nations Convention on the Rights of the Child at federal, provincial and territorial levels. [ABSTRACT FROM AUTHOR]

Pediatric Surveillance Units (PSUs) provide a unique model for the study of pediatric eating disorders (EDs). Australia, Britain, and Canada have surveillance programs that have generated valuable epidemiological and clinical data on early-onset eating disorders (EOED). The PSUs represent an important collaborative tool that has helped shape our understanding of EOEDs and offers potential to contribute to decisions regarding health resource allocation and public health policy. This paper reviews the role of PSUs as a unique model to study pediatric EDs and its success in translating the knowledge generated by these programs into improving the health of children and adolescents with EDs worldwide. [ABSTRACT FROM AUTHOR]

Background: The Child and Youth Mental Health (ChYMH) assessment system was developed by interRAI (i.e., an international collective of researchers and clinicians from over thirty countries) in response to the unprecedented need for a coordinated approach to delivery of children's mental health care. Many interRAI instruments are used across Canada and internationally, but the ChYMH represents the first assessment specifically for children and youth. In the present paper, a short overview of the development process of the ChYMH is provided, and then the psychometric properties of several embedded scales on the ChYMH are examined.Methods: Participants included 1297 children and youth and their families who completed the ChYMH after being referred to mental health agencies within Ontario, Canada. In addition, smaller subsets of participants (N = 48-53) completed additional criterion measures, including the Social Skills Improvement System (SSIS), the Child and Adolescent Functional Assessment Scale (CAFAS), the Child Behavior Checklist (CBCL), and the Brief Child and Family Phone Interview (BCFPI).Results: Results demonstrated that the ChYMH subscales had strong internal-consistency (Cronbach's higher than .70), and correlated well with the criterion measures.Conclusions: Findings support the clinical utility of the ChYMH for use among clinically referred children and youth. Implications for children's mental health assessment and practice are discussed. [ABSTRACT FROM AUTHOR]

There is a growing interest in English-speaking jurisdictions, including Australia, North America, Canada, the United Kingdom and New Zealand, about the prevention of sexual abuse perpetrated by children against other children. The aim of this review was to identify opportunities for research, policy and practice which could enhance the prevention agenda relating to the perpetration of sexual abuse by children through conducting a Critical Interpretive Synthesis. Eleven electronic databases were searched in the period from 22 April to 23 May 2013 and included: SocINDEX, Social Services Abstracts, Applied Social Sciences Index and Abstracts, Family and Society Studies Worldwide, Project Muse, PsychINFO, Family and Society Plus, Jstor, Expanded Academic ASAP, Web of Science and Google Scholar. Key individual journals were also searched, including Child Abuse and Neglect and the Journal of Interpersonal Violence, as well as the grey literature. The search was guided by the research question: How could the prevention agenda relating to sexual abuse perpetrated by children be enhanced? The systematic literature search yielded 3323 titles, and 34 of these papers were included in the final synthesis. The authors identified five domains operating in the evidence base: characteristics, causes, communications, interventions and treatments. A synthesising construct emerged from the review: prevention-enhancing interactions. This construct referred to the potential for enhancing the prevention agenda which exists as the evidence domains interact with one another, and with the public health model of prevention. The authors consider this review to be a timely contribution to the current agenda pertaining to sexual abuse perpetrated by children. It provides researchers, policy makers and practitioners in the field with an evidence-informed conceptualisation of opportunities for enhancing prevention work. [ABSTRACT FROM AUTHOR]

Abstract: Stuttering occurs across all languages and cultures. However, the impact of speaking more than one language on assessment and treatment of young children who stutter is not well documented. This paper discusses some of the challenges related to clinical issues pertaining to this population including (a) identifying stuttering in an unfamiliar language, (b) the influence of language proficiency, and (c) treatment of multilingual young children who stutter. The paper is written from the perspective of the author''s experience treating multilingual children who stutter within the context of the linguistic and cultural diversity of Canada, notably in the French speaking Province of Quebec where many children grow up speaking two or more languages in everyday life. Clinical examples will be taken from the evidence-based literature as well as the author''s clinical experience. Educational objectives: After reading this paper, the learner will be able to (1) summarize the literature regarding assessment and treatment of stuttering in young children speaking more than one language, (2) summarize some of the challenges related to this issue and (3) describe some of the findings associated with treatment of bilingual children who stutter and (4) be prepared to apply some of these suggestions in the treatment of bilingual children who stutter. [Copyright &y& Elsevier]

Abstract: Given the raised profile that parenting support and education is currently receiving on government family policy agendas in many nations, this paper reviews the ways in which parenting support and education policies are embedded within eight OECD countries. Drawing out the similarities and differences of policy and practice, and comparing the financial support each country affords to parenting support, it assesses the effectiveness of parenting support programmes in relation to national expenditure and links parenting policy to child outcomes. The paper concludes with some recommendations for policy makers and programme developers. The countries reviewed are: The UK, Netherlands, Canada, Ireland, the US, Finland, Australia and New Zealand. [Copyright &y& Elsevier]

Early child development (ECD) – the development of physical, social–emotional, and language–cognitive capacities in the early years – is a foundation of health, well-being, learning, and behaviour across the life course. Consequently, the capacity to monitor ECD is an important facet of a modern society. This capacity is achieved by having in place an ongoing flow of high-quality information on the state of early child development, its determinants, and long-term developmental outcomes. Accordingly, there remains a considerable need for research that merges community-centred, longitudinal, and linked-data approaches to monitoring child development. The current paper addresses this need by introducing one method of summarising and quantifying the developmental trajectories of British Columbian children at the neighbourhood- or district-level: computing the Community Index of Child Development (CICD) for each geographic area. A simple index that describes change in children's developmental trajectories at the aggregate level, the CICD is computable because of our capacity to conduct individual-level linkage of two population data sets: the Early Development Instrument (EDI), a holistic measure of children's readiness for school which is administered at Kindergarten, and the British Columbia Ministry of Education's Foundation Skills Assessment (FSA), a Grade 4 measure of academic skills. In this paper, we demonstrate: (a) wide variation in the CICDs according to the children's district of residence in Kindergarten; (b) an association of the CICDs with an indicator of the socioeconomic character of the neighbourhoods; and (c) contrasting patterns of neighbourhood convergence and divergence in two different school districts – such that, in some areas, children from high vulnerability neighbourhoods tend to catch up between Kindergarten and Grade 4 whereas, in other areas, they tend to fall further behind. [Copyright &y& Elsevier]

This paper illustrates how human ecological theory and hope theory were used to develop arts-based research tools and program interventions with refugee children in a Canadian inner city context. Building on key ideas such as: the contextualized, reciprocal, and dynamic nature of hope, the paper identifies a series of program activities. These include the use of photographs, a hope quilt, the development of narratives, followed by opportunities for children to share their hope work with others and for parents and other adults to undertake child-focused and hope-based discussions. Policy and program implications for refugee children are then discussed. [ABSTRACT FROM AUTHOR]

The paper briefly reviews the status and trends in physical activity, physical inactivity, and overweight/obesity in Canada; discusses the consequences of these trends; examines evidence that our frame of reference with respect to physical activity and obesity is changing; promotes the importance of getting “back to the basics” as a strategy for enhancing childhood physical activity; and provides suggestions for future research in this area. In addressing these topics, the paper explores and contrasts the lifestyles and characteristics of Old Order Amish and Old Order Mennonite children with children exposed to contemporary modern living. This exploration is used as a model to learn from traditional lifestyles, which were comparatively active and resistant to obesity. The fitness characteristics and physical activity levels of traditional and contemporary groups are compared and demonstrate significant differences among groups. This evidence may provide important insight for informing future physical activity recommendations. Idiosyncrasies of performing research on these traditional-living groups are also provided. Cet article présente brièvement les niveaux de pratique et les tendances au sujet de l’activité physique, de l’inactivité physique, du surpoids et de l’obésité au Canada. Par la suite, on analyse les conséquences et scrute les faits à l’appui du changement du cadre de référence concernant l’activité physique et l’obésité ; puis on insiste sur l’importance de revenir à la base pour inciter les jeunes à la pratique de l’activité physique et on propose des pistes de recherche dans ce domaine. De plus, cet article analyse et compare sous l’angle de ces thèmes les modes de vie des enfants de la société moderne à ceux des enfants du Vieil Ordre Amish et du Vieil Ordre Mennonite. Cette analyse constitue un modèle d’étude du mode de vie traditionnelle caractérisée par sa plus grande pratique de l’activité physique et par sa résistance à l’obésité. Cet article compare la condition physique et le niveau de pratique de l’activité physique selon ces modes de vie et constate des différences significatives. Ces observations pourraient fournir les arguments nécessaires en faveur de recommandations prochaines en matière d’activité physique. Finalement, cet article présente une approche idiosyncratique de la recherche sur ces modes de vie traditionnelle. [ABSTRACT FROM AUTHOR]

This paper focuses on the experiences of children and youth who were born into the Ukrainian Labour Farmer Temple Association (ULFTA) during the 1920s and 1930s. It examines the priorities of the movement's parents and male leaders and their efforts to implement activities that would serve to politicize and impart a strong sense of Ukrainianness in youngsters. It also considers the ways in which young people themselves contributed to the shape of the movement. Children and youth, because of their particular positions at specific intersections of class, ethnicity, age, and gender, experienced the ULFTA in ways that were distinct from their parents. Because of the ULFTA's emphasis on Ukrainian culture, their childhoods were also significantly different from other socialist children. The movement's emphasis on Marxist-Leninism and the class struggle also divided these children from their non-socialist Ukrainian and non-Ukrainian peers. By applying an intersectional perspective to the interwar Ukrainian left, this paper also seeks to broaden our understanding of the movement's connection with the Communist Party of Canada (CPC). The ULFTA and the CPC enjoyed a consistently difficult relationship through much of this period, particularly where Ukrainian cultural expression was concerned. An examination of youngsters' activities illustrates some of the many ways in which the ULFTA leaders and rank-and-file members (including the young people themselves) resisted the CPC's attempts to control the ULFTA and its resources. [ABSTRACT FROM AUTHOR]

This paper challenges the assumptions that women 'care' as a matter of course, that care work is natural, inevitable, and easy - requiring little skill and as a result should not be highly valued or rewarded. It does so by assessing the impact of Quebec's (Canada's) $7/day childcare program on an economically disadvantaged community near the Quebec/Ontario border. This pilot study of mothers and childcare workers marks the first phase of research in the community. This paper looks at some of the care work involved in childcare settings in small-town Quebec. At the same time, the paper aims to show the importance and impact of Quebec's childcare initiative on an economically hard-hit community. It shows that, despite mothers' recognition of the importance of the program to themselves, their children and their community, there is still evidence of the undervaluing of the care work that childcare providers do. [ABSTRACT FROM AUTHOR]

Abstract: Changes in public policy have led to increasing numbers of children with disabilities and complex medical needs being cared for in the homes of Canadians. Little work, however, has explored the ethical implications of these policies. This paper focuses on some of the shortcomings of current policy and describes a developing method for policy analysis with an explicit focus on ethics that could be adopted in other nations. Three forms of analyses—descriptive, conceptual and normative—conducted on Canadian homecare policy documents describe various dimensions of Canadian homecare policy. The descriptive analysis demonstrated that the jurisdiction of homecare services is dispersed across numerous programs and ministries with no single structure for policy implementation and accountability. The needs of children and youth are rarely mentioned in home healthcare policies, but instead are addressed under broader social policies that are focused upon children and family. The conceptual analysis revealed four over-arching themes that represent the predominant elements of a value-structure that underlie homecare policy. They include: (1) home and community care as ideal; (2) the importance of independence and self-care of citizens; (3) family as primary care provider; and (4) citizenship as entitlement to rights and justice. Overall, these themes tend to reflect a neoliberal ideology that shifts the responsibility of care from the state to the individual and his/her family. A normative framework based on critical healthcare ethics is used in the paper to make recommendations to redress the current imbalance between state and family support. For example, including homecare services within the Canada Health Act (CHA) or the development of separate legislation consistent with the principles of the CHA would make it possible to ensure that the principles of universality, accessibility, portability and public administration, as opposed to principles that reinforce competitive individualism, direct the provision of homecare services in Canada. [Copyright &y& Elsevier]

Rationale Living with a chronic illness poses many challenges, especially during the adolescent stage of development. Few studies have explored young people’s experiences of talking about their illness and how they go about deciding if and when they should tell others about their condition. Objective Our study sought the perspectives of Canadian children and adolescents living with inflammatory bowel disease (IBD) to determine how they go about deciding if and when to tell others about their illness. Methods Twenty-five participants with IBD, ranging in age from 10 to 17 years old, were interviewed about their experiences. Results Our participants highlighted that they generally preferred to conceal their illness. However, when they did disclose, they drew on a diverse range of contextual factors such as their knowledge of the illness as well as the severity of their illness, to make the decision. They also highlighted that one of the main challenges they experience is dealing with negative reactions to the news of their illness. This paper presents a decision-making model describing how children decide whether to disclose or conceal their IBD. Conclusion Our study illustrates that for children and adolescents, managing others’ knowledge about their illness has important implications for illness identity management. We argue that knowledge of how children with IBD make disclosure decisions is an important part of understanding the social experience of having IBD, and in creating environments that allow them to adapt to life with IBD. Our study clearly highlights the need for specific programs to be implemented to normalize IBD and to create supportive environments for children and adolescents diagnosed with IBD. [ABSTRACT FROM AUTHOR]