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Children with autism engage in active play in different ways than children who are neurotypical, but their active play behaviors are not well understood. Research with twins and triplets with autism offers a unique opportunity to gain a clear picture of the play behaviors of children with autism because twins and triplets share many similarities (age, access to toys, etc.). Through semistructured interviews, this descriptive phenomenological study aimed to describe the active play behaviors of 19 twins and triplets with autism from the perspective of their parents (N = 9). The interviews revealed two main themes: (a) parents' descriptions of active play and (b) parents' descriptions of social play. The results reveal the diverse active and social play behaviors of twins and triplets with autism; parents described their children's play behavior when engaging in sensory, indoor, outdoor, and organized play. These results suggest that children with autism may be meeting the definition of active play in nontraditional ways. [ABSTRACT FROM AUTHOR]

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a) language and definitions, (b) program information, (c) benefits of PA, (d) barriers to PA, and (e) PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation. [ABSTRACT FROM AUTHOR]

Identifying factors that influence physical activity (PA) among individuals with Down syndrome is essential for PA promotion. Insight can be gained from guardians and health professionals. The purpose of this study was to explore the perspectives of guardians and health professionals on facilitators and barriers of PA in individuals with Down syndrome. Interviews were conducted with 11 guardians (five mothers, four fathers, and two legal guardians) and 11 professionals (four PA specialists, three physical therapists, and four occupational therapists). Grounded theory was applied. Barriers and facilitators fit the levels of the ecological model of health behavior: (a) intrapersonal (perceived rewards), (b) interpersonal (interaction), (c) community (availability of programs), (d) organizational (school systems), and (e) policy (education). Guardians and professionals agreed on the importance of enjoyment, interaction, and programs to promote PA. Differences between groups were identified at the organizational and policy levels. PA in persons with Down syndrome is influenced by interactions between individual and environmental factors. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about how parents' transactions with health and educational professionals shape their experience of these systems, and impact on capacities to support their child with acquired brain injury (ABI). We explored experiences of specific transactions and perceptions of impact. Methods: A focus group and individual interviews were conducted with seven parents of children in the chronic phase of recovery following ABI. Thematic analysis was used to interpret the data. Results: Four superordinate themes were identified: "These Encounters Matter," "A Person not a Number—Interpersonal Skills that Count," "The Blind Leading the Blind," and "Becoming the Backbone." Findings highlighted that these transactions mattered to parents, promoting either distress or empowerment. Positive outcomes were characterized by transactions related to communication, empathy, trust, collaboration, and connection. However, there was a perception of the "blind leading the blind" and that ultimately parents needed to enter such transactions armed with knowledge and their own therapeutic goals. Conclusions: Our findings unpack contextual and transactional elements of parents' experiences with health and education professionals which empower or distress. Understanding and improving these processes is important, given the central role families play in child outcomes following ABI. Implications for clinical practice are discussed. IMPLICATIONS FOR REHABILITATION: Findings suggest encounters with health and education professionals impact parent functioning and enable, or undermine, them in supporting their child with acquired brain injury. Transactional processes between parents and professionals that led to empowering and positive, or disempowering and negative, outcomes were elucidated and professionals are invited to consider these. Training for health and education professionals related to knowledge of childhood acquired brain injury, but also attunement and interpersonal processes for consultations with parents, are highlighted as important. Findings suggest that helping parents develop effective advocacy skills for their child may also be indicated. [ABSTRACT FROM AUTHOR]

Purpose: Physical interventions during subacute rehabilitation have potential to improve functional recovery. This study explored the perspectives of children and adolescents with acquired brain injury (ABI) and their parents with respect to physical rehabilitation during the subacute phase. Methods: Thirteen children and adolescents with ABI and their parents were included and interviewed using semi-structured interviews. Interview transcripts were analysed using inductive thematic analysis approach. Results: Six themes were identified: 1) beliefs of physical rehabilitation, 2) content of physical rehabilitation, 3) tailored care, 4) impact of context, 5) communication and 6) transition. The importance of intensive physical practice was widely supported. The positive can-do mentality was emphasised to create an atmosphere of hope, meaning that every effort would be made to achieve maximum recovery. Intensive involvement of parents is considered essential during subacute rehabilitation including an open and mutual dialogue about the focus of rehabilitation, therapy goals and future participation in their own environment. Conclusions: Our findings highlight the need for an intensive rehabilitation approach, tailored to the individual's needs. The perspectives of children and adolescents and their parents in our study contribute to a better understanding of factors that are important for optimal recovery through physical rehabilitation during the subacute phase. IMPLICATIONS FOR REHABILITATION: Children with acquired brain injury and their parents indicate the potential and thus the importance of intensive physical practice to enhance optimal recovery. Involvement of parents and the potential of their continuous presence during subacute rehabilitation may have a positive impact on the effect of rehabilitation efforts. The positive can-do mentality of rehabilitation professionals creates an atmosphere of hope and is an important requisite to achieve maximum recovery. Open dialogue between clinicians and the family is warranted about the focus of interventions. [ABSTRACT FROM AUTHOR]

Background: While research has emphasized the importance of parental support for LGBTQIA + youth wellbeing, there remains limited understanding of parental experiences with nonbinary children, particularly those prepubescent. This study aimed to explore how parents of nonbinary children ages 5–8 learn to support their child's identity, examining initial reactions, emotional processes, supportive behaviors, societal responses, and associated challenges and rewards. Methods: A qualitative study was conducted using Reflexive Thematic Analysis (RTA) within a framework of ontological relativism and epistemological constructivism. Nine parents of nonbinary children aged 5–8 from the Northeastern United States participated in semi-structured interviews lasting 60–80 min. Questions explored various aspects of parenting nonbinary children, including the child's gender identity, parental feelings, experiences sharing the child's identity, and challenges and rewards of raising a gender-diverse child. The research team, comprising individuals who identify as trans, genderqueer, and nonbinary, employed collaborative coding and thematic development. Results: Four main themes were constructed: (1) Parents hear and support their child's nonbinary identity, this theme highlights immediate acceptance and efforts parents make to affirm their child's gender; (2) Parents learn about ways cisnormative society harms their child, here, parents recognize the societal pressures and barriers their children face; (3) Parents take significant and proactive steps to affirm their child, this theme documents the actions parents take to support their child in environments that invalidate their identity; and (4) Gender is just one aspect of who my child is, this theme reflects on parental insights of gender as just one part of their child's overall personhood. Conclusions: This study provides insights into the experiences of parents supporting young nonbinary children, emphasizing the importance of affirming expressed identity, the parent-child relationship, and proactive support in navigating cisnormative societal structures. Findings highlight the transformative experience of parenting nonbinary children, with parents often challenging their own preconceptions of gender and coming to more nuanced understandings. These results can inform supportive interventions and policies for nonbinary children and their families, and we hope to contribute to a growing body of research that shifts narratives towards joy, resilience, and community in trans and nonbinary experiences. [ABSTRACT FROM AUTHOR]

Introduction and aim: Ethnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents' experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden. Methods: Researchers' engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis. Results: The analysis resulted in three main themes and seven sub-themes representing different aspects of the program's meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls' physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences. Conclusions: The program's activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives. [ABSTRACT FROM AUTHOR]

The importance of parental engagement for children’s outcomes is indisputable. This paper studies whether teacher perceptions regarding parental engagement, their own proficiency, and contact possibilities for parent-teacher communication, as well as school type (by socioeconomic status), teacher, student, and parental characteristics can explain differences in parental engagement and parent-teacher communication. The results show that differences in school type, teacher perceptions regarding parental engagement, teachers’ perceived own proficiency, and contact possibilities are the main reasons for differences in the extent of parental engagement and parent-teacher communication. Teacher characteristics (such as gender and experience), student, and parental characteristics do not seem to play a role. [ABSTRACT FROM AUTHOR]

Background: Children's physical inactivity is a persisting international public health concern. While there is a large body of literature examining physical activity interventions for children, the unique physical activity context of low-density communities in rural areas and smaller urban centres remains largely underexplored. With an influx of families migrating to rural communities and small towns, evaluations of health promotion efforts that support physical activity are needed to ensure they are meeting the needs of the growing populations in these settings. The aim of this community-based research was to explore service providers' and parents' perspectives on physical activity opportunities available in their community and recommendations toward the development and implementation of efficacious physical activity programming for children in rural communities and smaller urban centres. Methods: Three in-person community forums with recreation service providers (n = 37 participants) and 1 online community forum with the parents of school-aged children (n = 9 participants) were hosted. An online survey and Mentimeter activity were conducted prior to the community forums to gather participants' views on the barriers and facilitators to physical activities and suggestions for activity-promoting programs. The service provider and parent discussions were audio-recorded, transcribed verbatim, and analyzed following a deductive approach guided by Hseih and Shannon's (2005) procedure for direct content analysis. A code list developed from the responses to the pre-forum survey and Mentimeter activity was used to guide the analysis and category development. Results: Seven distinct categories related to the existing physical activity opportunities and recommendations for programs in rural communities and smaller urban centres were identified during the analysis: (1) Recovery from Pandemic-Related Measures, (2) Knowledge and Access to Programs, (3) Availability, (4) Personnel Support, (5) Quality of Programs and Facilities, (6) Expenses and Subsidies, and (7) Inclusivity and Preferences. Conclusion: To improve the health and well-being of children who reside in low-density areas, the results of this study highlight service provider and parent recommendations when developing and implementing community-based physical activity programs and interventions in rural and smaller urban settings, including skill development programs, non-competitive activity options, maximizing existing spaces for activities, and financial support. [ABSTRACT FROM AUTHOR]

Summary Objective Methods Results Conclusion Assess longer‐term changes in food habits and anthropometry among Grades 1–2 primary school students from four public schools in Colombo, Sri Lanka, following a 3‐week programme including a classroom‐based motivational storybook discussion and self‐monitoring food diary (FD).This follow‐up study assessed changes from baseline (pre‐intervention) BMI z‐scores and food habits (increased healthy food‐item consumption/decreased unhealthy food‐item consumption reflected by an increase in FD score) and parental perceptions (anonymous questionnaires) among 863 students (aged 6–8 years), between 9 and 12 months after completing the programme (November 2019–February 2020).Food habits showed sustained improvement from baseline mean FD score (baseline vs. follow‐up: 51 ± 23% vs. 67 ± 22%, p < 0.001), with children from all BMI subgroups (underweight [UW], normal weight [NW], overweight [OW] and obesity [OB]) showing a significant increase in FD scores (ranging from 14.1% to 17.2%, p < 0.001). BMI z‐scores increased in children living with UW (−2.85 to −2.21, p < 0.00) and NW (−0.70 to −0.57, p < 0.001), but did not change in children with OW (+1.5 to +1.49, p = 0.83) and OB (+2.85 to +2.21, p = 0.19). Most parents (n = 497, 97.8%) reported satisfaction with programme outcomes.This programme led to sustained improvement in food habits among young primary school children from all BMI categories, increase in BMI towards the median among children living with UW and NW, and stabilization of BMI in children with OW and OB, suggesting it as a useful tool for improving nutritional status of young children in low‐ and middle‐income countries (LMIC) facing the double burden of under‐ and overnutrition. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the online delivery model became the primary mode of education. With multiple pressures on society and families, mental health issues for parents have become particularly pronounced. Most of the current research has focused on the psychological state of education practitioners and children, with little attention to parents' mental health issues. Therefore, this study explored the attitudes and coping styles of parents who experienced the process of their children being taught online over a long period and the factors influencing their mental health. This cross-sectional study was conducted between November 2021 and January 2022, using an anonymous online questionnaire to survey 1500 parents with children aged 6–13 years. The Chinese versions of the Patient Health Questionnaire Depression Scale (PHQ-9), the Parenting Stress Scale (PSS), the General Mental Health Questionnaire (GHQ-12), and the Brief Coping Style Scale (SCSQ), and a related factors questionnaire were used to survey the subjects. The normal distribution of the data was examined using the Shapiro–Wilk method. A multivariate regression analysis was conducted to identify factors significantly associated with parental mental health during the COVID-19 pandemic. Only 30.24% of parents agreed with online classes during the pandemic, and 52.28% used positive coping methods during stressful situations. Multivariate regression models identified significant factors associated with parental mental health: parent's gender, child's grade level, perceived stress about online classes, whether the child has ADHD, positive or negative coping styles, and subjective attitudes of support for online classes or not. The results of the study suggest that as online classes become more socially acceptable, it is necessary to be concerned about the risk of mental illness for parents and develop policies and interventions, especially for parents who adopt negative coping styles and endorse online classes. The focus should be on the stress of online classes on parents, improving the acceptance of online classes and psychological well-being, regulating the way parents deal with their children, and targeting subgroups of children with ADHD symptoms during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Parental mediation (PM) and parental phubbing (PP) are two pivotal factors that influence children's screen media use. This study used response surface analysis to examine the combined effect of PM and PP on screen time among preschool children. A total of 3,445 parents with preschool-aged children participated in this study, providing self-reported data on PM, PP, and their children's screen time (CST). The results revealed that CST decreased when parents enhanced their mediation behaviors and reduced phubbing behaviors in the cases of congruence between PM and PP. In instances of incongruence, reduced screen time was observed when parents exhibited lower frequency in mediating their CST and displayed fewer phubbing behaviors compared with situations where parents mediated their children more frequently but engaged in higher levels of phubbing behaviors. The findings suggest that PM play a significant role in mitigating preschool-aged children's excessive screen time. Moreover, it is critical to establish positive role modeling by reducing PP behaviors. [ABSTRACT FROM AUTHOR]

The home math environment is vital for early math development. Yet, there is limited understanding of how parents translated their attitudes towards helping children learn math (HCLM) into actions to influence their young children's math-related outcomes. Thus, the present study examined whether parents' perceived competence, value, and pressure about HCLM contributed to young children's math competence through parents' interest in HCLM, home math activities, and children's interest in math. One hundred forty-seven parents were surveyed about their attitudes, practices, and their children's math interest. Meanwhile, their children were individually tested on applied math problem solving. Results showed that parents' perceived competence and value about HCLM predicted their interest in HCLM, while parents' pressure about HCLM predicted children's math interest. Parents' interest in HCLM is positively linked to children's applied math problem solving via children's math interest. This study shed light on the importance of promoting parents' positive attitudes towards HCLM. [ABSTRACT FROM AUTHOR]

Children with Type 1 diabetes (T1D) and their parent-caregivers often experience diabetes distress due to the daily demands of diabetes management. Regular screening for diabetes distress is needed to prevent the deterioration of metabolic control and the development of mental health disorders. The aim of this analysis was to examine the psychometric properties of the German versions of the Problem Areas in Diabetes Scale for Children (PAID-C) and for caregiver burden in Parents (P-PAID-C). Data were collected from 136 children aged 7–12 years (46.7% females) and 304 parents (Mage = 42.9 (SD 6.1) years; 78% mothers) by using linguistically translated questionnaires in a multicenter study. Confirmatory factor analysis and correlational analyses were conducted. Results confirmed the two-factor model for the PAID-C and the four-factor model for the P-PAID-C with a slight modification. Cronbach's αs for children and parents were 0.88 and 0.92, respectively. The PAID-C and P-PAID-C scores had small positive associations with HbA1c (rs =.220 and.139, respectively, all p <.05) and strong inverse association with the KIDSCREEN-10 index (r = −.643 and −.520, respectively, all p <.001). P-PAID-C scores increased with increasing depressive symptoms measured in nine-item Patient Health Questionnaire among parents (rs =.534, p <.001). The scores produced by the German PAID-C and P-PAID-C were reliable and valid in measuring diabetes burdens. These German versions of PAID can be utilized to assess diabetes-specific distress and to design interventions for children and their parents experiencing high levels of diabetes distress. Public Significance Statement: Diabetes distress is associated with poor health outcomes; thus, regular screening is recommended as part of a holistic diabetes care model. This analysis confirms that linguistically translated German versions of the Problem Area in Diabetes Scale for Children and Parents are suitable tools for assessing diabetes-specific distress in both groups. These instruments can be of particular value to health care providers, enabling early detection of diabetes distress and tailoring interventions. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the feasibility, acceptability, and preliminary effectiveness of Parenting for Lifelong Health for Parents and Adolescents program in reducing the risk of child maltreatment in Chinese families with adolescents. Methods: A pre-post single-arm pilot trial was conducted in July and August, 2023, and involved 16 parents and 13 teenagers with a mixed-methods design to collect both quantitative and qualitative data. Results: Parents reported enhanced positive parenting and reduced child behavioral problems. Adolescents reported decreased general child maltreatment and emotional maltreatment, along with perceived improvements in positive parenting and parent-child communication. Thematic analyses suggested of tangible benefits for participants, as well as for their family dynamics. Discussion: The program demonstrated promising feasibility, and it was significantly associated with reduced adolescent maltreatment. Further rigorous randomized controlled trials are needed. [ABSTRACT FROM AUTHOR]

Informed by the social ecological model, which asserts that health behaviors and beliefs are the result of multiple levels of influence, we examined factors related to parents' support for in-school COVID-19 mitigation strategies. Using data from a survey of 567 parents/caregivers of public elementary and middle school students in eight Maryland counties, we employed regression models to examine relationships between parent-, child-, family-, school-, and community-level factors and acceptability of mitigation strategies. Acceptance of COVID-19 mitigation strategies was positively correlated with child- and family-level factors, including child racial identity (parents of Black children were more accepting than those of White children, odds ratio [ OR ]: 2.5, 95% confidence interval [CI] = [1.5, 4.1]), parent receipt of the COVID-19 vaccine (OR : 2.4, 95% CI = [1.5, 3.7]), and parent Democrat or Independent political affiliation (compared with Republican affiliation, OR : 4.2, 95% CI = [2.6, 6.7]; OR : 2.2, 95%CI = [1.3, 3.8], respectively). Acceptance was also positively associated with parents' perceptions of their school's mitigation approach, including higher school mitigation score, indicating more intensive mitigation policies (OR : 1.1, 95% CI = [1.0, 1.1]), better school communication about COVID-19 (OR : 1.7, 95% CI = [1.4, 1.9]) and better school capacity to address COVID-19 (OR : 1.9, 95% CI = [1.5, 2.4]). Community-level factors were not associated with acceptance. Child- and parent-level factors identified suggest potential groups for messaging regarding mitigation strategies. School-level factors may play an important role in parents' acceptance of in-school mitigation strategies. Schools' capacity to address public health threats may offer an underappreciated and modifiable setting for disseminating and reinforcing public health guidance. [ABSTRACT FROM AUTHOR]

The use of alcohol and other drugs is a major public health problem in adolescence. The implementation of evidence-based prevention strategies is still scarce in the global south. This study aimed to evaluate facilitators and barriers to the implementation of the Icelandic prevention model of adolescent substance use (IPM) in Chile. We conducted a qualitative study of stakeholders during the implementation process of the IPM in six municipalities of the Metropolitan Region of Santiago, Chile. We convened six focus groups with parents and professionals from schools and municipal prevention teams (38 participants). Recordings were transcribed and submitted to a six-step thematic analysis. The following facilitators emerged: Participants valued the contribution of the IPM to articulate existing programs and teams, its community focus, and the local data obtained through the survey. There were also several barriers: Those included resistance to adopting a foreign model, the tension between generating local strategies and looking for measures to ensure the fidelity of the implementation, socioeconomic differences between and within municipalities, low-risk perception and supervision of parents in Chile, and a culture that generally does not discourage adolescent substance use. Implementation of the IPM was largely accepted by the stakeholders who agreed with the community approach of the model. The main barriers to consider were related to cultural and socioeconomic factors that need to be addressed in further research and may limit the effects of the model in Chile. [ABSTRACT FROM AUTHOR]

Animals are increasingly being utilized to assist with therapies for people with various health conditions. Horses are often used as a mechanism of engagement and development for autistic children and adolescents. Horses offer a unique opportunity for interaction as the child or adolescent can physically ride and interact with the animal, thus creating a therapy that involves contact that is different to other animals. Benefits derived from equine-assisted therapies can be physical, social, behavioral, emotional, sensory, and cognitive. However, a current and specific research gap exists in understanding the potential mental health impacts of horse riding on autistic children and adolescents, as perceived and experienced by their parents, carers, and horse-riding service providers. This scoping review examined research on parents' and service providers' perceptions of the benefits of horse-related therapies, with a particular focus on perceptions of positive mental health impacts. A comprehensive electronic search across PubMed, Scopus and Cumulative Index to Nursing and Allied Health Literature identified 16 articles from 15 studies which met the inclusion criteria. Findings included non-mental health-related benefits (as perceived by parents and service providers), mental health-related benefits (as perceived by parents and service providers), benefits for those other than the child/adolescent, and limitations of equine-assisted therapies. With the increased use of equine therapy, and the mounting evidence of its positive impacts on mental health, it is timely to expand research on how to better harness interventions and maximize the mental health benefits for autistic children and adolescents. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted as a randomized controlled trial to evaluate the technology‐based parent school program. Design: The study was conducted in the well‐child care outpatient clinic of a hospital in Turkey. Data were collected between October 31, 2022 and February 17, 2023. The parent school was prepared based on Meleis' transition theory. Sample: Forty‐eight parents participated in the study. Parents in the intervention group participated in a 10‐week parent school program (five website modules, five online interactive group trainings, and counseling). Measures: Data were collected before the program, after the program, and 1 month after the program. Results: There were increases in the mean scores of the "Parent Skill Assessment Form" and "Skills Assessment Form for the Toddler Development" items in the intervention group compared to the control group. The difference between the groups in the mean scores of the Self‐Efficacy for Parenting Task Index Toddler Scale (1–3 years) was not statistically significant. However, the difference between the times was statistically significant. Conclusion: It was concluded that the technology‐based parent school training program could guide parents with children aged 1–3 years on child‐rearing. Trial registration: It was registered at ClinicalTrials.gov in May 2022 (NCT05370989). [ABSTRACT FROM AUTHOR]

Children and adolescents (henceforth "children") with both attention-deficit/hyperactivity disorder (ADHD) and anxiety experience greater difficulties than children with either alone, though qualitative methodologies are yet to be used to understand the challenges this population experiences. We aimed to explore parent-reported daily impacts of co-occurring anxiety in children with ADHD (ages 8–13 years). Participants were enrolled in an Australian trial evaluating an adapted anxiety intervention and were eligible if their child met diagnostic criteria for ADHD plus separation, social, and/or generalized anxiety disorder. A baseline measure of life impacts associated with child anxiety captured situations parents reported were difficult, due to their child's anxiety. Reflexive thematic analysis of free-text responses (N = 203) facilitated new insights via inductively generating key themes. Three overarching themes highlighted (1) child difficulties with everyday situations and processes due to their anxiety; (2) the nature of the child's anxiety being pervasive and unrelenting; and (3) the strain placed on the child's family system. This study enhances understanding of daily impacts associated with co-occurring anxiety and ADHD and may contribute to an improved understanding of support needs. Results reiterate the need to identify co-occurring difficulties in children with ADHD and support both children and their families. [ABSTRACT FROM AUTHOR]

Background: Parents' conceptualizations of adulthood for their emerging adults with Down syndrome have the potential to impact the transition planning process as families prepare for life after graduation. Aims: This study aimed to explore parent perceptions of the meaning of adulthood for their emerging adults with Down syndrome. Methods: In this qualitative study, we interviewed 11 parents of emerging adults with Down syndrome using phenomenological methodology and analysed these data using thematic analysis. Results: Three topics emerged: (1) Parents' constructions of the meaning of adulthood; (2) Parents' perceptions about the transition to adulthood; and (3) Parents' perceptions of current adult life skills. Ten themes arose out of these topics. Conclusions: Parents expressed ambivalence about the meaning of adulthood for their emerging adults with Down syndrome, sharing that in some ways they were adults and in others they were not. The meaning of adulthood was closely tied to obtained skills, particularly those related to personal safety. [ABSTRACT FROM AUTHOR]

Background: As a group, autistic children with high support needs (with adaptive functioning in the range of an intellectual disability) are at risk of significant literacy difficulties. We investigated the parent‐reported home literacy environment of this group of children. Method: Sixty‐two parents of autistic children (4.5 to 18.25 years) attending an autism‐specific school completed a home literacy survey reporting on their child's: (1) alphabet knowledge, (2) interest in reading, (3) activities/interactions around books, (4) reading ability, and (5) writing ability. Results: We found significant positive correlations between parent‐reported child interest in reading and literacy‐related interactions and skills, but not with child age. Children using spoken words to communicate obtained significantly greater scores on four home‐literacy subscales, but not on reading interest. Conclusions: A better understanding of the home literacy activities of autistic children with high‐support needs is needed to inform educational practices aimed at promoting literacy development in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: India has a significant prevalence of people with intellectual disabilities. Despite their higher prevalence, they receive poor support. Therefore, this review aims to explore the experiences of family carers in providing care for children with intellectual disabilities in India. Methods: A qualitative evidence synthesis was undertaken, searching databases such as MEDLINE, CINAHL, Web of Science, and PsycInfo up to October 2023. Grey literature was also searched for unpublished studies, with two reviewers assessing methodological quality. Eleven eligible studies, mostly qualitative in design, were included in the review. The data synthesis followed a thematic approach. Results: The synthesis found five themes representing family carers' experiences and perspectives. These were 'resilience and acceptance', 'parental response', 'care dynamic', 'preparing for transition to adulthood' and 'parental advocacy'. Conclusion: Family carers hold diverse views, while almost all consider providing care complex and challenging, with few positive experiences. [ABSTRACT FROM AUTHOR]

Participation is one key element of inclusive education. While the inclusion rate in German schools is rising, little is known with regard to children's participation in this context. This study examines the participation of children with and without impairments at three inclusive primary schools in Bavaria. Cross-sectional data was collected in parents and teachers of 124 3rd grade pupils (girls: n = 62, age: M = 9.5 years; boys: n = 62, age: M = 9.6). 27% of the parents stated their children had impairments (4.9% physical, 13.1% mental/ intellectual and 9.0% other/multiple). Participation in school and other life areas ('neighborhood & community', 'home' and 'living activities') was assessed by the 'Child and Adolescent Scale of Participation (CASP)'. Parents and teachers of children with impairments reported significantly lower scores in all CASP subsections and total score. In school, according to teacher rating, all pupils showed the lowest participation scores in educational activities with other children in the classroom and in communicating with children/adults. The results highlight the continuing challenges to reach meaningful participation of all children as a condition for effective inclusive education. This seems to be true not only for school but also for other social contexts. [ABSTRACT FROM AUTHOR]

This study was conducted to measure the digital parenting awareness, attitude and self‐efficacy perceptions of parents of children with special needs and to determine whether they differ according to the disability status of their children. A total of 180 parents of children with special needs from various regions of Turkey participated in the study. This study was conducted using a relational screening model. Data were collected using digital parenting awareness, attitude and self‐efficacy perception scales and analysed using descriptive and correlational statistical methods. The findings revealed that parents had moderate levels of awareness, positive attitudes and self‐efficacy perceptions regarding digital parenting, but these variables showed significant differences according to the disability status of the children. In particular, parents of children with learning disabilities had higher digital parenting awareness than parents of other disability groups. In addition, a positive and significant relationship was found between parents' digital parenting awareness, attitudes and self‐efficacy perception. The findings of this study are important and contribute to both the practical and theoretical perspectives. In applicable terms, this study revealed the needs and expectations of parents of children with special needs regarding digital parenting. Theoretically, this is a rare study that examines the situation and experiences of parents with children with special needs in digital parenting. This study emphasizes the need for further research on digital parenting.Practitioner notesWhat is already known about this topicExisting research underscores the importance of digital parenting in the contemporary era, highlighting the need for parents to navigate the challenges and opportunities presented by technology in child‐rearing.Parental self‐efficacy in managing digital resources has been identified as a crucial factor in promoting children's effective and safe use of technology.Positive parental attitudes towards technology have been associated with healthier digital habits and development in children.What this paper addsThis study contributes to the literature by specifically focusing on parents of children with special needs and recognizing the unique challenges and opportunities they face in the realm of digital parenting.Findings revealed that parents of children with learning disabilities exhibit higher levels of digital parenting awareness, emphasizing the need for tailored interventions and support for different disability groups.The positive and significant relationship identified between digital parenting awareness, attitudes and self‐efficacy underscores the holistic nature of these factors and highlights the potential impact of comprehensive digital parenting programs.Implications for practice and/or policyDevelop targeted digital parenting support programmes that address the specific needs of parents with children with special needs, considering the variations among different disability groups.Advocates of inclusive education policies that incorporate digital parenting education as a vital component, recognizing its significance in the overall well‐being.Recognize the role of both mothers and fathers in digital parenting and design interventions that consider the unique perspectives and challenges faced by each gender.Facilitate collaboration between digital parenting experts and special education professionals to create comprehensive resources and training materials that cater to the diverse needs of children with special needs.Conduct longitudinal studies to assess the long‐term impact of digital parenting interventions on the development, well‐being, and digital literacy of children with special needs. This can inform the refinement of future programs and policies in this domain. [ABSTRACT FROM AUTHOR]

This is the first large-scale study of resources as a form of language management – that is, a way of influencing children's language practices. We introduce the distinction between child-directed resources (i.e. those providing parents with opportunities to engage with their children in the languages they are transmitting) and parent-directed resources (i.e. those providing parents with information about multilingual child-rearing). This study focused on the awareness and use of, as well as the desire for, such resources among Québec-based parents (n = 819) raising infants/toddlers (0-4 years) with multiple languages in the home. Data were collected with a questionnaire. Quantitative data were analyzed statistically, and qualitative data were analyzed using a computer assisted discourse study. We compared parents transmitting at least one immigrant heritage language – usually in addition to English and/or French (HL parents), and parents transmitting only English and French (non-HL parents). Overall, the findings show that non-HL parents were comparatively satisfied with existing child- and parent-directed resources in English and French. By contrast, HL parents had a stronger desire for additional resources in their HLs. All parents desired multilingual resources. The paper discusses the theoretical and practical contributions of this study as well as directions for further research. [ABSTRACT FROM AUTHOR]

Primary objectives were to examine: (1) changes in movement behaviours (i.e., outdoor play (OP), organized physical activity (PA), screen time (ST), sleep) across the first 2 years of coronavirus disease-2019 (COVID-19) among Canadian toddlers and preschoolers, and (2) intrapersonal, interpersonal, community, and policy moderators of change in movement behaviors. Participants were 341 Canadian parents of children (start of study: 1–4 years; 48% female). Participants completed online questionnaires regarding their children's movement behaviours and intrapersonal, interpersonal, and community factors at five time-points before and throughout the pandemic (T1–T5). Data from government websites were also used for some community and policy factors. Linear mixed models were conducted. Compared to pre-COVID-19 (T1): OP was on average 30 min/day higher at T2 and T3; organized PA was on average 62, 44, and 37 min/day lower at T2, T3, and T4, respectively; ST was on average 67, 17, 38, and 52 min/day higher at T2, T3, T4, and T5, respectively; and sleep was on average 30, 36, and 82 min/day lower at T3, T4, and T5, respectively. Significant moderating variables were observed for OP (parental education, parental work inside home, COVID-19 restriction severity), organized PA (children's sex, started kindergarten, nonparental care, parental education, household income, parental employment status, house type, indoor home space and support for PA), ST (nonparental care, parental marital status) and sleep (children's T1 age group, started kindergarten, parental place of birth, parental employment status). All movement behaviors changed across the first 2 years of COVID-19 but patterns and moderators were behaviour-specific. Children from lower socioeconomic status families had the least optimal patterns. [ABSTRACT FROM AUTHOR]

While it's tempting to let drug users — including young adults and adolescents — use in solitude (out of sight, in other words), bear in mind one thing: as unpleasant as it sounds, having naloxone on hand and knowing your teen is using drugs can save his or her life, if someone is there when the drug is administered. [ABSTRACT FROM AUTHOR]

Little is known about care providers' expectations for children with autism spectrum disorders (ASD) and intellectual disabilities (ID) in Ghana. This study used group concept mapping (n = 9) and a quantitative survey (n = 128) to explore and compare service providers' and parents' expectations for children with ASD or ID. Data were analyzed using hierarchical clustering procedures and Multivariate Analysis of Variance (MANOVA). Concept mapping results revealed several expectation clusters, including independence, love and acceptance, equal social rights and opportunities, and professional and caregiver training. MANOVA results revealed significant differences between parents, teachers, and healthcare providers in their perceptions of the importance and likelihood of a child achieving these expectations. Results are discussed in reference to the cultural context, and implications are outlined. [ABSTRACT FROM AUTHOR]

Household chaos has been shown to adversely associate with children's behavioral adjustment. However, the mechanism underlying the relationship between household chaos and children's behaviors is not yet fully understood. The current study proposes mindful parenting as an important mediating and moderating factor in the relationship between household chaos and child problem behaviors. This study also examines cultural influences in this process, comparing the UK and Türkiye, considering both mothers' and children's perspectives on mindful parenting. Cross‐sectional questionnaires were administered to mothers and their children aged 11–16 years in the UK (n = 90; 53.3% girl) and Türkiye (n = 154; 54.5% girl) in 2021. Mother reports of the Confusion, Hubbub, and Order Scale and the Strengths and Difficulties Questionnaire, as well as mother and child reports of Mindful Parenting Inventories for Parents (MPIP) and Children (MPIC), were used to assess household chaos, child problem behaviors, and mindful parenting, respectively. Multiple‐group path analysis revealed that household chaos was a significant indirect predictor of child problem behaviors via mindful parenting in both countries. Furthermore, simple slopes analysis showed that mindful parenting moderated the link between household chaos and child problem behaviors in the UK. Overall, our study sheds light on the importance of micro‐ and macro‐environmental factors and their interactions in children's adjustment. [ABSTRACT FROM AUTHOR]

Early adolescent alcohol use is associated with adverse developmental and health outcomes. Parental knowledge can prevent or delay substance use, while youth behaviors may concurrently influence parenting. More research is needed to examine the role of youth's perceptions of legitimacy of parental authority. This multi‐informant study examined prospective bidirectional effects between parental knowledge and child disclosure alongside youth‐reported alcohol use and perceived legitimacy of parental authority. Data were analyzed across three waves in a community sample of 304 mother–child dyads. A cross‐lagged panel model was estimated using repeated measures of adolescent alcohol use, perceived legitimacy of parental authority, parental knowledge, and child disclosure. Positive reciprocal associations were found in early adolescence between child disclosure and both parental knowledge and perceived legitimacy of parental authority. Legitimacy of parental authority negatively predicted alcohol use across adolescence. Child alcohol use also negatively predicted parental knowledge among mothers in later adolescence. Effects were not reciprocated nor sustained. Novel findings demonstrate that the parental legitimacy beliefs predict reduced alcohol use and have a reciprocal association with child disclosure. Clinical implications to mitigate youth alcohol use initiation, by enhancing parental self‐efficacy and positive parenting, are discussed. [ABSTRACT FROM AUTHOR]

Language ability has been associated with emotion regulation (ER) ability. Children on the autism spectrum have greater rates of language delays and lower ER ability. Despite this, autism traits have not been considered or controlled for in past research. This study therefore examined the association between language ability and ER in young children with and without autism traits. An exploratory analysis was also conducted to examine the types of ER strategies used by young children with autism traits compared with young children without such traits. Ninety mother–toddler dyads participated in the study. Results showed greater receptive language ability was significantly associated with greater parent-reported ER ability both when children with, and children without, autism traits were included in the sample. Furthermore, greater expressive language ability was significantly associated with greater observed ER but only when children with autism traits were excluded from the analysis. These findings have clinical implications for early intervention development for both children with and without autism traits. [ABSTRACT FROM AUTHOR]

Parent education programs are important avenues through which parents of children with developmental delays can learn new skills to help them with child-rearing challenges. However, those in economic hardship often face problems with applying these skills at home where the child's learning and/or behavioral problems commonly occur. In this exploratory qualitative study, we adopted a positive deviance (PD) lens to explore strategies six economically disadvantaged parents used to support their children who were attending special and mainstream preschools concurrently. The PD perspective was first used in public health research with low-resource communities where a few individuals have been observed to adopt uncommon practices and behaviors that enable them to find better ways to prevent social or health problems than their neighbors facing similar constraints and risks. We identified adaptive parental behaviors, thoughts and feelings that helped them navigate daily hassles faced with "dual schooling" their children in Singapore. The study highlights important implications in the development and refinement of future parent training programs. [ABSTRACT FROM AUTHOR]

There are both theoretical accounts and empirical evidence for the fact that, in health communication, narratives (story telling) may have a persuasive advantage when compared with information (the provision of facts). The dominant explanation for this potential advantage is that narratives inhibit people's resistance to persuasion, particularly in the form of counterarguing. Evidence in this area to date has most often been gathered through lab or field experiments. In the current study we took a novel approach, gathering our data from naturally-occurring, non-experimental and organically evolving online interactions about vaccinations. We focus on five threads from the parenting forum Mumsnet Talk that centered on indecision about the HPV vaccination. Our analysis revealed that narratives and information were used by posters in similar quantities as a means of providing vaccination-related advice. We also found similar frequencies of direct engagement with both narratives and information. However, our findings showed that narratives resulted in a significantly higher proportion of posts exhibiting supportive engagement, whereas information resulted in posts exhibiting a significantly higher proportion of challenges, including counterarguing and other manifestations of posters' resistance to persuasion. The proportions of supportive versus challenging engagement also varied depending on the topic and vaccine stance of narratives. Notwithstanding contextual explanations for these patterns, our findings, based on this original approach of using naturalistic data, provide a novel kind of evidence for the potential of narratives to inhibit counterarguing in authentic health-related discourse. [ABSTRACT FROM AUTHOR]

Parents of children with a disability experience elevated levels of stress compared to parents of typically developing children, which represents a risk for their couple relationship. Research on families where a child has a disability is principally based on mothers. More knowledge is needed about the paternal perspective. We conducted semi-structured interviews with seven fathers (aged 36–54 years) of children with a disability (primary school age to early twenties). We analyzed the material using qualitative conventional content analysis, focusing on participants' descriptions of couple relationships. We categorized the participants' descriptions in two main categories: Couplehood and Co-parenting. Throughout the material, partners were described as romantic partners, co-parents, and collaborators. Participants described that couple communication and emotional expression within couples were affected by parenting a child with a disability. Moreover, participants described influence by cultural masculinity norms on their involvement as partners and parents, and on the dynamic within their couple relationships. An uneven division of labor was described. A practice implication is that communication and emotional expression styles within the parental couple should be a key focus when working with families of children with a disability. The findings also suggest more active involvement of fathers in children's health care. [ABSTRACT FROM AUTHOR]

Objectives: The current study aimed to examine: (1.1) causal beliefs about adolescent depression in a sample of adolescents with a clinical depression and their mothers and fathers; (1.2) within‐family overlap of causal beliefs; (2.1) mothers' and fathers' reflected causal beliefs about their child's perspective; (2.2) the accuracy of mothers' and fathers' reflected causal beliefs as related to their child's causal beliefs. Design: Qualitative study using a within‐family approach. Methods: Adolescents with a current clinical depression (MDD/dysthymia; N = 34) and their parents (N = 34 mothers, N = 26 fathers) were independently interviewed about their causal beliefs about the adolescents' depression. Parents were additionally interviewed about their perception of their child's causal beliefs (i.e., reflected causal beliefs). Results: The causal beliefs most frequently mentioned by adolescents, mothers and fathers are: characteristics of the child, social factors, school and various stressful experiences. Parent–child overlap was relatively low, specifically for the themes of bewilderment, cumulative effect and stressful life events, whereas overlap was relatively high for themes of social factors, school and stressful experiences outside of the family. Parents were relatively accurate in their reflected causal beliefs, but tended to underestimate their child's insights into possible causes of their depression. Accuracy of parents' reflected causal beliefs was particularly low for the theme cumulative effect and high for social factors. Conclusions: The various causal beliefs of adolescents and their parents could be used in therapeutic setting. Future research could examine whether (guided) conversations may promote alignment within families and treatment efficacy. [ABSTRACT FROM AUTHOR]

Developmental and epileptic encephalopathies (DEEs) cause disability and dependence affecting both children and the family. The aim of the study was to describe the perspective of parents of children with DEEs regarding the impact of the disease on the family. We carried out a qualitative study based on the interpretivist paradigm. Twenty-one participants were selected using purposive sampling. Parents of children with DEEs of SCN1A, KCNQ2, CDKL5, PCDH19, and GNAO1 variants were included. In-depth interviews and researcher notes were used for data collection. A thematic analysis was performed on the data. Three themes were identified in the results: (a) Assuming conflicts and changes within the couple, causing them to distance themselves, reducing their time and intimacy and leading them to reconsider having more children; (b) impact of the disorder on siblings and grandparents, where siblings perceived DEE as a burden in their lives, felt neglected, and needed to grow and mature alone; conversely, the grandparents suffered for their grandchildren and the parents, in addition to perceiving that their health worsened, and (c) reconciling the care of the child with family life and work; this led the parents to share tasks, abandon or reduce working hours and ask for help. Conclusions: Caring for a child with DEE can result in neglect of social, psychological, emotional, recreational, educational, or occupational needs and obligations that ultimately impact all family members. What is Known: • Children with DEE may develop seizures and experience developmental and cognitive problems. • Caring for a child with DEE has a social and psychological impact on the entire family.

Background: Family‐centred care (FCC), while a core value of paediatric hospitals, has not been well‐studied in the paediatric cardiac intensive care unit (PCICU). Aim: To describe parents' perceptions of FCC provided by nurses in the PCICU during their infant's recovery from neonatal cardiac surgery and explore associations of perceptions of FCC on parent post‐traumatic stress (PTS) 4 months post‐discharge. Study Design: Data obtained from a previously conducted randomized clinical trial (RCT) on telehealth home monitoring after neonatal cardiac surgery at three free‐standing paediatric hospitals were analysed from a subset of 164 parents who completed the FCC Scale at hospital discharge, which measures a parent's experience of nursing care that embodies core principles of FCC. The RCT intervention was provided after hospital discharge, having no influence on parent's perception of FCC. The intervention also had no effect on PTS. Results: Perceived FCC was lowest for items 'nurses helped me feel welcomed' and 'nurses helped me feel important in my child's care'. Having 12%–19% points lower perception of FCC at hospital discharge was associated with parent experience of six or more PTS symptoms, at least moderate PTS symptom severity, or PTS disorder diagnosis at 4‐month follow‐up. Every 10% increase in parental perceptions of FCC was associated with less PTS symptoms (β = −0.29, SE = 0.12; p =.02) and lower PTS symptom cluster scores of arousal (β = −0.18, SE = 0.08; p =.02). Conclusions: Parents who perceived lower FCC during their infants' hospitalization were at increased risk for the development of PTS symptoms, more PTS symptom severity and PTS disorder diagnosis 4‐months post‐discharge. Relevance to Clinical Practice: Nurses have a prominent role to support the implementation of FCC for infants with cardiac defects and their parents. FCC may positively influence overall parent mental health and well‐being, reducing the trauma and distress of the PCICU experience. [ABSTRACT FROM AUTHOR]

Background: There is limited literature regarding family and staff experiences of participating in clinical trials. A qualitative study was embedded in the NAVABronch feasibility trial evaluating the effectiveness of a novel mode of ventilation, neurally adjusted ventilatory assist (NAVA), in infants with acute viral bronchiolitis. Aim: The aim of this qualitative study was to explore the experiences of parents and health care practitioners (HCPs) involved in the NAVABronch Trial. Study Design: Semi‐structured interviews were conducted with two parents and two focus groups were held with six HCPs. Results: Four themes were identified from the focus groups: (1) Creating staff engagement, (2) Education to deliver NAVA, (3) Normalizing NAVA in clinical practice (4) Creating meaningful study outcomes and (5) support of parents during the trial, this theme was generated from the parent interviews. The findings indicated the need for education regarding NAVA for HCPs which would lead to increased confidence, better guidance around the use of NAVA and the need for NAVA to be normalized and embedded into the unit culture. Parents identified the need for further support around preparation for what may happen as a result of the interventions, particularly the weaning of sedation. Conclusion: Our study indicates that staff and parents had no concerns regarding the trial methods and procedures. Relevance to Clinical Practice: Conducting clinical trials in Paediatric Intensive Care Units (PICUs) is challenging and complex. There is limited literature regarding family and staff experiences of participating in clinical trials. Understanding their experiences is crucial in ensuring trial success. [ABSTRACT FROM AUTHOR]

A cross-sectional online survey was undertaken (July–August 2020) to ascertain parents' experiences during the COVID-19 pandemic of being at home with their newborn baby in the first 6 weeks. Participants (n = 371) were mostly biological mothers (n = 369, 99.4%), white British (n = 351, 94,5%), first baby (n = 186, 50%). A statistically significant positive correlation was found between maternal confidence and number of children (rho (369) = 0.295, p <.001) and baby's age at time of participation (rho (369) = 0.139, p =.009). Participants without higher educational qualifications (median = 62, SIQR = 3.5) had statistically significant higher confidence (U = 11831.500, p <.001) than participants with higher educational qualifications (median = 58, SIQR = 2). Parents of babies without health issues at birth (median, 61, SIQR = 3.5) had statistically significant higher confidence (U = 13213.500, p <.001) than parents of babies with health issues at birth (median = 58, SIQR = 5). Three qualitative themes have emerged: the impact of "no partner" restrictions; mixed emotions and lack of information and support. In conclusion, parenting during a pandemic created anxiety and fear, affected by "no partner" restrictions, not being allowed to appointments, scans, and during labor. Some parents were more confident and indicated benefits including heightening bonding with baby and partner during social distancing. IMPLICATIONS FOR PRACTICE: The strain of the pandemic on the mental health and well-being of parents could have a negative impact on future parenting. Healthcare professionals should not underestimate the potential consequences of declining perinatal mental health and should be vigilant to screen, enquire, and refer. Further research on this cohort of parents and children exploring the long-term impact of the COVID-19 pandemic on their ongoing health and wellbeing could be beneficial for future health-care policies and guidance. [ABSTRACT FROM AUTHOR]

This paper provides a discourse analysis of 12 Swedish sexuality education texts intended for preschool practitioners and published between 1969 and 2021. Using Fairclough's framework, we identify three discourses about children's sexual play in relation to children's sexual agency in the texts: child sexuality as encouraged and entangled with adult sexuality; child sexuality as conditioned by what is perceived as normal or abnormal in children; and child sexuality as repressed. These three discourses mainly appear chronologically, but also overlap and connect with one another. When analysis begins from children's position and a theoretical understanding of children's and adults' agency as interdependent, it becomes possible to see how the child is construed as agentic, and how the adult role changes from encouraging sexual play to regulating and monitoring behaviour so that it does not occur. Over time, discourse on young children's sexual play has changed our understanding of both adults and children. Adults are increasingly construed as less knowledgeable in relation to young children's sexuality, and young children have become understood as more dangerous and in need of having their sexuality constrained and civilised. [ABSTRACT FROM AUTHOR]

Recent years have witnessed growing acceptance of gender and sexuality diversity in Australia; yet, its inclusion in the school curriculum remains contentious. Despite evidence to the contrary, there is a commonly held belief that parents consider the inclusion of such topics inappropriate. In the light of this, this paper focuses on an analysis of three qualitative items from an Australian national survey of parents of children attending government-funded schools. Informed by the responses to these questions, we sought to better understand the concept of age-appropriateness present in the discourses deployed by a (minority) number of Australian parents who did not support gender and sexuality diversity-inclusivity in the curriculum. Thematic data analysis identified three key themes used by parents to warrant gender and sexuality diversity curriculum exclusion based on age inappropriateness: namely, inclusion is 'confusing'; children are too 'immature'; and children are too 'easily influenced'. [ABSTRACT FROM AUTHOR]

Both princesses and superheroes are highly salient parts of early childhood in the United States. Because of the gendered nature of both princesses and superheroes, it is possible that they represent a salient facet of children's early gendered environments, and may be associated with other facets of gendered parenting. The aim of this study is twofold: (1) to categorize patterns of young children's engagement with princess and superhero cultures using Latent Profile Analysis (LPA) and (2) to examine whether children's profiles of engagement with princesses and superheroes are systematically associated with indicators of gendered parenting; approval of boy-typed and girl-typed play, parents' implicit attitudes about gender, and parents use of gendered language with their children. Using a sample of 404 parent–child dyads, we completed a Latent Profile Analysis of children's engagement with princesses and superheroes, identifying four profiles, Low Engagement, Princesses, Heroes, and High Engagement. Children's gender was related to their profile of engagement, but indicators of gendered parenting were not predictive of children's profile of princess/superhero engagement, apart from parent approval of girl-typed play. Finally, child gender did not moderate the relationship between indicators of gendered parenting and children's profile of princess/superhero engagement. [ABSTRACT FROM AUTHOR]

Aims: To explore how parents experienced their child with delirium and how parents viewed our delirium management bundle. Design: We conducted a qualitative exploratory descriptive study using semi‐structured individual or dyad interviews. Methods: Twelve semi‐structured interviews with 16 parents of 12 critically ill children diagnosed with delirium in a paediatric intensive care unit were conducted from October 2022 to January 2023 and analysed through a reflexive thematic analysis. Findings: We generated five themes: (1) knowing that something is very wrong, (2) observing manifest changes in the child, (3) experiencing fear of long‐term consequences, (4) adding insight to the bundle, and (5) family engagement. Conclusion: The parents in our study were able to observe subtle and manifest changes in their child with delirium. This caused fear of lasting impact. The parents regarded most of the interventions in the delirium management bundle as relevant but needed individualization in the application. The parents requested more information regarding delirium and a higher level of parent engagement in the care of their child during delirium. Impact: This paper contributes to understanding how parents might experience delirium in their critically ill child, how our delirium management bundle was received by the parents, and their suggestions for improvement. Our study deals with critically ill children with delirium, their parents, and staff working to prevent and manage paediatric delirium (PD) in the paediatric intensive care unit. Reporting Method: The consolidated criteria for reporting qualitative research guidelines were used to ensure the transparency of our reporting. Patient or Public Contribution: No patient or public contribution to the research design. What does this Paper Contribute to the Wider Global Community?: ‐ It increases awareness of the parent's perspective on PD in critically ill children.‐ It shows how PD might affect parents, causing negative emotions such as distress, frustration, and fear of permanent damage.‐ It shows that the parents in our study, in addition to the care bundle, requested more information on delirium and more involvement in the care of their delirious child. [ABSTRACT FROM AUTHOR]

Background: SYNGAP1‐ related intellectual disability (SYNGAP1‐ID) is a rare genetic disorder presenting with intellectual disability (ID), epilepsy, maladaptive behaviours and communication challenges. To date, few studies have assessed the context in which these maladaptive behaviours occur. This study aims to investigate the prevalence of problem behaviours, characterise the behavioural phenotype and use well‐validated measures to explore variables that maintain the behaviours. Methods: Our sample includes 19 individuals diagnosed with SYNGAP1‐ID and their parents. Parents provided information on behaviours that their children engage in, as well as their general behavioural dispositions. Well‐validated measures (e.g., the Repetitive Behaviour Scale‐Revised, Sensory Profile‐2 and Vineland Adaptive Behaviour Scale) were used. A subset of individuals underwent further direct experimental assessment of their problem behaviour to identify the variables maintaining those problem behaviours. Parental reports were analysed using nonparametric statistical analysis; the direct assessments of individuals' problem behaviour were analysed using visual analysis and validated supplemental measures. Results: All 19 individuals engaged in some form of maladaptive problem behaviour. Ratings of ritualistic, sameness and restricted behaviours measured by the RBS‐R were commensurate with individuals diagnosed with idiopathic autism spectrum disorder (ASD) while self‐injurious behaviours were endorsed at a higher level in SYNGAP1‐ID when compared with idiopathic ASD. The problem behaviours in our cohort of patients with SYNGAP1‐ID were maintained by automatic reinforcement and social attention and are positively correlated with atypical sensory responses. Conclusions: Individuals with SYNGAP1‐ID engage in problem behaviours commensurate with other populations (e.g., those with ASD), they exhibit atypical response to sensory stimuli. Problem behaviours were frequently maintained by automatic reinforcement, which may result from a dysregulated sensory system. Children with SYNGAP1‐ID may benefit from strategies used in persons with ASD. [ABSTRACT FROM AUTHOR]

Objective: To describe acute and preventive treatment preferences among youth with migraine and their parents/guardians, and to describe the degree of youth–parent/guardian preference agreement. Background: Headache disorders are common in youth, but little is known about patient and family preferences for headache treatments and outcomes. Methods: In this cross‐sectional survey, a headache treatment preferences questionnaire was co‐created with stakeholders, piloted, and distributed to consenting youth with migraine aged 9–18 years and parents/guardians at a tertiary care headache clinic in western Canada. Response data were summarized for youth and parents/guardians separately, and agreement rates within a youth–parent/guardian pair were compared to a hypothesized agreement rate of 80% for the primary questionnaire items. Results: Seventy‐two youth and n = 94 parents/guardians participated, with n = 63 in youth–parent/guardian pairs. Freedom from pain and rapid relief, and reducing pain severity and headache frequency were top acute and preventive treatment priorities, respectively. More than 90% (69/72) agreed that ≥ 50% reduction in headache frequency was a good target. For both acute and preventive interventions, swallowed pill–based options were most often selected as the preferred first‐line treatment, with neuromodulation selected as the preferred second‐line treatment. The level of agreement within youth–parent/guardian pairs on preferred treatment modalities was lower than hypothesized for acute (63% [40/63], 95% confidence interval [CI] = 52–75%, χ2 = 10.73, p = 0.001) but not for preventive treatment (73% [46/63], 95% CI = 62–84%, χ2 = 1.92, p = 0.166). Regarding which treatment modalities were perceived as most effective, youth–parent agreement was lower than hypothesized for both acute (48% [30/63], 95% CI = 35–60%, χ2 = 41.29, p < 0.001) and preventive treatment (46% [29/63], 95% CI = 34–58%, χ2 = 45.43, p < 0.001). Conclusion: Youth and family preferences aligned qualitatively, but sometimes diverged quantitatively, from typical clinical trial outcomes. The level of agreement within youth–parent/guardian pairs on treatment preferences and perceptions was low. Clinicians should consider both perspectives as they may be divergent. Plain Language Summary: This research looked at what treatment children and adolescents with headaches and their parents prefer when it comes to treating and preventing headaches. The responses showed that there are clear preference patterns, and many times, youth and their parents disagree on what treatment they want. Pediatric clinicians should not assume that both parent and youth will want the same treatment when deciding how to help with headaches. [ABSTRACT FROM AUTHOR]

Previous studies have analyzed the characteristics and prevalence of sleep disturbances among Italian children. Less attention has been paid, however, to the factors involved in sleep disturbances in the first two years of life. The goals of the present study were, therefore: 1) to provide a developmental trajectory of Italian infants' night awakenings and duration during the first two years of life and 2) to analyze which factors affect night awakenings the most over time. Data for this study were collected in the NASCITA cohort. During the well-child visits conducted at 6, 12, and 24 months, pediatricians asked parents to report if the child had any sleep disturbances, especially frequent night awakenings. Univariate and multivariable analyses were performed to test the association between child and family variables and the likelihood of frequent awakenings. 2973 toddlers, out of 5054 initially enrolled newborns, were included in this study; 875 (29.4 %) of whom presented frequent awakenings in at least one visit (peak of prevalence of 19.8 % at 12 months). Bed-sharing (adjusted OR 2.53; 95%CI:2.05–3.12) and living in the northern Italy (aOR 2.25; 95%CI:1.80–2.81) were the variables more strongly associated with an increased likelihood of frequent awakenings in the binomial logistic regression, while sleeping alone was associated with a decreased chance (aOR 0.62; 95%CI 0.45–0.89). A short sleep duration (<11 h/day) was reported for 801 (26.9 %) at 12 months, for 743 (25.0 %) at 24 months of age; in 383 cases, the short sleep duration was reported at both time points. An association was observed between frequent awakenings at 12 or 24 months and short sleep duration (OR 1.23; 95%CI 1.05–1.44 -ꭓ2 6.25, p = 0.012). The current study identified some early predictors of frequent awakenings during the first two years of life. Since optimal sleep practices in children are essential for their development, effective, early interventions must be defined and integrated into pediatric care practices. • Many studies describe the characteristics and prevalence of sleep disturbances among Italian children. • The factors involved in sleep problems in the first two years of life have not been investigated. • Frequent awakenings are reported in at least one visit during the first two years of life for nearly 30 % of the children. • Bed-sharing and living in northern Italy increased the odds of problematic sleep patterns. • Environment, cultural contexts, and parental attitudes need to be considered when analyzing sleep disturbances. [ABSTRACT FROM AUTHOR]

Objective: Little is known about factors associated with treatment trajectory following brief paediatric admissions for children and young people (CYP) admitted for medical complications of their eating disorder (ED). This project aimed to identify possible factors and ways to improve the usefulness of paediatric admissions. Method: Retrospective NHS data was analysed to explore differences between paediatric admissions followed by community‐based care or inpatient psychiatric care. Twelve parents were interviewed to seek feedback about paediatric admissions. Results: Patients who received subsequent inpatient psychiatric care were unwell for longer, had longer paediatric admissions and more crisis team input, were more likely to have had previous admissions, and had higher parent‐reported anxiety and depression. However, the groups did not significantly differ in ED severity. The interviews identified recommendations for improving paediatric admissions, which included improving understanding of EDs, enhancing communication channels, and providing psychological support to parents. Conclusions: Factors linked with illness severity (but not illness severity itself) appear to be associated with the difference between CYP either returning to community‐based care or requiring more intensive psychiatric input. These factors may help clinicians understand who requires subsequent inpatient care, allowing clinicians to target more intensive support earlier and facilitate smoother transitions between services. Highlights: Children and adolescents appeared less likely to require intensive inpatient psychiatric care within 3 months following discharge from a paediatric ward if they had shorter stays in paediatric hospitals, shorter known duration of their eating disorder, less crisis team input, fewer previous paediatric and psychiatric admissions, and lower parent‐rated anxiety and depression.Paediatric admissions are a valuable component of the treatment pathway, and they could be improved further by improving understanding of eating disorders among staff, enhancing communication between services and with families, and providing psychological support to parents.For some families, paediatric admissions seemed to instigate recovery by helping them to both access necessary treatment and realise the severity of their child's health. [ABSTRACT FROM AUTHOR]