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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]

Background: The Parental Stress Scale (PSS) is a well-known tool widely used for assessing parenting stress. However, there is a lack of an Arabic-validated version. This study aimed to validate the PSS in Arabic for use with Lebanese individuals, specifically among parents in Lebanon. Methods: A cross-sectional study including 589 parents in Lebanon were performed between May and July 2023, using random sampling of parents from the five Lebanese governorates. The PSS was translated into Arabic and administered using an online survey. The study collected the sociodemographic data of the participants and incorporated supplementary measures such as the Pediatric Symptom Checklist and the InCharge Financial Distress/Financial Well-Being scale. Exploratory and confirmatory factor analyses were conducted to assess construct validity. Reliability was examined using Cronbach's alpha. Convergent validity was tested through Pearson correlations with the Pediatric Symptom Checklist and financial well-being. Results: One item of the PSS items was removed. The factor analysis of the PSS scale showed three factors that had an Eigenvalue over 1, showing that the items converged over a three-factor solution, explaining a total of 64.83% of the variance. The Cronbach's alpha values were 0.838, suggesting a good internal consistency. The CFI was 0.895 and TLI was 0.877. A significantly positive correlation was found between the PSS scale and the Pediatric symptom checklist. No correlation was found between the financial well-being scale and the PSS scale. Conclusion: The PSS scale showed appropriate psychometric properties, with high internal consistency, good construct validity, and adequate concurrent validity, which makes it a short, valid, and efficient tool, valuable for the evaluation of the Parental Stress Scale among parents in Lebanon. [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]

Trauma-informed care (TIC) is a relatively new topic in the Estonian child protection system, but it has become the particular focus of substitute care. The Estonian child protection system focuses on protecting children from maltreatment, and neglects the adult carers' right to adequate information about the child's trauma experience. This makes trauma-informed care vague. This article is based on focus groups conducted for a wider study that aims to develop the basis for a TIC training course for foster parents and staff members working as direct caregivers in residential substitute care. The foster parents and staff members participated in four focus groups, with special attention on their experiences with TIC. The participants eagerly shared their experiences, and thematic narrative analysis was used during the data analysis. The central theme of the participants' stories was the need for information about the child's traumatic past. The findings indicate that a complex interplay exists between the needs of children entering substitute care and the capacity of the foster parents and residential care staff to meet those needs. It is complicated for a child to heal from trauma if the child's past is hidden from their carers. This could result in re-traumatisation and hinder the child from making sense of past trauma. Estonia's child protection system needs greater awareness of the impact of trauma on the child's behaviour and how to help the child heal. This is directly connected to the need for clear and precise information, which is one of the basic rights of the child. [ABSTRACT FROM AUTHOR]

Purpose: We sought to conduct a pilot investigation of the reliability and administration fidelity of a new play-based measure of social communication for infants and toddlers with an autism diagnosis. Method: Our team adapted an existing measure, the Early Communication Indicator (ECI), for use with young autistic children in clinical and research contexts. In this brief report, we detail our adaptation process including administration and scoring of the final adapted measure based on data from a two-phase pilot study with young autistic children (N = 17). Results: This adapted measure, the Early Communication Indicator-Autism (ECI-A), captured a range of scores for the ECI, Initiation of Joint Attention, and Directed Communication in pilot testing. Interrater reliability was moderate to strong across the scored behaviors. Finally, parents were able to administer the ECI-A with high fidelity with support from the research staff. Conclusions: This two-phase pilot study demonstrated promise for the ECI-A as a brief measure of social communication that can be administered by parents and reliably scored by trained staff with limited background in autism assessments. Validation of the ECI-A is presently underway. [ABSTRACT FROM AUTHOR]

Background/Aims: Under-representation of pregnant women, their partners and parents from minority ethnic backgrounds has been reported in research involving the perinatal period. This study's aim was to explore the experiences of parents from minority ethnic groups who participated in research during the perinatal period, focusing on barriers and facilitators to participation. Methods: In-depth qualitative interviews were conducted via Microsoft Teams by all three researchers with a purposive sample of 16 parents. Data were analysed using thematic analysis. Results: Seven overarching themes were identified: motivating factors; unique contributions; language, understanding and access; cultural values, beliefs and practices; lack of time and other commitments; facilitators for participation; and experience of the current study. Conclusions: Understanding motivation for participation is essential to developing recruitment strategies that promote involvement of parents from minority ethnic backgrounds. A clear understanding of research goals and perceived benefits, and maximising access to studies, is likely to result in improved recruitment. Implications for practice: Ways to encourage research participation from parents in minority ethnic groups include using a range of advertising techniques and venues, offering a choice of time and place for activities and alternative methods of data collection, and disseminating information on available studies in early pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the influence of socioeconomic deprivation on language and developmental outcomes in toddlers with cleft palate with or without cleft lip (CP ± L). Other factors known to influence language outcomes were also considered, including home language history, history of hearing problems, syndromic diagnoses, and sex. Method: A multicenter, cross-sectional study design was conducted. Data for 566 16-month-old toddlers with CP ± L were collected from 17 outpatient cleft palate clinics located throughout the United States. Outcome measures included the MacArthur-Bates Communicative Development Inventories, LENA Developmental Snapshot, age at first word as reported by the caregiver, and the Ages and Stages Questionnaires-Third Edition (ASQ-3). Multivariable linear or logistic regression was used to determine the influence of socioeconomic deprivation, as measured by the Area Deprivation Index, on language and developmental outcomes. Results: Greater socioeconomic deprivation significantly predicted poorer language outcomes in toddlers with CP ± L, including receptive vocabulary words (p = .02), expressive vocabulary words (p = .02), and late-developing gestures (p = .02). Additionally, toddlers from less affluent neighborhoods produced their first words significantly later than their counterparts living in more affluent areas (p < .01). Lower maternal education levels predicted significantly increased risk for problem solving delays (p < .01), and patients with subsidized insurance were at significantly increased risk for personal-social delays on the ASQ-3 (p < .01). Conclusions: Children with CP ± L are susceptible to developmental delays associated with socioeconomic deprivation. These findings have implications for identifying a child's individual risk factors for developmental language disorders when conducting speech-language assessments. Future study should examine how inequities in care can be mitigated and addressed. [ABSTRACT FROM AUTHOR]

Background: The complex work of public health nurses (PHNs) specifically related to mental health assessment, intervention, and outcomes makes it difficult to quantify and evaluate the improvement in client outcomes attributable to their interventions. Objectives: We examined heterogeneity across parents of infants served by PHNs receiving different interventions, compared the ability of traditional propensity scoringmethods versus energy-balancing weight (EBW) techniques to adjust for the complex and stark differences in baseline characteristics among those receiving different interventions, and evaluated the causal effects of the quantity and variety of PHN interventions on client health and social outcomes. Methods: This retrospective study of 4,109 clients used existing Omaha System data generated during the routine documentation of PHNhome visit data. We estimated the effects of intervention by computing and comparing weighted averages of the outcomes within the different treatment groups using two weighting methods: (a) inverse probability of treatment (propensity score) weighting and (b) EBWs. Results: Clients served by PHNs differed in baseline characteristics with clients with more signs/symptoms. Both weighting methods reduced heterogeneity in the sample. EBWs were more effective than inverse probability of treatment weighting in adjusting for multifaceted confounding and resulted in close balance of 105 baseline characteristics. Weighting the sample changed outcome patterns, especially when using EBWs. Clients who received more PHN interventions and a wider variety of them had improved knowledge, behavior, and status outcomes with no plateau over time, whereas the unweighted sample showed plateaus in outcomes over the course of home-visiting services. Discussion: Causal analysis of PHN-generated data demonstrated PHN intervention effectiveness for clients with mental health signs/symptoms. EBWs are a promising tool for evaluating the true causal effect of PHN home-visiting interventions. [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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

Evaluate changes in two-wheel cycling skills and biking participation goals for children with neurodevelopmental disorders (ND) receiving a home visit and email following iCan Bike camp. Participants: 11 children with ND, 9–16 years, and one of their parents. A cycling skills checklist, two-wheel riding Goal Attainment Scaling (GAS), and biking participation GAS were completed before camp (T1), at support visit after camp (T2), and three months following camp (T3). Parents completed biking practice logs. Participants received a support visit to provide instruction, coaching, and address questions, and an email to check progress. Significant changes were made in two-wheel riding GAS T1 to T2 (p = 0.01), biking participation GAS T2 to T3 (p = 0.02), and cycling skills T1 to T2 (p = 0.01) and T2 to T3 (p = 0.02). Practice frequency was related to cycling skills (0.72, p = 0.01) and biking participation (0.86, p < 0.001); cycling skills were related to biking participation (0.81, p = 0.003). Children improved cycling skills and biking participation following camp, support visit, and email check-in. Children who practiced more had greater cycling skills and biking participation. Encouraging weekly bicycling and providing support may promote cycling skills and participation following camp. [ABSTRACT FROM AUTHOR]

Background: The core of postnatal care is that midwives recognise the needs of women and new‐born babies and provide the highest possible quality of care and medical safety to optimise the health and well‐being of new families. The study aimed to describe midwives' experiences in providing postnatal care for families during the first week after the birth of their baby. Method s : An interview study included 18 midwives who interchangeably worked within the models of traditional hospital care, hotel‐based care, home‐based care, hospital‐based check‐ups, and specialist care at a breastfeeding clinic at one university hospital in Sweden. Data collected were analysed using thematic analysis according to Braun and Clarke. Findings: The main theme: 'Like a torch that enlightens new parents along a narrow and winding path into parenthood – a midwife's transitional support' was explored and comprised two themes: (1) Strengthening parents' self‐confidence in their parental role by handling over parental responsibility; and (2) Challenging to facilitate parents' understanding of their parental role. Conclusions: Midwives expressed that supporting parents in the parental transition was a delicate task and included balancing mothers', babies', and partners' needs. The midwives guided parents into parenthood during postnatal care in a strategic manner by strengthening parents in their parental role. Postnatal care delivered by midwives is crucial for new parents and their babies. [ABSTRACT FROM AUTHOR]

Purpose: To describe parent, child, and service providers' use of metaphors to communicate the meaning of participation in life and therapy engagement in the field of childhood disability. Methods: Metaphors concerning participation and engagement were extracted from 59 qualitative articles recommended by a group of experts in pediatric rehabilitation. A systematic process of metaphor analysis was used, involving identification of source and target domains, categorization into target-source groupings, and interpretation. Results: 209 metaphors were identified and categorized into seven target-source groupings. These seven groupings reflected environmental, interpersonal, and personal domains of experience: (a) the service system and life context, (b) the interpersonal therapy context, and (c) personal aspects. Together, the groupings expressed experiences concerning service system complexity, therapy engagement, and personal experiences of adaptation. Speakers used several metaphor dichotomies to express different experiences (e.g., open vs closed doors to opportunities). Conclusions: When service providers pay attention to clients' use of metaphors, this can lead to a deeper, more evocative understanding of the meaning of their participation and engagement experiences. Service providers can use metaphors generated by clients to communicate their understanding to clients, thereby creating a common ground for collaboration and assisting clients to interpret their experiences in different ways. IMPLICATIONS FOR REHABILITATION: Metaphors are useful clinically as they provide a bridge to joint understanding between a speaker and listener(s), due to their cognitive and communicative functions Service providers can note and attend to clients' use of metaphors to understand clients' experiences in deeper ways Service providers can themselves use metaphors to express new ideas to clients, thereby encouraging clients to adopt new perspectives on their experiences By paralleling clients' use of metaphors, service providers can communicate that they understand clients' experience and provide them with a sense of support [ABSTRACT FROM AUTHOR]

Importance: Care partners' involvement is a key feature of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach that can enhance rehabilitation outcomes and promote the generalization and transfer of strategies and skills to everyday life. Gaining insight into care partners' experience with their child's CO-OP intervention is critical to understanding how to enhance care partners' involvement. Objective: To gain insight into the experience of care partners whose child with acquired brain injury (ABI) participated in CO-OP intervention. Method: A qualitative descriptive research design was used. Semistructured interviews were conducted at three time points (immediate postintervention and at 2 and 6 mo postintervention). Setting: Two rehabilitation centers. Participants: Thirteen care partners of 12 children or youth with severe ABI. Results: Three themes emerged from the analysis of 33 interviews: (1) The child is an active agent in their therapy, (2) the care partner is the keystone who helps solidify the elements of CO-OP, and (3) CO-OP mastery requires time and practice, and its use evolves over time. Conclusions and Relevance: These themes highlight the progressive nature of proficiency in CO-OP for both care partners and children. This was evident not only in the children's improvement in task performance, but also in their ability to problem solve. Care partners' role in supporting the CO-OP approach also unfolds over time as their confidence in their child's problem-solving abilities, and in their own ability to adequately provide guidance, increases. Engagement seems to be central in facilitating this progression for both children and their care partners. Plain-Language Summary: This is the first study to provide insights into the involvement of care partners in the Cognitive Orientation to daily Occupational Performance (CO-OP) approach for children and youth with executive function deficits after acquired brain injury. This is also the first study to explore the evolution of care partners' experiences over time. Involving care partners is a key feature of the CO-OP. Understanding care partners' experiences with their child's CO-OP intervention can improve a child's rehabilitation outcomes. The study found that care partners' role in supporting their child's CO-OP approach improved over time as their confidence in their child's problem-solving abilities increased. The care partners' own ability to adequately provide guidance to their child also increased over time. Engagement seems to be central in facilitating this progression for both children and their care partners. It is hoped that occupational therapists will consider the findings of this study to better support care partners in implementing the CO-OP approach with their child in their real-life context. Care partners' role in supporting their child's engagement with the Cognitive Orientation to daily Occupational Performance (CO-OP) occupational therapy approach improved over time as their confidence in their child's problem-solving abilities increased. [ABSTRACT FROM AUTHOR]

This study evaluated the level of knowledge among parents in Jazan, Saudi Arabia, regarding substances that can harm child development. The Prevention of Toxic Chemicals in the Environment for Children Tool (PRoTECT) was used for this assessment. A cross-sectional survey using a multi-stage cluster random sampling approach was undertaken among 424 parents who were enlisted from eight primary healthcare centers (PHCCs). The PRoTECT score's median value was 72 out of 90, suggesting a generally high level of awareness. The study found that individuals with higher education, particularly those with postgraduate degrees, had greater awareness of protecting their children's health. Interestingly, unemployed individuals and those residing in mountainous areas also demonstrated higher awareness, possibly due to having more time to focus on their children's health and well-being. Most participants (68.2%) acknowledged the correlation between exposure to toxic chemicals during pregnancy and early childhood, and the subsequent development of neurodevelopmental disorders. The study found a solid foundation of knowledge, with 85.1% of participants interested in learning more about reducing children's exposure, but it also stressed the need for specific actions to turn awareness into prevention. These findings would help policymakers develop effective strategies, such as targeted educational campaigns, collaboration with healthcare providers, utilization of media channels, and encouragement of community-led initiatives, to reduce children's exposure to developmental toxicants in line with national and global environmental health initiatives. Future research should focus on longitudinal consciousness and behavior evaluations and regional environmental contaminants. [ABSTRACT FROM AUTHOR]

Background Early detection of obesity-promoting dietary behavior patterns improves the identification of at-risk families and the implementation of interventions. This is accomplished through the use of the Child Eating Behavior Questionnaire (CEBQ). No study has been conducted using the CEBQ in children followed in Essonne's Maternal–Infant Protection (PMI) centers. We investigated, in a cross-sectional design, the differences in children's eating behavior with PMI follow-up according to their weight status. Methods A questionnaire addressed to parents was collected in PMI centers. Multiple hierarchical regression analysis was used to investigate the predictability of the child's CEBQ on body mass index (BMI). Results From January to April 2022, 850 children were selected, from which 500 (aged 1–6 years) were included, and of whom 10.6% were obese. There was a significant positive association between 'Food Responsiveness', 'Enjoyment of Food' and BMI. In contrast, there was a significant negative association between 'Satiety Responsiveness', 'Slowness in Eating' and BMI. Besides, 'Food approach' and 'food avoidance' behaviors were positively and negatively related to BMI z-scores, respectively. Conclusion Due to significant differences in children's eating behavior according to their weight, it is needed to raise awareness among parents about their impact on them. [ABSTRACT FROM AUTHOR]

Background: Tele‐dentistry can be useful for dental caries screening of children, especially in lower‐middle‐income countries (LMICs). Aim: To evaluate the diagnostic accuracy of mobile phone photographs taken by a community health worker (CHW) for caries detection in Iran. Design: Children aged 6–12 years were visually examined by a paediatric dentist. Following dental examinations, intraoral photographs were taken by a trained CHW. Two remote dentists assessed intraoral photographs for dental caries. Diagnostic accuracy of tele‐dentistry for caries detection was evaluated. In addition, the questionnaire about oral health and parents' views towards tele‐dentistry was prepared. Results: One hundred thirty‐one children aged 8.74 ± 1.62 years participated. The caries prevalence was 30% for the whole dentition. Tele‐dentistry demonstrated high accuracy, with a sensitivity exceeding 80% and specificity exceeding 90%. The inter‐rater reliability for remote dentists' assessments to the gold standard dental examination ranged from substantial to almost perfect (kappa: 75%–93%). Additionally, 80% of parents whose children participated in this study had positive views towards tele‐dentistry. Conclusion: Tele‐dentistry was shown to be an alternative approach to clinical examinations for caries detection among school children. Employing non‐dental care professionals in tele‐dentistry has been emerged as a reliable and cost‐effective approach, especially in LMICs. [ABSTRACT FROM AUTHOR]

Background: Dental caries is the most common chronic childhood disease. The recommended age for the first dental visit (FDV) is 1 year, yet a minority of children visit before the age of 3 years. Aim: The aim of the study was to estimate the patterns of and predictors for dental visits among a sample of children. Design: Parents of children between the ages of 6 months and 18 years, who attended the paediatric dentistry clinics and the well‐baby clinics, were recruited. A validated questionnaire was used to collect data. Logistic regression was utilized to assess the predictors of ever visiting a dentist. Results: The mean age at FDV was 5.8 ± 2.1 years. Parents' belief of not needing to see a dentist was the most common barrier to visiting a dentist (33%). Among the reasons for FDV, caries and pain were the most common (45% and 20%, respectively). Predictors of ever visiting a dentist were children who are not an only child and children of parents who visited a dentist themselves. Conclusion: Children visited the dentist at an age older than that recommended, and the reasons for FDV were mainly caries and its consequences. [ABSTRACT FROM AUTHOR]

Background: Within the NICU, there is a delicate equilibrium between providing assistance to parents by nurses and prioritising family-centred care (FCC). The FCC assumes the role of a mediator, effectively conveying compassion. The intricate dynamics between FCC, parental nurse support, and parental stress in neonatal intensive care units (NICUs) necessitate comprehensive investigation. Objective: This study examines the mediating effect of FCC on the relationship between parental nurse support and parental stress in NICUs. Methods: This cross-sectional observational study used convenience sampling to select 223 parents (202 mothers) from Mansoura City hospitals in Egypt. Data were collected using the Nurse Parent Support Tool (NPST), Family-Centered Care Self-Assessment Tool (FCCS-NICU), and the Parental Stressor Scale: NICU (PSS: NICU). Mediation analysis was used to examine the relationships between variables. Results: Nurse support was positively associated with FCC (β = 0.81, p < 0.001) and negatively related to parental stress (β=-1.156, p < 0.001). FCC was found to reduce parental stress (β=-0.18, p < 0.001). Mediation analysis confirmed that FCC partially mediated the relationship between nurse support and parental stress (indirect effect β = 0.145, 95% CI: 0.055–1.007). Conclusions: This study highlights a significant association in the mediating role of FCC between nurse support and parental stress. Strengthening FCC practices can be an effective strategy for nurses to support parents and alleviate their stress in NICU settings. Implications to practice: NICUs should implement FCC-oriented training for nurses, foster a culture that supports FCC principles, and develop policies to establish FCC as a cornerstone of neonatal care. [ABSTRACT FROM AUTHOR]

Background: Malaysian preschool children continue to exhibit a high prevalence of dental caries and poor oral hygiene. There is a need to gain an in-depth understanding of oral hygiene habits and design suitable interventions to improve oral hygiene in early childhood. Objective: To cross-culturally adapt and determine the psychometric properties of the Malay-translated Parenting and Child Tooth Brushing Assessment questionnaire (M-PACTA). Methodology: This cross-sectional study involved face and content validation, and forward and back-translation of PACTA. The M-PACTA was then tested for reliability and construct validity on 150 Malaysian parents of children aged 5 to 6 years old. Results: Face validity indicated that the M-PACTA items were clear and easy to understand. For content validity, some words had to be modified in accordance with the recommendations of the expert committees to make it more coherent to Malaysians. Some statements in the parental knowledge scales were modified according to the guidelines applicable in Malaysia. The content comparison of the back translation with the adapted PACTA revealed that all items were semantic and linguistically equivalent. Exploratory factor analyses of M-PACTA suggested a two-factor structure for three scales including child behaviour scale ('non-compliance' and 'avoidance behaviour'), parental attitudes ('lack of concern' and 'attitude of care'), and parental knowledge ('general tooth brushing knowledge' and 'awareness of tooth brushing care') while for the parental strategy scale, three-factor structure was extracted including 'routine positive methods', 'uncommon positive methods', and 'negative methods'. Internal consistencies for all scales were good (α > 0.9). Conclusion: M-PACTA did not replicate the construct of the original PACTA. Nonetheless, M-PACTA demonstrated good construct validity, internal consistency reliability, and test-retest reliability within Malaysian context. [ABSTRACT FROM AUTHOR]

Purpose: Participating in home and community activities can be influenced by environmental factors and parent strategies. Children on the autism spectrum are reported to participate less in home and community activities than their neurotypical peers. Little is known about environmental factors that may influence their participation, and ways parents support their child's participation. Materials and methods: Parents of children on the autism spectrum aged 5–6 years (n = 72) and 10–11 years (n = 94) completed the Participation and Environment Measure for Children and Youth. This study reports on the perceived support, barriers, and resources in the home and the community environment. Parents reported strategies they used to support their child's participation in home and the community. Results: Home environmental factors were identified as more supportive by the parents of younger children. The sensory quality of activities and social demands were factors identified as making community participation harder for both groups. Parents used a range of different strategies in the home and the community to support their child's participation. Conclusions: Identifying environmental barriers and supports to participation can assist in developing interventions to support meaningful participation in activities for children on the autism spectrum. Implications for rehabilitation: Skills required for the activity and preferences of children on the autism spectrum are important considerations when supporting their participation in activities. When exploring a child's level of participation, it may be helpful to ask parents about what their child can do with or without their support. The sensory quality of the environment is a consideration when supporting the participation of children on the autism spectrum in community activities. As sensory processing is an individual experience, the impact of sensory elements of the environment may differ for individuals. [ABSTRACT FROM AUTHOR]

Parents are an essential element of family intervention for all children, including those with autism spectrum disorders (ASDs). We can better understand and address parents' knowledge gaps about ASD through in-depth research and inquiry into parents' current level of understanding, attitude, and perception. We aimed to assess the knowledge, attitude, and perception of ASD and influencing factors towards ASD among a group of parents with and without a child diagnosed with ASD in Sakaka, Al-Jouf Region, Saudi Arabia. Using the cross-sectional study design, information from the parents was gathered using a pretested questionnaire that included validated scales for measuring knowledge, attitudes, and perceptions related to ASD. The required number of participants was selected using the convenience sampling method. We used Spearman's correlation test to determine the strength and direction of correlation between each domain. As a last step, we analyzed the influencing factors using binomial logistic regression. Among the 400 participants, 41.2% had high knowledge, 69.1% had a positive attitude, and 60.3% had a high perception of ASD. We found that knowledge was significantly higher among the parents with autistic individuals in the family (p = 038). The high and positive attitude was significantly greater among females (p = 0.010) and parents with high income (p = 0.007), and the perception was significantly associated with females (p = 0.037) and highly educated participants (p = 0.046). Furthermore, we found a positive correlation between knowledge, attitude, and perception. Overall, only less than half of the participants had a high knowledge of ASD. Hence, we recommend awareness-raising programs for the parents in this region. Furthermore, a prospective study involving parents from all provinces of Saudi Arabia is recommended. [ABSTRACT FROM AUTHOR]

Many children with developmental language disorder (DLD) have emotion recognition and regulation difficulties, but there are currently no known interventions enhancing emotional awareness in this population. This study explores the impact of parents' perspectives regarding children with DLD emotional understanding through a parent-led online emotion recognition (ER) intervention. Ten parents of children with DLD aged 6–11 participated in the study. A nonconcurrent multiple baseline design was employed, allowing for a rigorous analysis of changes in parental beliefs over time. Weekly data were collected through the Parents' Beliefs About Children's Emotions Questionnaire. Interviews were also conducted to gain deeper insights into parents' perceptions regarding the ER skills of their children. Results indicated that parents' beliefs about the need for guiding and supporting their child's ER skills increased over the intervention. Interviews also supported this, and three main themes were generated. The intervention program increased parents' awareness of (a) the importance of ER for children with DLD, (b) emotion-focused communication and engagement with their child, and (c) the integration of emotions into daily life. This study is the first known study that explores parents' beliefs about children with DLD ER skills, highlighting the importance of supporting parents through accessible interventions. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality. The primary objective of this study was to compare the frequency of documentation of postpartum blood pressure through remote blood pressure monitoring with text-message delivered reminders versus office-based follow-up 7–10 days postpartum. The secondary objective was to examine barriers and facilitators of both care strategies from the perspectives of individuals who experienced a hypertensive disorder of pregnancy. We conducted a randomized controlled trial at a tertiary care academic medical center in the southeastern US with 100 postpartum individuals (50 per arm) from 2018 to 2019. Among 100 trial participants, blood pressure follow-up within 7–10 days postpartum was higher albeit not statistically significant between postpartum individuals randomized to the remote assessment intervention versus office-based standard care (absolute risk difference 18.0%, 95% CI −0.1 to 36.1%, p = 0.06). Patient-reported facilitators for remote blood pressure monitoring were maternal convenience, clarity of instructions, and reassurance from the health assessments. These positive aspects occurred alongside barriers, which included constraints due to newborn needs and the realities of daily postpartum life. [ABSTRACT FROM AUTHOR]

Objective: Studies examining COVID-19 vaccine reactions and reasons for parental hesitancy to COVID-19 vaccines in allergic adolescents are few. This study aimed to identify post-vaccine reactions and parental vaccine refusal/hesitancy among adolescents with allergic diseases. Materials and Methods: Between January 2022 and April 2022, a questionnaire was completed by the parents of adolescents who were followed at the Pediatric Allergy outpatient clinic. Vaccination status, characteristics of reactions after vaccination, and the frequency of parental vaccine hesitancy were recorded. Results: Among 104 patients, 70 were followed for asthma, 64 for allergic rhinitis, 12 for drug allergy, 3 for food allergy, and 1 for chronic urticaria. 63.5% (n=66) of the patients were vaccinated. The rate of vaccination was 52.5% in those with a history of COVID-19 and 70% in those without a history of COVID-19 infection (p=0.07). Eight patients were not vaccinated due to recent COVID-19 infection. Reasons for parental vaccine hesitancy/rejection (n=30) included thinking that the vaccine is harmful (63.3%), not effective (53.4%), or not suitable for children (46.7%). 14 (21.2%) children experienced symptoms within the first 2 hours after vaccination. The most common symptom (n=10) was arm pain. Urticaria and itching were reported in one patient and respiratory symptoms were reported in another patient. Both patients could receive the second dose without any reaction. Conclusion: Vaccination was more frequent among children without a history of COVID-19 infection. One third of the patients were not vaccinated, and the most common reason for vaccine hesitancy was concern about the adverse effects of the vaccine on human health in the long term and distrust of the vaccine. However, vaccinated allergic children did not experience any serious events. [ABSTRACT FROM AUTHOR]

Child drowning is a significant public health issue in Indonesia, however, there is insufficient understanding of the issue and its associated risk factors within communities. This qualitative study aimed to explore parental and community perceptions and practices related to child drowning in Indonesian communities, and the perceived causes and risk factors. Seven focus group discussions (n  = 62) were conducted with parents of children aged under-5 years and village community leaders in seven villages across all districts of Lombok Island, West Nusa Tenggara Province of Indonesia. Participants were recruited using purposive and snowball sampling. The thematic analysis, guided by Braun and Clarke's framework, used both deductive approaches, utilizing the Health Belief Model's constructs and inductive approaches. Most participants were unaware of the susceptibility of their children and others in their community to drowning and of the potential severe outcomes of drowning such as injury, disability and death. Participants generally associated drowning with beaches or open seas. Unprotected wells, tubs and buckets were identified as notable risk factors for child drowning in and around the home, shaped by some experience of child drowning incidents in the community. Supervision was identified as protective factor, however, mothers were often unavailable to supervise children, and supervision responsibility was often delegated to other family and community members. This study highlights the urgent need to enhance public awareness regarding children's susceptibility to drowning. Further exploration of local contexts and social determinants of drowning in Indonesian communities is crucial for ensuring effective water safety and drowning prevention strategies. [ABSTRACT FROM AUTHOR]

This qualitative study explores the perceptions of impact associated with engaging in a therapeutic recreation-based bereavement camp for families whose child has died from serious illness. Interviews were completed with 12 parents who had participated in a three-camp cycle of the program over 12-month period, including a subgroup who had also attended a reunion camp. Interviews were also conducted with program staff. Thematic analysis generated key themes relating to the perceived impact which suggest that those engaged in this program perceived positive contributions associated with participation, including perceptions of positive impact on coping with bereavement, access to support and implications for family functioning. This study highlights the areas of impact associated with engagement in a therapeutic recreation-based bereavement intervention, and the potential contribution of wider access to these programs for families whose child has died from serious illness. [ABSTRACT FROM AUTHOR]

Social mobility beliefs play a significant role in shaping adolescents' adaptive developmental outcomes, including well-being and academic functioning. Nevertheless, existing research may not cast light on the distinct trajectories and potential protective factors of social mobility beliefs. The present study aims to identify heterogeneity in trajectory patterns of social mobility beliefs among Chinese adolescents (Mage = 12.45, SDage = 2.60; 55.1% boys; 40.0% rural adolescents) in a four-wave (i.e., fall 2017, fall 2018, spring 2019, and fall 2019) longitudinal design, and examines the protective roles of parental academic involvement and adolescent future orientation. Three distinct trajectories of social mobility beliefs were identified: high-increasing (35.1%; a positive trajectory with the best developmental outcomes, including the lowest problem behaviors and depression symptoms, and the highest life satisfaction and academic competence), moderate-stable (49.8%), and low-decreasing (15.1%; a negative trajectory with the worst developmental outcomes, including the highest problem behaviors and depression symptoms, and the lowest life satisfaction and academic competence). Apart from the main effects of parental academic involvement and future orientation, a significant interaction effect of these two protective factors and adolescent group was detected, and only rural adolescents who reported both high levels of parental academic involvement and future orientation have a greater chance of being placed in the high-increasing trajectory than the low-decreasing trajectory. These findings highlight the significance of clarifying individual differences in the dynamic process of social mobility beliefs during adolescence, and elucidate rural-urban disparities in the influences of protective factors on social mobility beliefs trajectories, and inform individualized intervention strategies. [ABSTRACT FROM AUTHOR]

Background/Aims: Cultural factors significantly impact maternal mortality during pregnancy and birth, and cultural norms can affect pregnancy, labour and care-seeking behavior. This study explored local cultural perspectives of birth preparedness in a rural area of Java, Indonesia. Methods: This descriptive qualitative study used individual semi-structured interviews with 16 purposively selected participants, including 10 pregnant women, two community midwives, two pregnant women's parents and two health cadres. Data were analysed thematically. Results: Three primary themes were found: the meaning of pregnancy in the sociocultural context, the meaning of childbirth and cultural values in pregnancy. Conclusions: Sociocultural factors have a significant impact on pregnancy and childbirth in rural Indonesian areas, and pregnant women may be unprepared for birth. It is essential to create a culturally appropriate intervention model for childbirth readiness that pregnant women and their families can easily understand. Innovation is vital to empower the community to promote childbirth preparation. [ABSTRACT FROM AUTHOR]

Purpose: Assessing patient and guardian experiences regarding their history of ovarian tissue cryopreservation (OTC) years after initial procedure. Methods: Cross-sectional follow-up telephone survey. A questionnaire developed by The Pediatric Initiative Network of the Oncofertility Consortium, modified to assess intent and attitudes regarding OTC, tissue access knowledge, financial burden of tissue storage, and intent to use tissue, was utilized. Interviews were conducted for those who underwent OTC at a metropolitan children's hospital between 2013 and 2022. Results: Of 60 eligible patients, 39 interviews were completed. Contacted patients were 3–28 years old, with minors accompanied by guardians. Average age at OTC was 8.5 years old, and 5.1% (2/39) were deceased at the time of contact. All interviewees underwent OTC for fertility preservation before gonadotoxic treatment. Seventy percent of patients (7/10) and 48.1% (13/27) of guardians stated they would use frozen tissue for pregnancy, with 50% (5/10) of patients and 59.3% (16/27) of guardians not understanding tissue access. Regret occurred in 10% (1/10) of patients and 3.4% (1/29) of guardians. It was associated with 10.8% (4/37) of tissue discard due to failed storage payments. Financial concerns occurred in 29.7% (11/37) of interviewees. Overall, 92.3% (36/39) would recommend OTC, and 94.9% (37/39) would repeat their choice to undergo OTC. Conclusion: Follow-up after OTC is essential to patient understanding of tissue status, access, and payments. Most do not regret OTC, except in cases of financial burden leading to tissue discard. Follow-up should be sequentially scheduled and include counseling on financial assistance programs. [ABSTRACT FROM AUTHOR]

Touch is a universal nonverbal action often used by romantic partners to demonstrate affection and care for each other. Attitudes toward touch might be particularly relevant across periods of relational strain—such as the transition to parenthood—when couples face many novel stressors and shifting priorities which can interfere with their sexual and affectionate experiences. New parent couples (N = 203) completed self-report measures online across six time-points (two prenatal). We tested whether couples' attitudes toward touch (touch aversion, touch for affection, touch for emotion regulation) at baseline (20 weeks mid-pregnancy) predicted their frequency of sexual and affectionate behaviors from mid-pregnancy through 12-month postpartum. Both partners' more positive attitudes toward touch (i.e., for affection and emotion regulation) and lower aversive attitudes toward touch, as measured in mid-pregnancy, predicted couples' higher frequency and variety of sexual and affectionate behaviors at 3-month postpartum. Touch attitudes generally did not predict the degree of change in the frequency or variety of sexual or affectionate behaviors, with one exception: non-birthing parents' more positive attitudes toward touch for emotion regulation in mid-pregnancy predicted a slower decline in couples' affectionate behaviors across pregnancy. Findings underscore a link between new parents' attitudes toward touch and their subsequent sexual and affectionate behaviors, particularly in the early postpartum period. New parents need to navigate novel sexual changes and a nonverbal strategy such as touch might be useful to promote intimacy and care. [ABSTRACT FROM AUTHOR]

Irritability is a common, impairing, and potentially multifaceted manifestation of psychopathology. We designed The Irritability and Dysregulation of Emotion Scale (TIDES-13) to determine whether various expressions of irritability in children and youth form multiple subdimensions with distinct correlates. We administered parent-report (n = 3875, mean age = 8.9) and youth self-report (n = 579, mean age = 15.1) versions of TIDES-13 in a population and community-based sample. We conducted exploratory/confirmatory factor analyses and regression analyses to examine the dimensionality of TIDES-13 and the associations of the scale with age, gender, anxiety, depression, ODD, ADHD traits, and the Affective Reactivity Index (ARI). A higher-order model with a global irritability dimension and four subdimensions, including proneness to anger (PA), internalized negative emotional reactivity (iNER), externalized negative emotional reactivity (eNER), and reactive aggression (RA), showed good to excellent fit in both parent-report and self-report. The global irritability dimension showed excellent internal reliability (⍵Total; parent-report = 0.97, ⍵Total; self-report = 0.95), explained a majority of the item variance (⍵Hierarchical; parent-report = 0.94, ⍵Hierarchical; self-report = 0.90), and was moderately correlated with the ARI (rparent = 0.68, rself = 0.77). Subdimensions PA, eNER, and RA were negatively associated with age in males, whereas iNER was positively associated with age in females. Traits of ODD and ADHD were associated primarily with the global irritability dimension, whereas iNER was strongly associated with anxiety and depression traits over and above the global irritability dimension. Our results support a unidimensional interpretation of irritability in a population sample. However, limited evidence of specific behavioral, age, and sex correlates with particular irritability subdimensions may warrant further investigation. [ABSTRACT FROM AUTHOR]

Objective: Family‐based treatment (FBT) is an efficacious treatment for adolescent anorexia nervosa (AN). A parent‐only guided self‐help version of FBT (GSH‐FBT) demonstrated preliminary efficacy in pilot investigations. To address challenges in access to care, we adapted GSH‐FBT into a parent‐only multi‐family group format (MF‐GSH‐FBT) delivered via videoconferencing. Method: This report details the feasibility and acceptability of a parent‐only group‐based multi‐family GSH‐FBT (MF‐GSH‐FBT) for adolescent AN delivered virtually. The MF‐GSH‐FBT intervention consisted of 12 weekly 60‐min sessions facilitated by a clinician in addition to online FBT video content and recommended readings. Adolescents and parents completed assessments at baseline and post‐treatment. Parents reported their child's weight each week. Results: A total of 13 adolescents (15.57 + 1.63 years; 92% female; 23% Hispanic) with AN and their parents enrolled and initiated treatment. Four consecutive cohorts of groups of 3–4 families were completed from April 2022 to April 2023. Across cohorts, parents attended 85% of sessions. Most parents rated the treatment sessions as helpful (79%; agree/strongly agree) and felt supported by the other group members (84%). All parents (100%) reported MF‐GSH‐FBT helped their child, and most (90%) reported their child had improved by end‐of‐treatment. On average, adolescents gained 3.53 kg (SD: 3.76) from pre‐ to post‐treatment, with percent estimated mean body weight increasing 5% on average. Parental self‐efficacy also increased from baseline to end‐of‐treatment. Discussion: MF‐GSH‐FBT for AN appears feasible and acceptable to parents participating in this pilot study. Challenges with recruitment and adolescent data collection remain questions for future investigation. Public significance: This study describes initial pilot testing of a virtual guided self‐help family‐based treatment for adolescents with anorexia nervosa delivered in a multi‐family group format. This treatment aims to enhance access to family‐based treatment for anorexia nervosa whilst providing additional support to parents. [ABSTRACT FROM AUTHOR]

The present study investigates the relationship between resilience and parental behaviours and examines the moderating role of parent and child age in this relationship. The cross‐sectional descriptive study was conducted with a sample of 204 parents of children aged 6 months to 12 years. The Resilience Assessment Scale and the Parenting Behaviours and Dimensions Questionnaire were used. The findings confirmed the existence of a positive relationship between parental resilience and desirable parental dimensions and a negative association with undesirable behaviours towards children. However, overall resilience was not associated with anxious intrusiveness. The moderating effect confirmed that parental age played a moderating role between resilience and punitive behaviours. Child age moderated the relationship between resilience and emotional warmth, permissiveness and anxious intrusiveness. The results of the study indicate the importance of positive resources, such as resilience, and demographic variables, such as parental and child age, in the development of positive parenting. [ABSTRACT FROM AUTHOR]