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The purpose of this study was to examine the factor structure of the Family Involvement Questionnaire--Elementary Version with families in Belize. Participants were 185 primary caregivers of children in primary education settings in Belize. Caregivers were given the Family Involvement Questionnaire--Elementary Version to measure their educational involvement in their children's schooling. Findings indicated the factor structure of the Family Involvement Questionnaire--Elementary Version in Belize was not congruent with the factor structures with samples from the United States and New Zealand. Exploratory factor analysis suggested a five-factor solution: (a) home-school communication, (b) home expectations and monitoring, (c) educational support, (d) school and community involvement, and (e) school attendance. In light of similar measurement studies in the literature, these data indicate that family educational involvement varies across geographic and cultural contexts. This suggests that interventions and policies to improve education outcomes via family involvement ought to consider the unique structure of families' involvement in the educational system. [For the corresponding grantee submission, see ED605729.]

Previous research studying language brokers (i.e. children/adolescents who translate for family members) has indicated some positive correlations between frequent language brokering and gains in cognitive development, although little of this research has been conducted on language brokers during the university/higher education years. At the same time, there is evidence documenting elevated levels of depression and anxiety in brokers who translate frequently, which may undermine positive cognitive developments. The purpose of this study was to examine the impact of accumulated brokering frequency on academic motivation and learning strategies in United States university students, while accounting for psychological health symptoms. Greater brokering experience uniquely predicted increases in academic motivation and learning strategies. In particular, these relations were driven by greater value components (i.e. intrinsic and extrinsic goal orientation, task value understanding) and cognitive and metacognitive strategy use. This suggests greater self-regulated learning abilities in the university setting for language brokers with more translation experience. The brokers' reported psychological health symptoms did not interact with these positive correlations. Overall, these findings help to more directly understand the context of the language broker in higher academia and the impact on cognitive outcomes during this important transition into adulthood.

In this project, the authors used the Essential Behavioral Leadership Qualities (EBLQ) method of measuring leadership effectiveness to assess and compare the effectiveness of principals (leaders) of residential schools for children with blindness or low vision in the United States (U.S.) and Nigeria. A total of 248 teachers (subordinates) in 25 schools in the U.S. and 271 teachers in 22 schools in Nigeria, assessed their principals against the qualities they (teachers) perceived to be essential for effective leadership in their respective countries. Differences found in perceived EBLQ items for leadership effectiveness in both countries demonstrated support for both the trans-cultural and culture-specific perspectives of leadership effectiveness. The outcomes in both countries indicated that the principals could derive a "coaching" effect from the two studies regarding the efforts needed to improve their leadership styles to achieve congruence between essentiality and effectiveness.

Introduction: In this study, executive function of school-aged children with visual impairments (that is, those who are blind or have low vision) is examined in the context of behavioral problems and communicative competence. Methods: Teachers assessed the executive function of a sample of 226 visually impaired students from mainstream schools and schools for students who are visually impaired, using a German version of the Behavior Rating Inventory of Executive Function (BRIEF-D) and a questionnaire measuring communicative competence and behavioral problems (German version of the Strengths and Difficulties Questionnaire; SDQ-D). Results: The results showed highly significant differences in all domains of executive function: the visually impaired students consistently scored more poorly compared to a normative sample of sighted children, even when visually impaired students with additional disabilities were not taken into account. A regression analysis revealed the significance of executive function for behavioral problems among students with visual impairments. Discussion: The findings demonstrate that a wide range of executive function domains that are significant for socioemotional development are not sufficiently developed in many visually impaired students. This lack of development seems to be particularly true for students who attend special schools. Implications for Practitioners: In educational concepts for visually impaired students, a specific and early focus on competencies such as attention shifting and emotional understanding seems to be necessary, especially in the context of inclusion. Moreover, reinforcing communicative competence might also enhance the development of executive function and help to reduce behavioral problems.

Background: The link between disorders of attachment and psychopathology is well documented. Consequently, a person's attachment style has a profound effect on his or her development and psychological well-being. At-risk populations such as adopted children are more prone to developing pervasive patterns of attachment, given the maternal disruptions they experience early in life. Objective: The aim of this review was to identify and systematically appraise the current literature addressing a range of attachment-based interventions for adopted chidren. Methods: A comprehensive search of the literature from the most recent decade was conducted. The Cochrane, Ebscohost, Sage, ScienceDirect, SpringerLink, and Wiley databases were used. Results: Three randomized controlled trials were included in this review. Two studies were conducted in the USA and one in the Netherlands. All studies made use of quantitative methodologies. Conclusion: Although each article highlighted significant findings in the respective study, there remains a deficit of empirical information aimed at addressing attachment-related behaviour in adopted children through intervention.

Relative to positive psychology, a focus on increasing psychological well-being has been recently supported. Positive psychology is the study of influences and processes that contribute to the successful and optimal functioning of individuals. Nurturing and encouraging wellness competencies creates a buffer against mental illness and fosters intensification of adaptive coping skills. The purpose of this study was to highlight results from a descriptive study of a large-scale sample of Asian youth (Japan, Korea, Taiwan, and Thailand) who responded to the Child and Adolescent Wellness Scale (CAWS) and compare them with a sample from the United States. The CAWS items reflect characteristics and cognitions of psychologically healthy and resilient children. As predicted, students generally perceived themselves as psychologically well, with all scores being above the theoretical midpoint score of 2.5. The average total CAWS score for the sample was 2.85 (on a 4-point Likert scale). Japanese students scored the lowest in most of the 10 dimensions. There were significant differences in each of the dimensions. The utilization of CAWS for practice with adolescents within a cross-cultural context and future studies is also discussed.

The association between thoughts of self-harm and help-seeking among youth with symptoms of depression was examined. Data were drawn from the Health Behavior of School-aged Children Study ("n" = 15, 686), a nationally representative sample of youth in the United States. Analyses focused on comparing help-seeking behaviors among youth with and without thoughts of deliberate self-harm (DSH) when depressed. Depressed youth with thoughts of DSH exhibited different patterns of help-seeking than those without. Both groups most frequently sought help from friends and parents. However, adolescents with thoughts of DSH were statistically more likely than youth without to seek help from friends (DSH: 69.9%; no DSH: 57.8%; AOR = 1.46), but less likely to seek help from parents (DSH: 53.7%; no DSH: 73.1%; AOR = 0.47). Youth with DSH were more likely to seek help from school officials (AOR = 1.05), health professionals (AOR: 1.83), or a counselor (AOR = 1.93) compared with those without thoughts of DSH who were more likely to seek help from a sibling (AOR: 0.77) or other relatives (AOR: 0.78). Results may help inform programs to improve identification of youth at risk of self-harm in community and school settings. (Contains 1 table.)

Purpose: In this article, the authors sought to determine whether the precise age of implantation (AOI) remains an important predictor of spoken language outcomes in later childhood for those who received a cochlear implant (CI) between 12 and 38 months of age. Relative advantages of receiving a bilateral CI after age 4.5 years, better pre-CI-aided hearing, and longer CI experience were also examined. Method: Sixty children participated in a prospective longitudinal study of outcomes at 4.5 and 10.5 years of age. Twenty-nine children received a sequential second CI. Test scores were compared with normative samples of hearing age mates, and predictors of outcomes were identified. Results: Standard scores on language tests at 10.5 years of age remained significantly correlated with age of first cochlear implantation. Scores were not associated with receipt of a second, sequentially acquired CI. Significantly higher scores were achieved for vocabulary as compared with overall language, a finding not evident when the children were tested at younger ages. Conclusion: Age-appropriate spoken language skills continued to be more likely with younger AOI, even after an average of 8.6 years of additional CI use. Receipt of a second implant between ages 4 and 10 years and longer duration of device use did not provide significant added benefit. (Contains 7 tables and 3 figures.)

The purpose of this study was to survey the opinions of speech-language pathologists (SLPs) on response to intervention (RTI). Questionnaires were mailed to 2,000 randomly selected elementary and secondary SLPs throughout the United States. Mean results of 583 respondents (29.15%) indicated that SLPs agreed on 37 Likert-type items and responded with "neither agree nor disagree" on 10 other items. The majority of participants acknowledged the importance of their role in RTI and the value of screening, progress monitoring, assessment, and prevention of continued failure. Some were uncertain whether multidisciplinary team members were knowledgeable and trained to implement RTI. More than 80% of participants indicated challenges related to training, funding, additional personnel, administrative leadership, and planning time. SLPs acknowledged the importance of prevention, collaboration, and well-trained educators in serving struggling learners. However, challenges in implementation of the model will require careful consideration in advancing the discussions on RTI. (Contains 5 tables.)

Although children with Down syndrome (DS) can learn to read, few studies have explored parental perspectives on the reading development of this group of children. This article, written by Leila Ricci and Anna Osipova, from California State University, explores visions and expectations regarding reading held by parents of children with Down syndrome in the US. Parents of 50 children with DS (aged three to 13 years) completed a survey about their children's interest in reading and responded to open-ended questions inquiring about their views on their children's reading development. A majority of parents in this study described their children's positive attitude toward reading, stated their reading-related goals for their children, defined their children's relative strengths in reading, and shared strategies used in the home to promote literacy in this population. Parents pay close attention to and have high expectations for their children's reading achievement, and thereby would benefit from partnerships with informed educators willing and capable of teaching reading to children with DS. (Contains 2 tables.)

Aim: To investigate the relationships among the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) in children with cerebral palsy (CP). Method: Using questionnaires describing each scale, mothers reported GMFCS, MACS, and CFCS levels in 222 children with CP aged from 2 to 17 years (94 females, 128 males; mean age 8y, SD 4). Children were referred from pediatric developmental/behavioral, psychiatry, and child neurology clinics, in the USA, for a case-control study of the etiology of CP. Pairwise relationships among the three systems were assessed using Spearman's correlation coefficients (r[subscript s]), stratifying by age and CP topographical classifications. Results: Correlations among the three functional assessments were strong or moderate. GMFCS levels were highly correlated with MACS levels (r[subscript s] = 0.69) and somewhat less so with CFCS levels (r[subscript s] = 0.47). MACS and CFCS were also moderately correlated (r[subscript s] = 0.54). However, many combinations of functionality were found. Of the 125 possible combinations of the three five-point systems, 62 were found in these data. Interpretation: Use of all three classification systems provides a more comprehensive picture of the child's function in daily life than use of any one alone. This resulting functional profile can inform both clinical and research purposes.

The researchers examined childhood family structure, age, and race/ethnicity as correlates of paternal relationships using the Father Presence Questionnaire. The sample consisted of 788 adult women aged 18 to 88 years from ethnically diverse backgrounds. The most consistent finding was the effect of family structure on participants' evaluations of their paternal relationships. Father absence because of divorce or separation produced less favorable evaluations on every scale and within every racial/ethnic category; however, when father's absence was attributable to death before 18 years, a consistent pattern of extremely positive evaluations resulted. The influence of race/ethnicity on women's evaluations of paternal relationships interacted with family structure. Among those living with both biological parents, non-Hispanic Whites gave the most positive ratings of their paternal relationships; among those not living with their biological father, African Americans had more favorable ratings than other ethnic categories. Increasing age tended to produce less favorable evaluations of father. (Contains 5 tables and 1 figure.)

Children with autism spectrum disorders (ASD) often participate in many treatments, requiring parents' dedication of time, money, and energy, and necessitating dealing with multiple service providers. To learn about parents' experience in seeking and using treatments for their child with ASD, the authors asked them, "What do you like/dislike about the treatment(s) you're currently using?" In this web-based, qualitative study, participants consisted of 486 parents (92% mothers) of children (80% boys; children's M age = 8.3 years) with autism (n = 290, 59.7%), Asperger syndrome (n = 115, 23.6%), or pervasive developmental disorder--not otherwise specified (n = 81, 16.7%). The families lived in the United States, Canada, Australia, New Zealand, England, and Ireland. Parents' written statements addressed more "dislikes" (70%) than "likes" (47%), and there were no universally liked or disliked interventions. Six themes emerged and are discussed: effectiveness of treatments, relationships with professionals, access to treatments, costs, medication concerns, and stress. (Contains 3 tables.)

Background: Accumulating studies have demonstrated that the Screen for Child Anxiety Related Emotional Disorders (SCARED), a modern youth anxiety questionnaire with scales explicitly designed to map onto specific DSM-IV-TR anxiety disorders, has good psychometric properties for children and adolescents from various countries. However, no study has yet been conducted as to the overall strength of the psychometric properties found in these studies. Methods: Studies were collected from the PsycINFO, PubMed, SSCI, SCI-Expanded, ERIC, and A&HCI databases from the year of the SCARED's first publication (1997) to the present. The inclusion criteria focused on all studies that examined the psychometric properties of the SCARED. Results: We retained 21 articles, reporting a total of 25 studies from predominately Europe (Belgium, Germany, Italy, the Netherlands) and the USA, as well as South Africa and China, which matched our inclusion criteria. It was found that the psychometric properties were robust for the SCARED scales related to the symptoms of DSM-IV-TR anxiety disorders, that females scored significantly higher than males and that age had a moderating effect on male and female score differences. Conclusions: This meta-analysis suggests that the SCARED can be utilized as a screening instrument for DSM-IV-TR anxiety disorder symptom dimensions for children and adolescents from various countries. (Contains 3 tables, 2 figures and 2 footnotes.)

Xhosa-speaking South African children in school settings face several academic and emotional challenges. These may be due to family obligation, conformity to authority figures and over expectations from parents, teachers and society. This study examines the differences in the number and types of reported fears and worries in 200 South African children and adolescents, between 14 and 18 years of age. Responses to a questionnaire investigating the inventory of fears and worries revealed significant differences in the number, pattern and level of fears. The participants endorsed school fears at higher levels than their Senegalese, Australian, Nigerian and American counterparts. Girls and children of low-income homes tend to exhibit higher levels of fears than children of upper-class homes. When interpreted within the cultural context, results further indicate that the number of fears decreased with age and that cultures that have fear-producing stimuli, and that favour inhibition and obedience serve to increase levels of fears and worries. (Contains 3 tables.)

Although sex is one of the strongest correlates of crime, contentions remain regarding the necessity of sex-specific theories of crime. The current study examines delinquent trajectories across sex among Puerto Rican youth socialized in two different cultural contexts (Bronx, United States; and San Juan, Puerto Rico). Results indicate similar substantive offending trajectories across males and females within each cultural context, that males exhibit a higher frequency of offending and higher levels of risk factors for delinquency, and more similarities than differences in how risk/protective factors relate to patterns of offending across male versus female youth. Study limitations and implications for sex-specific criminological theories are also discussed. (Contains 6 tables, 4 figures and 7 notes.)

The commercialisation of schools is a controversial issue, but very little is known about the actual situation in UK schools. The aim of this study was to investigate, with particular reference to health education and health promotion, commercial activities and their regulation in primary schools in the Yorkshire and Humber region of the UK. A questionnaire was sent to a random sample of 650 headteachers with respondents being asked whether a range of commercial activities had been present in their school during the previous 20 months. They also indicated whether the school had any policies on the types of activity covered by the questionnaire. The results showed that four types of commercial activity had been present in over 50% of responding schools. These were voucher/token collection schemes, business linked competitions/contests, business linked sports coaching and sponsorship. Voucher/token collection schemes were found to be the most common form of activity, with 85% of schools having participated in at least one of these initiatives. Only 4% of schools had any policies on the types of activity covered in the questionnaire. Further research in the UK on commercial activities in schools is recommended. (Contains 4 tables and 3 figures.)

In this article, the author states that, the problem of social adaptation is an object of research in many fields of knowledge, and every science approaches the study of it from its own point of view, leading to a diversity of conceptions. Social adaptation in its most general form is the interaction between an individual or group and the social environment, in the course of which the needs and expectations of the participants are reconciled. And what is most substantive in this definition is that adaptation calls for changing oneself, one's individuality, under the influence of external factors. And as a consequence, anyone who does not conform to the norms and values that are dominant in the culture is considered to be a poorly adapted outsider or even a lunatic. The adaptation can be expressed as a change in other people's attitudes toward the creative abilities of the specific individual, and in the creation of optimal conditions for their development on the part of society. There are a number of approaches to the analysis of this concept, but the most common practice is to single out three types of adaptation: (1) by adapting to circumstances as they are, by blending in to the environment and changing oneself; (2) by transforming the environment; and (3) by withdrawing or getting out of the environment. In this article, the author conducted a cross-cultural survey to explore questions concerning what conceptions about creative individuals and the characteristics of their adaptation are prevalent in today's society. And to analyze public opinion about the characteristics of adaptation of creatively gifted children. (Contains 1 figure.)

Objective: To evaluate the Strengths and Difficulties Questionnaire in a U.S. national population sample of children and adolescents, develop normative scoring bands, and test the association of high-scoring groups with service contacts or use for mental health reasons. Method: An Americanized version of the Strengths and Difficulties Questionnaire parent report was administered to parents of 10,367 4- to 17-year-olds in the 2001 National Health Interview Survey. Scoring bands were developed to differentiate low, medium, and high levels of emotional or behavioral difficulties. Children at high risk of serious difficulties were identified by three different scoring methods: (1) high symptom scores, (2) parental perception of definite or severe difficulties, and (3) high symptoms plus impairment. These ratings were validated against service contact or use and other well-established demographic and broader risk factors for child emotional and behavioral problems. Results: Results indicated good acceptability and internal consistency. Normative scoring bands were similar, though not identical, to the original British bands. Results of each scoring method had a strong association with service contact/use. Conclusions: This study supports the usefulness of the Strengths and Difficulties Questionnaire as an effective and efficient screener for child and adolescent mental health problems in the United States.

This paper reports on a qualitative research project undertaken with Y6 children. It draws on transcriptions of children's discussions; recordings of collaborative writing sessions; and the children's responses to a series of questions relating to Beanie soft toys, their origins, their intended market audience and their creator's entrepreneurial intentions in relation to the global market. The paper considers how far the children were motivated by working with popular icons as a purpose for collaborative writing. It also analyses children's stated views on the manufacturers who make, advertise and sell these types of popular toys and explores children's relationship to the consumerist ideology which surrounds popular culture.

Purpose: The aim of this study was to determine median audiograms and prevalence of hearing loss for U.S. 6- to 19-year-olds. Method: U.S. national audiometric data for 2,709 six- to 19-year-olds from the National Health and Nutrition Examination Survey 2017-2020 were analyzed. Analyses were primarily descriptive and relied on distribution-free medians, cumulative distribution functions (CDFs), and population-weighted prevalence estimates. Differences between CDFs were examined using Cohen's h effect size. Results are presented for the age range of 6-19 years. Main effects of sex, age, and race/ethnicity were examined. Results: Differences in the audiograms between the sexes and among the various race/ethnicity groups were minor, but age group differences were notable. Pure-tone thresholds at 500 and 8000 Hz for the 6- to 9-year age group were 3-5 dB higher (worse) than those of the other age groups. The overall prevalence of hearing loss among 6- to 19-year-olds, defined as either of the puretone averages (PTAs) for 500, 1000, and 2000 Hz (PTA512) or 3000, 4000, 6000, and 8000 Hz (PTA3468k) exceeding 15 dB HL in either ear, was 11.24% (95% confidence interval [10.00%, 12.48%]). Binary logistic regression analyses found the odds of hearing loss to be significantly higher for individuals from families with a low income as well as for those with abnormal otoscopy or abnormal tympanometry. Conclusions: For children and adolescents in the United States, hearing was unaffected by differences in sex and race/ethnicity, with only age impacting pure-tone thresholds and only at the lowest (500 Hz) and highest (8000 Hz) frequencies examined. The overall prevalence of hearing loss was about 11%. [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]

Mindfulness strategies can have a large impact on emotional regulation, emotional intelligence, and interpersonal relationships. Parents of children on the autism spectrum may experience greater stress, depression, and strained interpersonal relationships than those with typically developing children or those with children experiencing other developmental delays. The purpose of the current study was to evaluate the feasibility, acceptability, and initial effects of a virtual Mindful Self-Compassion workshop for parents of children on the autism spectrum and the impact on stress, self-compassion, parenting self-efficacy, and mindfulness. This pilot study used a mixed-method approach to test this hypothesis. Participants completed surveys before and after the brief workshop and participated in a 1-hr focus group within 1 week of completing the surveys. The findings indicate that a short, 3-day virtual workshop may be effective toward improving parents' mindfulness and self-compassion. Parents reported feeling more mindful in their day-to-day life, more self-compassionate during difficult times, and more patient with themselves and other people in their family. A brief, virtual workshop may be effective for short-term improvements in outcomes for parents of children on the autism spectrum. [ABSTRACT FROM AUTHOR]

Objective: Our goal was to compare data collected from 3- and 7-day Infant with Clefts Observation Outcomes (iCOO) diaries. Design: Secondary data analysis of an observational longitudinal cohort study. Caregivers completed the daily iCOO for 7 days before cleft lip surgery (T0) and for 7 days after cleft lip repair (T1). We compared 3- and 7-day diaries collected at T0 and 3- and 7-day diaries collected at T1. Setting: United States. Participants: Primary caregivers of infants with cleft lip with and without cleft palate (N = 131) planning lip repair and enrolled in original iCOO study. Main Outcomes Measure(s): Mean differences and Pearson correlation coefficients. Results: Correlation coefficients were high for global impressions (>0.90) and scaled scores (0.80–0.98). Mean differences were small across iCOO domains at T0. T1 comparisons reflected the same pattern. Conclusions: Three-day diary data is comparable to 7-day diaries for measuring caregiver observations using iCOO across T0 and T1. [ABSTRACT FROM AUTHOR]

BACKGROUND: The bag-valve-mask (BVM) or manual resuscitator bag is used as a first-line technique to ventilate patients with respiratory failure. Volume-restricted manual resuscitator bags (eg, pediatric bags) have been suggested to minimize overventilation and associated complications. There are studies that both support and caution against the use of a pediatric resuscitator bag to ventilate an adult patient. In this study, we evaluated the ability of pre-hospital clinicians to adequately ventilate an adult manikin with both an adult- and pediatric-size manual resuscitator bag without the assistance of an advanced airway or airway adjunct device. METHODS: This study was conducted at an international conference in 2022. Conference attendees with pre-hospital health care experience were recruited to ventilate an adult manikin using a BVM for 1 min with both an adult and pediatric resuscitator bag, without the use of adjunct airway devices, while 6 ventilatory variables were collected or calculated: tidal volume (VT), breathing frequency, adequate breaths (VT > 150 mL), proportion of adequate breaths, peak inspiratory pressure (PIP), and estimated alveolar ventilation (EAV). RESULTS: A total of 208 participants completed the study. Ventilation with the adult-sized BVM delivered an average VT of 290.4 mL compared to 197.1 mL (P < .001) when using the pediatric BVM. PIP with the adult BVM was higher than with the pediatric BVM (10.6 cm H2O vs 8.6 cm H2O, P < .001). The median EAV with the adult bag (1,138.1 [interquartile range [IQR] 194.0-2,869.9] mL/min) was markedly greater than with the pediatric BVM (67.7 [IQR 0-467.3] mL/min, P < .001). CONCLUSIONS: Both pediatric- and adult-sized BVM provided lower ventilation volumes than those recommended by professional guidelines for an adult. Ventilation with the pediatric BVM was significantly worse than with the adult bag when ventilating a simulated adult subject. [ABSTRACT FROM AUTHOR]

Background: For the past 50 years, standard guidelines have recommended the use of sex-adjusted mid-parental height to predict a child's final height. Here, we studied the accuracy of this procedure. Methods: We used height data in a cohort of 23 very large nuclear families (mean = 11 adult children per family). We compared the actual final height of the children to their height predicted by the standard procedure, as well as to alternative height predictions that incorporate corrections of mid-parental height for age, sex, and regression to the mean. Results: Standard mid-parental height explained 36% of the variance in children's heights, with a heritability of 74%, and children were on average 2.7 cm taller than predicted by their target heights. When we introduced a nonlinear correction for the age of the parents, employed a multiplicative (rather than additive) correction for sex, and accounted for regression to the mean, the variance explained increased to 40%, heritability increased to 80%, and prediction bias was reduced from 2.7 cm to 0.14 cm (representing an improvement in prediction by half a standard deviation of the height distribution). We further measured the empirical distribution of the heights of adult children around their predicted height. We describe how this distribution can be used to estimate the probability that a child's height is within the normal expected range. Conclusions and Relevance: Based on these observations, we propose an improved method for predicting children's target heights. Our procedure for determining whether the deviation of a child's projected height from the target height is in the normal range can be used to assess whether the child should be tested further for potential medical abnormalities. [ABSTRACT FROM AUTHOR]

Background: Early detection of autism spectrum disorder (ASD) has the potential to significantly reduce the impact of the condition, however previous reviews have found little evidence to support screening programs for ASD in young children. Methods: We conducted a review with the aim of updating evidence on 3 aspects: (a) diagnostic stability of ASD in young children; (b) accuracy of ASD screening tools in young children; and (c) the benefits of early interventions in screen-detected young children with ASD. Results: A total of 33 studies were included in our review. Five studies looking at diagnostic stability reported estimates ranging from 71.9% to 100%, however the majority only included a follow-up of 24 months and all studies raised concerns regarding the risk of bias due particularly to lack of blinding, sample size, and patient flow. A total of 25 studies, reported in 26 articles, were identified that reported accuracy data on 11 screening tools. Most of the reports were concerned with versions of M-CHAT, reporting sensitivity estimates from 0.67 to 1.0; however, many of these were deemed to be of high risk of bias due to lack of blinding and follow-up. Four studies reported on early interventions in screen-detected children; however, the majority did not find significant improvements on the relevant outcomes. Conclusions: Overall, the evidence on screening for ASD in young children captured by this review is not conclusive regarding the 3 aspects of screening in this population. Future studies should attempt to ensure blinded diagnostic assessments, include longer follow-up periods and limit attrition. [ABSTRACT FROM AUTHOR]

Purpose: Emerging literature suggests caregiver self-efficacy is an important factor related to caregivers’ shared reading practices with their children. Reduced shared reading has been documented among families of caregiver(s) with language-based learning disabilities (LBLD). Yet, it remains unclear whether caregivers’ history of language and reading difficulties is associated with caregiver self-efficacy. The purpose of this study was to examine whether self-efficacy in language- and reading-related caregiver activities related to caregiver history of language and reading difficulties and shared reading practices. Method: One hundred seventy-six caregivers of children aged 18–60 months completed a custom self-efficacy in language- and reading-related caregiver activities questionnaire, as well as demographic, history of language and reading difficulties (used both as a continuous measure and to dichotomize caregivers with and without LBLD history), and shared reading measures in a one-time survey. Results: Caregivers with a history of LBLD reported an overall lower self-efficacy and a reduced amount of time reading with their children per week than caregivers without LBLD history. Examining caregiver history of language and reading difficulties continuously across the whole group, self-efficacy mediated the relationship between caregiver difficulties and shared reading practices, even when caregiver education was incorporated as an additional mediator in models. Conclusions: Findings indicate that self-efficacy and caregiver education mediate the relationship between caregiver history of language and reading difficulties and shared reading practices. Consideration of self-efficacy by clinicians and educators is warranted when promoting shared reading practices to caregivers of young children. There is a need for future research to examine relationships between self-efficacy and shared reading among caregivers with LBLD of culturally and linguistically diverse backgrounds. [ABSTRACT FROM AUTHOR]

Background: Individuals with autism spectrum disorder (ASD) have social communication difficulties and restricted, repetitive, and/or sensory behaviors or interests. The prevalence of ASD is now 1 in 36 individuals. Parents of individuals with ASD face challenges that can affect their physical and psychological well-being. Objective: With the long-term goal to tailor an exercise program, the purpose of this study was 2-fold: (1) establish the baseline physical and mental health of parents of individuals with ASD and (2) estimate the relationship of physiologic variables with psychological variables of health for parents of individuals with ASD. Methods: This descriptive, cross-sectional study (N = 44) explored physical health measures and the correlation between physical and psychological health, using measures of anxiety, stress, parenting depression, and positive thinking for parents who care for individuals with ASD. Results: The common characteristics that these parents shared was high body fat and low physical activity. Body fat was negatively correlated to total step count (r = −0.428, P <.05), grip strength (r = −0.319, P <.5), and total distance walked in the week (r = −0.661, P <.01), and positively correlated to 5-times sit to stand (r = 0.337, P <.05). Low activity correlated to increased parenting stress of advocating for child's needs (r = −0.310, P =.043). Conclusions: Understanding relationships between physical and psychological health informs effective interventions and support systems for parents. Parents need supports to be able to prioritize exercise. Future studies should include a larger sample to verify these effects. [ABSTRACT FROM AUTHOR]

Shame-proneness refers to one's dispositional tendency to experience shame across a variety of situations. Shame-proneness is significantly related to a wide range of mental health disorders including depression, anxiety, post-traumatic stress, substance abuse, and more. Attachment theory and interpersonal neurobiology suggest that secure attachment protects against shame-proneness, whereas insecure attachment contributes to shame-proneness. However, there is scant empirical research exploring this relationship. This study explored childhood attachment with primary caregivers as a predictor of shame-proneness in adulthood. A sample of 340 adults, U.S. residents aged 18 and over, was recruited through Amazon Mechanical Turk (MTurk), an online crowdsourcing platform. Multiple regression analyses revealed that certain insecure attachment styles, specifically anxiety and disorganization, significantly related to shame-proneness, whereas avoidance did not. Secure attachment was negatively related to shame-proneness, but the relationship was statistically insignificant. Social workers and other mental health professionals can benefit from an increased understanding of the relationship between childhood attachment and shame-proneness that this study provides. [ABSTRACT FROM AUTHOR]

This multi-center study examined the safety and effectiveness of cochlear implantation of children between 9 and 11 months of age. The intended impact was to support practice regarding candidacy assessment and prognostic counseling of pediatric cochlear implant candidates. Data in the clinical chart of children implanted at 9–11 months of age with Cochlear Ltd devices at five cochlear implant centers in the United States and Canada were included in analyses. The study included data from two cohorts implanted with one or two Nucleus devices during the periods of January 1, 2012–December 31, 2017 (Cohort 1, n = 83) or between January 1, 2018 and May 15, 2020 (Cohort 2, n = 50). Major adverse events (requiring another procedure/hospitalization) and minor adverse events (managed with medication alone or underwent an expected course of treatment that did not require surgery or hospitalization) out to 2 years post-implant were monitored and outcomes measured by audiometric thresholds and parent-reports on the IT-MAIS and LittlEARS questionnaires were collected. Results revealed 60 adverse events in 41 children and 227 ears implanted (26%) of which 14 major events occurred in 11 children; all were transitory and resolved. Improved hearing with cochlear implant use was shown in all outcome measures. Findings reveal that the procedure is safe for infants and that they show clear benefits of cochlear implantation including increased audibility and hearing development. [ABSTRACT FROM AUTHOR]

Purpose: Subjective wellbeing (SWB) is a significant contributor to quality of life and overall wellbeing in childhood through adulthood. However, less is known about the modifiable factors that support SWB among urban children. This study explored the association between socio-ecological factors (family, peers, and neighborhood) and child SWB. Method: A convenience sample of 69 students were recruited from the 3rd (n = 40) and 5th (n = 29) grades at two urban elementary schools in a mid-Atlantic state. The average age for participants was 9.32 (SD = 1.33) and most of the sample identified as female (60.9%). We expected that better perceived family and peer relationships, and neighborhood quality would be positively associated with higher child SWB. Regression analyses were conducted by SWB outcome, which included global and domain-specific life satisfaction (i.e., personal wellbeing), and core affect. Results: Study findings indicated that family relationships were positively associated with overall life satisfaction and personal wellbeing. Neighborhood quality was also positively associated with student life satisfaction and core affect. Peer relationships were not associated with any of the SWB outcomes. Discussion: The findings highlight the importance of strengthening a child's relationships and environment to sustain positive child SWB. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Pediatric cerebellar mutism syndrome (pCMS) can occur following resection of a posterior fossa tumor and, although some symptoms are transient, many result in long-lasting neurological deficits. A multi-disciplinary rehabilitation approach is often used in cases of pCMS; however, there have been no clinical trials to determine gold standards in rehabilitation practice in this population, which remains a research priority. The purpose of this study was to identify and compare intervention practices used in pCMS throughout the disciplines of occupational and physical therapy, speech-language pathology, and neuropsychology across geographic regions. METHODS: A 55-question e-survey was created by an international multidisciplinary research group made up of members of the Posterior Fossa Society and sent to rehabilitation professionals in pediatric neuro-oncology centers in the US, Canada, and Europe. RESULTS: Although some differences in the type of intervention used in pCMS were identified within each discipline, many of the targeted interventions including dose, frequency, and intensity were similar within disciplines across geographic regions. In addition, there were common themes identified across disciplines regarding challenges in the rehabilitation of this population. CONCLUSION: These results provide a foundation of current practices on which to build future intervention-based clinical trials. [ABSTRACT FROM AUTHOR]

This longitudinal study applied the integrated model of self-determination theory (SDT) and the theory of planned behaviour (TPB) to explain COVID-19 preventive behaviours among parents of young children in the United States. The study adopted a two-wave longitudinal study design. Parents (N = 681) completed self-report questionnaires related to measures of SDT and the TPB constructs and behavioural adherence at baseline and after one month. We used standardised residual change scores to test the structural relationships of the integrated model. The parameter estimates of the model (CFI >.96, TLI >.86, RMSEA =.05, SRMR =.03) fit acceptably well to the data. Psychological need support was positively and significantly linked to autonomous and controlled motivation and amotivation. Autonomous motivation was positively and significantly correlated with TPB factors, and intention. Intention was a significant and positive predictor of behavioural adherence. The integrated model of SDT and the TPB appeared to be applicable to the explanation of COVID-19 prevention among the U.S. parents. Longitudinal data showed that a psychological need supportive social environment was related to favourable motivation, social cognition beliefs, intention and behavioural adherence to the preventive behaviours of parents protecting their young children from COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 3400 infants die suddenly and unexpectedly each year in the United States; many of these deaths include modifiable risk factors (such as a non‐supine position, sleeping on a soft surface, or loose bedding or items in the environment). Interventions have been successful at improving parental knowledge about recommendations to reduce risk of sleep‐related infant deaths, as well as improving intention to adopt recommendations. However, follow‐up studies have found a disconnect between knowledge/intentions to adhere to recommendations and actual practices. Exploring maternal decision‐making about infant sleep practices can better elucidate the disconnect between knowledge of infant sleep recommendations and the practice of it, and thus, inform more effective safe sleep interventions. The purpose of this study was to gain a more in‐depth understanding of decision‐making around infant sleep practices, and barriers and facilitators to adopting safe infant sleep recommendations. Methods: Semi‐structured in‐home interviews were conducted with 22 families (20 mothers and 2 mother–father dyads) of infants up to 6 months of age. Results: Thematic analysis of the transcripts revealed six themes: Plans changed when baby came, Trying things to figure out what works (infant preferences), Safety concerns, What's comfortable for me (maternal preferences), They say...(advice), and Trying to be careful. Conclusion: These results suggest that knowledge of infant sleep recommendations alone is not enough to ensure adherence and that decision‐making is a dynamic and ongoing process affected by multiple factors. Findings have implications for timing and content of risk reduction efforts, as well as for data collection in research studies. [ABSTRACT FROM AUTHOR]

Learning to descend stairs requires motor and cognitive capacities on the part of infants and opportunities for practice and assurance of safety offered by caregivers. The American Academy of Pediatrics prescribes the age strategy to teach toddlers to safely descend stairs but without much consideration for individual differences in infants' skills or caregivers' techniques. The purpose of this study was to observe the natural ways in which caregivers teach infants to descend stairs at home and the extent to which infants abide. Of particular interest was to examine the dynamic nature of caregivers' teaching and infants' learning over the session with attention to individual differences. Dyads (N = 59) were videorecorded on Zoom for 10 min interacting on stairs at home in the United States, Brazil, Canada, Italy, and Spain. Infants (n = 30 girls, 29 boys; 13-month-olds ± 1 week) were novice walkers (M = 2.04 months walking experience). Caregivers used a variety of teaching strategies and focused on "backing" and "scooting." Infants were more likely to heed caregivers' guidance when caregivers provided hands-on support and verbal encouragement suggesting infants were engaged and responsive to caregivers' overtures. Infants' walking experience predicted change in descent strategy over the session. Although infants did not show evidence of learning over the session, consistent caregiver instruction suggested caregivers were persistent, if not effective, teachers. Teaching and learning motor skills in a potentially risky task creates a unique opportunity for interaction, allowing infants and caregivers to learn from one another. Public Significance Statement: This work contributes to the general body of knowledge regarding infant motor development and problem solving in specific contexts. This study is one of the first to explore the nature of caregiver-infant interaction on stairs and identifies caregiver teaching strategies and infant motor characteristics that are associated with safe infant stair descent. By doing so, we hope to encourage further investigation of infant behavior in this context, upon which recommendations to caregivers for safe infant descent may be based. [ABSTRACT FROM AUTHOR]

Using data from The Family Life Project (N = 700), this study examined the pivotal behavior model by testing the hypothesis that children's social engagement at 24 months mediates the relationship between maternal responsiveness at 24 months and children's language outcomes at 36 months. Maternal responsiveness during parent-child interaction in a jigsaw puzzle task when children were 24 months old served as a predictor, and children's social engagement during the same (i.e., persistence, enthusiasm, and compliance) at 24 months, which was assessed during the same task served as the mediator. Children's language comprehension, language expression, and fluency when children were 36 months old served as the dependent variable. Children's expressive communication at 24 months was controlled for. The results supported our hypothesis. Higher maternal responsiveness was related to children's social engagement, which in turn facilitated children's language development. Children's language outcomes also were directly related to caregivers' sensitivity and responsiveness to children's needs, gestures, and expression. Highlights: We test the pivotal behavior model with families from rural areas. Maternal responsiveness is found to be directly related to child language skills. Children's social engagement links maternal responsiveness with child language skills. The pivotal behavior model is supported for people with limited economic resources. [ABSTRACT FROM AUTHOR]

Background: Youth mental health has declined since the COVID-19 pandemic began. Health coaching and mindfulness-based intervention may support therapeutic processes that promote resilience in the face of risk factors for adverse mental health outcomes. Building Resilience for Healthy Kids (HK) is a school-based intervention designed to support mental health through targeting these processes. Objective: In this study, we tested HK in a pilot randomized controlled trial. Specifically, we examined intervention effects on the theoretically-informed therapeutic processes of emotion regulation, mindfulness, self-efficacy, and resilience and the clinical outcomes of depression and anxiety symptoms. The trial took place between April and June 2021, offering an opportunity to assess the impact of HK in the context of COVID-19. Methods: Participants were early adolescents (N = 230), randomized to HK or assessment-only. Participants in the intervention condition received weekly one-on-one sessions with health coaches. All youth completed validated self-report measures at baseline and post-intervention. Results: Linear mixed effects models indicated that participants who received HK had a greater reduction in emotion regulation difficulties, relative to assessment-only controls (d = 0.84, large effect). Follow-up analyses revealed that youth who endorsed negative affectivity at baseline experienced more benefits than those who did not, and youth who attended more HK sessions increased in self-efficacy, in addition to improved emotion regulation. Intervention effects did not reach significance for other outcomes. Conclusions: Findings suggest that HK may support youth in reducing difficulties in emotion regulation, which are precursors to the development of mental health concerns in adolescence. TRN: NCT04202913, 12/16/2019. [ABSTRACT FROM AUTHOR]

Despite advances in the field of augmentative and alternative communication (AAC), outcomes among children who require AAC remain discouraging. Practitioners may benefit from guidelines to aid decision-making in relation to supporting pre-linguistic communicators. We conducted an open-ended questionnaire of 30 AAC professionals from six countries—Australia, Denmark, the Netherlands, New Zealand, the United Kingdom, and the United States—to determine if consensus existed regarding the assessment information needed, the communication skills to teach, and the instructional strategies to employ to support AAC learning for pre-linguistic communicators. We analyzed the responses using qualitative content analysis in four iterative phases. We provide five statements that reflect areas of consensus and divergence among the participating AAC professionals. These findings provide important insights related to assessment, communicative competence, instructional strategies, decision-making, and communication partner instruction. Findings of this preliminary exploration indicate the need for ongoing and targeted research related to AAC decision-making guidance that attends to context (e.g., languages spoken, service structures) and pre- and in-service training in AAC decision-making. [ABSTRACT FROM AUTHOR]

Simple Summary: This cross-sectional study analyzed how multilevel social factors affect patient-reported outcomes in children under 18 who survived cancer. Study participants include 293 pairs of these survivors who received survivorship care at a U.S.-based comprehensive cancer center between 2017 and 2018 and their primary caregivers. Findings indicate that higher caregiver anxiety is linked to worse depression, stress, fatigue, sleep problems, and lower positive affect in survivors of pediatric cancer. The study also found that family conflicts are associated with sleep issues in childhood cancer survivors. Furthermore, survivors living in socioeconomically deprived areas experience poorer sleep quality, and those residing in environments with high physical deprivation experience more psychological stress and fatigue, alongside reduced positivity and mobility. These results highlight the significant impact of parental, familial, and neighborhood factors on a range of patient-reported outcomes among young cancer survivors, suggesting these social factors as crucial targets for intervention. In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children's Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors' and caregivers' PROs. General linear regression tested associations of social determinants with survivors' PROs. We found that caregivers' higher anxiety was significantly associated with survivors' poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p < 0.05); caregivers' sleep disturbances were significantly associated with lower mobility in survivors (p < 0.05). Family conflicts were associated with survivors' sleep problems (p < 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors' poorer sleep quality (p < 0.05), while higher physical environment deprivation was associated with survivors' higher psychological stress and fatigue and lower positive affect and mobility (p < 0.05). Parental, family, and neighborhood factors are critical influences on young survivors' quality of life and well-being and represent new intervention targets. [ABSTRACT FROM AUTHOR]

Purpose: Women and children continue to miss preventive visits. Which neighborhood factors predict inadequate prenatal care (PNC) and well-child visit (WCV) attendance remain unclear. Description: In a retrospective case–control study at Virginia Commonwealth University Health System, mothers with less than 50% adherence or initiation after 5 months gestation were eligible as cases and those with ≥ 80% adherence and initiation before 5 months were eligible as controls. Children in the lowest quintile of adherence were eligible as cases and those with ≥ 80% of adherence were eligible as controls. Cases and controls were randomly selected at a 1:2 ratio and matched on birth month. Covariates were derived from the 2018 American Community Survey. A hotspot was defined as a zip code tabulation area (ZCTA) with a proportion of controls less than 0.66. ZCTAs with fewer than 5 individuals were excluded. Weighted quantile regression was used to determine which covariates were most associated with inadequate attendance. Assessment: We identified 38 and 35 ZCTAs for the PNC and WCV analyses, respectively. Five of 11 hotspots for WCV were also hotspots for PNC. Education and income predicted 51% and 34% of the variation in missed PNCs, respectively; language, education and transportation difficulties explained 33%, 29%, and 17% of the variation in missed WCVs, respectively. Higher proportions of Black residents lived in hotspots of inadequate PCV and WCV attendance. Conclusion: Neighborhood-level factors performed well in predicting inadequate PCV and WCV attendance. The disproportionate impact impact of inadequate PCV and WCV in neighborhoods where higher proportions of Black people lived highlights the potential influence of systemic racism and segregation on healthcare utilization. Significance: What is already known on this subject? Many pregnant women and children continue to miss preventive visits. It is not known what geographic factors contribute to missed visits. What this study adds? Neighborhood-level factors performed well in predicting inadequate prenatal care and well-child attendance. There were disproportionate missed preventive visits in neighborhoods where higher proportions of Black people lived, highlighting the role of systemic racism and segregation on healthcare utilization. [ABSTRACT FROM AUTHOR]

Importance: Differences in sensory reactivity are a core feature of autism; however, more remains to be learned about their role in classroom learning. Objective: To use direct observational measures to investigate whether there is a link between sensory reactivity differences and classroom behaviors of autistic children. Design: Correlational study. Setting: Two special educational needs schools. Participants: Children with a clinical diagnosis of autism, ages 5 to 18 yr (N = 53). Outcomes and Measures: Sensory reactivity differences were assessed with the Sensory Assessment for Neurodevelopmental Differences. Classroom behaviors were measured using the Behavior Assessment for Children–Second Edition Student Observation System. Results: Total sensory reactivity differences were correlated positively with behaviors that impede learning (r =.31, p <.05) and negatively with behaviors that facilitate learning (r = −.38, p <.05). Hyporeactivity differences were correlated positively with behaviors that impede learning (r =.28, p <.05) and negatively with behaviors that facilitate learning (r = −.31, p <.05). Hyperreactivity and sensory-seeking differences were not significantly correlated with behavior. Conclusions and Relevance: Results suggest a link between sensory reactivity differences and classroom behaviors, highlighting a need for further research using observational measures in special education settings. Plain-Language Summary: Differences in hyporeactivity for children with autism may play a bigger role in classroom behavior and learning than previous literature has suggested. This has implications in occupational therapy practice for how to tailor support for children with hyporeactivity differences. The results of this study suggest that differences in hyporeactivity for children with autism may play a bigger role in classroom behavior and learning than previous literature has suggested. [ABSTRACT FROM AUTHOR]

Deciding whose words to trust profoundly impacts children's knowledge acquisition. In evaluating informants' trustworthiness, children are attentive to their social dominance. Previous studies have shown that children's trust preferences may differ across cultures based on the dominance of the informant: children in Western cultures prefer to trust in testimony from dominant informants, whereas children in Eastern cultures prefer to trust subordinate informants (Bernard et al., 2016; Charafeddine et al., 2019). We aim to investigate the potential cultural difference in the trust preferences of European American children (in the United States) and Chinese children (in China) from informants of varying levels of dominance, using a more refined method to assess children's trust preferences. We propose that different levels of authoritarianism – advocacies to obey authorities – in Western and Eastern cultures may explain the potential difference in children's selective trust. Specifically, as impacted by societal cultures, Chinese parents may possess a higher level of authoritarianism than European American parents and may place a higher emphasis on obedience in their parenting. Consequently, Chinese children may show stronger trust preferences from subordinate informants over dominant informants than European American children. Our research will offer insights into the potential mechanism underlying children's different learning preferences across cultures. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the impact of a culturally based intervention, the Intertribal Talking Circle program, compared to a standard alcohol and drug abuse education, the Be A Winner program. Community‐based participatory research was used to implement a two‐condition, quasi‐experimental study. The sample included 540 Native American youth ages 10−12 years old from three tribal areas in the United States. Data were collected at baseline, 6 and 12‐months post‐intervention for both the intervention and control groups using demographic, cultural identity, alcohol use, and drug use questionnaires. Regression models evaluated participants' improvement in decreasing alcohol and drug use and increasing cultural identity. Findings revealed that alcohol and drug use decreased more significantly among youth who participated in the Intertribal Talking Circle (ITC) intervention program than youth who participated in a standard alcohol and drug abuse education Be A Winner (BAW) program. Cultural identity also increased more significantly among participants who completed the Talking Circle intervention program. Native American youth ages 10−12 years old respond positively to a culturally based intervention for the reduction of alcohol and drug use. The findings highlight the importance of cultural values and identity and their significance in preventing and reducing alcohol and drug use among Native American youth. [ABSTRACT FROM AUTHOR]

Schools' health screenings can identify students' missed health concerns. Data from the 2016 School Health Policies and Practices Study were used to determine the proportion of U.S. school districts with physical and mental health screening policies and the proportion that arrange off-campus mental health services. We also examined differences between districts with and without mental health screening policies regarding having physical health screening policies, patterns of these policies, and off-campus mental health service arrangements. Eleven percent of districts had no policies on any of the four physical health screenings assessed, and 87% lacked policies on mental health screenings, the latter especially concerning considering the impact of COVID-19. Districts with policies on mental health screenings were significantly more likely to have body mass index (p <.01) and oral health (p <.001) screening policies, and to arrange for off-campus case management (p <.001), family counseling (p <.05), group counseling (p <.01), self-help (p <.05) and intake evaluation (p <.05). [ABSTRACT FROM AUTHOR]