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The U.S. Report Card on Physical Activity for Children and Youth has tracked 10 physical activity (PA) indicators common to the Active Healthy Kids Global Matrix since 2014. This article expands on the U.S. report cards by presenting PA indicator assessments among children and adolescents with disabilities. Grades for indicators were assigned based on a search of peer-reviewed articles presenting nationally representative data. The Global Matrix 3.0 benchmarks and grading framework guided the process. Grades for overall PA, sedentary behaviors, organized sports, and school were F, D+, D+, and D, respectively. Insufficient evidence existed to assign grades to the remaining six indicators. There is a need in the United States for targeted PA promotion strategies that are specific to children and adolescents with disabilities. Without a commitment to this effort across sectors and settings, the low grades identified in this para report card are expected to remain. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Repurposed medications for acute coronavirus disease 2019 (COVID-19) continued to be prescribed after results from rigorous studies and national guidelines discouraged use. We aimed to describe prescribing rates of nonrecommended medications for acute COVID-19 in children, associations with demographic factors, and provider type and specialty. METHODS: In this retrospective cohort of children <18 years in a large United States all-payer claims database, we identified prescriptions within 2 weeks of an acute COVID-19 diagnosis.We calculated prescription rate, performed multivariable logistic regression to identify risk factors, and described prescriber type and specialty during nonrecommended periods defined by national guidelines. RESULTS: We identified 3082626 COVID-19 diagnoses in 2 949 118 children between March 7, 2020 and December 31, 2022. Hydroxychloroquine (HCQ) and ivermectin were prescribed in 0.03% and 0.14% of COVID-19 cases, respectively, during nonrecommended periods (after September 12, 2020 for HCQ and February 5, 2021 for ivermectin) with considerable variation by state. Prescription rates were 4 times the national average in Arkansas (HCQ) and Oklahoma (ivermectin). Older age, nonpublic insurance, and emergency department or urgent care visit were associated with increased risk of either prescription. Additionally, residence in nonurban and low-income areas was associated with ivermectin prescription. General practitioners had the highest rates of prescribing. CONCLUSIONS: Although nonrecommended medication prescription rates were low, the overall COVID-19 burden translated into high numbers of ineffective and potentially harmful prescriptions. Understanding overuse patterns can help mitigate downstream consequences of misinformation. Reaching providers and parents with clear evidence-based recommendations is crucial to children's health. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the association between congenital cytomegalovirus (cCMV) and autism spectrum disorder (ASD) administrative diagnoses in US children. METHODS: Cohort study using 2014 to 2020 Medicaid claims data.We used diagnosis codes to identify cCMV (exposure), ASD (outcome), and covariates among children enrolled from birth through ≥4 to <7 years. Covariates include central nervous system (CNS) anomaly or injury diagnosis codes, including brain anomaly, microcephaly within 45 days of birth, cerebral palsy, epilepsy, or chorioretinitis. We used Cox proportional hazards regression models to estimate hazard ratios and 95% confidence intervals, overall and stratified by sex, birth weight and gestational age outcome (low birth weight or preterm birth), and presence of CNS anomaly or injury. RESULTS: Among 2 989 659 children, we identified 1044 (3.5 per 10 000) children with cCMV and 74 872 (25.0 per 1000) children with ASD. Of those with cCMV, 49% also had CNS anomaly or injury diagnosis codes. Children with cCMV were more likely to have ASD diagnoses (hazard ratio: 2.5; 95% confidence interval: 2.0-3.2, adjusting for birth year, sex, and region). This association differed by sex and absence of CNS anomaly or injury but not birth outcome. CONCLUSIONS: Children with (versus without) cCMV diagnoses in Medicaid claims data, most of whom likely had symptomatic cCMV, were more likely to have ASD diagnoses. Future research investigating ASD risk among cohorts identified through universal cCMV screening may help elucidate these observed associations. [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]

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]

Young children are biased to treat new information communicated to them as conventional, shareable, and known by others in their community. However, some information is privileged in the sense that is not intended to be shared with or known by all. The current study compared judgements regarding sharing conventional versus privileged information. Seventy‐four 3‐ to 5‐year‐olds and adults responded to vignettes in which a protagonist had to decide whether to share conventional (an object name) or privileged information (surprise). Consistent with our hypothesis, there was no developmental change in sharing judgements for conventional information but a clear decrease with age for sharing privileged information. Nonetheless, even 3‐year‐olds were more likely to judge that conventional information should be shared more than privileged information, though this difference increased with age. While children overall treat information as shareable, there is an emerging ability to distinguish how conventional versus privileged information should be shared. [ABSTRACT FROM AUTHOR]

Most children in the United States consume low-quality diets. Identifying children's dietary patterns and their association with sociodemographic characteristics is important for designing tailored youth dietary interventions. This study's objective was to use cluster analysis to investigate children's dietary patterns and these patterns' associations with sociodemographic characteristics. Data from two cycles (2015-2016 and 2017-2018) of the National Health and Nutrition Examination Survey were evaluated to examine dietary patterns. Participants included 3,044 US youth aged 2 to 11 years who completed at least 1 valid 24-hour diet recall. The main outcome measures were Healthy Eating Index (HEI) 2015 component and composite scores. A cluster analysis was performed on standardized scores of 11 components of the HEI-2015 to identify dietary patterns. One logistic analysis combined the two higher-HEI score clusters and the 2 lower-HEI score clusters to form a 3-category variable of higher-, medium-, and lower-HEI score clusters. Another logistic analysis contrasted 2 higher- and then the 2 lower-HEI clusters with each other to examine sociodemographic factors contributing to cluster membership. Five clusters were identified, each displaying a distinct dietary pattern. Older, non-Hispanic Black, and overweight children had higher odds of being in the higher-HEI clusters than the medium-HEI cluster. Being older and non-Hispanic Black were linked to higher odds of being in the lower-HEI clusters than the medium-HEI cluster. Conversely, being Mexican American and living with a college-educated reference person were associated with lower odds of being in the lower-HEI clusters compared with the medium-HEI cluster. Among the higher-HEI clusters, Mexican American and Asian American children had higher odds of being in the Pescatarian cluster. Among the lower-HEI clusters, children who were racially or ethnically minoritized had lower odds of being in the Excess Sugar cluster. Children in this study displayed different dietary patterns, with key sociodemographic variation. [ABSTRACT FROM AUTHOR]

This retrospective study utilized the National Electronic Injury Surveillance System (NEISS) database to identify pediatric emergency department (ED) patients with playground-associated craniofacial injuries between January 2012 and December 2021. A total of 25 414 patients were identified. The majority of injuries occurred in preschool and elementary school–age children (90.3%) and patients were more commonly boys (59.3%). Injuries most often involved the head/scalp (52.4%), face (30.4%), and mouth (11.9%). Infant (32.7%) and teen (40.0%) injuries most commonly involved swings, whereas preschool (23.1%) and elementary school (28.1%) injuries were mostly associated with slides and climbers, respectively. Most patients were treated in the ED and discharged to home (96.5%), a small portion required hospitalization (1.6%), and one death was reported. Although the majority of the injuries were relatively minor and resulted in same-day discharges, these injuries can result in serious physical harm, emotional stress, and unexpected financial burdens. Proper education and supervision regarding safe play is important to prevent these injuries. [ABSTRACT FROM AUTHOR]

This study evaluates the epidemiology of nonfatal head injuries among children aged 1 to 4 years associated with consumer products and identifies the specific consumer products associated with these injuries. Data for children aged 1 to 4 years who presented to emergency departments (EDs) from 2015 to 2019 for a nonfatal head injury were extracted from the National Electronic Injury Surveillance System. An estimated 1 032 429 (95% confidence interval [CI]: 675 822-1 389 063) children presented to US EDs for head injuries, averaging 566 injuries daily. The average rate of head injury did not change over the 5-year study period (slope = −0.003; P =.852); it was highest among children aged 1 year (2.06 per 100 children aged 1 year), which was nearly 3 times that of children aged 4 years (rate ratio = 2.75; 95% CI: 2.73-2.77). Most injuries occurred at home (80.4%) and occurred from interacting with home furnishings (45.1%). This study underscores the need for increased head injury mitigation efforts among young children. [ABSTRACT FROM AUTHOR]

The significant population of Chinese rural-to-urban migrant children has sparked considerable domestic and international concern regarding their disadvantaged family circumstances and their escalating prevalence of internalizing and externalizing problems. Derived from the resource substitution hypothesis, non-cognitive factors such as personality traits may act as "substitution" resources for educational outcomes of children from less privileged families. Yet, the compensatory role of personality traits as substitution resources in children's mental health has received limited attention, including that of migrant children. This study examined the interplay of trait-like grit and family SES on emotional and conduct problems among Chinese migrant and urban children. The current sample consisted of 770 migrant children (Mage = 10.45 and SDage = 0.68 years; 38.4% girls) and their 222 urban counterparts (Mage = 10.34 and SDage = 0.46 years; 45.5% girls). Moderated polynomial regressions with response surface analysis on a two-wave data with an interval of over six months showed that grit served as a "substitution" resource for the less socioeconomically advantaged children. The compensatory effect of perseverance of effort on urban children's emotional problems and that of consistency of interest on migrant children's conduct problems were visualized. Moreover, the two compensatory effects were found to be robust and unique, even after children's effortful control, a grit-related construct, was taken into account. These findings not only support the resource substitution hypothesis, but also underscore the protective role that grit plays in children under less privileged environments. [ABSTRACT FROM AUTHOR]

Despite consensus on the importance of early detection and intervention for autistic children, health disparities exist, limiting access to timely services. One specific service type in the United States is Individuals with Disabilities Education Act, Part C Early Intervention programs, which are federally funded interventions for children birth-to-three with developmental delays. This study aimed to assess access to Part C, Early Intervention services for children who were evaluated for autism spectrum disorder and to examine factors that predicted parent-reported access to these services. This study extracted sociodemographic and service access data from the medical records of 709 children aged 12–40 months who were evaluated for autism spectrum disorder. Results showed that only 50% of the sample had reportedly accessed Part C, Early Intervention services. Those who identified as Black had decreased odds of having accessed Part C, Early Intervention, relative to those who identified as White, while those with a lower age of first parent concern had increased odds of having accessed Part C, Early Intervention. When inputting the independently significant variables into the model, both variables, identifying as Black and a lower age of first concern, remained significantly associated with accessing Part C, Early Intervention. Future work should investigate how these disparities come to be. Health disparities are defined as preventable differences in the opportunities to achieve optimal health outcomes experienced by marginalized and underrepresented communities. For families with autistic children, health disparities limit accessing early intervention services—which have been found to improve quality of life and other outcomes. One specific early intervention service in the United States is Individuals with Disabilities Education Act, Part C Early Intervention programs, which are federally funded interventions for children birth-to-three with developmental delays. This study adds to this topic by examining which factors impact accessing Part C, Early Intervention services for children who were evaluated for autism. Results showed that only half of the sample received these services despite there being concerns about development for all children. In addition, results showed that those who identified as Black had decreased odds of having accessed Part C, Early Intervention compared to those who identified as White. These results suggest that there are disparities when it comes to accessing important early intervention services that may be negatively impacting the Black autistic community. [ABSTRACT FROM AUTHOR]

Emerging research suggests that episodic memory challenges are commonly encountered by autistic individuals; however, the specific nature of these memory challenges remains elusive. Here, we address critical gaps in the literature by examining pattern separation memory, the ability to store distinct memories of similar stimuli, and its links to the core autistic trait of repetitive, restricted interests and behaviors. Utilizing a large sample of over 120 autistic children and well-matched non-autistic peers, we found that autistic children showed significantly reduced performance on pattern separation memory. A clustering analysis identified three distinct pattern separation memory profiles in autism, each characterized by reduced or increased generalization abilities. Importantly, pattern separation memory was negatively correlated with the severity of repetitive, restricted interest and behavior symptoms in autism. These findings offer new evidence for challenges in pattern separation memory in autism and emphasize the need to consider these challenges when assessing and supporting autistic individuals in educational and clinical settings. Memory challenges remain understudied in childhood autism. Our study investigates one specific aspect of memory function, known as pattern separation memory, in autistic children. Pattern separation memory refers to the critical ability to store unique memories of similar stimuli; however, its role in childhood autism remains largely uncharted. Our study first uncovered that the pattern separation memory was significantly reduced in autistic children, and then showed that reduced memory performance was linked to their symptoms of repetitive, restricted interest and behavior. We also identified distinct subgroups with profiles of reduced and increased generalization for pattern separation memory. More than 72% of autistic children showed a tendency to reduce memory generalization, focusing heavily on unique details of objects for memorization. This focus made it challenging for them to identify commonalities across similar entities. Interestingly, a smaller proportion of autistic children displayed an opposite pattern of increased generalization, marked by challenges in differentiating between similar yet distinct objects. Our findings advance the understanding of memory function in autism and have practical implications for devising personalized learning strategies that align with the unique memory patterns exhibited by autistic children. This study will be of broad interest to researchers in psychology, psychiatry, and brain development as well as teachers, parents, clinicians, and the wider public. [ABSTRACT FROM AUTHOR]

Argumentation is a fundamental communicative ability that children develop over time through formal schooling and daily practice with peers and family members. Literature on children's argumentation appears to have focused on their social interactions out of school, clinical environment, or informal pedagogic contexts. Even though there are research inquiries into children's argumentation in formal academic learning, many have been focused on argumentative writing in math or science classes. Much less is known about teacher-led argumentation and the youngest children's emerging argumentation in language art classes, where argumentation is formally and systematically introduced and learned. This paper reports a year-long ethnographic study on argumentation in a first-grade English language art classroom in the United States. Ethnographic discourse analysis was conducted to analyze two key literacy events from the daily reader's and writer's workshop. It is supplemented with qualitative analysis of the researchers' field notes and the students' artifacts. Our findings highlight the inherent intertextual nature of children's argumentation and a critical role the teacher played in eliciting and steering the children's argumentation construction through strategic instructional conversations (especially accountable talk). Our findings also revealed teacher-led children's intertextual argumentation as a powerful heuristic process and tool to enrich students' learning. The paper concludes some classroom argumentation teaching practices based on the research findings. [ABSTRACT FROM AUTHOR]

Background: The primary objective of this cross‐sectional retrospective study was to describe the implementation of dietitian prescribed nutrition recommendations in malnourished paediatric patients in the hospital and ambulatory settings. We also aimed to investigate other characteristics that could be associated with differences in implementation. Methods: Data were collected from 186 hospitalised and 565 ambulatory patients between February 2020 and January 2021. Data included age, hospital or ambulatory specialty departments, primary diagnosis, malnutrition status, hospital length of stay (LOS), and medical nutrition therapy recommendations. Implementation by the medical team in the hospital setting and adherence by the family in the outpatient setting were categorised as "Full", "Partial" or "None". "Partial" and "None" were combined for analysis. Results: Dietitian prescribed recommendations were implemented in 79.6% of hospitalised patients. In the ambulatory population, 46.4% of patients were adherent with nutrition recommendations. Within the hospital, there was a significant difference in implementation of nutrition recommendations based on age (p = 0.047), hospital department (p = 0.002) and LOS (p = 0.04), whereas, in the ambulatory population, there were no significant differences in the rate of adherence among any of the studied characteristics. Conclusions: Dietitian recommendations are frequently implemented in the hospital, whereas adherence to such recommendations is poor in the outpatient population. Interventions to improve adherence to nutrition recommendations in the ambulatory setting are needed. Key points: Adherence to and implementation of nutrition therapy recommendations provided by dietitians is important to patient care in children.In the inpatient setting, approximately 80% of dietitian recommendations were implemented.In the outpatient setting, fewer than half of patients adhered to such recommendations. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Metabolic dysfunction‐associated steatotic liver disease (MASLD) is the most common chronic liver disease among US children. Studies have associated food insecurity with MASLD in adults, but there are few studies of pediatric MASLD, particularly in high‐risk populations. We assessed the impact of household food insecurity at 4 years of age on MASLD in Latinx children. Methods: Using a prospective cohort design, Latina mothers were recruited during pregnancy and followed with their children until early to mid‐childhood. Our primary exposure was household food insecurity at 4 years of age measured using the validated US Household Food Security Food Module. Our primary outcome, MASLD, was defined as alanine transaminase (ALT) ≥95th% for age/gender plus body mass index (BMI) ≥85% at time of ALT measurement (assessed between ages 5–12). We used multivariable logistic regression models to test for independent associations between household food insecurity and pediatric MASLD. Results: Among 136 children, 28.7% reported household food insecurity at 4 years of age and 27.2% had MASLD in early to middle childhood. Approximately 49% of children with MASLD and 21% of children without MASLD were food insecure (p < 0.01). Exposure to household food insecurity at age 4 was independently associated with a 3.7‐fold higher odds of MASLD later in childhood (95% CI: 1.5–9.0, p < 0.01). Conclusions: Exposure to household food insecurity at 4 years of age was associated with increased risk for MASLD later in childhood. Further studies are needed to explore mechanism(s) and impact of reducing food insecurity on risk for MASLD. [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]

We assess how immigrant parent legal status shapes children's physical and mental health. Using the Hispanic Community Health Study of Latino Youth—a multi-site dataset—we evaluated mean differences in multiple physical and mental health indicators and parents' and children's stress and resilience by parents' (primarily mothers') legal status (N = 1177). We estimated regression models of two overall child health outcomes—allostatic load and any internalized disorder. Average allostatic load was 28% higher (0.36 standard deviations) and average prevalence of any internalizing disorder was 16% points greater for children of foreign-born unauthorized versus US-born parents. Higher levels of socioeconomic and acculturative stress contributed to children of foreign-born unauthorized parents' heightened health risk, while resilience factors—parental health and familial support—protected their health. Children with unauthorized immigrant parents experience both negative physical and mental health outcomes that can have potential long-term costs. [ABSTRACT FROM AUTHOR]

Background: There is a lack of longitudinal data to examine the impact of COVID‐19 on all types of clinical encounters among United States, underrepresented BIPOC (Black, Indigenous, and people of color), children. This study aims to examine the changes in all the outpatient clinical encounters during the pandemic compared to the baseline, with particular attention to psychiatric encounters and diagnoses. Method: This study analyzed 3‐year (January 2019 to December 2021) longitudinal clinical encounter data from 3,394 children in the Boston Birth Cohort, a US urban, predominantly low‐income, Black and Hispanic children. Outcomes of interest were completed outpatient clinical encounters and their modalities (telemedicine vs. in person), including psychiatric care and diagnoses, primary care, emergency department (ED), and developmental and behavioral pediatrics (DBP). Results: The study children's mean (SD) age is 13.9 (4.0) years. Compared to 2019, psychiatric encounters increased by 38% in 2020, most notably for diagnoses of adjustment disorders, depression, and post‐traumatic stress disorders (PTSD). In contrast, primary care encounters decreased by 33%, ED encounters decreased by 55%, and DBP care decreased by 16% in 2020. Telemedicine was utilized the most for psychiatric and DBP encounters and the least for primary care encounters in 2020. A remarkable change in 2021 was the return of primary care encounters to the 2019 level, but psychiatric encounters fluctuated with spikes in COVID‐19 case numbers. Conclusions: Among this sample of US BIPOC children, compared to the 2019 baseline, psychiatric encounters increased by 38% during 2020, most notably for the new diagnoses of adjustment disorder, depression, and PTSD. The 2021 data showed a full recovery of primary care encounters to the baseline level but psychiatric encounters remained sensitive to the pandemic spikes. The long‐term impact of the pandemic on children's mental health warrants further investigation. [ABSTRACT FROM AUTHOR]

An editorial is presented that focuses on the integration of ultrasound technology into pediatric rehabilitation medicine, particularly its role in diagnosing and treating musculoskeletal disorders in children. It highlights the transformative impact of US in guiding therapeutic interventions such as botulinum toxin injections and nerve blocks, as well as its utility in assessing nerve injuries, joint conditions, and musculoskeletal problems commonly encountered in pediatric rehabilitation.

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]

Explanatory models are culturally informed representations of illness that convey understandings of the etiology and expected course of disease. Substantial research has explored lay explanatory models, but examining physicians' clinical explanatory models can also provide insight into patients' understandings of illness because physicians are a foundational source of authoritative knowledge that shapes lay concepts of illness and disease. This study characterized the explanatory models used by pediatric gastroenterologists when explaining inflammatory bowel disease (IBD) to children. We conducted semi-structured qualitative interviews with 20 pediatric gastroenterologists across the United States about their clinical communication and explanatory models. We identified two primary explanatory models used to describe immune dysregulation in pediatric IBD: the defense and protection model, which characterizes the immune system as an army that erroneously sees the body as "non-self" and attacks it; and the switch model, which conceptualizes treatment as activating a switch that turns off a faulty immune response. We also identified two models used by some physicians to describe inflammation: the scratch and scrape model, which compares IBD inflammation to scratches or scrapes on the skin; and the bonfire model, which compares inflammation to a fire in need of extinguishing. While the use of militaristic metaphors is pervasive in medicine, describing autoimmunity as a battle against the self may lead children to perceive their body as the enemy. This may be compounded by describing the immune system as "confused" while noting its ongoing protective function. Use of these explanatory models may nevertheless improve patient disease-related knowledge. [ABSTRACT FROM AUTHOR]

This study examined the role of parental aggravation in the pathway from maternal depression to child depression in different family structures. While studies have extensively examined the transmission of maternal depressive symptoms to children, there is still a limited emphasis on potential contributors, such as parental aggravation. Meanwhile, cohabiting and single‐parent families are more vulnerable to multiple risk factors than married families. Using a large national longitudinal dataset, this study examined the indirect effect of parental aggravation on the association between maternal depression and child depression among married, cohabiting and single‐mother families. Secondary data analysis was performed using multigroup mediation analysis on three waves from the Future of Families and Child Wellbeing Studies (n = 3 117). The study results show that only in cohabiting households did maternal depression have a direct association with child depression. Furthermore, in married, cohabiting and single‐mother families, parental aggravation had indirect effects on the association between maternal depression and child depression. Implications for social work professionals to address the mental health of parents and children from non‐traditional families are discussed. [ABSTRACT FROM AUTHOR]

Service coordinators (SCs) play a vital role in assisting families in accessing and navigating the system of Early Intervention services that provide vital support to young children with disabilities and/or developmental delays (YCwD/DD). The study reports findings of focus group interviews with 14 SCs in three states in the United States that were subsequently coded and analyzed using a thematic analysis framework. SCs identified many ways that libraries support YCwD/DD through provisions of materials, services, spaces, and collaborative partnerships with community agencies. However, they pointed to additional measures libraries could take to better serve YCwD/DD and their families. Libraries might consider implementing changes to aspects of their policies and collaborative relationships in order to improve their responsiveness to the needs of YCwD/DD and their families. [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]

Interdisciplinary collaboration is critical to address the multiple and varied needs of students with social/emotional and behavioral (SEB) challenges. Yet little is known about the nature of collaboration between two specialist groups who commonly support them: behavior analysts and mental health specialists. Considering expectations for collaboration, and the potential challenges unique to this partnership, we conducted a series of interviews in the U.S. state of Tennessee to explore these specialists' experiences and perspectives around collaboration. We used a qualitative description approach, which led to identifying themes related to (a) specialists' preparation to collaborate, (b) facilitators and barriers to effective collaboration, and (c) supports needed to collaborate more effectively in their current roles. Specialists from both groups felt their pre-service training inadequately prepared them to collaborate with one another. They identified several factors that impacted their ability to meaningfully collaborate and expressed needs for cross-discipline education, collaborative conversations, and training on "soft skills" to partner more effectively. We highlight distinct and overlapping perspectives within and across themes between behavior analysts and mental health specialists and discuss implications for improving the quality of these important partnerships. [ABSTRACT FROM AUTHOR]

Black students' school experiences are important for their mental health. The current study explored the link between school connectedness in middle childhood and depressive symptoms and aggressive behaviors among Black adolescents. Participants were Black youth (Mage = 9.36 years, SD = 0.38 at time 1), (Mage = 15.59 years, SD = 0.60 at time 2), and 50.2% female. The findings demonstrated a significant association between school connectedness assessed at age nine and reduced depressive symptoms and aggressive behaviors reported at age fifteen. Notably, gender moderated the relationship between school connectedness and depressive symptoms, with a stronger association found for girls. These results offer valuable insights into how early perceptions of school connectedness impact the mental health of Black adolescents as they grow older. These findings also indicate that girls might be more attuned to the social and emotional aspects of their schools. These findings validate the significance of a sense of connection to school with mental health outcomes among Black adolescents and indicate the possibility of school connectedness interventions to enhance their overall well-being. [ABSTRACT FROM AUTHOR]

Do children think of genetic inheritance as deterministic or probabilistic? In two novel tasks, children viewed the eye colors of animal parents and judged and selected possible phenotypes of offspring. Across three studies (N = 353, 162 girls, 172 boys, 2 non‐binary; 17 did not report gender) with predominantly White U.S. participants collected in 2019–2021, 4‐ to 12‐year‐old children showed a probabilistic understanding of genetic inheritance, and they accepted and expected variability in the genetic inheritance of eye color. Children did not show a mother bias but they did show two novel biases: perceptual similarity and sex‐matching. These results held for unfamiliar animals and several physical traits (e.g., eye color, ear size, and fin type), and persisted after a lesson. [ABSTRACT FROM AUTHOR]

Purpose: This work aims to assess the association of sleep duration with cardiometabolic risk (adiposity, blood pressure, lipids, albuminuria and A1C) and to investigate lifestyle factors (physical activity, light exposure, caffeine consumption and sugar consumption) associated with sleep duration in children. Methods: A nationally representative sample of 3907 children ages 6–17 years enrolled in NHANES from 2011 to 2014 was included in this cross‐sectional study. Sleep duration was defined as the daily average time spent sleeping over 7 days as measured by a physical activity monitor (PAM). Participants without valid sleep data for ≥95% of the study were excluded. Regression models were adjusted for age, sex, race, body mass index (BMI) Z score, physical activity and light exposure. Results: In adjusted regression models, longer sleep duration was associated with lower systolic blood pressure index (β = −3.63 * 10−5, 95% CI −6.99 * 10−5, −2.78 * 10−6, p = 0.035) and BMI Z score (β = −0.001, 95% CI −0.001, 0.000, p = 0.002). In logistic regression models, longer sleep duration was associated with lower odds of obesity (OR = 0.998, 95% CI 0.997, 0.999, p < 0.001) and overweight status (OR = 0.998, 95% CI 0.997, 0.999, p = 0.004). Greater light exposure (β = 6.64 * 10−5, 95% CI 3.50 * 10−5, 9.69 * 10−5, p < 0.001) and physical activity (β = 0.005, 95% CI 0.004, 0.006, p < 0.001) were associated with longer sleep. Conclusion: Longer sleep duration was associated with lower blood pressure and adiposity measures in children. Improving sleep quality by increasing physical activity and light exposure in childhood may decrease the lifetime risk of cardiometabolic disease. [ABSTRACT FROM AUTHOR]

Couples raising a child diagnosed with autism spectrum condition (ASC) experience unique challenges that can affect their relationship. This grounded theory study explores how couples maintain functioning in their relationship despite ongoing stressors related to raising a child on the spectrum. The presented model shows what couples can do to create and maintain their relationship functioning. It utilises four major themes developed from our analysis of interviews with 19 couples in the United States with a child diagnosed with ASC. This study increases understanding of couple functioning when raising a child on the spectrum. The grounded theory defines couple functioning for couples with a child diagnosed with ASC as balancing four mutually influential themes: togetherness, adaptability, resilience and communication. We also discuss clinical implications for systemic therapists to work with couples with a child diagnosed with ASC effectively. [ABSTRACT FROM AUTHOR]

Background: Adult patients with biliary acute pancreatitis (BAP) or choledocholithiasis who do not undergo cholecystectomy on index admission have worse outcomes. Given the paucity of data on the impact of cholecystectomy during index hospitalization in children, we examined readmission rates among pediatric patients with BAP or choledocholithiasis who underwent index cholecystectomy versus those who did not. Methods: Retrospective study of children (< 18 years old) admitted with BAP, without infection or necrosis (ICD-10 K85.10), or choledocholithiasis (K80.3x–K80.7x) using the 2018 National Readmission Database (NRD). Exclusion criteria were necrotizing pancreatitis with or without infected necrosis and death during index admission. Multivariable logistic regression was performed to identify factors associated with 30-day readmission. Results: In 2018, 1122 children were admitted for index BAP (n = 377, 33.6%) or choledocholithiasis (n = 745, 66.4%). Mean age at admission was 13 (SD 4.2) years; most patients were female (n = 792, 70.6%). Index cholecystectomy was performed in 663 (59.1%) of cases. Thirty-day readmission rate was 10.9% in patients who underwent cholecystectomy during that index admission and 48.8% in those who did not (p < 0.001). In multivariable analysis, patients who underwent index cholecystectomy had lower odds of 30-day readmission than those who did not (OR 0.16, 95% CI 0.11–0.24, p < 0.001). Conclusions: Index cholecystectomy was performed in only 59% of pediatric patients admitted with BAP or choledocholithiasis but was associated with 84% decreased odds of readmission within 30 days. Current guidelines should be updated to reflect these findings, and future studies should evaluate barriers to index cholecystectomy. [ABSTRACT FROM AUTHOR]

Teachers set the tone for their classrooms, but what teacher beliefs shape students' sense of belonging? We investigate how teachers' mindsets—or their beliefs about learning and school—relate to adolescents' individual and collective reports of classroom belonging. Our pre-registered analyses include a multilevel design of how 1,200 US middle school students (ages 11–13; 50% female; 49% low income; 40% White, 30% Latinx, 13% Black, 9% Asian) and their teachers responded to surveys on educational mindsets. We find teachers' growth mindset and confidence in teaching positively relate to students' math class belonging—explaining between 30 and 40% of belonging among classes. Our data suggest a teacher's own sense of school belonging is unrelated to the belonging students feel in class, suggesting teachers' broad feelings of belonging may not influence students' specific classroom feelings of belonging as anticipated. These findings reinforce the notion that what teachers think and believe influence how students feel when in class. [ABSTRACT FROM AUTHOR]

Childhood adversity can have detrimental impacts on life course mental and physical health. Timing, nature, severity, and chronicity of adversity are thought to explain much of the variability in health and developmental outcomes among exposed individuals. The current study seeks to characterize heterogeneity in adverse experiences over time at the individual, family, and neighborhood domains in a cohort of predominantly Black children (85% Black and 15% White, 46.2% girls, 67.2% free/reduced lunch in first grade), and to examine associations with mental health from sixth grade to age 26. Participants were part of a randomized universal preventive interventions trial in first grade with prospective follow-up through early adulthood. Separate models characterized heterogeneity in adversity in elementary, middle, and high schools. Changes in adversity over time and relationships with mental health (anxiety, depression, suicidal behaviors) were investigated using a random-intercept latent transition analysis (RI-LTA). We identified three-class solutions in early childhood, middle school, and high school. Generally, both a higher and a lower poly-adversity class were observed at each time point, with varying nature of adversity characterized by the third class. RI-LTA indicated prevalent within-individual changes in adverse exposure over time and differential associations with mental health and suicidal behaviors. Results suggest that treating adverse exposures as a static construct may limit the ability to characterize salient variation over time. Identifying complexity in adverse experiences and their relation to health and well-being is key for developing and implementing effective prevention and early intervention efforts to mitigate negative effects through the life course. Public Significance Statement: Children are exposed to changing forms of adversity across development with differential impacts on mental health. Focusing on repeated, adaptive, coordinated, and multilevel preventive mental health efforts will be crucial to support the well-being of children and adolescents throughout the life course. [ABSTRACT FROM AUTHOR]

Nirsevimab, a monoclonal antibody with an extended half‐life, is approved for the prevention of respiratory syncytial virus (RSV) disease in all infants in Canada, the EU, Great Britain, and the USA. A population pharmacokinetics (PK) model was built to describe the PK of nirsevimab in preterm and term infants, and to evaluate the influence of covariates, including body weight and age, in infants. Nirsevimab PK was characterized by a 2‐compartment model with first‐order clearance (CL) and first‐order absorption following intramuscular (IM) administration. The typical CL in a 5 kg infant was 3.4 mL/day. Body weight and postmenstrual age were the primary covariates on CL, with minor effects for race, second RSV season, and antidrug antibody status (deemed not clinically relevant). Congenital heart disease (CHD) and chronic lung disease (CLD) did not significantly impact nirsevimab PK. The final population PK model, based on 8987 PK observations from 2683 participants across 5 clinical trials, successfully predicted PK in an additional cohort of 967 healthy infants. Weight‐banded dosing (50 mg in infants <5 kg; 100 mg in infants ≥5 kg) was predicted to be appropriate for infants ≥1 kg in their first RSV season. Together, these data support weight‐banded dosing of nirsevimab in all infants in their first RSV season, including in healthy infants, infants with CHD or CLD, and in infants born prematurely. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We aimed to examine the impact of a quality improvement (QI) collaborative on adherence to specific recommendations within the American Academy of Pediatrics' Clinical Practice Guideline (CPG) for well-appearing febrile infants aged 8 to 60 days. METHODS: Concurrent with CPG release in August 2021, we initiated a QI collaborative involving 103 general and children's hospitals across the United States and Canada. We developed a multifaceted intervention bundle to improve adherence to CPG recommendations for 4 primary measures and 4 secondary measures, while tracking 5 balancing measures. Primary measures focused on guideline recommendations where deimplementation strategies were indicated. We analyzed data using statistical process control (SPC) with baseline and project enrollment from November 2020 to October 2021 and the intervention from November 2021 to October 2022. RESULTS: Within the final analysis, there were 17 708 infants included. SPC demonstrated improvement across primary and secondary measures. Specifically, the primary measures of appropriately not obtaining cerebrospinal fluid in qualifying infants and appropriately not administering antibiotics had the highest adherence at the end of the collaborative (92.4% and 90.0% respectively). Secondary measures on parent engagement for emergency department discharge of infants 22 to 28 days and oral antibiotics for infants 29 to 60 days with positive urinalyses demonstrated the greatest changes with collaborative-wide improvements of 16.0% and 20.4% respectively. Balancing measures showed no change in missed invasive bacterial infections. CONCLUSIONS: A QI collaborative with a multifaceted intervention bundle was associated with improvements in adherence to several recommendations from the AAP CPG for febrile infants. [ABSTRACT FROM AUTHOR]

The adoption of Ukrainian children, by US citizens, is examined as the Ukrainian government ceases adoptions of children during the chaos of war. Intercountry adoption dynamics are presented with data from 2021, prior to the conflict in 2022. Then, the situation regarding child rights and the official Ukrainian government position are considered. Implications for guardianship and foster care of unaccompanied refugee minors are presented along with other critical risks to Ukrainian children living in another country. Implications for social work practice are concluded and child rights advocacy is encouraged as a macro intervention. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder and developmental disabilities (ASD/DD) face barriers to participation in health promotion programs due to the lack of available and/or affordable programs and trained staff at recreation centers. Children with ASD/DD in Korean immigrant families are one of the most underserved minority groups due to language, racial/ethnic discrimination, and stigma and shame within their own ethnic community. However, little research is available on development, implementation, and evaluation of a culturally adapted community health promotion program in this population. The purpose of this study is to assess effectiveness of a pilot program for children with ASD/DD from first-generation Korean immigrant families. The pilot study used a quantitative, quasiexperimental design (one-group design with pre- and posttest) following a seven-week health promotion program. We recruited 15 children with ASD/DD, ages nine through 16, from first-generation Korean immigrant families. The findings of the study suggest that the pilot program was effective in gaining nutrition knowledge and increasing physical involvement among participants. Given the fact that Asian immigrants are a fast-growing population and that nearly 75 percent of them were born abroad, development and evaluation of a community-based, culturally adapted health promotion program is urgently needed. [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]

Introduction: Due to the risk of thrombosis, nearly all children supported by extracorporeal membrane oxygenation (ECMO) receive systemic anticoagulation. While heparin has traditionally been used, there are reports of increased use of direct thrombin inhibitors. We sought to describe the use of anticoagulation in children supported by ECMO in the United States using a large administrative database. Methods: We performed a retrospective cohort study of children supported by ECMO within the Pediatric Health Information System (PHIS) database. Pediatric encounters involving ECMO from 2012 to 2020 were identified. Data regarding demographics, diagnoses, anticoagulation, complications, and outcomes were extracted for eligible encounters. Results: Eleven thousand five hundred ninety-five encounters that involved ECMO were identified. Fifty-four percent were male with an age range of 0–17 years and a median (IQR) age of 0 (0–2) years. Unfractionated heparin (UFH) only was used in 94% (95% CI: 93.6–94.5%) of encounters and UFH followed by bivalirudin in 5% (95% CI: 4.3–5.1%) of cases. There was a significant difference in the use of bivalirudin from 2012 to 2020 (p < 0.001). Differences in anticoagulation regimens were observed between infants and children (p = 0.004) and between those with and without cardiac indications for ECMO (p < 0.001). Four percent (95% CI: 4.1–4.8%) of encounters were associated with diagnostic coding for thrombosis and differences in occurrence of thrombosis were observed between different anticoagulant regimens (p < 0.001). Conclusions: Though the majority of children on ECMO in the United States receive heparin anticoagulation, there is an increase in use of direct thrombin inhibitors. Prospective studies must evaluate the efficacy of different anticoagulants in this patient population. [ABSTRACT FROM AUTHOR]

Introduction: Few studies have evaluated the health of Middle Eastern and North African (MENA) women and children in the United States. Objectives were to determine the odds of well-visits, preventive behaviors during pregnancy, and low birthweight among foreign-born non-Hispanic MENA women and children compared to their US- and foreign-born non-Hispanic White counterparts after adjusting for covariates (hereafter, reported as MENA and White). Methods: We analyzed 2000–2018 National Health Interview Survey data (411,709 women, 311,961 children). Outcomes included well-woman visits (past 12 months); dentist visits (past 6 months) and current smoking among pregnant women; and low, moderately low, and very low birthweight among children. Covariates included age, family income, and health insurance for children. Education and marital status were also evaluated among women. Results: Over half (53.4%) of foreign-born MENA women were of childbearing age (ages 18–45) compared to 47.7% US-born and 43.2% foreign-born White women. The odds of completing a well-women visit were 0.73 times lower (95% CI = 0.38–0.89) among foreign-born MENA women compared to US-born White women after adjusting for age, education, and marital status. There was no statistically significant difference in dental visits between groups. No foreign-born MENA pregnant women reported current smoking. Foreign-born MENA children had higher odds of low (OR = 1.65; 95% CI = 1.16–2.35) and moderately low birthweight (OR = 1.78; 95% CI = 1.19–2.66) compared to US-born White children in adjusted models. Discussion: MENA women and children are classified as White by the federal government. Our results highlight that the health of foreign-born MENA women and children differ from their White counterparts. Significance: What is already known on this subject?: National studies have evaluated maternal and perinatal health among minoritized groups; however, none have presented results among Middle Eastern and North African (MENA) women and children. The few studies that have evaluated MENA maternal and child health (MCH) outcomes have provided only state and local estimates. What this study adds?: This study provides nationally representative baseline data on the maternal and perinatal health of foreign-born MENA women and children. This is the first study to examine oral health among pregnant MENA women compared to US- and foreign-born pregnant White women. [ABSTRACT FROM AUTHOR]

Thyroid cancer is the most common endocrine malignancy in the pediatric population. A recent study has revealed a recent decline in overall US thyroid cancer incidence rates. The aim of this study is to assess whether there has been a corresponding decline in incidence rates in the pediatric population. We used the Surveillance, Epidemiology, and End Results (SEER) database to analyze the pediatric thyroid cancer incidence rate. The results demonstrate that the incidence rate of pediatric thyroid cancer continued to increase from 2000 to 2018. Future studies are needed to understand how recent changes in guidelines are affecting incidence rates. [ABSTRACT FROM AUTHOR]

This study aimed to understand Brazilian immigrant parents' experience and needs using an explanatory sequential design with two phases: survey and structured interviews. The results identified several challenges these parents face, the most prevalent being a lack of social support, as well as cultural values and parenting styles. These findings are important for informing counselors and other professionals working with this community how to better develop intervention and advocacy tools tailored to their unique needs. [ABSTRACT FROM AUTHOR]

This study examined the prevalence of citing inadequate housing as a removal reason at the state level by utilizing data from the Adoption and Foster Care Reporting and Analysis System (AFCARS) and investigated the relationship between inadequate housing and reunification outcomes. The results revealed heterogeneity in citing inadequate housing as a reason for removal at the state level. Moreover, when children are from families struggling with both inadequate housing and substance abuse, the likelihood of reunification is significantly lower. Therefore, it is critical to submit consistent and standardized data to AFCARS and provide wrap-around resources for these vulnerable families. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) has a profound impact on millions of families in the United States. While Hispanic families represent the most rapidly growing demographic group within this population, little research explores their unique experiences in coping with the family impacts of ASD. This phenomenological study explored the lived experiences of Hispanic mothers of children with ASD. Findings suggested that their experiences were reflective of existing knowledge around the family impacts of ASD as participants articulated the challenges of managing emotional stressors and balancing family needs with the needs of the child with a disability. However, findings also suggested ways in which the construction of the role of motherhood in Hispanic culture held unique implications for participants as they sought and struggled to find this balance. Implications for practice with Hispanic families of children with ASD based on their unique experiences are discussed. [ABSTRACT FROM AUTHOR]

The present study examined genetic, prenatal, and postnatal environmental pathways in the intergenerational transmission of anxiety and depressive symptoms from parents to early adolescents (when these symptoms start to increase), while considering timing effects of exposure to parent anxiety and depressive symptoms postnatally. The sample was from the Early Growth and Development Study, including 561 adopted children (57% male, 55% White, 13% Black/African American, 11% Hispanic/Latine, 20% multiracial, 1% other; 407 provided data in early adolescence) and their birth (BP) and adoptive parents (AP). Using a trait–state–occasion model with eight assessments from child ages 9 months to 11 years, we partitioned trait-like AP anxiety and depressive symptoms from time-specific fluctuations of AP anxiety and depressive symptoms. Offspring anxiety and depressive symptoms were assessed at 11 years (while controlling for similar symptoms at 4.5 years). Results suggested that time-specific fluctuations of AP1 (mostly mothers) anxiety/depressive symptoms in infancy (9 months) were indirectly associated with offspring anxiety/depressive symptoms at 11 years via offspring anxiety/depressive symptoms at 4.5 years; time-specific fluctuations of AP1 anxiety/depressive symptoms at child age 11 years were concurrently associated with offspring anxiety/depressive symptoms at 11 years. AP2 (mostly fathers) anxiety/depressive symptoms were not associated with offspring symptoms. Genetic and prenatal influences measured by BP internalizing problems were not associated with offspring symptoms. Results suggested infancy and early adolescence as developmental periods when children are susceptible to influences of parent anxiety and depressive symptoms. Preventive interventions should consider time-specific fluctuations in parent anxiety and depressive symptoms during these developmental periods. Public Significance Statement: Anxiety and depressive symptoms run in families mainly through environmental influences. We found that time-specific fluctuations of adoptive parent (mostly mothers) anxiety and depressive symptoms during infancy and early adolescence were associated with early adolescent anxiety and depressive symptoms. Programs aimed at preventing anxiety and depressive symptoms during early adolescence could screen for time-specific fluctuations of parent (mainly mothers) anxiety and depressive symptoms during infancy and early adolescence. [ABSTRACT FROM AUTHOR]

Although parent–child conversations about race are recommended to curb White U.S. children's racial biases, little work has tested their influence. We designed a guided racism discussion task for U.S. White parents and their 8–12-year-old White children. We explored whether children's and parents' (a) pro-White implicit biases changed pre to postconversation, (b) racial socialization messages (color conscious, external attributions for prejudiced behavior and colorblind racial ideology [CBRI]) predicted changes in each other's implicit biases, and (c) associations varied by the type of racism (subtle vs. blatant) discussed. Children's and parents' biases significantly declined, pre to postdiscussion. Parents' color conscious messages predicted greater declines and messages reflecting CBRI and external attributions predicted smaller declines in children's bias. These patterns were observed during discussions of subtle, but not blatant bias. Effects of children's messages on parents' bias were mixed. Our findings suggest that color conscious parent–child discussions may effectively reduce implicit pro-White bias in White children. Public Significance Statement: Although they believe it to be beneficial, many White U.S. parents avoid discussing racism with their children or downplay the importance of race when they have these conversations. In the current study, we developed a method to encourage color conscious conversations in White families and found that parents' and children's racial biases reduced after the discussion. Our findings suggest that parent–child discussions about racism may effectively reduce racial biases in White families. [ABSTRACT FROM AUTHOR]

Although studies have investigated and found an association between adverse childhood experiences and poor health and mental health outcomes, there is a dearth of studies investigating the association between adverse childhood experiences and unmet health care needs among children. The objective of this study is to examine the association between adverse childhood experiences and unmet health care needs after adjusting for predisposing, enabling, and need factors of health care service utilization. Data for this study came from the 2016–2017 National Survey of Children's Health. An analytic sample of 46,081 children (51.3% males; average age 11.5 years) was analyzed using negative binomial regression. Based on parent reports, about 3.5% of children had unmet health care needs, and half (50%) of the sample had experienced at least one childhood adversity. Controlling for other factors, children who experienced three or more childhood adversities had 4.51 times higher odds of having unmet health care needs (AOR = 4.51, p <.001, 95% CI = 3.15–6.45) when compared to their counterparts with no childhood adversity. Children with parents who have someone to turn to for everyday emotional support were 31% less likely to have unmet health care needs (AOR =.69, p <.01, 95% CI =.54–.89). Adverse childhood experiences have a detrimental effect on unmet health care needs. The findings of this study offer an important opportunity for further research on how best to prevent adverse childhood experiences and mitigate their impact on families. [ABSTRACT FROM AUTHOR]

This naturalistic study examines how broad societal events like the COVID-19 pandemic affect children's gratitude expressions for general and specific categories of needs. Gratitude expressions (N = 6908) written by children in the United States (N = 3613, Mage = 6.96 years) before the pandemic (November 2018, 2019) and during the pandemic (November 2020, 2021) were collected from online newspapers. The gratitude expressions were coded for general and specific categories based on Maslow's Theory of Motivation. Between time periods, there was no difference in prevalence of gratitude for the fulfillment of the general categories of deficiency needs (physiological, safety, belongingness and love, esteem) and growth needs (cognitive, aesthetic, self-actualization, and transcendence) as well as the specific sub-categories that they subsume. However, within time periods, there was a greater prevalence for the fulfillment of deficiency than growth needs, especially the specific category of love and belongingness. Together these results highlight the enduring nature of particular categories in the face of a broad societal event and have implications for public policies and services aimed at protecting children and meeting their needs. [ABSTRACT FROM AUTHOR]

The article describes how socioeconomic inequities contribute to discrepant unintentional injury risks and calls for an expansion of investment in innovative and targeted prevention strategies to narrow this disparity. Topics include the impact of poverty on injury, barriers and opportunities to implementation of injury prevention, and recommendations for advocacy groups, health care organizations, and community organizations.

Purpose: Among the varied roles and responsibilities of school-based speech-language pathologists (SLPs) are the planning and delivery of effective vocabulary intervention for students with language disorders. Despite the abundant literature regarding effective vocabulary intervention, practice patterns indicate that the research has not yet translated to practice. The purpose of this study was to examine SLPs' beliefs and expectations regarding vocabulary instruction and the content of Individualized Education Program (IEP) goals to better inform continuing education and research programs to generate lasting effects on SLP practices. Method: We queried a national sample of school-based SLPs via an online survey regarding their perspectives on robust vocabulary instruction, vocabulary intervention practices, and IEP goal development targeting vocabulary skills for school-age children with language disorders. Results: There was consistency across the sample for SLPs' beliefs about the importance and impact of robust vocabulary instruction. However, they reflected varied expectations about the vocabulary intervention they provide. Qualitative analysis of IEP goals for vocabulary reveals the range and frequency of strategies and intervention targets as an artifact of implementation of robust vocabulary instruction. Conclusions: School-based SLPs believe that vocabulary is important and have a strong understanding of the impact robust vocabulary instruction can have on reading and writing outcomes. SLPs in this sample had varying expectations regarding the way their instruction is implemented and generalized. Implications and limitations of these results are discussed [ABSTRACT FROM AUTHOR]

Summary: Objective: Rising prevalence of obesity has led to increased rates of prediabetes and diabetes mellitus (DM) in children. This study compares rates of prediabetes and diabetes using two recommended screening tests (fasting plasma glucose [FPG] and haemoglobin A1c [HbA1c]). Study Design: Data were collected prospectively from 37 multi‐component paediatric weight management programs in POWER (Paediatric Obesity Weight Evaluation Registry). Results: For this study, 3962 children with obesity without a known diagnosis of DM at presentation and for whom concurrent measurement of FPG and HbA1c were available were evaluated (median age 12.0 years [interquartile range, IQR 9.8, 14.6]; 48% males; median body mass index 95th percentile [%BMIp95] 134% [IQR 120, 151]). Notably, 10.7% had prediabetes based on FPG criteria (100–125 mg/dL), 18.6% had prediabetes based on HbA1c criteria (5.7%–6.4%), 0.9% had DM by FPG abnormality (≥126 mg/dL) and 1.1% had DM by HbA1c abnormality (≥6.5%). Discordance between the tests was observed for youth in both age groups (10–18 years [n = 2915] and age 2–9 years [n = 1047]). Conclusion: There is discordance between FPG and HbA1c for the diagnosis of prediabetes and DM in youth with obesity. Further studies are needed to understand the predictive capability of these tests for development of DM (in those diagnosed with prediabetes) and cardiometabolic risk. [ABSTRACT FROM AUTHOR]