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Purpose/Objective: To investigate the occurrence of behavioral problems 7 years after severe pediatric traumatic brain injury (TBI), and their evolution from 3 months to 7 years postinjury. Method/Design: Thirty-four participants, 38% girls, M (SD) age at injury 7.6 (4.7) years, age at assessment 15 (4.6) years, underwent comprehensive assessments 7 years after severe TBI from March 2014 to March 2016 and were matched to a control group by age, gender, and parental education. A subgroup of 20 participants had available behavioral assessments at 3, 12, and 24 months postinjury. Internalizing, externalizing, and total behavioral problems were assessed with self- and parent reports of the Achenbach's Behavioral Checklist. Additional data included sociodemographic background, initial injury severity, and specific outcomes assessed concurrently 7 years postinjury. Results: Compared to controls: (a) a significant proportion of participants with severe TBI fell above the clinical cutoff for self- (42%) and parent-reported (36%) externalizing problems, but not for self- (33%) or parent-reported (45%) internalizing problems; (b) withdrawn/depressed, intrusive behavior, and somatic complaints were significantly higher in self-reports; and (c) rule-breaking behavior, attention, and social problems were significantly higher in parent reports. Parent-reported internalizing problems were associated with older age at injury, whereas externalizing problems correlated with greater injury severity and concurrent levels of greater overall disability, lower intellectual ability, and poorer family functioning. In multiple hierarchical regression analyses, overall disability and worse family functioning significantly predicted externalizing problems. Parent-reported internalizing and externalizing problems persisted over time. Conclusions/Implications: These results highlight the importance of long-term follow-up and individualized behavioral interventions for children who sustained severe TBI. Impact and Implications: Approximately half of the parents of children who sustained severe pediatric traumatic brain injury (TBI) report clinically significant internalizing and externalizing behavior problems 7-year postinjury, indicating long-term persistence of behavioral issues with significant consequences on participation and overall academic achievement. Concordance between parent- and self-reports assessing internalizing and externalizing behavioral problems is high, suggesting that patients who sustained severe childhood TBI and their parents might perceive and deal more frequently with symptoms related to more overtly noticeable behaviors, such as externalizing symptoms, but might also be particularly aware of symptoms pertaining to withdrawnness, depression, and somatic complaints in the long-term. These internalizing symptoms should not be neglected and appropriate support should be considered, even in the absence of externalized behaviors. Persistence of internalizing and externalizing problems 7 years after severe TBI underlines the importance of follow-up interventions aimed at behavioral adjustment. During follow-up, it is important to organize and implement serial assessments of neuropsychological and general functioning, educational attainment, and school issues, as well as mood and behavior, in order to detect and quantify disorders, and to implement timely, individualized, patient- and family-centered targeted interventions. [ABSTRACT FROM AUTHOR]

The current study examined whether age and parental reports of children's problematic lying, behavioural inhibition system (BIS) activity, and reward responsiveness predicted children's antisocial lie‐telling. Children from mostly middle and upper‐class Canadian families (ages 3–12, M = 6.23, SD = 2.52) participated in a modified Temptation Resistance Paradigm (TRP), where they were given opportunities to tell a self‐protective lie (to conceal a transgression) and an instrumental lie (to obtain a reward). Parents completed measures of their children's problematic lying tendencies, BIS activity, and reward responsiveness. Age and parent‐reported problematic lying and BIS activity were significant predictors of lie‐telling behaviour in the TRP. Instrumental liars were younger than dual liars (those who told both types of lies) and truth‐tellers. Truth‐tellers had lower parent‐reported problematic lying than instrumental and dual liars but not self‐protective liars. Dual liars had lower parent‐reported BIS activity than truth‐tellers; there were no differences among truth‐tellers, self‐protective liars, and instrumental liars. This study contributes to our understanding of the role of temperamental factors in children's lie‐telling propensity and the predictive utility of parent‐reported predictors for children's antisocial lie‐telling propensity. Our findings indicate that parents can identify and potentially address their children's problematic lying using their knowledge about their children's temperamental traits. [ABSTRACT FROM AUTHOR]

Most children who are removed from their homes by social services have siblings. Yet, siblinghood is an unnoticed and understudied field of interest. Professionals lack a framework for addressing this common issue in out‐of‐home placement decision‐making and caregiving. The current study examined how professionals in family group homes in Israel perceive and approach sibling bonds, as well as the main barriers and benefits they identify regarding siblinghood among children in out‐of‐home placements. Five focus groups were held with 34 professionals, and a thematic analysis was conducted. The participants identified siblings as a source of support, comfort and security to one another. On the other hand, they worried about the sibling bond inhibiting a child's development. They also revealed two approaches regarding the role of out‐of‐home placements: a space for individual development versus a transition station in the child's and family's life journey. They also referred to the uniqueness of every sibling group and, hence, the significant weight of professional intuition in decision‐making processes. The discussion addresses the challenges of intuitive decision‐making in cases of siblings in out‐of‐home placements and stresses the need for more informed decision‐making processes. [ABSTRACT FROM AUTHOR]

With the widespread use of digital media in our deeply mediatized society, parental mediation can be viewed as a dynamic and processual media practice that is integrated into everyday family life. We therefore advocate that parental mediation should be seen as part of the socialization that changes over time due to an ongoing stream of negotiations, instead of focusing purely on strategies. It is particularly important to us to show that this process is not only situational and procedural, but also relational. In the text, we present four case studies that illustrate how these aspects influence parental mediation. The cases were chosen from a longitudinal qualitative panel study with three survey waves. They were analyzed from the perspective of parents and children. The study itself focused on the process of socialization and its transformation through mediatization. On this basis we demonstrate that parental mediation is a relational process that is influenced by parents' own biography, by other parents, friends or the wider family context as well as by negotiations with the affected children and their media repertoires. Impact Summary: Prior State of Knowledge: Although a majority of studies analyze parental mediation, literature lacks the perspective of children on the topic. Further, there are almost no longitudinal studies on the subject. Novel Contributions: The article shows that parental mediation can only be fully understood as an element of socialization that is situational, dynamic, processual and repeatedly negotiated. It emphasizes relationality, as parental mediation depends on the biographies of the parents, people outside the family and the children involved. Practical Implications: Since parental mediation is not trivial, parents should be encouraged to seek support in this task. In addition, practitioners should take into account the relationality of mediation practices rather than pointing to an ideal way of parental mediating. [ABSTRACT FROM AUTHOR]

This study examined memorable messages about the decision to have children and become a parent. A total of 440 memorable messages were coded, and three main themes were found. Advice and considerations included warnings, messages about delaying having children, predictions about changing one's mind, messages about financial and relational stability, and messages emphasizing personal choice. The theme of positive emphasis included children bring meaning/purpose to life, general positivity, messages about how children complete a family, and messages about how the parent–child relationship is unique and special. Family expectations and influence included messages about a family expectation to have children, family lineage, how the child becomes the caregiver, the parents' desire to become grandparents, and marriage being a necessity. The memorable messages overall offered both positive and negative portrayals of having children. The continued theorizing about memorable messages is also discussed. [ABSTRACT FROM AUTHOR]

The development of competencies specific to specialized populations is a growing area of interest in the counseling profession. The rise of rates of autism spectrum disorder in children in the United States has garnered the attention of service providers advocating for the advancement of practice to promote comprehensive, quality care to this underserved population. In an extension of these efforts, this phenomenological investigation examined counselors' competencies in treating autism in children. Analysis of in-depth interviews with 14 counselors resulted in the identification of four themes: (a) Exposure to Autism, (b) Autism Knowledge, (c) Intervention Services, and (d) Counselor Identity. Contributions to promote services for this population in clinical practice and counselor education are discussed. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder is a prolonged stress and anxiety response that occurs after exposure to a traumatic event. Research shows that both parental and child posttraumatic stress symptoms (PTSS) are correlated but parental executive functions (EFs) could buffer this link. EFs refers to a group of high‐level cognitive processes that enable self‐regulation of thoughts and actions to achieve goal‐directed behaviours and can be of importance for both positive parenting interactions and effective coping skills for PTSS. Our study aimed to (1) examine the link between maternal and child PTSS and the moderating role of varying degrees of exposure to severe security threats context, and (2) to identify the moderating role of maternal EFs in this interaction, among families living in southern Israel. Our sample included 131 mothers in their second pregnancy and their firstborn children. Mothers performed computerised tasks to assess their EFs and they reported on their own and their child's PTSS. Results revealed a positive correlation between maternal PTSS and child PTSS. However, the link between maternal and child PTSS was moderated by maternal working memory updating abilities and threat context severity. Among mothers with lower updating capacities, the association between maternal and child symptoms was stronger under higher threat contexts; conversely, among mothers with higher maternal updating abilities, threat context did not modulate the link between maternal and child PTSS, suggesting a stress‐buffering effect. Our study contributes to the growing literature on the significant role of parental EFs in the context of parent‐child interactions. [ABSTRACT FROM AUTHOR]

Children in foster care have complexity around medical decision-making because of their unique custody status. When medical decision-making is necessary for a child in foster care, what perspectives are important? What if opinions are not aligned? Who makes the final decision for consent? This Ethics Rounds focuses on a young child in foster care who has had repeated ear infections. Foster caregivers and family of origin are not in agreement on the treatment plan. Two experts, a foster care pediatrician and a child welfare professional, comment on the important considerations for the case, including involvement of legal representation and best interest representation in medical decision-making as well as the variability in child welfare response by state. [ABSTRACT FROM AUTHOR]

Background and Aims: Children with autism spectrum disorder (ASD) present with impairments in social interaction and stereotypic behaviors. About a third may exhibit delays in verbal expression beyond preschool age, potentially categorizing them as nonverbal/minimally verbal (NV/MV), a condition that can persist into adulthood and affect their quality of life. The risk and prognostic factors associated with this reduced verbal outcome remain uncertain. This study aims to identify such factors within children diagnosed with ASD in Cyprus. Methods: In this case-control study, 56 children aged 3–12 years, with an ASD diagnosis, participated. Among them, cases were 22 children classified as ASD-NV/MV, and controls were 34 children classified as verbal (ASD-V), matched by age group and gender. Retrospective information on familial, perinatal, and developmental risk and prognostic factors were collected to calculate the familial risk score (FRS), perinatal risk score (PRS), and developmental risk score (DRS). Early development information was collected for the Early Development Score (EDS) and Early Gesture Score (EGS), to measure the children's skill level as toddlers across milestones. A low EDS and/or low EGS reflected general developmental delays and decreased frequency of early gestures and were considered in the DRS. A parent report questionnaire was utilized to determine the current overall linguistic level and status of participants, distinguishing cases from controls. Results: Age group and gender-matched cases and controls were similar in socioeconomic status and demographic characteristics (p >.05). Among the various familial (e.g., sibling with ASD), perinatal (e.g., prematurity), and developmental (e.g., ASD regression) factors examined individually, as well as collectively as scores in a conditional logistic regression (CLR) model, only a high DRS (p =.03), due to low EDS (p =.04) was significantly associated with linguistic status. When considering all risk scores in a multivariate CLR model, children with a high DRS were more likely to belong to the cases than to the control group (p =.02). In a subsequent model with low EDS and low EGS, only the low EDS was significantly associated with the case group. Results showed that children with ASD and a low EDS, reflecting general delays in early development, were 4.5 times more likely to belong to the cases group than those with a high EDS (p =.02). Conclusions: Early developmental delays in developmental milestones across various domains like gesture, motor, play, linguistic, cognition, and joint attention, in toddlerhood, were associated with later decreased verbal outcomes. Children in the sample with such early delays (low EDS), had a higher likelihood of persistent language delays (ASD-NV/MV) even at late school age. Future studies are needed to duplicate findings and explore possible contributing factors affecting linguistic outcome in ASD through prospective studies exploring within ASD differences. Implications: These findings emphasized the importance of monitoring early development closely for children at risk for ASD, pre-diagnosis, to provide additional early support for those more likely to be ASD-NV/MV. Parents and specialists like pediatricians, educators, speech-language pathologists, among others, can track the EDS score of children at risk for ASD and refer to the appropriate specialists for early stimulation, intervention, and parent consultation promptly. [ABSTRACT FROM AUTHOR]

Purpose: To measure the prevalence of speech-language pathologist (SLP) involvement and associated trends for critically ill children in United States (US) paediatric intensive care units (PICU) through secondary analysis of the Prevalence of Acute Rehab for Kids in the PICU (PARK-PICU) study data. Method: A secondary analysis of cross-sectional point prevalence study conducted over 1 day in 82 US PICUs. Data collected included SLP presence, patients' age, length of stay, medical interventions, aetiology, admission data, Glasgow Coma Scale scores, staffing involvement, and family presence. Result: Among 961 patients, 82 were visited by an SLP on the study day for a prevalence of 8.5%. Most visits were for children <3 years old. The odds of SLP involvement were lower for children who were 7–12 years old (vs. age 0–2; adjusted odds ratio [aOR] 0.28; 95% CI 0.1–0.8), were mechanically ventilated via endotracheal tube (vs. room air; aOR 0.02; 95% CI 0.005–0.11), or had mild or severe disability (mild vs. no disability; aOR 0.34; 95% CI 0.16–0.76 and severe vs. no disability; aOR 0.39; 95% CI 0.17–0.90). Concurrent physical and/or occupational therapy involvement was associated with higher odds of SLP involvement (aOR 3.6; 95% CI 2.1–6.4). Conclusion: SLP involvement is infrequent in US PICUs. PICU teams should be educated about the scope of SLP practice, to support communication and oral feeding needs during early recovery from critical illness. [ABSTRACT FROM AUTHOR]

Background: Voiding dysfunction (VD) is a frequent reason for primary care referrals to urologists and pediatric urologists. VD symptoms include urine incontinence (UI), urinary tract infection (UTI), hyperactive bladder, and constipation. Early detection of Nocturnal enuresis is critical due to its high frequency and the consequences for families and children regarding psychological and behavioral aspects. Objectives: This study aims to determine the prevalence of voiding disorder in Palestine and its relationship to demographic, family, and behavioral risk factors. Design: A cross-sectional study. Methods: This study administered a 2-part validated questionnaire to the mothers of primary school-age children who had no history of urological disease between December 2022 and March 2023. Results: Out of 169 children; daytime incontinence was found in 39 (23.2%) of the sample, whereas nocturnal enuresis was found in 49 (28.4%). Age was significantly correlated with voiding dysfunction, in which 25 (55.6%) were under the age of 7 years (P =.025). Conclusion: According to our data, VD is a widespread health issue in primary school. Expanding our understanding of voiding dysfunction is important to eliminate the social stigma associated with voiding disorder and encourage parents and children to seek treatments and therapies. Furthermore, raising awareness will aid in early diagnosis, resulting in fewer long-term problems and earlier treatments. Raising awareness can be accomplished through educational programs focusing on primary care screening. [ABSTRACT FROM AUTHOR]

Equitable access to appropriate care, emergency department services, and in-home support aids are needed to minimize the occurrences of adverse events that have a significant impact on families. However, many families of children with medical complexity (CMC) lack consistent care due to issues of health inequity. We conducted 11 qualitative interviews with primary caregivers who were asked about their experiences of providing care to children who have a tracheostomy and are supported by multiple life-saving machines at home. Guided by ecological systems theory, we identified three themes that contextualize the lived experiences of the participants who expressed needs that arose from poor interactions within the mesosystem. Findings convey participant frustrations that result from insufficient support, ineffective training, and inadequate healthcare coverage. Although each theme is organized systematically to emphasize specific concerns within the mesosystem, together these themes emphasize the inextricable relationship between daily needs with systemic barriers to care. We provide a discussion of these needs with a broader context that also impacts the perceived quality of care among families managing the needs of their children who are supported by life-saving technology. By addressing existing challenges and identifying opportunities for improvement within the healthcare system, we seek to contribute to the collective effort of advocating for ethical systemic change on behalf of CMC and their families. [ABSTRACT FROM AUTHOR]

Purpose: Equitable representation of children with hearing loss who are members of marginalized or minority groups in behavioral intervention studies enhances inclusivity in the scientific process and generalizability of results. The goal of this systematic review was to ascertain the percentage of studies conducted in the United States in the past 2 decades that reported relevant demographic variables. Method: Studies were searched across eight databases and clinical trial registries in October 2022. Variations of the following search strings were used to retrieve peer-reviewed published studies and unpublished clinical trials: children, hearing loss, and intervention. Results: Thirty-nine intervention studies met the inclusion criteria. The selected studies were reviewed and coded for the following demographic variables: area and type of intervention, participant age, hearing technology data, sample size, gender, race/skin color and ethnicity, primary/home language(s), additional disabilities, parental education, family income, and parental occupation. Results revealed that many demographic variables were remarkably underreported, with parental education, family income, and parental occupation variables being the least reported data. Conclusions: Demographic data can be an important tool for changing disparities related to intervention outcomes. This systematic review suggests that inclusive research practices should be extended to low-literacy or low-economic resources, non-White, and non--English-speaking groups. Inclusion practices coupled with sufficient sample sizes will ultimately aid in identifying hearing health disparities. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The purpose of this study was to develop, pilot, and evaluate a culturally grounded, family-based program to prevent adverse childhood experiences (ACEs) among low-income and Indigenous children aged 10 to 14. The Tiwahe Wicagwicayapi program (TWP) is a 7-session program that teaches skills to prevent ACEs and is rooted in Lakota culture, language, and history. METHODS: A total of 124 families (124 caregivers [96% Indigenous; 90% reported yearly income <$40 000] with 194 children aged 10 to 14 [93% Indigenous]) were randomly assigned to treatment (N = 66 families and 173 individuals) or waitlist (N = 58 families and 145 individuals) control groups. Caregivers and children completed a baseline, immediate posttest, and 6-month follow-up survey. RESULTS: Treatment effects were detected, indicating, compared with control participants, reductions in the incidence of child ACEs (incidence rate ratio [IRR] = 0.64), bullying victimization (odds ratio = 0.53), depression (d = -0.20), and externalizing behaviors (d = -0.23) and increased parent-child communication (g = 0.27) and child help-seeking behaviors (d = 0.28). For caregivers, the effects indicated that the program prevented intimate partner violence victimization (IRR = 0.36) and perpetration (IRR = 0.45), harsh parenting (g = -0.35), and depression (d = -0.24) and increased emotion regulation (d = 0.37), social support (d = 0.33), and cultural connection (d = 0.34). CONCLUSIONS: The TWP holds great promise in preventing ACEs among low-income, Indigenous children, showing potential promise for widespread public health impact. Future rigorous research on the TWP is warranted. [ABSTRACT FROM AUTHOR]

Background: In Germany, the nutritional situation of adults and children living in households at risk of poverty has been insufficiently studied so far. Aim: The aim of the mixed-methods study MEGA_kids is to gain a deeper understanding of the nutritional situation including socioeconomic, behavioral, and attitudinal factors and health characteristics among persons living in families at risk of poverty. Method: MEGA_kids is a mixed-methods cross-sectional study consisting of four modules combining quantitative and qualitative methods. The first module (A) applies self-administered questionnaires to assess the individual's diet, household food insecurity, and several other factors among adults and children of 500 households. Cash receipts are used to assess household's food expenses. For the second module (B), a semistructured interview guide is used to identify factors influencing food security and nutritional quality from the perspective of a subsample of module A (n = 20). The third module (C) applies the participatory World Café technique to explore experiences and generate ideas for tailored support measures for a healthy diet from the perspective of 40 parents participating in module A. Finally, the fourth module (D) investigates the knowledge and usage of existing nutrition-related preventive measures among 200 parents at risk of poverty by using an online questionnaire. Conclusion: By providing a comprehensive picture of nutritional aspects of families living at risk of poverty, MEGA_kids will guide officials to target and prioritize public health nutrition measures, inform policy makers to implement and improve healthy policies and, finally, identify research gaps to be prioritized. [ABSTRACT FROM AUTHOR]

Using a sample of 286 mothers and fathers from ethnically and socioeconomically diverse backgrounds, we tested the associations between the frequency and quality of parents' shared book reading (SBR) with infants aged 9 months, and language skills of infants aged 18 months, and whether infants' attention during SBR at 9 months mediated these associations. Frequency of SBR was parent‐report and quality of SBR (i.e., number of reading strategies) and infants' attention were coded from recorded SBR interactions at home. The majority of mothers and fathers reported reading to their 9‐month‐olds at least weekly, and mothers reported reading, on average, significantly more often than fathers. There was large variability in parents' SBR quality ranging from 0 to 15 strategies per minute, with labelling being the most common. Path analysis showed that mothers' SBR frequency at 9 months was significantly associated with infants' receptive and expressive language skills at 18 months, whereas, SBR quality by either parent was not significant. Infants' attention did not mediate these associations. These findings suggest that early SBR is beneficial for language development and programmes targeting early language development should encourage both mothers and fathers to read often to their infants during the first year. [ABSTRACT FROM AUTHOR]

Background: Arsenic (As) is a toxic element that can lead to various health issues in humans. The primary exposure to As is through the consumption of water contaminated with high As levels, particularly in Bangladesh. Previous studies have shown that urinary arsenic (UAs) concentration can reflect As exposure and metabolism in individuals. However, little is known about how other factors, such as age, sex, and socioeconomic status, may affect UAs concentrations in children. Objective: This study aimed to investigate the influence of factors such as age, sex, and socioeconomic status on UAs concentrations in children, in addition to the impact of drinking water arsenic (WAs) levels. Methods: We conducted our study on elementary school-going children aged 8 ‒11 years from rural Araihazar in Bangladesh. We measured UAs (available for a subset of 391 children) and WAs levels and collected information on demographic and socioeconomic characteristics. We employed regression analysis and t -tests to analyze the data. Results: Our findings revealed that younger children (𝛽 = 197.95, 95% confidence interval [CI]: 111.97 to 283.94), female children (𝛽 = 93.95, 95% CI: 8.49 to 179.40), and children with less educated fathers (𝛽 = 138.03, 95% CI: 26.47 to 249.58) had higher UAs levels, particularly when they consumed water with high As content. Conclusion: The study concludes that children's As exposure and UAs concentration may vary depending on their age, sex, and socioeconomic status. Therefore, these factors should be considered when assessing the health risks associated with As. [ABSTRACT FROM AUTHOR]

Background and Objectives: There is no standardised approach to toilet training in children. This study aimed to determine the factors affecting the duration of toilet training in children aged 0–5 years and to develop a tool to assess the child's readiness to start toilet training. Materials and Methods: This cross-sectional study was conducted on 409 children aged 0–5 years. Social, economic, behavioural, and developmental characteristics that are effective in toilet training in healthy children were evaluated. A scale assessing children's readiness for toilet training (Toilet Training Readiness Scale-TTRS) was developed and content validated. Results: The mean age of the 409 children included in this study was 44.69 ± 13.07 months (min = 4; max = 60 months). The mean age of initiation of toilet training was 26.8 months. Most frequently, urine and faeces trainings were started together (52.1%). In the logistic regression analysis performed to evaluate the factors affecting the duration of toilet training, it was found that the TTRS score, mother's employment status, family type, child's first reaction, toilet type, and continuity of training were important predictors. The duration of toilet training showed a weak negative correlation with the scores obtained from the TTRS and the number of children in the family but a weak positive correlation with the age at the beginning of toilet training. The TTRS scores were inversely proportional to the duration of toilet training. Conclusions: Family characteristics, socioeconomic conditions, and readiness of the child for and no interruption in toilet training are important in completing toilet training in a short time and successfully. If a child-focused approach is adopted, evaluating the child from this point of view and initiating the training at the appropriate time may help to complete a more successful and shorter toilet training. We recommend that the scale we have developed be studied in other studies and different groups. [ABSTRACT FROM AUTHOR]

Recovery-oriented practice has become taken for granted and seen as the most ideal way of working for social workers alongside other allied health practitioners in the mental health field. Recovery-oriented practice is defined as a person-centred and strengths-based approach, providing interventions, as well as facilitating environmental and multidisciplinary resources to support the individual's independence. The applicability of recovery in a child and youth mental health (CYMH) context, however, continues to be questioned. Although some research has explored what recovery means for young people, there is scant literature that examines how recovery-oriented practice is enacted when working with children and their families. This scoping review, guided by the Arksey and O'Malley's framework explores how recovery is conceptualised and translated into practice with children aged two to twelve years who have identified 'mental health concerns' and their families. Qualitative and grey literature from the last twenty years was thematically analysed. The findings highlight the primacy placed on global recovery-oriented principles and expose the superficial articulation of the application of recovery-oriented practice with children. Findings underscore the need to critically investigate how social workers enact recovery approaches when working in a clinical CYMH setting, dominated by the medical model which prioritises evidence-based intervention and marginalises children's knowledge. [ABSTRACT FROM AUTHOR]

Education plays a central role in promoting social inclusion, respect and dignity and therefore contributes significantly to economic and social progress. The accessibility and quality of education are directly related to the development of any country. Therefore, ensuring equal access to quality education is crucial for sustainable economic growth, especially in developing countries. UNICEF's ranking of Pakistan as the country with the second highest number of school dropouts in the world stimulated this study to address the alarming problem of large numbers of out-of-school children in marginalized communities such as Pakistan. The study aims to examine the multiple factors that stimulate dropout rates or out of school, including socioeconomic status, geographical location, child-related characteristics, child labor, skills and attitudes. Using data from MICS Wave 6 in Pakistan, this study proposes recommendations for educators and policymakers aimed at promoting equal educational opportunity and inclusive growth around the world. [ABSTRACT FROM AUTHOR]

In 2022, 54% of 1.5 million children (age 0–14) living with HIV had access to anti-retroviral medication (ART). Adherence to ART for pregnant or breastfeeding HIV + women is critical for maintaining their personal health and to prevent mother-to-child-transmission (MTCT). For HIV + infants, adherence is essential to establish early viremic control and is contingent on caregiver administration. We conducted a scoping review to systematically identify and categorize the influences on ART adherence for pregnant or breastfeeding HIV + women and their HIV + infants. We searched databases in June 2023 and employed the Social-Ecological Model (SEM) to organize facilitators and barriers to adherence referenced in published articles. All articles published before 2016 were excluded due to updated guidelines from WHO on MTCT and ART. Our analysis included 52 articles. 50/52 took place in Africa and used cross-sectional and mixed-methods design. Barriers to adherence for pregnant or breastfeeding HIV + women included maternal education, self-efficacy, social support, and social/economic context. Barriers to infant adherence included development, nutrition, age of treatment initiation, disclosure, and ART side effects. Additional facilitators and barriers to adherence are presented at family, extra-familial, and socio-cultural SEM levels. Stigma was the most salient barrier referenced across the entire continuum of HIV care and all SEM levels. This review revealed a dearth of literature focusing on HIV + infants who are dependent on their caregivers for ART adherence and lack of a standard adherence measure. We identified multi-leveled influences on adherence impacting both the mother and infant and are amenable to public health intervention. [ABSTRACT FROM AUTHOR]

Abstract Background The pandemic and its preventive measures disrupted daily routines and posed unforeseen obstacles for families. Users of public online forums chronicled these challenges by freely expressing their sentiments in unrestricted text-length formats. We explored a German COVID-19 forum to understand family perspectives and experiences of pandemic measures, particularly in terms of testing and vaccinating children. Our findings aim to inform future epidemic health policies. Methods We retrieved all 11,207 entries from a COVID-19 forum during its lifespan (June 2020 - December 2021), posted during the height of the pandemic. We classified the entries into topic clusters including general pandemic situation, testing, or vaccination using state-of-the-art text embeddings and clustering algorithms. The clusters were selected based on the research’s aims and analysed qualitatively using a health policy triangle framework. Results Users generally appreciated pandemic public health safety measures for everyone’s protection, yet voiced concerns about inconsistent policies and disproportional disadvantages for children compared to other societal groups, like the elderly. Non-compliers were overwhelmingly regarded with skepticism and critiqued. Users found COVID-19 (exit) strategies and information about the benefits of vaccination unclear. This created hurdles for parents and caregivers in navigating their children’s school and social life. Users endorsed vaccinating children mainly for “normalising” children’s lives rather than for their physical health benefits. Some users suggested prioritising teachers and early childhood educators on the vaccination eligibility list to speed up a return to “normality”. Conclusions During pandemics, governments should prioritize addressing the societal and mental health needs of children by implementing participatory and family-oriented public health measures for schools and kindergartens. Clear communication coupled with consistent design and implementation of safety measures and regulations, would be crucial for building trust in the general population and for ensuring compliance regarding testing and vaccination. Communicating the benefits and risks of vaccinating children is of paramount importance for informed decision-making among parents. In future epidemics, computer-aided analysis of large online qualitative data would offer valuable insights into public sentiments and concerns, enabling proactive and adaptive epidemic responses.

This is an overview of the results from 14 countries or jurisdictions in a Global Matrix of Para Report Cards on physical activity (PA) of children and adolescents with disabilities. The methodology was based on the Active Healthy Kids Global Alliance's Global Matrix 4.0. Data were aligned with 10 indicators (Overall PA, Organized Sport, Active Play, Active Transport, Physical Fitness, Sedentary Behavior, Family & Peers, Schools, Community & Environment, and Government) to produce Para Report Cards. Subsequently, there were 139 grades; 45% were incomplete, particularly for Active Play, Physical Fitness, and Family & Peers. Collectively, Overall PA was graded the lowest (F), with Schools and Government the highest (C). Disability-specific surveillance and research gaps in PA were apparent in 14 countries or jurisdictions around the world. More coverage of PA data in Para Report Cards is needed to serve as an advocacy tool to promote PA among children and adolescents with disabilities. [ABSTRACT FROM AUTHOR]

Abstract Background and aim The evidence about the acceptability and effectiveness of innovative paediatric models of care for Type 1 diabetes is limited. To address this gap, we synthesised literature on implemented models of care, model components, outcomes, and determinants of implementation and sustainability. Methods A systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Database searches of Medline, CINAHL, EMBASE and Scopus were conducted. Empirical studies focused on Type 1 diabetes paediatric models of care, published from 2010 to 2022 in English were included. Results Nineteen extant studies reported on models and their associations with health and psychosocial outcomes, patient engagement with healthcare, and healthcare costs. Thirteen studies described multidisciplinary teamwork, education and capacity building that supported self-care. Four studies involved shared decision making between providers and patients, and two discussed outreach support where technology was an enabler. Fourteen studies reported improvements in health outcomes (e.g. glycaemic control), mostly for models that included multidisciplinary teams, education, and capacity building (11 studies), outreach support or shared care (3 studies). Four studies reported improvements in quality of life, three reported increased satisfaction for patients and carers and, and one reported improved communication. Four of five studies describing shared care and decision-making reported improvements in quality of life, support and motivation. Outreach models reported no negative outcomes, however, accessing some models was limited by technological and cost barriers. Eight studies reported on model sustainability, but only half reported implementation determinants; none reported applying a theoretical framework to guide their research. Conclusion Some health and psychosocial benefits were associated with newer models. To address knowledge gaps about implementation determinants and model sustainability, longitudinal studies are needed to inform future adoption of innovative models of care for children with Type 1 diabetes.

Purpose: Asian children and youth with disabilities often experience multiple barriers, stigmas and discrimination within and outside their families; yet less is understood about their lived experiences. This systematic review explored the experiences of ableism among Asian children and youth with disabilities and their families. Methods: We conducted a systematic review of qualitative studies and a qualitative meta-synthesis. We searched six databases including Ovid Medline, Embase, PsychInfo, Healthstar, Web of Science, and Scopus. Results: Forty-two articles met our inclusion criteria involving 17 countries and regions over a 22-year period. The findings were synthesized into four themes: (1) individual- and family-level ableism (i.e., stigma, fears, concerns, stress and anxieties, physical abuse, bullying, reduced engagement in community activities); (2) institutional-level ableism (i.e., barriers to accessing and navigating supports, ableist attitudes among service providers, unavailable services); (3) societal-level ableism (i.e., cultural and religious stigma, social rejection, discrimination, environmental and policy barriers); and (4) coping strategies (i.e., self-care activities, supports from family, friends and people with similar conditions, religious beliefs). Conclusions: Our results highlight the ableist experiences that Asian children and youth with disabilities and their caregivers often encounter and the strong need for further supports to address ableism using culturally responsive strategies. IMPLICATIONS FOR REHABILITATION: Asian children and youth with disabilities encounter multiple forms of ableism at the individual, family and institutional levels. It is important for healthcare providers to customize resources that are culturally appropriate and aligned with the cultural and language backgrounds of the clients they serve. Clinicians and service providers should engage in culturally sensitive training and education to understand the barriers faced by the clients they serve. Clinicians and service providers should continue to advocate for marginalized and equity-deserving groups. [ABSTRACT FROM AUTHOR]

Challenging behavior (CB) is a common occurrence in early childhood and frequently occurs in young children with disabilities. CB is also culturally perceived and includes differences in how caregivers understand and define the topography of CB. Despite the cultural interpretation, CB is known to impact the child and their family but there has been little exploration of what marginalized caregivers perceive as the impact of the CB that their young children with disabilities exhibit. We used semi-structured interviews to explore the perceptions of 24 caregivers, who identified as Black, Mexican American, and White, about the impact of their child's CB. Caregivers shared how the CB impacted themselves, their families, their child, and others. Although much of the impact was similar among caregivers, we discuss nuanced differences across ethnic groups. [ABSTRACT FROM AUTHOR]

Real-time attention coordination in parent–toddler dyads is often studied in tightly controlled laboratory settings. These studies have demonstrated the importance of joint attention in scaffolding the development of attention and the types of dyadic behaviors that support early language learning. Little is known about how often these behaviors occur in toddlers' everyday lives. We brought wireless head-mounted eye trackers to families' homes to study the moment-to-moment patterns of toddlers' and parents' visual attention and manual activity in daily routines. Our sample consisted of English- and Spanish-speaking families who all reported being middle- or upper middle-class. Toddlers were 2 to 3 years old. Consistent with the findings from previous laboratory studies, we found variability in how frequently toddlers attended to named objects in two everyday activities—Object Play and Mealtime. We then tested whether parent–toddler joint attention in the seconds before a naming utterance increased toddler's attention on the named object. We found that joint attention accompanied by the attended object being held increased the child's attention to the labeled object during naming. We posit that in the rich, noisy world of toddlers' everyday lives, embodied attention plays a critical role in coordinating dyadic behaviors and creating informative naming moments. Our findings highlight the importance of studying toddlers' natural behavior in the real world. Public Significance Statement: This study used eye-tracking glasses to measure toddler and parent attention at home and to test whether findings from laboratory tasks matter in the real world. Toddlers' attention to an object while it is named by their parent is thought to be important for word learning. We found that toddlers' attention to a named object increases when they and their parent coordinate their attention to held objects, supporting previous lab-based work. [ABSTRACT FROM AUTHOR]