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Bimodal bilingualism involves the use of a sign language and a spoken language, and offers a unique opportunity to explore the cognitive effects of growing up bilingual. The aim of this study was to investigate the relationship between bimodal bilingualism and executive function (EF) in hearing children who are native users of a sign language. We studied three groups of children: bimodal bilinguals (users of a sign language and a spoken language), unimodal bilinguals (users of two spoken languages), and monolinguals, performing three cognitive tasks to measure different components of EF: visuospatial working memory (Odd One Out task), cognitive flexibility (Children's Colored Trails Test) and conflict resolution (Simon task). All groups of children obtained similar scores on the Odd One Out task and the Children's Colored Trails Test. Bimodal bilinguals displayed distinct patterns of conflict resolution in comparison to monolingual children: bimodal bilinguals had better overall accuracy and slower overall reaction time in the Simon task. The subsequent analysis did not find a straightforward trade-off between speed and accuracy. These results suggest that bimodal language experience and/or visual-spatial language usage may explain the small bimodal bilingual advantage in the Simon task that we observed in hearing children who are native signers.

The aim of this study is twofold: To examine if deafness is invariably associated with deficits in executive function (EF) and to investigate the relationship between sign language proficiency and EF in deaf children of deaf parents with early exposure to a sign language. It is also the first study of EF in children acquiring Polish Sign Language. Even though the mothers of the deaf children (N = 20) had lower levels of education compared with the mothers of a hearing control group, the children performed similarly to their hearing peers (N = 20) on a variety of EF task-based assessments. Only in the Go/No-go task were weaker inhibition skills observed in younger deaf children (6-9 years) compared with hearing peers, and this difference was not seen in older children (10-12 years). Hence, deafness does not necessarily impair EF; however, attentional and inhibition abilities may be acquired via a different route in deaf children. Sign language receptive skills predicted EF in deaf children. In conclusion, we highlight the importance of deaf parenting building the scaffolding for EF in deaf children.

Background: Urban and rural areas have been experiencing major demographic and structural changes, characterized by an aging population in rural areas and a growth of cities in number and size. However, it is poorly researched how children's physical activity and screen time developed in urban and rural areas. To address this deficit, we investigated physical activity and screen-time trends in Germany's pediatric population across four urbanicity levels (rural, small town, medium-sized town, city). Method: We obtained weighted data at three cross-sectional timepoints between 2003 and 2017, representative for Germany's child and adolescent population. Physical activity and screen time were self-reported. We analyzed trends using a structural equation modeling framework for the overall sample and calculated interactions between the trends and age and gender, respectively. Results: In total, 12,161 children and adolescents between 4 and 17 years participated in the study. Children and adolescents in rural areas experienced a downward trend in total physical activity. Outdoor play and leisure-time physical activity decreased across all areas, with the strongest decline in rural areas. Computer and gaming time increased across all areas except for cities, with the sharpest increase in rural areas. The decline in outdoor play and the incline in computer and gaming time were driven by adolescents. Females showed stronger increases in computer and gaming time than males. Conclusion: Our findings suggest that in a representative sample of children and adolescents in Germany, detrimental trends in children's physical activity and screen time occur at a higher rate in rural areas compared with urban environments. This provides critical information for health policy: While all children and adolescents should be targeted for physical activity promotion, a special focus should be on tailoring interventions for rural areas to prevent and mitigate inequalities in physical activity across urban and rural areas.

Children with specific language impairment (SLI) perform poorly on sentence repetition tasks across different spoken languages, but until now, this methodology has not been investigated in children who have SLI in a signed language. Users of a natural sign language encode different sentence meanings through their choice of signs and by altering the sequence and inflections of these signs. Grammatical information is expressed through movement and configurational changes of the hands and face. The visual modality thus influences how grammatical morphology and syntax are instantiated. How would language impairment impact on the acquisition of these types of linguistic devices in child signers? We investigated sentence repetition skills in a group of 11 deaf children who display SLI in British Sign Language (BSL) and 11 deaf controls with no language impairment who were matched for age and years of BSL exposure. The SLI group was significantly less accurate on an overall accuracy score, and they repeated lexical items, overall sentence meaning, sign order, facial expressions, and verb morphological structures significantly less accurately than controls. This pattern of language deficits is consistent with the characterization of SLI in spoken languages even though expression is in a different modality. We conclude that explanations of SLI, and of poor sentence repetition by children with this disorder, must be able to account for both the spoken and signed modalities.

Although speechreading has always served an important role in the communication of deaf people, educational interest in speechreading has decreased in recent decades. This paper reviews speechreading in terms of speech processing, neural activity and literacy, and suggests that it has an important role in intervention programmes for all deaf children, including those with cochlear implants. (Contains 3 figures and 1 footnote.)

In the course of language development children must solve arbitrary form-to-meaning mappings, in which semantic components are encoded onto linguistic labels. Because sign languages describe motion and location of entities through iconic movements and placement of the hands in space, child signers may find spatial semantics-to-language mapping easier to learn than child speakers. This hypothesis was tested in two studies: a longitudinal analysis of a native signing child's use of British Sign Language to describe motion and location events between the ages 1-10 and 3-0, and performance of 18 native signing children between the ages of 3-0 and 4-11 on a motion and location sentence comprehension task. The results from both studies argue against a developmental advantage for sign language learners for the acquisition of motion and location forms. Early forms point towards gesture and embodied actions followed by protracted mastery of the use of signs in representational space. The understanding of relative spatial relations continues to be difficult, despite the iconicity of these forms in the language, beyond 5 years of age.

Background: Specific language impairment has previously solely been documented for children acquiring spoken languages, despite informal reports of deaf children with possible sign language disorder. The paper reports the case of a deaf child exposed to British Sign Language (BSL) from birth, who has significant developmental deficits in the comprehension and production of BSL grammar based on formal assessment and linguistic analyses of his sign communication in comparison with age-matched unimpaired signers. Results: It is shown that linguistic difficulties with BSL verb morphology underlie the child's poor performance compared with same-age native signers. Conclusions: The appearance of linguistic impairments in sign and spoken languages in comparable domains supports cross-linguistic and modality free theories of specific language impairment. (Contains 1 figure.)

This study focuses on the mapping of events onto verb-argument structures in British Sign Language (BSL). The development of complex sentences in BSL is described in a group of 30 children, aged 3;2-12;0, using data from comprehension measures and elicited sentence production. The findings support two interpretations: firstly, in the mapping of concepts onto language, children acquiring BSL overgeneralize the use of argument structure related to perspective shifting; secondly, these overgeneralizations are predicted by the typological characteristics of the language and modality. Children under age 6;0, in attempting to produce sentences encoded through a perspective shift, begin by breaking down double-verb constructions (AB verbs) into components, producing only the part of the verb phrase which describes the perspective of the patient. There is also a prolonged period of development of non-manual features, with the full structure not seen in its adult form until after 9;0. The errors in the use of AB verbs and the subsequent protracted development of correct usage are explained in terms of the conceptual-linguistic interface. (Contains 1 footnote.)

Abstract Background Outdoor play, sedentary behavior (SB), and moderate-to-vigorous physical activity (MVPA) are related to youth’s health, however, there are research gaps regarding 1) associations between outdoor play, SB, and MVPA across a broad pediatric age range (6–17 years), and 2) longitudinal associations between outdoor play, SB, and MVPA across childhood and adolescence. Two studies were conducted to address those research gaps: Study 1 aimed to investigate relationships between outdoor play and accelerometer-assessed SB and MVPA in a cross-sectional nationwide sample of children and adolescents in Germany. Study 2 aimed to investigate prospective associations between outdoor play and self-reported screen-time SB and MVPA and in a sample of children with three measurement timepoints across 11 years. Methods Data were obtained of the German national representative Motorik-Modul (MoMo) Study and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). In Study 1, N = 2278 participants (6–17 years) were included with self-reported outdoor play and accelerometer-assessed SB and MVPA. Associations were examined via multiple linear regressions. In Study 2, N = 570 participants (baseline: 4–7 years) were included in the longitudinal analysis with follow-ups six and 11 years later. Screen-time SB (TV watching and PC/Gaming), MVPA, and outdoor play were self-reported. Associations were investigated through a path prediction model. Results Study 1 showed that compared to

Abstract Background Participation in sports and physical activity (PA) is a critical resource for children’s health and social development. This study analyzes how the parental socioeconomic status (SES) of children and adolescents affects their PA in sports clubs (organized sports) and outside of sports clubs (unorganized sports) and tests whether the potential impact of parental SES is mediated by the opportunity structure of their residential area (walkability, infrastructure, etc.) and by family and peer support for PA. Furthermore, PA is analyzed respecting differences by gender and migration background. Methods Using representative data from the MoMo/KiGGS study (2009–2012 and 2014–2017), we take into account about 8000 measurements from about 7000 subjects. We estimate hurdle regression models to analyze the minutes per week spent on sports activities. Results Results show that children with a higher parental SES, children living in areas with many opportunities for PA, and children receiving family and peer support are more physically active than children without these features. Controlled for opportunities and support, status effects are small but visible. The differences regarding parental SES are much more apparent for organized sports than for unorganized sports, indicating the relevance of economic resources. Boys are more active than girls, whereas there is no clear effect of migration background. Conclusions The coefficient of parental SES on organized sports most probably relates to the resources needed to participate in sports clubs, including fees and equipment. Lower membership fees might potentially help to integrate children with low parental SES into sports clubs and thereby make organized sports more accessible to all social classes.

INTRODUCTION: Pediatric end of life (EOL) care skills are a high acuity, low occurrence skill set required by pediatric clinicians. Gaps in education and competence for this specialized care can lead to suboptimal patient care and clinician distress when caring for dying patients and their families. METHODS: A half-day workshop using a deliberate practice approach was designed by an inter-professional workgroup including bereaved parent consultants. Pediatric fellows (neonatal-perinatal medicine, critical care, hematology oncology, blood and marrow transplant) and advanced practice providers learned and practiced EOL skills in a safe simulation environment with instruction from interprofessional facilitators and standardized patients. Participant perceived competence (self-efficacy) was measured before, immediately-post, and 3 months post workshop. RESULTS: There were 28 first-time (of 34 total) participants in 4 pilot workshops. Participants reported significantly increased self-efficacy post-workshop for 6 of 9 ratings, which was sustained 3 months afterwards. Most (92%, n = 22 of 24 respondents) reported incorporating the workshop training into clinical practice at 3-month follow-up. CONCLUSIONS: With early success of the pilot workshops, future iterative work includes expanding workshops to earlier, interprofessional learners and collecting validity evidence for a competency-based performance checklist tool. A project website (https://z.umn.edu/PECS) was developed for local and collaborative efforts. [ABSTRACT FROM AUTHOR]

With high prevalence of overweight and obesity in developed countries, the assessment of body composition in children and adolescents is of growing interest. The aim of this study was (i) to provide up-to-date population wide percentiles for meaningful diagnostic bioelectrical impedance outcome parameters and (ii) to specify reference values for these measures in a normal weight subpopulation. A representative nationwide sample of 4 to 24-year-old children and adolescents (n = 3593) was drawn out of 167 primary sample points across Germany from 2009 to 2012 (Motorik-Modul study wave 1). Fat free mass index (FFMI), fat mass index (FMI), body cell mass index (BCMI) and phase angle (PA) were derived from four electrodes 50 kHz bioelectrical impedance analyses. Sex-specific percentiles were calculated using the LMS-method for the total study population and a normal weight subsample (defined according to the international BMI-standard by Cole). Percentile curves for body composition parameters are similar between boys and girls until puberty. Subsequently, girls show a higher FMI than boys, and boys increase their FFM, BCM, and PA time-shifted, in that order. Differences in FMI between the overall and the normal weight sample increase with age, showing an age-dependent prevalence for overweight and obesity among the representative German sample. Results from the normal weight sample can be used as reference values to define a healthy body composition. Differences in body composition between the representative German sample and the normal weight subsample reveal a high prevalence of elevated fat mass in the population of children and adolescents living in Germany. [ABSTRACT FROM AUTHOR]

This paper presents the features of an online test framework for a receptive skills test that has been adapted, based on a British template, into different sign languages. The online test includes features that meet the needs of the different sign language versions. Features such as usability of the test, automatic saving of scores, and score reporting have been implemented. The background information of the children and the test results are saved in a secure databank. When consent has been granted, these data can be used for cross-linguistic research in the future. This will not only help us to broaden our understanding of deaf children's sign language development, but will also help us to further improve sign language testing. Furthermore, implications for research and practice will be discussed. [ABSTRACT FROM AUTHOR]

• Children born deaf show typical left-hemisphere dominance during language production. • No evidence of an association between left-lateralisation and language proficiency. • Exposure to auditory speech via a cochlear implant is not a prerequisite for left hemisphere language dominance. The effect of sensory experience on hemispheric specialisation for language production is not well understood. Children born deaf, including those who have cochlear implants, have drastically different perceptual experiences of language than their hearing peers. Using functional transcranial Doppler sonography (fTCD), we measured lateralisation during language production in a heterogeneous group of 19 deaf children and in 19 hearing children, matched on language ability. In children born deaf, we observed significant left lateralisation during language production (British Sign Language, spoken English, or a combination of languages). There was no difference in the strength of lateralisation between deaf and hearing groups. Comparable proportions of children were categorised as left-, right-, or not significantly-lateralised in each group. Moreover, an exploratory subgroup analysis showed no significant difference in lateralisation between deaf children with cochlear implants and those without. These data suggest that the processes underpinning language production remain robustly left lateralised regardless of sensory language experience. [ABSTRACT FROM AUTHOR]

BackgroundSeveral theories have been established to explain physical activity (PA) participation. However, many of these theories might not be applicable to adolescent PA behavior as they require a high level of cognitive reflection. Weiss suggests a model for youth which is based on the theoretical concept of Harter, focusing on self-esteem within social, emotional, and developmental aspects to explain behavior. The aim of this study was to test the original and a social support focused alternative version of the Weiss-Harter-model, and to cross-validate the findings in two separate studies.MethodsData from two cross-sectional studies was retrieved and the models tested using structural equation modeling. Participants aged 11–17 years were recruited from a school (Study 1: N = 182) and from the German MoMo study (Study 2: N = 2,274). They filled in questionnaires about perceived competence, social support, self-esteem, PA enjoyment, and minutes of moderate-vigorous PA (MVPA).ResultsNone of the studies showed a good model fit for the original model [Study 1: CFI = 0.870, RMSEA 0.118 (90% CI 0.081–0.158), χ2 = 38.7, p < 0.01; Study 2: CFI = 0.871, RMSEA 0.148 (90% CI 0.140–0.155), χ2 = 1112.6, p < 0.01], explaining only 12% and 17% of MVPA variance, respectively. The alternative model which added the direct paths of social support to MVPA and PA enjoyment had a very good model fit for both Study 1 [CFI = 1.000, RMSEA 0.000 (90% CI 0.000–0.031), χ2 = 4.8, p > 0.05] and Study 2 [CFI = 0.990, RMSEA 0.043 (90% CI 0.035–0.051), χ2 = 103.7, p < 0.01]. The addition of these paths led to changes in effect size and directions of other path coefficients, with self-esteem having a small to meaningless impact on MVPA. The revised models accounted for 38% and 42% explained variance in MVPA, respectively.DiscussionThe prominent role of self-esteem in the original model could not be confirmed. Instead, the results emphasize the role of social support for PA and PA enjoyment, which is in line with current research. Interventions to increase adolescent PA levels should thus focus more on components of social support instead of self-esteem. Future studies are needed to examine the interplay between social support, PA enjoyment and perceived competence as PA determinants.

Increasing physical activity and reduction of sedentary behaviour play important roles in health promotion and prevention of lifestyle-related diseases in children and adolescents. However, the question of how much physical activity is useful for which target group is still a matter of debate. International guidelines (World Health Organization; European Association for the Study of Obesity), which are mainly based on expert opinions, recommend 60 min of physical activity every day. Age- and sex-specific features and regional differences are not taken into account. Therefore, expert consensus recommendations for promoting physical activity of children and adolescents in Germany were developed with special respect to national data, but also with respect to aspects of specific target groups, e.g., children with a lower socio-economic status (SES) or with migration background. They propose 90 min/day of physical activity, or at least 12,000 steps daily. Additionally, lifestyle factors, especially restriction of media consumption, were integrated. The recommendations provide orientation for parents and caregivers, for institutions such as schools and kindergartens as well as for communities and stakeholders.

Abstract Background Regular physical activity (PA) is a prerequisite for normal growth and maturation, health, and fitness of children and adolescents. Because of the growing evidence of the health benefits of regular PA, several national and international public health organisations have established PA guidelines. The purpose of this study was to assess the percentage of children and adolescents in Germany who meet the PA guideline of 60 minutes of moderate-to-vigorous PA each day and to evaluate socio-demographic correlates of compliance with the PA guideline. Methods The sample consists of 4,529 children and adolescents aged between 4 and 17 years who lived and were registered in the Federal Republic of Germany between 2003 and 2006. The compliance with the PA guideline was assessed using a widely accepted screening measure. Socioeconomic status, immigration background and residential area were assessed using a parent questionnaire. Results Overall, 13.1% of girls and 17.4% of boys complied with the national guideline of 60 minutes of moderate-to-vigorous PA daily. While compliance was significantly lower in older participants of both gender groups, the steepest decrease in compliance was observed for age groups around the transition time from primary to secondary school. Logistic regression revealed that socioeconomic status and a migration background were significant predictors for compliance in girls and residential area for compliance in boys. Conclusions Programs and policy action addressing the problem of decreasing compliance with PA guideline with increasing age are warranted. The transition from primary school to secondary school seems to be a critical stage in life with respect to PA behaviour. Therefore, specific interventions should aim at restructuring and reorganising their daily and physical activities during this transition.