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Background: While research has emphasized the importance of parental support for LGBTQIA + youth wellbeing, there remains limited understanding of parental experiences with nonbinary children, particularly those prepubescent. This study aimed to explore how parents of nonbinary children ages 5–8 learn to support their child's identity, examining initial reactions, emotional processes, supportive behaviors, societal responses, and associated challenges and rewards. Methods: A qualitative study was conducted using Reflexive Thematic Analysis (RTA) within a framework of ontological relativism and epistemological constructivism. Nine parents of nonbinary children aged 5–8 from the Northeastern United States participated in semi-structured interviews lasting 60–80 min. Questions explored various aspects of parenting nonbinary children, including the child's gender identity, parental feelings, experiences sharing the child's identity, and challenges and rewards of raising a gender-diverse child. The research team, comprising individuals who identify as trans, genderqueer, and nonbinary, employed collaborative coding and thematic development. Results: Four main themes were constructed: (1) Parents hear and support their child's nonbinary identity, this theme highlights immediate acceptance and efforts parents make to affirm their child's gender; (2) Parents learn about ways cisnormative society harms their child, here, parents recognize the societal pressures and barriers their children face; (3) Parents take significant and proactive steps to affirm their child, this theme documents the actions parents take to support their child in environments that invalidate their identity; and (4) Gender is just one aspect of who my child is, this theme reflects on parental insights of gender as just one part of their child's overall personhood. Conclusions: This study provides insights into the experiences of parents supporting young nonbinary children, emphasizing the importance of affirming expressed identity, the parent-child relationship, and proactive support in navigating cisnormative societal structures. Findings highlight the transformative experience of parenting nonbinary children, with parents often challenging their own preconceptions of gender and coming to more nuanced understandings. These results can inform supportive interventions and policies for nonbinary children and their families, and we hope to contribute to a growing body of research that shifts narratives towards joy, resilience, and community in trans and nonbinary experiences. [ABSTRACT FROM AUTHOR]

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

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

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

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

Aim: To synthesize the literature on breastfeeding outcomes associated with exposure to internationally recognized best practices, such as the Baby‐Friendly Hospital Initiative, for patients in the United States during the postpartum period, contextualized within the Missed Care Model. Design: The authors employed Whittemore and Knafl's integrative review framework and the 2020 PRISMA guidelines for data extraction, synthesis, reporting and assessment. Methods: Five electronic databases were searched for articles published between 2007 and 2023. Eligible articles reported on exposure to breastfeeding best practices and outcomes or the experiences, views, perceptions and attitudes of parents, nurses or lactation consultants regarding hospital breastfeeding support. Extracted data were compared to identify in‐hospital exposure to breastfeeding best practices and breastfeeding outcomes, and differences in exposure and outcomes based on patient and provider characteristics. Results: Twenty‐one quantitative, qualitative and mixed methods articles met inclusion criteria. A higher reported adherence to best practices was associated with greater odds of breastfeeding; some practices demonstrated greater effects overall or for specific groups. Higher exposures to best practices and higher breastfeeding rates were found for non‐Hispanic white patients, and those with more education, private insurance and who live in urban areas. Disparities in support and outcomes were related to patients' race/ethnicity, language, weight and age. Qualitative findings reflected missed care concepts, such as internal processes related to habits and group norms, relevant to breastfeeding support. Conclusion: Review findings also include an adapted Missed Care Model specific to breastfeeding support, which can inform future research related to providers' internal processes that may influence breastfeeding or equitable breastfeeding care. Implications for the Profession and/or Patient Care: Missed care can be influenced by a variety of factors, including providers' internal values and beliefs. Study findings suggest the existence of inequities in breastfeeding care and underscore the need to address and eliminate breastfeeding disparities. Impact: This study addressed how patient exposure to best practices in breastfeeding support relates to breastfeeding outcomes and whether exposure and outcomes differ by patient or provider characteristics, connecting this to the Missed Care in Breastfeeding Support Model. The main findings were that higher reported exposure to best practices in breastfeeding support related to improved breastfeeding outcomes; inequities exist in exposure to best practices; and patients and providers identify the importance of providers' internal processes in the delivery of breastfeeding support, which aligns with the Missed Care in Breastfeeding Support Model. Study findings will have the potential to impact how nurses, lactation consultants and other providers who deliver breastfeeding support in the postpartum hospital setting. Reporting Method: The authors adhered to relevant 2020 PRISMA reporting guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic is a historic event impacting children around the globe. Prior research on the educational experiences of children during the COVID-19 pandemic focused almost exclusively on spring 2020. This article extends this literature past the initial shock of spring 2020, capturing the first full school year (2020–2021) during the COVID-19 pandemic. This registered report study utilized a national sample of 1,666 United States twins in kindergarten through 12th grade from 43 states to provide the current descriptive report of children's educational experiences during this time, as reported by their parents. Specifically, we reported on school format, parents' role in education, parent–teacher interactions, schoolwork struggles, technology access, and school services. About half of children attended in-person schooling, with many children switching from online to in-person throughout the school year. Parents saw the pandemic as a risk to their children's education. During the 2020–2021 school year of the pandemic, parents felt they had a larger role in their children's education and were less satisfied in their interactions with teachers than what they experienced during the prepandemic part of the 2019–2020 school year. Children experienced more schoolwork struggles than they had in previous years, and this was similar across age groups. For most constructs, results were equivalent across age group, but parents of younger children tended to provide more schoolwork help. Overall, this article highlights the disruptions in their educational environments that children continued to experience through the first full school year (2020–2021) of the COVID-19 pandemic. Public Significance Statement: This study provides important insights into what the educational experiences were of U.S. families with K-12 children during the first full school year (2020–2021) of the coronavirus disease 2019 pandemic, in many cases how this differed from the prepandemic part of the 2019–2020 school year. [ABSTRACT FROM AUTHOR]

Background: A growing body of literature examines the utility of emotion-focused parenting programs, as behaviorally based programs currently dominate the parenting literature. Few of those studies examine differences in how Black parents may benefit. This mixed-methods pilot study examined preliminary fidelity, efficacy, and acceptability of Tuning in to Kids (TIK), an emotion-focused parenting program targeting parenting practices and children's emotion regulation through a strengths-based approach. Methods: Pre, post, and one-month follow-up measurements were collected from 21 parents in the United States who were randomly assigned to a treatment (i.e., TIK) or waitlist control group. They were assessed across several self-report parent measures (parental emotion regulation, emotion socialization parenting practices and beliefs) and parent-report of children's social-emotional competence. Parents in the TIK group completed interviews to further understand their experience participating in the intervention. Results: Descriptive analyses showed general improvements and positive change in parenting practices, beliefs, parental emotion regulation, and children's self-regulation. Large effect sizes indicate reductions of parents emotion dismissing and distressed reactions to children's negative emotions. TIK was overall rated as a highly acceptable intervention. Parent interviews offer essential information to provide context to Black parents' experiences utilizing TIK as well as themes related to challenges in raising Black children with self-regulation difficulties. Conclusions: Overall, these preliminary mixed-methods outcomes suggest that TIK is a promising parenting program to improve Black parents' emotion regulation, emotion coaching beliefs and positive parenting practices. Further research is needed to investigate the effectiveness of TIK and other emotion-focused parenting programs with Black parents and assess the necessity of future cultural adaptations. [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]

How Black Americans in the United States (U.S.) make sense of a sociopolitical climate marked by racist imagery, tensions, and police violence is important to understand given the numerously documented detrimental effects of racism‐related stress on the well‐being of Black parents and children. Informed by Racism‐Related Stress Theory, the current study employed a convergent parallel mixed methods design to better understand the ways racism‐related stressors in the sociopolitical climate impacted the daily lives and mental health of a sample of Black families with low income. Seventy‐eight Black American preadolescents (Mage = 11.0; 43.6% girls) and their parents (79% mothers; 76% living below the U.S. federal poverty level [FPL]) from the southwestern U.S. reported their symptoms of depression and how they had been affected by racial stressors in the sociopolitical climate between Fall 2018 and Summer 2019. A nested sample of 10 parents (80% mothers; 80% living below the FPL) from the quantitative sample also participated in a semi‐structured interview. Meta‐inferences across methods were drawn pertaining to the influence of child gender on parents' interpretation of effects for children, the toll racism‐related stress in the sociopolitical climate takes on Black families, and the transferal of effects on parents to children through parenting and parental depressive symptoms. Findings spotlight the need for policies and family‐centered programming that address the racism‐related stress faced by many Black youth and their families. Providing families with opportunities and tools that can potentially mitigate harmful effects and foster empowerment could promote positive and lasting change. [ABSTRACT FROM AUTHOR]

Echolalia has been described as the repetition of words, phrases, songs or other more elaborate dialogues uttered by another person, which may be immediate or delayed (International Classification of Diseases, 11th Revision; Diagnostic and Statistical Manual of Mental Disorders, 5th ed.). Some classify echolalia as a communication impairment reflective of delay, while others consider it a restricted, repetitive pattern of behaviours, without meaningful communicative function. Little attention is given to the experiences of non-clinicians, such as parents or teachers who may hold valuable insights to further our understanding of this phenomenon. This study forms part of a larger programme of inquiry which interviewed parents (N = 133) about their experiences of their sons' and daughters' echolalia. Using hermeneutic phenomenological analysis in an abductive framework, we present a perspective of echolalia that has largely remained silent in literature: echolalia as an expression of neurodiversity. Participants push back against the status quo of intervention, reclaiming echolalia as being a part of their child's identity. Participants want their children to not only enjoy their echolalia but to fully embrace it as being a part of their individual identity. We propose alternatives to a purely clinical perspective of echolalia; alternatives that may place the neurodiversity-affirmative perspectives of our participants in a co-existing tension with clinicians. Echolalia is a commonly found speech and language condition in autistic children. Children with echolalia repeat words and phrases they previously hear in place of proving a non-repetitive response. In research and when visiting speech and language services, one of the common goals is to modify these repetitions so that these children may, more socially, engage with their surrounding environment. In our research, we identified that not all parents want their children's echolalia to be modified. Some parents want their child to be able to enjoy echolalia and others don't want anyone to intervene because they see it as something that makes their child unique and being unique is something to be celebrated. We believe that there might be a way for speech and language services who want to modify echolalia and the parents in our study who do not want their child's echolalia to be modified, to be able to exist side-by-side. [ABSTRACT FROM AUTHOR]

Child corporal punishment (CP) may lead to child physical abuse, which is a public health concern in the United States. The present study examined major risk factors predicting attitudes toward CP among a sample of Black parents (N = 394), including frequency and valence of experiences of CP during childhood, outcome expectancies of CP, and perceptions of self-efficacy and response efficacy of non-physical discipline strategies. Structural equation modeling results revealed that the indirect associations between CP frequency and attitudes through self-efficacy and response efficacy were moderated by CP valence. Results extend the literature and point to the need for incorporating information about efficacy of evidence-based non-physical discipline strategies into intervention messages targeting prevention of child physical abuse. [ABSTRACT FROM AUTHOR]

Emotion socialization is conceptualized as a relational process, yet children's role in socializing parents' emotions is rarely considered. This study explored longitudinal patterns of mother-child emotion socialization from early to middle childhood. Participants were 349 children (51% boys, 49% girls) and their mothers from the southeastern United States. Children were 79.4% White, 12% Black or African American, and 8.3% multi-racial or other; 6.3% were Hispanic/Latino. Mother-child dyads completed an etch-a-sketch task when children were 3, 4, and 6 years old. At each time, mothers' and children's expression, coaching, and dismissing of positive and negative emotions were observed. Hierarchical Linear Modeling analyses identified developmental trajectories and within-dyad associations of emotion coaching and dismissing with emotion expression. Over time, expression of positive emotions decreased and expression of negative emotions showed no change for both mothers and children. Mothers decreased in coaching children's positive emotions and showed no change in coaching children's negative emotions. Children increased in coaching mothers' positive emotions and showed no change in coaching mothers' negative emotions over time. Both mothers and children decreased in dismissing emotions over time. Within dyads, mothers' increases in coaching and in dismissing related to children's increased expression. Children's increases in coaching related to mothers' increased expression. Findings highlight complexity and dynamics of emotion socialization processes over time. Highlights: Children play an active role in emotion socialization transactions. Mothers decreased and children increased in coaching of positive emotions over time. Maternal emotion coaching and emotion dismissing related to children's increased expression over time. Children's emotion coaching related to mothers' increased expression over time. [ABSTRACT FROM AUTHOR]

Purpose: To compare the degree of acceptance of behavior guidance techniques (BGT) in pediatric dentistry between American and Colombian parents. Methods: American parents (n=150) and Colombian parents (n=150) of children between three and 12 years of age undergoing pediatric dental treatment participated in this multicenter cross-sectional study. Parents viewed a video depicting 10 BGTs approved by the American Academy of Pediatric Dentistry and rated their acceptance on a visual analog scale. Differences in the degree of acceptance were analyzed using quantile regression analysis. The level of significance was set at five percent. Results: American parents generally demonstrated higher median acceptance scores across various BGTs compared to Colombian parents (P<0.05). American parents exhibited higher acceptance levels of tell-show-do, voice control, non-verbal communication, positive reinforcement, distraction, presence/absence of parents and nitrous oxide, with statistically significant differences noted. American parents also displayed higher acceptance scores for advanced techniques such as protective stabilization, conscious sedation and general anesthesia. Conclusion: American parents consistently exhibited higher acceptance BGTs, suggesting variations in cultural attitudes toward pediatric dental care between the two groups. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to better understand how neonatology (Neo) and maternal–fetal medicine (MFM) physicians approach the process of shared decision-making (SDM) with parents facing extremely premature (<25 weeks estimated gestational age) delivery during antenatal counseling. Study Design Attending physicians at U.S. centers with both Neo and MFM fellowships were invited to answer an original online survey about antenatal counseling for extremely early newborns. Preferences for conveying information are reported elsewhere. Here, we report clinicians' self-assessments of their ability to engage in deliberations and decision-making and perceptions of what is important to parents in the SDM process. Multivariable logistic regression analyzed respondents' views with respect to individual characteristics, such as specialty, gender, and years of clinical experience. Results In total, 74 MFMs and 167 Neos representing 94% of the 81 centers surveyed responded. Neos versus MFMs reported repeat visits with parents less often (<0.001) and agreed that parents were more likely to have made delivery room decisions before they counseled them less often (p < 0.001). Respondents reported regularly achieving most goals of SDM, with the exception of providing spiritual support. Most respondents reported that spiritual and religious views, risk to an infant's survival, and the infant's quality of life were important to parental decision-making, while a physician's own personal choice and family political views were reported as less important. While many barriers to SDM exist, respondents rated language barriers and family views that differ from those of a provider as the most difficult barriers to overcome. Conclusion This study provides insights into how consultants from different specialties and demographic groups facilitate SDM, thereby informing future efforts for improving counseling and engaging in SDM with parents facing extremely early deliveries and supporting evidence-based training for these complex communication skills. Key Points Perceptions differed by specialty and demographics. Parents' spiritual needs were infrequently met. Barriers to shared decision-making exist. [ABSTRACT FROM AUTHOR]

Not all pregnant individuals want to become parents and "parenting intention" can also vary within individuals during different pregnancies. Nevertheless, the potential impact of parenting intention on health-related behavior during pregnancy has been heavily underexplored. In this study, we employed a within-person between pregnancy design to estimate the effect of parenting-specific influences on smoking, separate from pregnancy-specific and individual-level influences. We quantified within-mother differences in smoking during pregnancies of infants they reared (n = 84) versus pregnancies of infants they placed for adoption at birth (n = 65) using multivariate mixed-effects Poisson regression models. Mean cigarettes/day declined as the pregnancy progressed regardless of whether infants were reared or placed. However, participants smoked fewer cigarettes/day during reared pregnancies. Relative to "adopted" pregnancies, smoking during "reared" pregnancies was lower by 24%, 41%, and 54% in first (95% CI 0.64–0.90; p = 0.001), second (95% CI 0.48–0.72; p < 0.001), and third trimesters (95% CI 0.36–0.59; p < 0.001), respectively, independent of between-pregnancy differences in maternal age, fetal sex, parity, and pregnancy complications. Female sex and nulliparity were protective. Parenting intention was associated with a protective effect on pregnancy smoking independent of pregnancy-specific influences and individual characteristics. Failure to consider the impact of parenting intention on health-related behavior during pregnancy could perpetuate an unrealistic expectation to "do what's best for the baby" and stigmatize women with unintended or unwanted pregnancies. [ABSTRACT FROM AUTHOR]

The study objectives were: (i) to develop and administer a survey to assess childhood lead poisoning (CLP) knowledge, attitudes, practices and prevention barriers (KAP-B) among the Nepali-Speaking Bhutanese (NSB) community in Northeast Ohio; and (ii) to examine the association between socio-demographic characteristics of NSB parents and their understanding of CLP as measured by the constructs of knowledge and attitudes. A Nepali language KAP-B questionnaire was developed and 200 NSB parents with at least one child ≤ 7 years of age from the Akron Metropolitan Area, Ohio were interviewed. NSB parents demonstrated a low level of knowledge about CLP prevention measures. While 82% lived in pre-1978 houses, only 27.5% perceived their house/neighborhood to be potentially lead contaminated. Only 33% of the parents reported understanding lead-related information provided by their child's healthcare provider. Low-level CLP awareness among NSB community emphasizes a need for culturally tailored and linguistically appropriate community-level CLP educational intervention programs in this vulnerable community. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic changed the setting of education for many children in the U.S. Understanding COVID-19 vaccination coverage by educational setting is important for developing targeted messages, increasing parents' confidence in COVID-19 vaccines, and protecting all children from severe effects of COVID-19 infection. Using data from the Household Pulse Survey (n = 25,173) collected from December 9–19, 2022, January 4–16, 2023, and February 1–13, 2023, this study assessed factors associated with COVID-19 vaccination and reasons for non-vaccination among school-aged children 5–11 and adolescents 12–17 by educational setting. Among children 5–11 years, COVID-19 vaccination coverage was higher among those who received in-person instruction (53.7%) compared to those who were homeschooled (32.5%). Furthermore, among adolescents 12–17 years, COVID-19 vaccination coverage was higher among those who received in-person instruction (73.5%) or virtual/online instruction (70.1%) compared to those who were homeschooled (51.0%). Children and adolescents were more likely to be vaccinated if the parental respondent had been vaccinated compared to those who had not. Among children and adolescents who were homeschooled, main reasons for non-vaccination were concern about side effects (45.4–51.6%), lack of trust in COVID-19 vaccines (45.0–50.9%), and lack of trust in the government (32.7–39.2%). Children and adolescents who were home-schooled during the pandemic had lower vaccination coverage than those who attended school in person, and adolescents who were home-schooled had lower vaccination coverage than those who received virtual instruction. Based on the reasons for non-vaccination identified in this study, increasing parental confidence in vaccines, and reducing barriers to access are important for supporting COVID-19 vaccination for school-age children. [ABSTRACT FROM AUTHOR]

Children and adolescents benefit from positive intergroup peer interactions, but they are unlikely to have many opportunities for these interactions if their parents are uncomfortable with them. Drawing primarily on social identity theory (SIT), this study investigated how U.S. parents' (N = 569) comfort with their children's potential intergroup peer interactions (a) differed by child and peer group gender (boy, girl), race (Black, White), and social class (higher-, middle-, or lower-subjective social status), (b) changed over the transition from childhood to adolescence (8–10, 11–13, and 14–16 years), and (c) varied by context intimacy (hanging out vs. sleeping over). The sample was equally balanced between parents of children reflecting those same group memberships. Consistent with SIT, when asked to choose, parents were typically most comfortable with their child spending time with middle-class peers who shared their child's gender and racial ingroup membership. Moreover, parents often explained their decisions with reference to similarities between these peers and their own child or family. Parents' comfort did not differ systematically by child age, but many parents were less comfortable with cross-gender peer interactions in the more intimate sleepover context than the less intimate hangout context. All groups of parents also exhibited at least some openness to cross-group interactions. These findings advance developmental scientists' understanding of parents' roles as potential facilitators or gatekeepers of their children's intergroup peer interactions. Public Significance Statement: Children benefit from positive interactions with peers from different gender, racial, and social class backgrounds. However, in this study, most parents preferred their children to spend time with middle-class peers who shared their same gender and racial background. Parents were especially uncomfortable with other-gender peers at a sleepover versus a hangout. This is important because parents who are uncomfortable may try to limit their children's cross-group peer interactions. [ABSTRACT FROM AUTHOR]

Background: Across several sites in the United States, we examined whether kindergarten conduct problems among mostly population‐representative samples of children were associated with increased criminal and related (criminal + lost offender productivity + victim; described as criminal + victim hereafter) costs across adolescence and adulthood, as well as government and medical services costs in adulthood. Methods: Participants (N = 1,339) were from two multisite longitudinal studies: Fast Track (n = 754) and the Child Development Project (n = 585). Parents and teachers reported on kindergarten conduct problems, administrative and national database records yielded indexes of criminal offending, and participants self‐reported their government and medical service use. Outcomes were assigned costs, and significant associations were adjusted for inflation to determine USD 2020 costs. Results: A 1SD increase in kindergarten conduct problems was associated with a $21,934 increase in adolescent criminal + victim costs, a $63,998 increase in adult criminal + victim costs, a $12,753 increase in medical services costs, and a $146,279 increase in total costs. In the male sample, a 1SD increase in kindergarten conduct problems was associated with a $28,530 increase in adolescent criminal + victim costs, a $58,872 increase in adult criminal + victim costs, and a $144,140 increase in total costs. In the female sample, a 1SD increase in kindergarten conduct problems was associated with a $15,481 increase in adolescent criminal + victim costs, a $62,916 increase in adult criminal + victim costs, a $24,105 increase in medical services costs, and a $144,823 increase in total costs. Conclusions: This investigation provides evidence of the long‐term costs associated with early‐starting conduct problems, which is important information that can be used by policymakers to support research and programs investing in a strong start for children. [ABSTRACT FROM AUTHOR]

Objectives: Effective health communication can increase intent to vaccinate. We compared 8 messages that may influence parents' intent to vaccinate their children against COVID-19. Methods: In a cross-sectional survey of adults in the United States administered online in August 2021, 1837 parents and legal guardians were exposed to 8 messages (individual choice, gain/practical benefits, nonexpert, health care provider recommendation, altruism/community good, safety/effectiveness, safety, and effectiveness) to determine message reception and influence on intent to vaccinate their children. Parents responded to 10 questions using a Likert scale. We computed odds ratios (ORs) for each message, with an OR >1.0 indicating greater observed odds of participant agreement with the follow-up statement as compared with a reference message. We compared outcomes individually across messages with ordinal logistic regression fit using generalized estimating equations. Results: The individual choice message had the highest odds of agreement for understanding intent (OR = 2.10; 95% CI, 1.94-2.27), followed by the health care provider recommendation message (OR = 1.58; 95% CI, 1.46-1.71). The individual choice message had the highest odds of memorability, relatability, and trustworthiness. The altruism/community good message was at or near second best. The altruism/community good message had the highest or near-highest odds of increasing parents' intent to vaccinate their children, asking friends and family for their thoughts, and searching for additional information. The message that most motivated parents to vaccinate their children depended on parental intent to vaccinate prior to being exposed to the tested messages. Conclusions: Messages with themes of individual choice, health care provider recommendation, and altruism/community good may be used in future message campaigns. Further research is needed to refine message concepts related to altruism/community good. [ABSTRACT FROM AUTHOR]

Objective: To examine the feasibility and acceptability of augmenting family‐based treatment (FBT) for adolescents with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) with a parent emotion coaching intervention (EC) focused on reducing parent expressed emotion. Method: In this pilot effectiveness trial, families of adolescents with AN/AAN exhibiting high expressed emotion received standard FBT with either (1) EC group or (2) support group (an attention control condition focused on psychoeducation). Results: Forty‐one adolescents with AN or AAN were recruited (88% female, Mage = 14.9 ± 1.6 years, 95% White: Non‐Hispanic, 1% White: Hispanic, 1% Bi‐racial: Asian). Most study adolescents were diagnosed with AN (59%) while 41% were diagnosed with AAN. Participating parents were predominantly mothers (95%). Recruitment and retention rates were moderately high (76% and 71%, respectively). High acceptability and feasibility ratings were obtained from parents and interventionists with 100% reporting the EC intervention was "beneficial"–"very beneficial." The FBT + EC group demonstrated higher parental warmth scores at post‐treatment compared to the control group (standardized effect size difference, d = 1.58), which was maintained at 3‐month follow‐up. Finally, at post‐treatment, the FBT + EC group demonstrated higher rates of full remission from AN/AAN (40%) compared to FBT + support (27%), and were nine times more likely to be weight restored by 3‐month follow‐up. Discussion: Augmenting FBT with emotion coaching for parents with high expressed emotion is acceptable, feasible, and demonstrates preliminary effectiveness. Public Significance: Family based treatment for AN/AAN is the recommended treatment for youth but families with high criticism/low warmth are less likely to respond to this treatment. Adding a parent emotion coaching group (EC) where parents learn to talk to their adolescents about tough emotions is feasible and well‐liked by families. [ABSTRACT FROM AUTHOR]

Informed by the goodness-of-fit model, goal theories, and literature on support gaps, this study examines the associations between congruence/discrepancies in parent-adolescent expectations of the adolescent's educational and career goals and adolescents' perceived overparenting. Data were collected through a survey of 122 parent-adolescent dyads from four high schools in the U.S. Results from second-order polynomial regression with response surface analysis indicated that parental high educational or career goal expectation alone was not necessarily related to adolescents' perception of overparenting. Rather, adolescents' perception of overparenting depended on the congruence/discrepancies in parents' and adolescents' expectations. Compared to parent-adolescent congruence in high or low expectations, either direction of expectation discrepancies—either parents' expectation exceeds adolescents' expectation, or adolescents' expectation exceeds their parents—was more likely to be associated with adolescents' perception of overparenting. Parenting intervention and educational programs should acknowledge that discrepancies in parents' and adolescents' educational and career goals could potentially contribute to parental overparenting. Fostering communication and negotiation of goal expectations between parents and adolescents may help reduce the practice of overparenting. [ABSTRACT FROM AUTHOR]

Objectives: Little is known about the early stress experiences of parents of infants with serious life-limiting/life-threatening conditions during the initial months after discharge from hospital. The aim of the study was to measure change, and predictors of change, in parenting stress at the time of transition from hospital to home (T1) with a medically fragile infant, and after a 3-month period (T2). Methods: Parents of infants identified as meeting ≥ 1 palliative care referral criterion were recruited in a Midwestern United States tertiary pediatric hospital (2012–2014) within 2 weeks of hospital discharge. A repeated measures design was used to assess change on a validated parenting stress inventory over the two timepoints (T1 and T2). Fifty-two parents (61 infants) participated at T1 and 44 (85%) at T2. Results: On discharge (T1) stress was moderately high 3 months post discharge (T2) overall and domain-specific stress scores improved, except stress related to parent role functioning and participation in their child's medical care. Independent predictors of improvement in overall parenting stress scores (T2-T1) were being a younger parent and having experienced prior pregnancy-related loss. Conclusions for Practice: The time of discharge from hospital to home is often stressful for parents of medically fragile infants. Improvements were found during the first 3 months at home, but improvement was minimal for stress related to role function and providing medical care. Past experience with pregnancy-related loss and being younger were associated with improvement in stress across theoretical domains. Screening for stress should be included as part of routine pre- and post-neonatal intensive care unit discharge psychosocial assessments of parents caring for infants with serious illness to ensure their unique support needs continue to be met over time. Significance: What is already known about the topic? Stress in parents of sick infants is well-documented in the post-birth hospitalization period. Early management of parent stress after a child is born with a life-limiting/life-threatening condition is critical in promoting healthy infant attachment and development. What this study adds? Parents of medically fragile infants experience notable stress during the initial months at home. Pre-hospital discharge attention to medical and psychosocial characteristics of infants and parents may help health care teams anticipate post-discharge parenting challenges and facilitate personalized home support strategies aimed at minimizing parent stress and poor parent–child outcomes. [ABSTRACT FROM AUTHOR]

Research has shown that during the COVID-19 pandemic, approximately 20% of children and adolescents in the United States experienced mental health issues that became a significant social concern. However, recent studies have demonstrated that the majority of adolescents maintain positive emotions despite the crisis. This cross-sectional and descriptive study delves into the emotional states of adolescents during the pandemic, considering the viewpoints of both adolescents and their parents, with a specific focus on Hispanic adolescents. Survey results revealed that most adolescents reported positive and happy moods. However, a percentage of adolescents experienced worry, significant changes in feelings, and loneliness as a result of the physical and social isolation associated with virtual learning. Unfortunately, most surveyed Hispanic parents did not adequately recognize their adolescents' mood changes well. This lack of awareness, caused by factors such as an insufficient understanding about the importance of adolescent mental health, cultural reasons, language barriers, low education, unstable jobs, and more, could lead to missed opportunities for timely mental health interventions. This study seeks to provide a comprehensive discussion on the mental health of adolescents, while also advocating for the emotional wellbeing of Hispanic adolescents. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to examine parent-reported ratings of temperament in toddlers with and without prelingual hearing loss. Method: The parent-completed Early Childhood Behavior Questionnaire (ECBQ) was used to assess temperament in toddlers aged 18–36 months. Three dimensions of temperament were examined: surgency, negative affectivity, and effortful control. Analyses were conducted to (a) examine differences in temperament across toddlers with and without prelingual hearing loss; (b) examine possible associations between temperament, demographic, and communication factors; and (c) determine if the ECBQ is sensitive to differences in hearing, communication, and listening skills among toddlers with prelingual hearing loss. Results: The parent-completed ECBQ revealed that toddlers with prelingual hearing loss differed from their hearing peers on some but not all dimensions of temperament. Specifically, children with prelingual hearing loss were rated as displaying higher levels of surgency and lower levels of effortful control but comparable levels of negative affectivity when compared to their hearing peers. Regression analyses revealed that chronological age and communication strategy predicted scores of effortful control in toddlers with prelingual hearing loss, whereas chronological age alone predicted scores of effortful control in toddlers with hearing. Finally, the ECBQ appears to contain “listening” items that skew (lower) levels of effortful control in toddlers with prelingual hearing loss, such that only the group effect of higher levels of surgency remained after removing these “listening” items. Correlations between the original and our modified ECBQ (removing the “listening” items) revealed strong associations, reflective of high construct validity. Conclusions: This was the first study to measure temperament in toddlers with prelingual hearing loss using the ECBQ. Our results revealed differences between children with and without prelingual hearing loss centering on the dimension of surgency. Examining differences in temperament during the toddler period of development may be particularly important and useful for predicting functional outcomes following prelingual hearing loss. [ABSTRACT FROM AUTHOR]

While most parents support their adolescents receiving school-based sex education, there is variability in which sex education topics receive the most support from parents. Conservative political orientation and greater religiosity have been independently associated with parents' lack of support for school-based sex education; however, no studies have examined the intersection of these two factors. The three goals of this study were to: 1) identify how specific sexual education topics cluster together to form content areas; 2) examine if religiosity and political orientation are uniquely associated with these content areas; and 3) examine if political orientation moderates the relationship between parents' religiosity and their perceived importance for the specific sex education content areas. Participants were a national sample of 881 US parents. The sex education topics clustered into three content areas: Factual Knowledge (e.g., STI transmission), Practical Skills (e.g., how to access condoms), and Pleasure and Identity (e.g., pleasurable aspects of sex). Politically conservative and more religious parents reported the lowest perceived importance for each content area. Importantly, these main effects were qualified by a significant interaction: parents who reported both political conservativism and high levels of religiosity reported the lowest perceived importance for these three content areas being taught. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore U.S. parents' and caregivers' understanding about children's bullying—what bullying is and how to address it. We analyzed 2017, 2018, and 2019 Fall ConsumerStyles online panel survey data from U.S. parents/caregivers of children ages 10 to 17 years (N = 1,516), including 20 items representing statements consistent or inconsistent with the bullying prevention evidence and best practices. Percentage of endorsement for each item and a summary measure of understanding about bullying were calculated. The association between low overall understanding about bullying and sociodemographic characteristics was explored. Most parents identified bullying as harmful (77%), repetitive (63%), and involving power imbalance (51%). At least half of parents answered 13 or more items (20 total) consistent with the bullying prevention evidence or best practices. Being male, non-Hispanic Black or Hispanic, having high school or less education, and small household size were associated with higher odds of low overall understanding about bullying. Awareness of parents' understanding about bullying and how to appropriately address it is vital for bullying prevention. Findings can inform the strategic development of bullying prevention health messages for parents. [ABSTRACT FROM AUTHOR]

An under-explored strategy to increase youth mental health service uptake is pursuing a direct-to-consumer approach with parents; however, a prerequisite for informing and evaluating such efforts is a psychometrically sound measurement of parent beliefs that relate to their likelihood of youth service use. The Parental Attitudes Toward Psychological Services Inventory (PATPSI; Turner, 2012) was developed to assess parents' perspectives on youth services use across three reliable and valid factors (Help-Seeking Attitudes, Help-Seeking Intentions, and Stigmatization). Although the PATPSI has since been used to investigate parents' service-related attitudes and intentions in association with a variety of service use behaviors, no published studies have revisited the factor structure of the original, English-language PATPSI. This investigation conducted a confirmatory factor analysis on the PATPSI with a diverse community sample of 343 parents. Our results suggested that the three-factor model fit the data well, and internal consistencies for the three scales and the Total measure ranged from acceptable to good. For convergent validity, the Help-Seeking Intentions scale was significantly and positively associated with all three empowerment facets measured by the Family Empowerment Scale; the Stigmatization scale was significantly and negatively related with two of three empowerment scales; and we did not observe expected correlations between the Help-Seeking Attitudes and the empowerment scales. Furthermore, the associations between the PATPSI scales all performed significantly in the expected direction. Overall, this is the first study to replicate the PATPSI's factor structure, and evidence good reliability and validity, with a large, multiethnic United States sample. Highlights: The PATPSI's three-factor model of Help-Seeking Attitudes, Help-Seeking Intentions, and Stigmatization was supported within an ethnically diverse parent sample All three factors' internal consistency coefficients ranged from acceptable to good. Convergent validity findings varied by PATSPI scale, such that Help-Seeking Intentions and Stigmatization scales demonstrated greater convergent validity with the Family Empowerment Scale subscales compared to the PATPSI Help-Seeking Attitudes scale. The PATPSI may be a useful tool to assess diverse parents' perspectives during the help-seeking process for youth mental health services. [ABSTRACT FROM AUTHOR]

There is a dearth of research examining what parents in MENA region know about children's brain development and the type of activities they engage their young children at home to promote their cognitive development. This article describes and compares the views and behaviors of parents with children 0–6 years old from Casablanca, Morocco, the US, and the UK on early parental engagement. Seventy-eight Moroccan parents were compared to 1066 US/UK parents. The study utilizes survey data and explores parents' understanding of and support for their children's early cognitive development. Results reveal that more than fifty percent of Moroccan parents do not see themselves as having an impact on brain development until after the first year of their child's life compared to 10% of US parents, in part because they believe that babies' capacity for learning in the earliest years is limited. Yet Moroccan parents reported higher frequencies of teaching their young children letters and numbers and reading a book to them than US parents. These differences in at-home teaching practices may reflect the higher percentage of US/UK children who participate in early learning programs outside their own homes; such programs are not culturally accepted in Morocco. The belief that there is little capacity for learning in children's earliest years among Moroccan parents may minimize parents' motivation to function as their child's first teacher in the absence of early education programs. Policy implications and interventions are discussed concerning ways to change parents' knowledge and beliefs to motivate early learning activities. Highlights: Moroccan parents view themselves as having limited impact on their children's cognitive development in the early years compared to US parents. Moroccan parents reported higher frequencies of teaching their young children numbers and reading compared to UK parents. Sending very young children to early education centers is less acceptable in Morocco than in the US/UK. Moroccan parents turn to their extended family more than US parents do for guidance on child-rearing. Interventions should be culturally relevant and target sources to whom parents turn for support; home visits are promising. [ABSTRACT FROM AUTHOR]

The mental health care of future generations is a global imperative. Therefore, this study used a modified consensual qualitative research design to explore the perspective of parents living in the United States about the barriers to accessing parent training programs for better supporting the mental health of infants and young children. Participants (N=20) responded to an online survey with open-ended questions to share their perceptions. The results indicated domains that include parental awareness, accessibility, support, and predicted benefits of infant and early childhood mental health care. This includes the recommendation for consistent screening and assessment practices, within integrated service models. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was twofold: (a) to explore hearing aid management experiences of Spanish-speaking parents who have young children using hearing aids and (b) to explore parents' access to the Internet and perceptions about remote audiology services. Method: The study used a mixed methods design. Data were collected through a phone interview. Results: Eleven mothers of children aged 14-60 months participated. Most of the children (9/11) had a bilateral hearing loss, and two had an additional disability. Three themes emerged for hearing aid management experiences: audiology services, routines, and emotional challenges/supports. Parents had variable levels of confidence in their skills ranging from no confidence to complete confidence, with the greatest variability for three items: (a) using the listening tube to make sure that the sound quality of the hearing aid is good, (b) removing moisture from the earmold tubing, and (c) troubleshooting problems when your child's hearing aids are not working. All participants reported having consistent Internet access and had positive perceptions about the possibility of remote audiology services. Conclusions: This study provided insights into hearing aid management experiences and perceptions of Spanish-speaking parents. Parents described variability for audiology services, routines for hearing aid use and care, and access to other parents of children with hearing loss. Spanish-speaking parents present additional elements in the hearing care process that need to be incorporated in planning. Remote services may be an opportunity to enhance access to support that could improve effectiveness of hearing aid management. [ABSTRACT FROM AUTHOR]

Understanding why sports and energy drinks remain increasingly popular among adolescents despite declines in other sugar sweetened beverages is critical. This study points to memory for advertising exposure and adolescent athletic identity as two aspects that together help to explain consumption. An online survey of U.S. adolescents aged 14–18 (n = 503) was combined with Nielsen data for television and social media advertising expenditures by sports and energy drink brands in participants' designated market areas (DMAs). Advertisement recall mediates the relationship between social media DMA expenditures and sports and energy drink consumption. Recall for television advertisements is related to consumption but is unrelated to television DMA expenditures. Athletic identity moderated the relationship between recall and consumption such that consumption increased as both recall and athletic identity increased, suggesting a role for motivated memory and motivated processing of ad messages based on athletic identity consistent with the limited capacity model of motivated media message processing. Based on these results, we conclude that effectiveness of expenditures in influencing behavior is dependent upon both ad recall and ad relevance, and that athletic identity is an important factor in ad effectiveness in the context of sports and energy drinks advertising. [ABSTRACT FROM AUTHOR]

Children's early socialization shapes their development and well-being. To date, research examining the socialization of preschool-aged Latine children remains limited, and primarily focused on immigrant, Spanish-speaking families. Given the heterogeneity in language(s) spoken, nativity, and education within Latine families, the present study used focus groups among 112 Latine families of children attending Head Start to understand and compare salient parenting beliefs, attitudes, and self-reported practices as they pertained to supporting their children's development among both English- and Spanish-speaking caregivers. Results showed that English- and Spanish-speaking caregivers viewed their children's bicultural socialization as critical to supporting their development. Caregivers actively socialized their children to be bicultural through an emphasis on two superordinate goals: fostering bilingualism and simultaneous transmission of heritage and US values. Although caregivers across groups shared many of the same beliefs, attitudes, and practices concerning bilingualism and transmission of values (respeto, egalitarian gender roles), differences were also found. Specifically, ethnic pride was more salient for caregivers in the English than Spanish groups, and the value of familismo was only discussed in the English groups. Additionally, caregivers in the English and Spanish focus groups described experiencing different language-related challenges that undermined their efforts to raise bicultural children. These findings can inform future efforts seeking to support low-income, Latine families reach the goals they have for their children from a culturally and contextually informed lens. Highlights: Comparisons between English and Spanish-speaking Latine families showed both aimed to raise bicultural children early on. Bicultural socialization was promoted by fostering bilingualism and by simultaneously instilling US and heritage values in children. Nuanced differences between language groups were found in the ways families fostered bilingualism and instilled values. Spanish and English-speaking caregivers encountered different language-related challenges in socializing their children to be bicultural. [ABSTRACT FROM AUTHOR]

Approximately 60% of deployed service members leave behind immediate family members, and although military families tend to be adaptive and resilient, evidence suggests that deployments are challenging and difficulties can arise during transitions and family separation, especially for adolescents. Grounded in the family attachment network model and the ABC‐X model of family stress, the current study utilized a sample of 204 military families with an active‐duty father, civilian mother and adolescent and examined parents' perceptions of adolescents' difficulties during deployment in relation to all three family members' perceptions of the adolescents' mental health (i.e., anxiety symptoms) following deployment. First, analyses of measurement invariance indicated that service members and civilian parents were generally reporting on the same underlying construct of their adolescents' difficulties during parental deployment. Next, a structural equation model demonstrated considerable overlap in service member and civilian parent reports of their adolescents' difficulties during a parental deployment (r = 0.47). Finally, both parents' perceptions of adolescent difficulties during parental deployment were related to their own perceptions of the adolescent's current anxiety but not to the adolescents' reports of their own anxiety symptoms or to the other parent's report of the adolescents' anxiety symptoms. Findings provide support for utilizing these theories in combination, such that disruptions to the family system, and the attachment relationships within that system, in one stage of the deployment cycle, may imply that there are implications for individual‐level functioning, namely, anxiety, in the next stage of the deployment cycle. Findings also underscore the importance of examining our measurement tools and collecting data from multiple family members to understand family processes. [ABSTRACT FROM AUTHOR]

Attitudes and beliefs of parents about sport specialization may indicate why youth athletes decide to specialize. The purpose of this study was to determine the association between sport specialization level, ice hockey position, and the parent/guardians' attitudes and beliefs on sport specialization. Our results demonstrate that goalies were the most likely to specialize, and parents of specialized ice hockey players tend to believe that sport specialization helps their child achieve future sporting aspirations. Increased sport specialization may put ice hockey goalies at an increased risk for overuse injuries, and parents' beliefs about sport specialization may impact their child's sporting behaviors. [ABSTRACT FROM AUTHOR]

Background: Dentists often use sedative medications such as nitrous oxide inhaled sedation and general anesthesia (GA) to help decrease patient fear and manage paediatric patients' behavior during treatment. Aim: The goal of this study was to examine factors associated with dental fear changes after restorative dental treatment under nitrous oxide or GA in children 4–12 years old. Design: A prospective cohort study of 124 children examined changes in dental fear, number of treatment visits, and parental factors among children receiving restorative dental treatment under nitrous oxide (n = 68) or GA (n = 56) sedation. Data were collected at pretreatment (T1), 16 weeks post‐treatment (T2), and at 29‐month follow‐up (T3). Results: Dental fear increased slightly, but not significantly, under both forms of sedation between T1 and T3. Children's dental fear was associated with parents' poor dental experiences and oral health, but not with number of treatment visits. Conclusions: Progression of children's dental fear seems not dependent solely on the type of sedation used but is likely predicted by factors including pretreatment dental fear and dental needs. Dentists recommending sedation for children's dental care may consider pretreatment dental need, fear levels, and parental factors when determining which type of sedation to use. [ABSTRACT FROM AUTHOR]

Background: Male newborn circumcision is a common practice in the U.S. Objective: To elucidate which factors affect the parental decision to request or decline newborn circumcision in our institution. We decided to evaluate parental knowledge of the benefits and disadvantages of the procedure. Design/Methods: Prospective, questionnaire-based study. A questionnaire was filled out by all consented parents of male newborns in the first week of life. Included: All male infants admitted to NICU and nursery from April 2020 to February 2021. Excluded: Infants with major congenital malformations, chromosomal aberrations, and infants with contraindications to the procedure. Demographics, cultural information, medical history, and questions about the benefits and disadvantages of the procedure were included. Local IRB approval 19-197. Statistical analysis: T-test for continuous and Chi-square, or Fisher exact test for categorical variables. Logistic regression for demographic variables. Results: Of 97 responders, 73 supported circumcision, while 24 opposed it. More African American parents desired circumcision than Hispanic parents, who often rejected the procedure (P=0.0001). The most frequent reasons for pursuing circumcision were hygiene (71.2%), the father being circumcised (42.5%), and the penis looking better after circumcision (31.5%). The reasons most often reported for rejecting circumcision were uncircumcised father (41.7%), it is not medically necessary (37.5%), other sons were uncircumcised (29.2%), and baby does not have input in the decision (20.8%). Parents that supported circumcision knew more about the Conclusion: Parental decision on neonatal circumcision was influenced by ethnicity, cultural background, the father being circumcised, and hygiene rather than medical reasons. [ABSTRACT FROM AUTHOR]

The protective effects of talk with parents about sex in delaying sex and reducing young people's risky sexual behaviour may extend from adolescence to emerging adulthood. However, little is known about the content and process of this communication, or how parents and their emerging adult children perceive their conversations about sex and relationships. This study offers a novel exploration of family talk about sex during emerging adulthood and addresses topics that are not typically assessed as part of communication research, such as consent and positive talk about sexuality. This study uses thematic analysis to investigate perceptions of family talk about sex in a qualitative sample of 16 pairs of parents and their emerging adult children in the USA, and includes talk about protection, sexual behaviour, pregnancy and parenting; the positive aspects of sex; consent; and sexual orientation. Findings identified variation across topics in terms of 1) similarities and differences in parents' and emerging adults' comfort in talking with each other about sexual topics; and 2) how they perceive this communication across a range of sexual issues. Findings can inform the development of resources to support parents on how to talk with their emerging adult children about sexual issues in a developmentally appropriate way. [ABSTRACT FROM AUTHOR]

This study provides the first nationally representative estimates of parent-reported barriers to mental health services for children with mental health conditions in the United States. It identifies individual, family, and environmental characteristics associated with the most common barriers to mental health care for children with common mental health disorders reporting the need for mental health services. Cost barriers, inconvenient service times, and lack of service availability or transportation barriers were the most reported barriers to mental health services. Children with more severe conditions reported these barriers at significantly higher rates than children with less severe conditions. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, parents quickly assumed the role of teachers to support their children's learning at home. Deaf and hard of hearing (DHH) students often rely on additional accommodations to access their education. The authors investigated the perspectives of 40 parents of K–12 DHH students on the use of virtual learning during the pandemic. An electronic survey was distributed through Qualtrics to gain an understanding of the new learning environment of remote instruction. The participants' responses revealed that they felt that challenges occurred in the areas of time management, language access, technology, motivation, and children's ability to function independently. The respondents were almost evenly split between satisfaction and dissatisfaction with their child's overall educational experience during the pandemic. The results indicated that degree of access significantly influenced the children's experiences of education in virtual learning settings. [ABSTRACT FROM AUTHOR]

Limited evidence for early indicators of childhood apraxia of speech (CAS) precludes reliable diagnosis before 36 months, although a few prior studies have identified several potential early indicators. We examined these possible early indicators in 10 toddlers aged 14–24 months at risk for CAS due to a genetic condition: 7q11.23 duplication syndrome (Dup7). Phon Vocalisation analyses were conducted on phonetic transcriptions of each child's vocalisations during an audio-video recorded 30-minute play session with a caregiver and/or a trained research assistant. The resulting data were compared to data previously collected by Overby from similar-aged toddlers developing typically (TD), later diagnosed with CAS (LCAS), or later diagnosed with another speech sound disorder (LSSD). The Dup7 group did not differ significantly from the LCAS group on any measure. In contrast, the Dup7 group evidenced significant delays relative to the LSSD group on canonical babble frequency, volubility, consonant place diversity, and consonant manner diversity and relative to the TD group not only on these measures but also on canonical babble ratio, consonant diversity, and vocalisation structure diversity. Toddlers with Dup7 also demonstrated expressive vocabulary delay as measured by both number of word types orally produced during the play sessions and primary caregivers' responses on a standardised parent-report measure of early expressive vocabulary. Examining babble, phonetic, and phonotactic characteristics from the productions of young children may allow for earlier identification of CAS and a better understanding of the nature of CAS. [ABSTRACT FROM AUTHOR]

Background: Familial hypercholesterolemia (FH) is an inherited disease which causes premature atherosclerotic cardiovascular disease. However, less than 10% of individuals with FH have been identified. Objective: To assess parental perspectives for inclusion of FH on routine newborn screening (NBS) and to highlight potential benefits, harms, and ethical concerns. Methods: Telephone interviews of two groups were conducted: 1) parents of children diagnosed with FH, and 2) parents of children diagnosed with a genetic condition through NBS. Stratified purposive sampling was used to ensure adequate representation. The 11 telephone interviews were conducted in 30-min sessions guided by a semi-structured interview script. At the beginning of the interview, participants were educated on the NBS process and FH. The interviews were transcribed verbatim, and a thematic analysis was performed in multiple steps. Results: All interviewees indicated that they would be interested in having their child be screened for FH on the newborn screen. Reasons supporting screening during the newborn period included knowing their child's diagnosis, the ability to screen family members for FH, incorporation of lifestyle changes, and access to preventive care. Negatives surrounding screening during the newborn period included increased stress or anxiety, knowledge, stigma, and the delay from diagnosis to initiation of pharmacotherapy for FH. Conclusion: While these interviewees were in favor of NBS for FH, further education of parents and clinicians is needed to ensure proper implementation. The results of this study may be useful to formulate family notification and care protocols for newborns diagnosed with FH and other diseases. Significance: What is already known on this subject? Familial hypercholesterolemia is a common inherited disorder that predisposes to early cardiovascular disease, but most affected individuals are not diagnosed. Childhood cholesterol screening is an effective but underutilized diagnostic tool. Previous studies report parents find childhood cholesterol screening acceptable, but it is not known if screening newborns would also be acceptable. What does this study add? Interviewees found screening newborns for familial hypercholesterolemia acceptable and would agree to screen their own newborn. The ability to screen other family members and access to early treatment were important factors in their decision to screen. Education of clinicians about familial hypercholesterolemia was an important concern raised by interviewees. [ABSTRACT FROM AUTHOR]

Limited access to sexual health information is a significant problem faced by young adults with intellectual and developmental disabilities. In a survey of family members and school-based professionals, we assessed which sexual health topics are covered by whom, as well as from whom survey respondents believe young adults with intellectual and developmental disabilities should be getting information. Participants report providing some sexual health information but that more information should be provided, especially on topics such as sexual orientation and gender identity. Results demonstrate medical providers are being expected to provide more sexual health information, and that the internet is a non-preferred source of education. These findings should inform recommendations about who should be providing sexual health education for young adults with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

Advancing equity in early childhood education is crucial as our broader society faces issues of inequities across systems, including education. Professionals must honor children's home language and cultural contexts, coming from a perspective of value and respect rather than from a traditionally dominant Eurocentric perspective. Through this study, we share the perspectives of 22 U.S. parents of dual-language learners (DLLs) as they experienced an evaluation for preschool special education. Through a mixed-methods approach using survey and interview data, three primary themes emerged: (a) relationships and interactions, (b) home language and cultural context, and (c) the evaluation process. Significant differences in satisfaction emerged between those who had participated in Part C Early Intervention services versus those who had not. [ABSTRACT FROM AUTHOR]

Adolescent sexual harassment victimization is increasingly recognized as a strong risk factor for dating violence victimization and perpetration. Research on this association has focused on older adolescents and on sexual harassment at a single time point rather than chronic exposure. Furthermore, potential mechanisms, such as psychological distress, are not well understood. The goals of this study were to identify whether sexual harassment victimization and psychological distress were reciprocally related, whether chronic psychological distress and sexual harassment victimization in early adolescence were associated with higher levels of dating violence involvement measured in mid-adolescence, and whether these relationships differed between boys and girls. We used longitudinal data from 4,718 US middle school students to fit regression models for the associations between sexual harassment victimization and psychological distress. We then used data from a subset of 1,279 students followed up in high school to fit marginal structural models for sixth- to eighth-grade psychological distress and sexual harassment victimization as predictors of dating violence involvement measured in ninth grade. We found that (1) sexual harassment victimization was positively, concurrently associated with psychological distress, with a stronger association among girls than boys; (2) psychological distress was positively, prospectively associated with sexual harassment victimization among girls but not boys; (3) chronic sixth- to eighth-grade psychological distress was not significantly associated with dating violence victimization or perpetration measured in ninth grade; and (4) chronic sixth- to eighth-grade sexual harassment victimization was associated with significantly higher levels of dating violence victimization and perpetration measured in ninth grade. The results support a reciprocal relationship between distress and sexual harassment victimization for early adolescent girls, and they call for further attention to gender differences in the content and impact of sexual harassment. Furthermore, the findings indicate that preventing sexual harassment in early adolescence may be critical in reducing dating violence. [ABSTRACT FROM AUTHOR]

Death and loss are often uncomfortable topics for adults to discuss with young children. Disruptions caused by the COVID-19 pandemic, however, made the avoidance of these topics nearly impossible. The current study explored how 20 parents engaged with their young children (ages 3–6) in discussions about death, dying, and loss as they jointly experienced this global crisis. Interviews were conducted both prepandemic (Summer/Fall 2019) and a year later, at the early stage of the COVID-19 pandemic, before vaccines were approved (Summer 2020). Results suggest parents largely sought to balance sheltering children from stress and socializing them with socioemotional competencies. The pandemic context, however, brought parents a sense of urgency to scaffold their children's ability to remain resilient after experiencing losses. Practical implications are discussed regarding how family nurses and other practitioners can provide support to families of young children during the COVID-19 pandemic and potential future global crises. [ABSTRACT FROM AUTHOR]

This study explores Korean–American parents' perceptions on successful transition to kindergarten (TTK) for their child on the autism spectrum. It further examines challenges experienced during this process, and possible predictors for their challenges. Findings from an online survey (N = 212) indicate that participants consider their child's behavioral readiness and cooperation with teachers as the most important school readiness skills for successful TTK. They further consider building positive relationships with teachers and providing support at home as the most important support parents could provide during this process. Moreover, the child being a vocal communicator, higher income and parent's educational level were found to buffer against their reported challenges, while first-generation immigrant status and restrictive school placement were found to predict more challenges. [ABSTRACT FROM AUTHOR]

Importance: Limited research has elucidated factors predicting occupational therapy–specific service utilization by children with autism. Such research is needed to inform reasons for receipt of services. Objective: To examine factors associated with occupational therapy service utilization by children with autism. We hypothesized that elevated sensory hyperresponsiveness; greater sensory interests, repetitions, and seeking; and lower adaptive behavior would predict more service utilization. Design: Analysis of extant data from a prospective, longitudinal survey study about autism symptom severity, adaptive behavior, sensory features, and demographic and service utilization information of children with autism ages 3 to 13 yr. Setting: Online parent survey regarding child behaviors during daily activities and contexts. Participants: 892 parents of children with autism from 50 U.S. states. Outcomes and Measures: We used scores on the Vineland Adaptive Behavior Scale–Second Edition, the Social Responsiveness Scale, and the Sensory Experiences Questionnaire Version 3.0 and responses to a demographic questionnaire. We formulated hypotheses after data collection but before analysis. Results: Predictors of higher occupational therapy service utilization were lower enhanced perception; lower adaptive behavior; elevated sensory interests, repetitions, and seeking behaviors; younger child age; and higher household income. Conclusion and Relevance: Results partially support our hypotheses. Sensory interests, repetitions, and seeking behavior predicted occupational therapy service utilization, whereas other sensory response patterns did not, suggesting a possible referral bias for certain sensory response patterns. Occupational therapy practitioners can educate parents and teachers about the scope of practice, which includes addressing sensory features beyond sensory interests, repetitions, and seeking behaviors. What This Article Adds: Children with autism who have impairments in adaptive functioning and high levels of sensory interests, repetitions, and seeking behaviors receive more occupational therapy services. Occupational therapy practitioners should be well trained to address such concerns and advocate for the profession's role in mitigating the impact of sensory features on daily life. This study found that sensory interests, repetitions, and seeking behavior predicted occupational therapy service utilization by children with autism, whereas other sensory response patterns did not, suggesting a possible referral bias for certain sensory response patterns and the opportunity for occupational therapy practitioners to educate parents and teachers about the scope of practice. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity is important for children's health and well-being. Supportiveness for physical activity of home and neighborhood environments may affect children's PA, but most studies are cross-sectional. We examined environmental predictors of change in children's physical activity over two years. Methods: Data were from the longitudinal, observational cohort study, 'Neighborhood Impact on Kids'. Participants were children (initially aged 6–12 years) and their parent/caregiver (n = 727 dyads) living in neighborhoods throughout San Diego County, California and King County (Seattle area), Washington, USA. Children's moderate-to-vigorous physical activity (MVPA) was measured using accelerometers at T1 (Time 1 or baseline, 2007–2009) and T2, the two-year follow-up. At T1, parents survey-reported on physical activity (PA) equipment at home and demographics. Neighborhood environment was measured using spatial data in Geographic Information Systems (intersection density; park availability) and in-person audits (informal play space near home; park-based PA facilities; land use; support for walking/cycling). Generalized additive mixed models estimated total effects, then direct effects, of environmental attributes on MVPA at T1. Two-way moderating effects of child's sex and age were examined at T1. To examine associations of environmental exposures with changes in MVPA, we estimated interaction effects of environmental attributes on the association between time and MVPA. Results: On average, children accumulated 146 min/day (standard deviation or SD = 53) of MVPA at T1, and 113 (SD = 58) min/day at T2. There were no significant total or direct effects of environmental attributes on MVPA at T1, and no significant two-way interaction effects of child's age and sex for T1 MVPA. Having informal play spaces proximal to home with more amenities was associated with less MVPA decline from T1 to T2. Higher residential density, higher land use mix, and higher number of PA facilities in nearby parks were unexpectedly associated with greater MVPA decline. Conclusion: Higher quality informal play spaces close to home may help offset declines in MVPA during middle childhood, as they may promote unstructured active play with opportunities for parental or neighbor surveillance. Unexpectedly, environmental factors consistent with higher walkability were associated with greater declines in children's MVPA. As physical activity differs across the lifespan, so may environmental factors that facilitate it. [ABSTRACT FROM AUTHOR]