Héctor E. Alcalá, Zeruiah V. Buchanan, Jun Chu, Dylan H. Roby, Mienah Z. Sharif
Background
Adverse childhood experiences (ACEs) have been associated with poor health and underuse of preventive health services. However, less is known about how ACEs are associated with quality of care that children receive, like care that involves shared decision-making.
Methods
Using data from the 2021–2022 National Survey of Children's Health (n = 47 179) the association between ACEs, both individual and cumulative and (1) needing medical decisions made in the past 12 months and (2) three different measures of always receiving care that involved shared decision-making. Logistic regression models were used to calculate odds of each outcome. Each of the 11 ACEs and the cumulative number of ACEs served as independent variables each in separate models.
Results
After accounting for confounders, the number of ACEs experienced, and most individual ACE items were associated with higher odds of needing medical decisions made, and lower odds of receiving health care that involved providers always engaging in the three measures of shared decision-making.
Conclusions
This study expands the research showing a deleterious impact of ACEs on utilization of health care by showing that ACEs are associated with lower quality health care. This can be particularly determinantal to children with a history of ACEs because they have a greater need for health care and are less likely to use many types of health care. Efforts to improve health care quality for all children will be of particular benefit to vulnerable groups, like those with a history of ACEs.
{"title":"Does Early Life Adversity Limit Delivery of High-Quality Health Care Among Children?","authors":"Héctor E. Alcalá, Zeruiah V. Buchanan, Jun Chu, Dylan H. Roby, Mienah Z. Sharif","doi":"10.1111/cch.70081","DOIUrl":"https://doi.org/10.1111/cch.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adverse childhood experiences (ACEs) have been associated with poor health and underuse of preventive health services. However, less is known about how ACEs are associated with quality of care that children receive, like care that involves shared decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data from the 2021–2022 National Survey of Children's Health (<i>n</i> = 47 179) the association between ACEs, both individual and cumulative and (1) needing medical decisions made in the past 12 months and (2) three different measures of always receiving care that involved shared decision-making. Logistic regression models were used to calculate odds of each outcome. Each of the 11 ACEs and the cumulative number of ACEs served as independent variables each in separate models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After accounting for confounders, the number of ACEs experienced, and most individual ACE items were associated with higher odds of needing medical decisions made, and lower odds of receiving health care that involved providers always engaging in the three measures of shared decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study expands the research showing a deleterious impact of ACEs on utilization of health care by showing that ACEs are associated with lower quality health care. This can be particularly determinantal to children with a history of ACEs because they have a greater need for health care and are less likely to use many types of health care. Efforts to improve health care quality for all children will be of particular benefit to vulnerable groups, like those with a history of ACEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Gomes Mota, Rafael Miranda Tassitano, Luís Lemos, Anthony Okely, Eline Coppens, Érika Alice dos Santos, Jorge Mota, Matthieu Lenoir, Clarice Maria de Lucena Martins
Background
Compliance with the WHO 24-Hour Movement Guidelines (i.e., physical activity, screen time and sleep duration) has been reported in studies comprising children in the early years. Despite the importance of these behaviours for healthy development, there is limited data on the proportion of toddlers who meet these recommendations. This study reported the compliance with the 24-h movement behaviours guidelines among low-income Brazilian toddlers.
Methods
Physical activity (PA) was objectively measured using Actigraph wGT3X accelerometer in 144 toddlers (73 girls; 12–35 months of age). Sleep duration and screen time were parent-reported. Descriptive analyses were performed, and toddlers were classified as compliant/noncompliant with the 24-h movement guidelines, according to age and sex. The chi-square test and the Mann–Whitney test were used to explore differences and association according to age and sex.
Results
Only 21% of the assessed toddlers complied with the overall movement behaviours guidelines. The highest prevalence of compliance was observed for PA among both boys and girls (98.63% and 98.59%, respectively), and among 1- and 2-year-old toddlers (100% and 97.61%, respectively). In contrast, the lowest compliance rates were observed for screen time (23.94% for boys and 32.87% for girls; and 16.66% for 1-year-old and 36.90% for 2-year-old toddlers). More than 60% of the assessed toddlers complied with sleep duration recommendation (74.64% and 67.12% for boys and girls, respectively; 73.33% and 69.04%, for 1-year-old and 2-year-olds, respectively).
Conclusion
Implementing strategies to encourage toddlers’ compliance with the 24-h movement guidelines in Brazilian low-income families should focus on maintaining PA levels and reducing screen time.
{"title":"Compliance With the 24-h Movement Behaviours Guidelines Among Brazilian Toddlers","authors":"Jessica Gomes Mota, Rafael Miranda Tassitano, Luís Lemos, Anthony Okely, Eline Coppens, Érika Alice dos Santos, Jorge Mota, Matthieu Lenoir, Clarice Maria de Lucena Martins","doi":"10.1111/cch.70083","DOIUrl":"https://doi.org/10.1111/cch.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Compliance with the WHO 24-Hour Movement Guidelines (i.e., physical activity, screen time and sleep duration) has been reported in studies comprising children in the early years. Despite the importance of these behaviours for healthy development, there is limited data on the proportion of toddlers who meet these recommendations. This study reported the compliance with the 24-h movement behaviours guidelines among low-income Brazilian toddlers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Physical activity (PA) was objectively measured using Actigraph wGT3X accelerometer in 144 toddlers (73 girls; 12–35 months of age). Sleep duration and screen time were parent-reported. Descriptive analyses were performed, and toddlers were classified as compliant/noncompliant with the 24-h movement guidelines, according to age and sex. The chi-square test and the Mann–Whitney test were used to explore differences and association according to age and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only 21% of the assessed toddlers complied with the overall movement behaviours guidelines. The highest prevalence of compliance was observed for PA among both boys and girls (98.63% and 98.59%, respectively), and among 1- and 2-year-old toddlers (100% and 97.61%, respectively). In contrast, the lowest compliance rates were observed for screen time (23.94% for boys and 32.87% for girls; and 16.66% for 1-year-old and 36.90% for 2-year-old toddlers). More than 60% of the assessed toddlers complied with sleep duration recommendation (74.64% and 67.12% for boys and girls, respectively; 73.33% and 69.04%, for 1-year-old and 2-year-olds, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementing strategies to encourage toddlers’ compliance with the 24-h movement guidelines in Brazilian low-income families should focus on maintaining PA levels and reducing screen time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Self-help groups offer an approach to empowering the lives of caregivers and their children with disabilities in settings of limited resources and support. A study was conducted over a 5-year period (2018–23) to assess the sustainability of 11 self-help groups in Kilifi, Kenya, during which there was the COVID-19 pandemic.
Methods
An integrated framework of action research and mixed methods was carried out over three stages. Stage 1: pre-pandemic, three self-help groups participated in focus group discussions. Template analysis structured around the five pillars of the WHO community-based rehabilitation matrix (CBR: health, education, livelihood, social, empowerment) was carried out. Stage 2: inter-pandemic, a bespoke questionnaire was administered to monitor each group. Descriptive statistics were reported (Questions 1–6) and the CBR template was applied to free-field responses (Questions 7–8). Stage 3: post-pandemic, a quality of life (QoL) questionnaire was administered to 21 caregivers of children with disabilities and a control group of 11 parents of typically developing children in the same geographical area and 8 caregivers pre- and post-pandemic. Descriptive statistics were applied.
Results
Pre-pandemic, there was food security, medicine availability, school attendance, social connections and livelihood. Group plans involved livelihood and social inclusion developments. However, member commitment, community attitudes and environmental conditions were ongoing challenges. Inter-pandemic, some socially distanced group meetings focus on COVID-19 prevention, livelihood and social support. Livelihood activities were affected variously with reported difficulties including food insecurity, school closures and reduced meeting frequency. Post-pandemic comparison between caregivers and a control group revealed overall significantly higher caregiver QoL scores. Pre- to post-pandemic evaluations demonstrated overall significantly improved caregiver QoL.
Conclusions
Despite the changing context brought by the COVID-19 pandemic, the self-help groups appear to have afforded some protection against the worst psychosocial and economic effects and helped to sustain the caregivers.
{"title":"The Sustainability of Self-Help Groups for Caregivers of Children With Disabilities in Kilifi, Kenya: The Changing Context of the COVID-19 Pandemic","authors":"K. Bunning, J. K. Gona, S. W. Wanjala, S. Hartley","doi":"10.1111/cch.70079","DOIUrl":"https://doi.org/10.1111/cch.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Self-help groups offer an approach to empowering the lives of caregivers and their children with disabilities in settings of limited resources and support. A study was conducted over a 5-year period (2018–23) to assess the sustainability of 11 self-help groups in Kilifi, Kenya, during which there was the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An integrated framework of action research and mixed methods was carried out over three stages. Stage 1: pre-pandemic, three self-help groups participated in focus group discussions. Template analysis structured around the five pillars of the WHO community-based rehabilitation matrix (CBR: health, education, livelihood, social, empowerment) was carried out. Stage 2: inter-pandemic, a bespoke questionnaire was administered to monitor each group. Descriptive statistics were reported (Questions 1–6) and the CBR template was applied to free-field responses (Questions 7–8). Stage 3: post-pandemic, a quality of life (QoL) questionnaire was administered to 21 caregivers of children with disabilities and a control group of 11 parents of typically developing children in the same geographical area and 8 caregivers pre- and post-pandemic. Descriptive statistics were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pre-pandemic, there was food security, medicine availability, school attendance, social connections and livelihood. Group plans involved livelihood and social inclusion developments. However, member commitment, community attitudes and environmental conditions were ongoing challenges. Inter-pandemic, some socially distanced group meetings focus on COVID-19 prevention, livelihood and social support. Livelihood activities were affected variously with reported difficulties including food insecurity, school closures and reduced meeting frequency. Post-pandemic comparison between caregivers and a control group revealed overall significantly higher caregiver QoL scores. Pre- to post-pandemic evaluations demonstrated overall significantly improved caregiver QoL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the changing context brought by the COVID-19 pandemic, the self-help groups appear to have afforded some protection against the worst psychosocial and economic effects and helped to sustain the caregivers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This short communication illustrates how the 2024 movie Out of My Mind, starring a protagonist (Melody) with cerebral palsy, embodies the ‘F-words’ for child development—the paediatric adaptation of the World Health Organization International Classification of Functioning Disability and Health (ICF). The ‘F-words’ provide a strengths-based and holistic framework to view childhood development, disability and functioning that can benefit service providers, researchers and families alike. If we want the world to adopt the values of the ‘F-words’, we must bring these values to the world by applying them outside of academia. This short communication outlines how Out of My Mind illustrates and exemplifies each ‘F-words’ domain, as well as the interconnectedness with other domains, from the perspective of a speech-language pathologist and PhD student in Rehabilitation Science. Key reflections include the impact of social, attitudinal and physical environments on the protagonist's participation and how Fun and Functioning are shown in the movie's first-person perspective. This short communication also highlights the impact of attitudinal, physical and system-level barriers on participation and can inspire us all to change the way we think to shape the society we aspire towards.
{"title":"How the Movie ‘Out of My Mind’ Brings the F-Words for Child Development to Life","authors":"Maya Albin","doi":"10.1111/cch.70080","DOIUrl":"https://doi.org/10.1111/cch.70080","url":null,"abstract":"<p>This short communication illustrates how the 2024 movie <i>Out of My Mind</i>, starring a protagonist (Melody) with cerebral palsy, embodies the ‘F-words’ for child development—the paediatric adaptation of the World Health Organization International Classification of Functioning Disability and Health (ICF). The ‘F-words’ provide a strengths-based and holistic framework to view childhood development, disability and functioning that can benefit service providers, researchers and families alike. If we want the world to adopt the values of the ‘F-words’, we must bring these values to the world by applying them outside of academia. This short communication outlines how <i>Out of My Mind</i> illustrates and exemplifies each ‘F-words’ domain, as well as the interconnectedness with other domains, from the perspective of a speech-language pathologist and PhD student in Rehabilitation Science. Key reflections include the impact of social, attitudinal and physical environments on the protagonist's participation and how <i>Fun</i> and <i>Functioning</i> are shown in the movie's first-person perspective. This short communication also highlights the impact of attitudinal, physical and system-level barriers on participation and can inspire us all to change the way we think to shape the society we aspire towards.</p>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tze-Hsuan Wang, Ameer Helmi, Rafael Morales Mayoral, Lucas Yao, April Murray, Naomi T. Fitter, Samuel W. Logan
Background
Understanding the relationships among accelerometer placements and the agreements between cut points is essential to enhancing the accuracy of physical activity measurement for toddlers. This study aimed to compare the magnitudes and relationships of activity counts from hip, wrist and ankle ActiGraph GT9X accelerometers in toddlers and to assess the agreement between age-specific cut points at group and individual levels.
Methods
Accelerometer data were collected from nine toddlers (three girls, 22.2 ± 6.1 months) during 12 weekly 20-min free-play sessions. Activity counts were downloaded using specific epoch lengths and filters according to the studies validating the cut points. One-way repeated ANOVAs were used to compare the activity counts per 15 s across placements. Interplacement relationships were examined using Spearman's rank correlation coefficients. Agreements were assessed with Bland–Altman plots between three sets of hip cut points and one wrist cut point. Ankle data were not analysed because of a lack of validated cut points.
Results
The wrist placement yielded the highest counts, followed by ankle and hip. The correlation coefficient was strongest between hip and ankle vector magnitude counts (rs = 0.88), whereas relatively weaker between wrist and hip (rs = 0.65) and wrist and ankle (rs = 0.60). The Bland–Altman plots indicated that time estimates for sedentary, light and moderate-to-vigorous physical activity were significantly different between most cut points. At the individual level, considerable variations in interplacement correlations and physical activity time estimates were observed.
Conclusion
The strong correlation between hip and ankle activity counts suggests that the ankle could be a feasible sensor-wearing location. The moderate correlation between wrist and hip suggests that multiple accelerometers may be needed to enhance accuracy. Discrepancies across cut points indicate that more research is needed to validate cut points for accurately measuring physical activity in toddlers, especially considering individual differences in movement behaviours.
{"title":"Comparing Hip, Wrist and Ankle-Worn ActiGraph Accelerometers for Measuring Physical Activity in Toddlers","authors":"Tze-Hsuan Wang, Ameer Helmi, Rafael Morales Mayoral, Lucas Yao, April Murray, Naomi T. Fitter, Samuel W. Logan","doi":"10.1111/cch.70074","DOIUrl":"https://doi.org/10.1111/cch.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Understanding the relationships among accelerometer placements and the agreements between cut points is essential to enhancing the accuracy of physical activity measurement for toddlers. This study aimed to compare the magnitudes and relationships of activity counts from hip, wrist and ankle ActiGraph GT9X accelerometers in toddlers and to assess the agreement between age-specific cut points at group and individual levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Accelerometer data were collected from nine toddlers (three girls, 22.2 ± 6.1 months) during 12 weekly 20-min free-play sessions. Activity counts were downloaded using specific epoch lengths and filters according to the studies validating the cut points. One-way repeated ANOVAs were used to compare the activity counts per 15 s across placements. Interplacement relationships were examined using Spearman's rank correlation coefficients. Agreements were assessed with Bland–Altman plots between three sets of hip cut points and one wrist cut point. Ankle data were not analysed because of a lack of validated cut points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The wrist placement yielded the highest counts, followed by ankle and hip. The correlation coefficient was strongest between hip and ankle vector magnitude counts (<i>rs</i> = 0.88), whereas relatively weaker between wrist and hip (<i>rs</i> = 0.65) and wrist and ankle (<i>rs</i> = 0.60). The Bland–Altman plots indicated that time estimates for sedentary, light and moderate-to-vigorous physical activity were significantly different between most cut points. At the individual level, considerable variations in interplacement correlations and physical activity time estimates were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The strong correlation between hip and ankle activity counts suggests that the ankle could be a feasible sensor-wearing location. The moderate correlation between wrist and hip suggests that multiple accelerometers may be needed to enhance accuracy. Discrepancies across cut points indicate that more research is needed to validate cut points for accurately measuring physical activity in toddlers, especially considering individual differences in movement behaviours.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vila-Nova, F., Sá, C., Leite, H., Cadete, A., Folha, T., Longo, E., Martins, M. and Oliveira, R. (2025), The 24-Hour Activity Checklist for Cerebral Palsy: Translation, Content Validity and Test–Retest Reliability of Portuguese Versions. Child: Care, Health and Development, 51: e70057. https://doi.org/10.1111/cch.70057.
{"title":"Correction to ‘The 24-Hour Activity Checklist for Cerebral Palsy: Translation, Content Validity and Test–Retest Reliability of Portuguese Versions’","authors":"","doi":"10.1111/cch.70073","DOIUrl":"https://doi.org/10.1111/cch.70073","url":null,"abstract":"<p>\u0000 <span>Vila-Nova, F.</span>, <span>Sá, C.</span>, <span>Leite, H.</span>, <span>Cadete, A.</span>, <span>Folha, T.</span>, <span>Longo, E.</span>, <span>Martins, M.</span> and <span>Oliveira, R.</span> (<span>2025</span>), <span>The 24-Hour Activity Checklist for Cerebral Palsy: Translation, Content Validity and Test–Retest Reliability of Portuguese Versions</span>. <i>Child: Care, Health and Development</i>, <span>51</span>: e70057. https://doi.org/10.1111/cch.70057.\u0000 </p>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Michiels, Jonathan Michiels, David De Coninck, Shauni Van Doren, Jaan Toelen
Background
The presence of pupils with ADHD in the classroom can influence the learning climate, impacting both the individual pupil and the broader class group. However, limited research has examined teachers' perspectives on this impact and on effective classroom approaches to support pupils with ADHD.
Method
We conducted five semistructured focus group discussions with 22 elementary school teachers from different school networks in Flanders, the Dutch-speaking part of Belgium. Data analysis was independently conducted by two researchers.
Results
According to teachers in this study, ADHD behaviour shapes the learning climate both for the pupil and their peers, as well as the broader class relations. Interventions in the approach to a pupil with ADHD can be categorized based on the level of application: individual pupil level or class context level, each encompassing multiple interventions. A key finding is that Flemish primary teachers often feel inadequately trained to address behavioural or attention disorders. Despite available resources in Belgium, such as an ADHD toolkit, their limited awareness and under-implementation in practice pose challenges.
Conclusions
The positive characteristics of a pupil with ADHD were more apparent in our research than in previously conducted studies. We also shed light on interventions within the classroom environment to support learning, such as teachers' mixed feelings about medication administration and the importance of providing information to peers. Most teachers unanimously expressed a significant lack of knowledge regarding classroom interventions due to minimal coverage in their teacher training, highlighting a need for accessible and relevant tools to address ADHD in pupils.
{"title":"Navigating ADHD in Belgian Elementary Schools: Teacher Insights and Intervention Gaps","authors":"Laura Michiels, Jonathan Michiels, David De Coninck, Shauni Van Doren, Jaan Toelen","doi":"10.1111/cch.70070","DOIUrl":"https://doi.org/10.1111/cch.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The presence of pupils with ADHD in the classroom can influence the learning climate, impacting both the individual pupil and the broader class group. However, limited research has examined teachers' perspectives on this impact and on effective classroom approaches to support pupils with ADHD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted five semistructured focus group discussions with 22 elementary school teachers from different school networks in Flanders, the Dutch-speaking part of Belgium. Data analysis was independently conducted by two researchers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>According to teachers in this study, ADHD behaviour shapes the learning climate both for the pupil and their peers, as well as the broader class relations. Interventions in the approach to a pupil with ADHD can be categorized based on the level of application: individual pupil level or class context level, each encompassing multiple interventions. A key finding is that Flemish primary teachers often feel inadequately trained to address behavioural or attention disorders. Despite available resources in Belgium, such as an ADHD toolkit, their limited awareness and under-implementation in practice pose challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The positive characteristics of a pupil with ADHD were more apparent in our research than in previously conducted studies. We also shed light on interventions within the classroom environment to support learning, such as teachers' mixed feelings about medication administration and the importance of providing information to peers. Most teachers unanimously expressed a significant lack of knowledge regarding classroom interventions due to minimal coverage in their teacher training, highlighting a need for accessible and relevant tools to address ADHD in pupils.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For families with young children, securing reliable childcare may present a significant challenge. Rising costs, limited resources and the COVID-19 pandemic have heightened the precarity of childcare arrangements. Childcare precarity, defined as a state of insecure or unreliable childcare arrangements while parents work or attend school, reflects unpredictability in family life and early care and education settings and has important implications for families' economic and psychosocial well-being. This study aims at broadening the conceptualization of childcare precarity to include childcare search status and examine its association with caregiver and child emotional distress.
Methods
Participants were 3115 caregivers in the United States (88% female, 67% white) who completed the RAPID Survey between November 2022 and December 2023 and reported working or attending school. We assess whether including a childcare search status as an indicator of precarity improves the cross-sectional prediction of caregiver and child emotional distress beyond commonly used indicators (unreliability and disruptions). Using a person-centred approach, we also conduct an exploratory latent class analysis (LCA) to identify distinct experiences of childcare precarity and associated emotional distress.
Results
Childcare unreliability and disruptions were associated with caregiver distress. For children, unreliability was associated with fear/anxiety, while disruptions were associated with fussiness/defiance. Childcare search status was also linked to both caregiver and child emotional distress, improving model fit compared to baseline models. Our exploratory LCA identified a five-class solution as optimal, with emotional distress outcomes varying significantly across classes and correlating with levels of precarity.
Discussion
Our findings highlight the importance of a multidimensional approach to childcare precarity. Identifying distinct precarity profiles can inform targeted policy interventions to support diverse family needs. Future research should validate these findings and explore the broader impact of early life unpredictability.
{"title":"Understanding the Association Between Childcare Precarity and Emotional Distress","authors":"Mateus M. Mazzaferro, Sihong Liu, Philip Fisher","doi":"10.1111/cch.70076","DOIUrl":"https://doi.org/10.1111/cch.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For families with young children, securing reliable childcare may present a significant challenge. Rising costs, limited resources and the COVID-19 pandemic have heightened the precarity of childcare arrangements. Childcare precarity, defined as a state of insecure or unreliable childcare arrangements while parents work or attend school, reflects unpredictability in family life and early care and education settings and has important implications for families' economic and psychosocial well-being. This study aims at broadening the conceptualization of childcare precarity to include childcare search status and examine its association with caregiver and child emotional distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 3115 caregivers in the United States (88% female, 67% white) who completed the RAPID Survey between November 2022 and December 2023 and reported working or attending school. We assess whether including a childcare search status as an indicator of precarity improves the cross-sectional prediction of caregiver and child emotional distress beyond commonly used indicators (unreliability and disruptions). Using a person-centred approach, we also conduct an exploratory latent class analysis (LCA) to identify distinct experiences of childcare precarity and associated emotional distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Childcare unreliability and disruptions were associated with caregiver distress. For children, unreliability was associated with fear/anxiety, while disruptions were associated with fussiness/defiance. Childcare search status was also linked to both caregiver and child emotional distress, improving model fit compared to baseline models. Our exploratory LCA identified a five-class solution as optimal, with emotional distress outcomes varying significantly across classes and correlating with levels of precarity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings highlight the importance of a multidimensional approach to childcare precarity. Identifying distinct precarity profiles can inform targeted policy interventions to support diverse family needs. Future research should validate these findings and explore the broader impact of early life unpredictability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Visuomotor integration (VMI) impairments are common in children with cerebral palsy (CP) and can impact performance of goal-directed upper-extremity tasks. VMI impairment is clinically assessed using the gold-standard Beery-Buktenica test, whereas research paradigms use computerized assessments incorporating eye and hand movement tracking with touchscreen displays. Immersive virtual reality (VR) may potentially enable more ecologically valid VMI assessments through the inclusion of 3D tasks and visual distractions. However, the potential of immersive VR as a VMI assessment method in children with CP has not been evaluated. The current study aims to investigate how VR can assess VMI impairments in children with CP.
Methods
Twelve children with CP completed the Beery-Buktenica VMI test and performed eye-only, hand-only and eye-hand VMI tasks in touchscreen, visually simple VR and visually complex VR conditions. Eye and hand endpoint accuracy and task completion time quantified VMI performance. We compared performance on each task and in each environment between children with below- versus above-average Beery-VMI scores.
Results
There were no significant relationships between Beery-VMI score and eye-hand task performance in visually simple VR. Compared to the touchscreen task, participants demonstrated significantly reduced eye and hand endpoint accuracy in visually simple VR, with no difference between Beery-VMI groups. Children with below-average Beery-VMI scores decreased eye endpoint accuracy and increased trial completion time in visually complex VR.
Conclusion
Findings from this pilot study do not support immersive VR as a VMI assessment method in children with CP.
{"title":"Visuomotor Integration Assessment Using Immersive Virtual Reality for Children With Cerebral Palsy: A Pilot Study","authors":"Minxin Cheng, Alexa Craig, Danielle E. Levac","doi":"10.1111/cch.70072","DOIUrl":"https://doi.org/10.1111/cch.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Visuomotor integration (VMI) impairments are common in children with cerebral palsy (CP) and can impact performance of goal-directed upper-extremity tasks. VMI impairment is clinically assessed using the gold-standard Beery-Buktenica test, whereas research paradigms use computerized assessments incorporating eye and hand movement tracking with touchscreen displays. Immersive virtual reality (VR) may potentially enable more ecologically valid VMI assessments through the inclusion of 3D tasks and visual distractions. However, the potential of immersive VR as a VMI assessment method in children with CP has not been evaluated. The current study aims to investigate how VR can assess VMI impairments in children with CP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve children with CP completed the Beery-Buktenica VMI test and performed eye-only, hand-only and eye-hand VMI tasks in touchscreen, visually simple VR and visually complex VR conditions. Eye and hand endpoint accuracy and task completion time quantified VMI performance. We compared performance on each task and in each environment between children with below- versus above-average Beery-VMI scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant relationships between Beery-VMI score and eye-hand task performance in visually simple VR. Compared to the touchscreen task, participants demonstrated significantly reduced eye and hand endpoint accuracy in visually simple VR, with no difference between Beery-VMI groups. Children with below-average Beery-VMI scores decreased eye endpoint accuracy and increased trial completion time in visually complex VR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings from this pilot study do not support immersive VR as a VMI assessment method in children with CP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Precious Madzimbe, Jermaine Dambi, Lieselotte Corten, Soraya Maart
Background
Neuro-developmental delays (NDDs) present significant challenges for children and families, especially in low- and middle-income countries (LMICs). Full family participation in home rehabilitation programmes is essential for optimal functional outcomes. However, the involvement of fathers and siblings is suboptimal and underexplored. This study investigates the perspectives of rehabilitation professionals on the involvement of fathers and/or siblings in home rehabilitation programmes for children with NDD in Bulawayo, Zimbabwe.
Methods
A qualitative exploratory study was conducted. Data were collected through focus group discussions (FGDs) with 18 rehabilitation professionals. The FGDs were transcribed verbatim, coded, and thematically analysed.
Results
Rehabilitation professionals highlighted the critical role of fathers and siblings in home rehabilitation; noting fathers' emotional support and provision of financial stability and siblings' contributions to social interactions and play therapy. Barriers to involvement included cultural norms and time constraints for fathers, while siblings faced challenges such as limited age-appropriate understanding and the emotional burden of coping with the caregiving role.
Conclusion
According to rehabilitation professionals, involving fathers and siblings seems important for successful home rehabilitation of children with NDD. Addressing cultural and practical barriers to participation requires context-specific strategies, including culturally sensitive community outreach programmes and targeted interventions to promote family-centred care. Such efforts could help overcome these barriers, fostering greater participation of fathers and siblings and enhancing the effectiveness of home rehabilitation within the local context.
{"title":"Involvement of Fathers and Siblings in Home Rehabilitation Programmes of Children With Neuro-Developmental Delay: Insights From Rehabilitation Professionals in Bulawayo, Zimbabwe","authors":"Precious Madzimbe, Jermaine Dambi, Lieselotte Corten, Soraya Maart","doi":"10.1111/cch.70060","DOIUrl":"https://doi.org/10.1111/cch.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neuro-developmental delays (NDDs) present significant challenges for children and families, especially in low- and middle-income countries (LMICs). Full family participation in home rehabilitation programmes is essential for optimal functional outcomes. However, the involvement of fathers and siblings is suboptimal and underexplored. This study investigates the perspectives of rehabilitation professionals on the involvement of fathers and/or siblings in home rehabilitation programmes for children with NDD in Bulawayo, Zimbabwe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative exploratory study was conducted. Data were collected through focus group discussions (FGDs) with 18 rehabilitation professionals. The FGDs were transcribed verbatim, coded, and thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Rehabilitation professionals highlighted the critical role of fathers and siblings in home rehabilitation; noting fathers' emotional support and provision of financial stability and siblings' contributions to social interactions and play therapy. Barriers to involvement included cultural norms and time constraints for fathers, while siblings faced challenges such as limited age-appropriate understanding and the emotional burden of coping with the caregiving role.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>According to rehabilitation professionals, involving fathers and siblings seems important for successful home rehabilitation of children with NDD. Addressing cultural and practical barriers to participation requires context-specific strategies, including culturally sensitive community outreach programmes and targeted interventions to promote family-centred care. Such efforts could help overcome these barriers, fostering greater participation of fathers and siblings and enhancing the effectiveness of home rehabilitation within the local context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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