Child Care Health and Development最新文献_第5页

Exclusion and Truancy of Autistic Adolescents in a UK Population Representative Sample 英国人口代表性样本中自闭症青少年的排斥和逃学。

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-21 DOI: 10.1111/cch.70187

Vasiliki Totsika, Kylie M. Gray, Francesca Solmi

Background

Autistic students experience many problems with school attendance. School exclusion and truancy are among the least researched school attendance problems in this population. The study aimed to describe levels of exclusion and truancy in a UK population-representative sample of autistic adolescents and identify child, family and school factors associated with each school attendance problem.

Methods

Data were drawn from the Millennium Cohort Study where exclusion and truancy information was available for 460 autistic 14-year-olds. Descriptive statistics were used to report the weighted prevalence of exclusion and truancy. A bio-ecological framework guided the selection of available child, family and school factors potentially associated with exclusion and truancy for modelling. Univariable and multivariable logistic regression models were fitted to investigate associations.

Results

Twenty-five percent of autistic adolescents were temporarily or permanently excluded at least once. Fifteen percent of autistic adolescents reported truanting at least once. Externalising problems were strongly associated with higher odds of exclusion and truancy. The level of school support was strongly associated with higher odds of exclusion. There was weak evidence of an association between exclusion and low parental school engagement and between truancy and the absence of intellectual impairment.

Conclusion

Poor mental health and in particular externalising difficulties seem to be strongly associated with a greater likelihood of parent-reported exclusion and adolescent-reported truancy. The role of school support and adaptation to the child's needs warrants further investigation.

背景：自闭症学生在上学方面遇到很多问题。在这一人群中，学校排斥和逃学是研究最少的出勤问题。该研究旨在描述英国人口中具有代表性的自闭症青少年的排斥和逃学水平，并确定与每个上学问题相关的儿童、家庭和学校因素。方法：数据来自千禧年队列研究，其中有460名14岁自闭症儿童的排斥和逃学信息。描述性统计用于报告排斥和逃学的加权患病率。生物生态框架指导选择可用的儿童、家庭和学校因素，这些因素可能与建模的排斥和逃学有关。拟合单变量和多变量logistic回归模型来研究相关性。结果：25%的自闭症青少年至少被暂时或永久地排除在外一次。据报道，15%的自闭症青少年至少逃过一次学。外化问题与被排斥和逃学的几率较高密切相关。学校的支持水平与较高的被排斥几率密切相关。有微弱的证据表明，排斥与父母学校参与度低、逃学与没有智力障碍之间存在关联。结论：心理健康状况不佳，特别是外化困难，似乎与父母报告的排斥和青少年报告的逃学的更大可能性密切相关。学校支持和适应儿童需要的作用值得进一步调查。

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引用次数: 0

The Identity Development in Adolescents With Mental Disorders During Their Return-to-School Experiences: Evidence From a 4-Year Longitudinal Qualitative Study 精神障碍青少年返校期间的身份发展：一项为期4年的纵向定性研究的证据。

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-20 DOI: 10.1111/cch.70189

Yihan Wu, Yahui Wang, Sijia Han, Xiaohan Jiang, Marcus Yu Lung Chiu

Background

Identity development plays a crucial role in the rehabilitation of adolescents with mental disorders. Understanding the key factors influencing self-identity during adolescence can enhance rehabilitation strategies, especially in the context of mental health recovery.

Methods

This study employed a 4-year longitudinal qualitative research design, involving in-depth interviews conducted from 2020 to 2024. The study explored the dynamics of identity development and identified critical factors at different developmental stages. Data analysis utilised constructivist grounded theory and longitudinal comparative analysis. A total of 10 adolescents with mental disorders participated in the study.

Results

The results revealed five key factors influencing identity development: (1) struggling with back-to-school adjustment, (2) perceiving stress, (3) strengthening and growing positive social support networks, (4) embracing self-acceptance and adapting to future expectations and (5) building resilience and toughness. Over time, adolescents showed a positive developmental trajectory in self-identity, supporting the previously established notion of the nonlinear nature of identity development.

Conclusion

The study emphasises the importance of collaborative efforts between family and school in supporting adolescents' rehabilitation. It advocates for long-term, individualised strategies that adapt to the evolving self-identity needs of adolescents at different developmental stages. The focus should be on cultivating resilience and providing appropriate support to foster a stable and positive sense of self.

背景：认同发展在青少年精神障碍的康复中起着至关重要的作用。了解影响青少年自我认同的关键因素可以提高康复策略，特别是在心理健康康复的背景下。方法：本研究采用4年纵向定性研究设计，从2020年到2024年进行深度访谈。本研究探讨了认同发展的动态，并确定了不同发展阶段的关键因素。数据分析采用建构主义扎根理论和纵向比较分析。共有10名患有精神障碍的青少年参与了这项研究。结果：研究结果揭示了影响认同发展的五个关键因素：(1)努力适应返校；(2)感知压力；(3)加强和发展积极的社会支持网络；(4)拥抱自我接纳和适应未来期望；(5)建立弹性和韧性。随着时间的推移，青少年在自我认同方面表现出积极的发展轨迹，这支持了先前建立的认同发展的非线性本质的概念。结论：本研究强调了家庭和学校在支持青少年康复中的重要性。它提倡长期的、个性化的策略，以适应处于不同发展阶段的青少年不断变化的自我认同需求。重点应放在培养弹性和提供适当的支持，以培养稳定和积极的自我意识。

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引用次数: 0

Impact of Premature Birth and Delayed Cuddling on Maternal Support Needs and Satisfaction With Postnatal Care and Changes in Support Over Time 早产和延迟拥抱对母亲支持需求和产后护理满意度的影响以及支持随时间的变化。

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-20 DOI: 10.1111/cch.70170

Achim Fieß, Alica Hartmann, Alexander K. Schuster, Stephanie D. Grabitz, Dirk Wackernagel, Michael S. Urschitz, Jonas Tesarz, Manfred E. Beutel, Mareike Ernst, Eva Mildenberger, Sandra Gißler

Background

Preterm birth and early bonding disruptions such as delayed first cuddling may increase parental vulnerability and support needs in the postnatal period. However, little is known about how these factors interact to shape paternal perceptions of care and unmet support needs across different domains.

Methods

This retrospective cohort study drew on data from 1559 individuals aged 4–52 years and linked parental reports from 940 mothers and 614 fathers. Participants were categorised by gestational age of the children into extremely preterm (≤ 28 weeks), very preterm (29–32 weeks), moderately preterm (33–36 weeks) and term (≥ 37 weeks). Multivariable logistic regression was used to examine associations between gestational age, birth weight percentile and delayed first cuddling with maternal desires for administrative, social and medical support. Perceived quality of care from healthcare providers was also assessed.

Results

Mothers of preterm infants who experienced delayed cuddling reported significantly higher needs for administrative, social and medical support compared to mothers of term infants. Delayed cuddling emerged as a consistent predictor of increased support needs across all domains. Mothers of preterm infants were more likely to rate physician care positively, while delayed cuddling and low birth weight percentile were associated with lower satisfaction with midwifery care. Fathers showed similar but less pronounced patterns, with administrative support needs elevated in preterm groups.

Conclusion

Preterm birth and delayed first cuddling are associated with greater maternal support needs and lower satisfaction with certain aspects of care, particularly midwifery services. These findings underscore the importance of early, well-coordinated and responsive postnatal support structures, especially for mothers of preterm infants and those who experienced bonding disruptions. Tailored interventions addressing administrative, social and emotional support needs may help reduce long-term stress and improve parent–infant outcomes.

背景：早产和早期联系中断，如第一次拥抱延迟可能会增加父母的脆弱性和出生后的支持需求。然而，这些因素如何相互作用，形成父亲对不同领域的照顾和未满足的支持需求的看法，我们知之甚少。方法：这项回顾性队列研究收集了1559名年龄在4-52岁之间的人的数据，并将940名母亲和614名父亲的父母报告联系起来。参与者按胎龄分为极早产儿（≤28周）、极早产儿（29-32周）、中度早产儿（33-36周）和足月早产儿（≥37周）。使用多变量逻辑回归来检查胎龄、出生体重百分位数和延迟第一次拥抱与母亲对行政、社会和医疗支持的渴望之间的关系。还评估了医疗保健提供者的感知护理质量。结果：与足月婴儿的母亲相比，经历过延迟拥抱的早产儿母亲对行政、社会和医疗支持的需求明显更高。在所有领域，延迟拥抱都是支持需求增加的一致预测指标。早产婴儿的母亲更有可能对医生护理给予积极的评价，而延迟拥抱和低出生体重百分位数与助产士护理的满意度较低有关。父亲表现出类似但不那么明显的模式，在早产儿群体中，行政支持需求增加。结论：早产和第一次拥抱延迟与更多的产妇支持需求和更低的护理满意度有关，特别是助产服务。这些发现强调了早期、协调良好和反应迅速的产后支持结构的重要性，特别是对早产儿的母亲和那些经历过联系中断的母亲。针对行政、社会和情感支持需求量身定制的干预措施可能有助于减少长期压力，改善亲子关系。

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引用次数: 0

Does Learning to Ride a Bike at School in France Address Environmental Issues? 在法国学校学习骑自行车能解决环境问题吗？

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-19 DOI: 10.1111/cch.70185

Raingeaud Fanny*, Collinet Cécile

Background

Against the background of the climate crisis, the transport sector is being targeted by policies aimed at encouraging low-carbon means of transport such as cycling. In France, teaching children to ride a bicycle is one approach being taken, following the creation in 2018 of the scheme Savoir Rouler à Vélo (Learn to Ride a Bike), SRAV for short. The scheme is run as part of the curriculum at primary school, an institution which, since the start of this century, has broadened its goals to educate pupils about the environment and sustainable development.

Aim

This study aimed to examine how much environmental issues were considered in the implementation of an educational policy encouraging children to learn to cycle.

Methods

The collection and analysis of the data were based on a qualitative methodology. Forty semi-structured interviews were carried out with participants in the SRAV scheme, to which were added approximately 100 h of observation. The three levels at which the public policy was implemented—at national, departmental and school level—were investigated. The field part of the study was complemented by documentary analysis.

Results

The modes of the scheme's administration, which are reflected in the mechanisms that accompany the scheme, hamper the utilisation of the SRAV as a means to educate youngsters about climate change. The scheme's many different partners and the incompatibility of their perspectives on cycling, on the one hand, and the manner in which the skills developed by pupils at the end of a learning cycle are treated, on the other, illustrate these difficulties.

Conclusion

The government's policy to encourage children to learn to ride a bike—as represented by the SRAV scheme—runs up against obstacles when it comes to meeting the environmental challenge.

背景：在气候危机的背景下，交通部门正受到旨在鼓励低碳交通方式（如骑自行车）的政策的关注。在法国，教孩子骑自行车是一种方法，在2018年创建了Savoir Rouler SRAV（学习骑自行车）计划，简称SRAV。该计划是小学课程的一部分，自本世纪初以来，小学已经将其目标扩大到教育学生有关环境和可持续发展的知识。目的：本研究旨在考察在实施鼓励儿童学习骑自行车的教育政策时考虑了多少环境问题。方法：采用定性方法对资料进行收集和分析。与SRAV方案的参与者进行了40次半结构化访谈，其中增加了大约100小时的观察时间。对执行公共政策的三个层次——国家、部门和学校——进行了调查。研究的实地部分由文献分析补充。结果：该计划的管理模式，反映在伴随该计划的机制中，阻碍了SRAV作为一种教育年轻人气候变化的手段的利用。一方面，该计划有许多不同的合作伙伴，他们对骑自行车的看法不一致，另一方面，学生在学习周期结束时发展的技能被对待的方式也说明了这些困难。结论：政府鼓励儿童学习骑自行车的政策——以SRAV计划为代表——在应对环境挑战时遇到了障碍。

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引用次数: 0

The Indirect Effect of a Brief Couple Intervention on Child Mental Health Challenges via the Interparental Relationship 短暂夫妻干预通过父母关系对儿童心理健康挑战的间接影响。

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-19 DOI: 10.1111/cch.70178

Maya Koven, Jazzmin Demy, Jasmine Zhang, Mark Wade, Heather Prime

Background

Child mental health challenges have long-term implications for social and emotional functioning. The quality of the interparental relationship is an important contributor to children's mental health challenges. Evidence supports the use of brief couple interventions to enhance couple functioning, though secondary benefits to child outcomes are unknown. The current study examines whether changes to the interparental relationship following participation in a brief couple intervention, in turn, lead to changes in child mental health challenges.

Methods

Participants come from a secondary dataset from a randomized controlled trial of Love Together, Parent Together, a brief couple intervention, and included 267 parents (140 couples) with at least one child under 6 years old. Parents reported on 10 indicators of the interparental relationship and their child's mental health challenges at baseline, 1 week post-intervention and 1- and 3-month follow-ups.

Results

Based on an exploratory factor analysis including all 10 indicators of the interparental relationship, a two-factor model emerged, which included interparental conflict and general relationship quality. Structural equation modelling was used to test indirect effects with interparental conflict and relationship quality, respectively, as mediators, and child mental health challenges at 1- and 3-month follow-ups, respectively, as outcomes. The intervention did not significantly predict couples' T2 conflict, nor did T2 conflict predict follow-up child mental health challenges. The intervention significantly improved the couples' T2 relationship quality, though there were no reliable effects found on child mental health challenges.

Conclusions

In sum, though findings are consistent with the idea that conflict and relationship quality are unique factors of the interparental relationship, there is no evidence for benefits of a brief couple intervention to child mental health challenges. Future studies should carefully consider measurement selection and assessment schedules to detect developmental cascades following couple interventions.

背景：儿童心理健康挑战对社会和情感功能具有长期影响。父母间关系的质量是造成儿童心理健康挑战的一个重要因素。证据支持使用简短的夫妻干预来增强夫妻功能，尽管对儿童结局的次要益处尚不清楚。目前的研究考察了在短暂的夫妻干预后，父母间关系的改变是否会导致儿童心理健康挑战的改变。方法：参与者来自随机对照试验“爱在一起，父母在一起”的辅助数据集，这是一个简短的夫妻干预，包括267对父母（140对夫妇），他们至少有一个6岁以下的孩子。父母在基线、干预后1周以及1个月和3个月的随访中报告了10项父母间关系指标和孩子的心理健康挑战。结果：通过对父母间关系的10个指标进行探索性因子分析，建立了包含父母间冲突和一般关系质量的双因素模型。结构方程模型用于测试父母间冲突和关系质量的间接影响，分别作为中介，以及儿童心理健康挑战分别在1个月和3个月的随访中作为结果。干预不能显著预测夫妻的T2冲突，T2冲突也不能预测后续的儿童心理健康挑战。尽管在儿童心理健康挑战方面没有发现可靠的效果，但干预显著改善了夫妻的T2关系质量。结论：总之，尽管研究结果与冲突和关系质量是父母间关系的独特因素的观点一致，但没有证据表明短暂的夫妻干预对儿童心理健康挑战有好处。未来的研究应仔细考虑测量选择和评估时间表，以检测一对干预后的发育级联。

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引用次数: 0

Reallocation of 24-h Movement Behaviours and Their Effects on Preschoolers' Fundamental Movement Skills: A Compositional Data and Dose–Response Analysis 24小时运动行为的再分配及其对学龄前儿童基本运动技能的影响：成分数据和剂量反应分析。

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-16 DOI: 10.1111/cch.70182

Xinyu Wang, Xu Zhang, Miaomiao Wan, Jane Jie Yu, Xu Wen

Background

Physical activity (PA), sedentary behaviour (SB) and sleep (SLP)—key components of 24-h movement behaviours—have each been independently linked to motor development in preschool children. However, the lack of understanding regarding their integrated and mutually exclusive nature has limited research on their combined impact on early health outcomes. This study employed compositional data analysis (CoDA) to examine the relationships between these behaviours and fundamental movement skills (FMS), as well as potential changes in FMS resulting from isotemporal reallocation.

Methods

A cross-sectional study was conducted with 292 preschool children (3–6 years old; 149 boys and 143 girls). SB, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured using accelerometers, whereas sleep duration was parent-reported. FMS, including locomotor skills, object-control skills and total motor skills (total MS), were assessed using the third edition of the Test of Gross Motor Development (TGMD-3). CoDA was used to analyse the relationship between 24-h movement behaviours and FMS.

Results

After adjusting for gender, age, family socioeconomic status (SES) and the number of children in the household, a higher proportion of MVPA was significantly positively associated with both total MS (β = 9.39, p = 0.008) and locomotor skills (β = 6.69, p = 0.003). In a 15-min isotemporal reallocation model, substituting MVPA for other behaviours resulted in significant improvements in both total MS and locomotor skills. Dose–response analysis revealed that reallocating even a small amount of time (e.g., 15 min) to MVPA resulted in meaningful benefits for FMS. Notably, this relationship was asymmetric: The negative impact of reducing MVPA outweighed the gains from increasing MVPA.

Conclusion

These findings highlight the importance of prioritizing MVPA within the 24-h movement behaviours framework to optimize motor development in preschool-aged children.

背景：身体活动（PA）、久坐行为（SB）和睡眠（SLP）是24小时运动行为的关键组成部分，它们分别与学龄前儿童的运动发展有独立的联系。然而，由于缺乏对其综合和相互排斥性质的了解，限制了对其对早期健康结果的综合影响的研究。本研究采用成分数据分析（CoDA）来研究这些行为与基本运动技能（FMS）之间的关系，以及等时间再分配导致的FMS的潜在变化。方法：对292名3 ~ 6岁学龄前儿童（男孩149名，女孩143名）进行横断面研究。睡眠时间、轻度体力活动（LPA）和中度至剧烈体力活动（MVPA）使用加速度计测量，而睡眠时间由父母报告。FMS包括运动技能、物体控制技能和总运动技能（总MS），采用第三版大运动发展测试（TGMD-3）进行评估。采用CoDA分析24 h运动行为与FMS的关系。结果：在调整性别、年龄、家庭社会经济地位（SES）和家庭子女数后，较高比例的MVPA与总MS （β = 9.39, p = 0.008）和运动技能（β = 6.69, p = 0.003）均呈显著正相关。在15分钟等颞叶再分配模型中，用MVPA代替其他行为导致总MS和运动技能的显著改善。剂量-反应分析显示，即使重新分配少量时间（例如15分钟）到MVPA也会对FMS产生有意义的益处。值得注意的是，这种关系是不对称的：减少MVPA的负面影响超过了增加MVPA的收益。结论：这些发现强调了在24小时运动行为框架中优先考虑MVPA对优化学龄前儿童运动发展的重要性。

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引用次数: 0

Association Between Exposure to Smartphones and Tablets and Motor Development in Early Childhood: A Systematic Review 儿童早期接触智能手机和平板电脑与运动发育的关系：一项系统综述

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-15 DOI: 10.1111/cch.70180

Rinelly Pazinato Dutra, Yasmin Marques Castro, Veridiana Moran, Vicente Gabriel Wink Mattos, Paulo Victor Moura Rodrigues, Eliane Denise Araújo Bacil, Michael Pereira da Silva

Background

This systematic review investigated the association between smartphone/tablet exposure and motor development in children aged 0–6 years.

Methods

Observational studies in Portuguese, English or Spanish were included following the Participants, Exposure, Comparison, Outcomes and Study Design. A search conducted in November 2024 across seven databases identified 3228 records. After screening titles, abstracts and full texts, seven studies met the eligibility criteria, comprising sample sizes that ranged from 25 to 715 participants, for a combined total of 1339. Exposure was assessed via parental report, considering variables such as average daily time of use, frequency and age at first exposure, although definitions varied across studies. Methodological quality was assessed using the AXIS tool, and findings were synthesised qualitatively.

Results

Findings were heterogeneous; one study reported negative associations with gross motor skills, two with fine motor skills and one with overall motor performance. Conversely, three studies indicated potential benefits for fine motor skills, and one found no significant associations. The relationship appears complex and may depend on the context, frequency and duration of use.

Conclusions

The findings underscore the importance of guiding parents, educators and healthcare providers to balance smartphone/tablet exposure with motor-enriching activities. Future longitudinal studies are needed to clarify causal pathways and the long-term effects of these exposures (PROSPERO: CRD420251008664).

本系统综述调查了0-6岁儿童智能手机/平板电脑暴露与运动发育之间的关系。方法采用葡萄牙语、英语或西班牙语的观察性研究，跟踪受试者、暴露、比较、结果和研究设计。2024年11月，在7个数据库中进行的搜索确定了3228条记录。在筛选标题、摘要和全文后，有7项研究符合入选标准，样本量从25到715人不等，总共1339人。通过家长报告评估接触情况，考虑到诸如平均每日使用时间、频率和首次接触年龄等变量，尽管不同研究的定义有所不同。使用AXIS工具评估方法学质量，并对研究结果进行定性综合。结果研究结果具有异质性；一项研究报告了与大运动技能的负相关，两项与精细运动技能有关，一项与整体运动表现有关。相反，三项研究表明精细运动技能的潜在益处，其中一项研究没有发现显著的关联。这种关系看起来很复杂，可能取决于上下文、使用频率和持续时间。研究结果强调了指导家长、教育工作者和医疗保健提供者平衡智能手机/平板电脑暴露与运动丰富活动的重要性。未来的纵向研究需要阐明这些暴露的因果途径和长期影响（PROSPERO: CRD420251008664）。

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引用次数: 0

Impact of the Use of Interactive Screens on Language Development in Children up to 6 Years of Age: A Systematic Review 使用互动屏幕对6岁以下儿童语言发展的影响：一项系统综述。

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-14 DOI: 10.1111/cch.70176

Djalma Carmo da Silva Junior, Yasmin Marques Castro, Rinelly Pazinato Dutra, Douglas Pinheiro Caumo, Michael Pereira da Silva

Objective

The study aims to examine the association between interactive screen use and language development in children up to 6 years of age through a systematic review of observational studies.

Methods

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search included four databases and used the PECOS strategy. Observational studies—either cross-sectional or longitudinal—that investigated the relationship between the use of mobile devices (such as smartphones and tablets) and language development in children aged 0–6 years were included. Duplicate records were removed using Rayyan software. Screening was carried out in pairs in two stages: title/abstract review and full-text reading.

Results

Most of the evidence suggests a negative association between excessive screen time and language development, particularly in expressive language and vocabulary. However, some studies found no statistically significant association, suggesting that factors such as exposure time, quality of interactions and family context influence the observed outcomes. Methodological heterogeneity limited direct comparisons between findings.

Conclusions

Although the results are not consistent, there is evidence of negative effects of prolonged and unsupervised use of electronic devices on young children's language development.

目的：本研究旨在通过对观察性研究的系统回顾，研究6岁以下儿童互动屏幕使用与语言发展之间的关系。方法：本系统评价按照系统评价和荟萃分析首选报告项目（PRISMA）指南进行。文献检索包括4个数据库，采用PECOS策略。观察性研究——无论是横断面研究还是纵向研究——调查了0-6岁儿童使用移动设备（如智能手机和平板电脑）与语言发展之间的关系。使用Rayyan软件删除了重复记录。筛选分为两个阶段：标题/摘要审查和全文阅读。结果：大多数证据表明，过多的屏幕时间与语言发展之间存在负相关，特别是在表达性语言和词汇方面。然而，一些研究没有发现统计上显著的关联，这表明暴露时间、互动质量和家庭背景等因素会影响观察到的结果。方法异质性限制了研究结果之间的直接比较。结论：虽然结果不一致，但有证据表明，长期和无监督地使用电子设备对幼儿的语言发展有负面影响。

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引用次数: 0

What Is Known About Eating Disorders and Disordered Eating in Individuals With Physical Disabilities? A Narrative Review 关于身体残疾患者的饮食失调和饮食失调我们知道些什么？叙述性评论。

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-14 DOI: 10.1111/cch.70184

Revi Bonder, Meaghan Walker, Alene Toulany, Amy C. McPherson

Individuals with physical disabilities may be at a high risk for developing eating disorders/disordered eating (ED/DE) and body image concerns yet are often excluded from research in this field. This has created a critical gap in our understanding of eating patterns and body image concerns among individuals with disabilities, which may impact physical and mental health outcomes long term. This narrative review explores existing literature on ED/DE and body image in individuals with physical disabilities and identifies unique factors that may increase risk. Time-sensitive, developmentally appropriate and specialized treatment options are needed to support this population.

身体残疾的人可能有很高的风险患上饮食失调/饮食失调（ED/DE）和身体形象问题，但往往被排除在这一领域的研究之外。这在我们对残疾人饮食模式和身体形象的理解上造成了严重的差距，这可能会长期影响身心健康。本文回顾了现有的关于肢体残疾患者ED/DE和身体形象的文献，并确定了可能增加风险的独特因素。需要对时间敏感、适合发展和专门的治疗方案来支持这一人群。

引用次数: 0

Validity, Reliability and Application of the Paediatric Posterior Drooling Scale 小儿后流口水量表的效度、信度及应用。

IF 2 4区医学 Q2 PEDIATRICS

Child Care Health and Development

Pub Date : 2025-11-14 DOI: 10.1111/cch.70153

Denise C. R. M. Koeken, Karen van Hulst, Marloes L. J. Lagarde, Robert F. Pangalila, Corrie E. Erasmus, Lenie van den Engel-Hoek

Aims

This study aims to assess the construct validity, inter-rater and intra-rater reliability and application of the newly developed Paediatric Posterior Drooling Scale (PPDS), a novel clinical screening tool that uses cervical auscultation (CA) to evaluate posterior drooling in children with neurological disorders.

Methods

In this cross-sectional observational study, 69 children with central neurological disorders aged 1–18 years (mean 8.4 years, 50 males, 19 females) were included for analysis. CA was used by expert and trained speech language therapists (SLT). Due to the correlation between posterior drooling and oropharyngeal dysphagia, two classification systems for eating and drinking ability were used for convergent construct validity calculations: the Functional Oral Intake Scale (FOIS) for children complemented with the Eating and Drinking Ability Classification System (EDACS) in the case of cerebral palsy.

Results

PPDS had a moderate, negative correlation with the FOIS (Spearman's rho = −0.54, p < 0.001) and a moderate, positive correlation with the EDACS (Spearman's rho = 0.70, p < 0.001). PPDS had an excellent intra-rater (intraclass correlation coefficient = 0.91, p < 0.001) and a good inter-rater reliability (intraclass correlation coefficient = 0.85, p < 0.001). The perfect agreement percentage of the test–retest reliability was high (84%) for the score 0.

Conclusions

The PPDS is a valid and reliable clinically applicable screening tool for assessing posterior drooling by the SLT. The PPDS enables SLTs to identify posterior drooling more efficiently, non-invasively and reliably in routine clinical settings. Timely recognition of posterior drooling can significantly impact clinical management, particularly by reducing respiratory complications. Performing subsequent PPDS assessments at different times when posterior drooling is suspected is important for the treating paediatrician to determine the underlying cause of posterior drooling. To establish the diagnosis of posterior drooling, the PPDS should not be used as a stand-alone tool but as a bridge between clinical observations and the need for an instrumental assessment.

目的：本研究旨在评估新开发的儿科后流口水量表（PPDS）的结构效度、量表间和量表内信度及其应用。PPDS是一种新型的临床筛查工具，使用颈椎听诊（CA）来评估神经系统疾病儿童的后流口水。方法：本横断面观察研究纳入69例1-18岁中枢性神经障碍患儿（平均8.4岁，男50例，女19例）进行分析。CA由专家和训练有素的语言治疗师（SLT）使用。由于后口流口水与口咽吞咽困难之间存在相关性，我们采用两种饮食能力分类系统进行收敛结构效度计算：儿童功能性口服摄入量表（FOIS）和脑瘫患者饮食能力分类系统（EDACS）。结果：PPDS与FOIS呈中度负相关（Spearman’s rho = -0.54, p）。结论：PPDS是一种有效、可靠的临床适用的SLT评估后流涎的筛查工具。PPDS使SLTs能够在常规临床环境中更有效、无创和可靠地识别后侧流口水。及时识别后流口水可以显著影响临床管理，特别是通过减少呼吸并发症。当怀疑后流口水时，在不同时间进行PPDS评估对于治疗儿科医生确定后流口水的潜在原因很重要。为了建立后流口水的诊断，PPDS不应作为一个独立的工具，而应作为临床观察和仪器评估之间的桥梁。

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