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Systematic review of educator behaviours associated with physical activity of early years children 对与幼儿体育活动相关的教育者行为进行系统审查
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-19 DOI: 10.1111/cch.13308
Chris Wright, Sarah Kirkhope, E. Jean Buckler

Background

Educators in early years settings influence children's physical activity (PA) levels through their pedagogical choices and behaviours. To date, minimal research has been conducted on the relationship between educator action and children's PA levels. The purpose of this systematic review was to understand which educator behaviours and actions in early years settings have been shown to engage children in PA.

Methods

Five online databases (Academic Search Complete, ERIC, SPORTDiscus, CINAHL Complete and PubMed) were searched for articles that showed an association between educator behaviour and the PA level of children between the ages of zero and eight.

Results

Eleven studies met all inclusion criteria, yet showed great variability in design and data collection methods. The risk of bias was assessed using previously published criteria adapted to this study and inline with the CONSORT statement. A binomial test on the data revealed a statistically significant deviation from chance expectation (p < .001) in relation to educator action influencing child PA. Ten of the studies focussed on educator PA, four studies highlighted the use of prompting and encouragement, three studies analysed broad statements of adult interaction, two studies called for planning activity sessions and discussions and two studies encouraged role modelling. The low number of studies included in the review and the high risk of bias indicates that caution with these results is needed.

Conclusions

While this review highlights the importance of educator PA (and other behaviours that had a positive association) on child PA level, it underscores the need for high-quality research to examine the relationship between educator actions and child PA. (PROSPERO registration: CRD42022338819).

背景 幼儿教育机构的教育者通过其教学选择和行为影响儿童的体育活动(PA)水平。迄今为止,有关教育者的行为与儿童 PA 水平之间关系的研究极少。本系统性综述的目的是了解幼儿教育机构中哪些教育者的行为和行动已被证明能让儿童参与体育锻炼。 方法 在五个在线数据库(Academic Search Complete、ERIC、SPORTDiscus、CINAHL Complete 和 PubMed)中搜索显示教育者行为与 0-8 岁儿童 PA 水平之间存在关联的文章。 结果 有 11 项研究符合所有纳入标准,但在设计和数据收集方法上存在很大差异。根据 CONSORT 声明,我们采用之前发布的标准对偏倚风险进行了评估。对数据进行二项式检验后发现,在教育者的行为影响儿童 PA 方面,与预期结果存在显著的统计学偏差(p < .001)。其中 10 项研究侧重于教育者的 PA,4 项研究强调了提示和鼓励的使用,3 项研究分析了成人互动的广泛陈述,2 项研究呼吁规划活动课程和讨论,2 项研究鼓励榜样示范。由于纳入综述的研究数量较少且存在较高的偏倚风险,因此需要谨慎对待这些结果。 结论 虽然本综述强调了教育者 PA(以及其他具有正相关性的行为)对儿童 PA 水平的重要性,但同时也强调了需要开展高质量的研究,以探讨教育者的行为与儿童 PA 之间的关系。(PROSPERO 注册:CRD42022338819)。
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引用次数: 0
Factor structure of FUNDES-Child-SE measuring the participation and independence of children with disabilities 衡量残疾儿童参与和独立性的 FUNDES-Child-SE 的因子结构。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-16 DOI: 10.1111/cch.13306
Jennifer Gothilander, Anna Karin Axelsson, Henrik Danielsson, Lena Almqvist, Anna Ullenhag

Background

FUNDES-Child-SE is a proxy rating questionnaire for measuring participation and independence in children with disabilities in a Swedish context. It includes the components of frequency of attendance, engagement and independence. The original, Taiwanese FUNDES-Child 7.0, has previously been found to have a four-factor structure for frequency of participation and a two-factor structure for independence. The aim of this study was to test the factor structure in FUNDES-Child-SE. The factor structure is an important part of construct validity.

Methods

Caregivers of 163 children with disabilities aged 6–18 years participated in this cross-sectional study. Exploratory factor analysis was used to find the factor structure for Engagement. Confirmatory factor analysis was used to test the factor structure for all three components.

Results

The proposed factor structure for frequency of participation (daily living participation frequency, mobility participation frequency, learning participation frequency and community participation frequency) and independence (daily living independence and social participation independence) fit with data from FUNDES-Child-SE after excluding three to five items and adding two to five covariances of residuals. In the engagement component, two factors, named engagement in informal activities and engagement in formal activities, were found. After excluding one item and adding 10 covariances of residuals, the factor structure had an acceptable fit to data.

Conclusions

Differences in components' factor structure indicate that attendance and engagement are separate aspects of participation. Before using numeric scores from FUNDES-Child-SE in clinical settings, responsiveness and interpretability should be evaluated.

背景:FUNDES-Child-SE是瑞典用于衡量残疾儿童参与度和独立性的代理评级问卷。它包括出席频率、参与度和独立性三个部分。台湾原版的 FUNDES-Child 7.0 曾被发现在参与频率方面具有四因素结构,在独立性方面具有双因素结构。本研究旨在测试 FUNDES-Child-SE 的因子结构。因子结构是建构效度的重要组成部分:163 名 6-18 岁残疾儿童的照顾者参与了这项横断面研究。研究采用探索性因子分析来确定 "参与 "的因子结构。结果:所提出的参与频率的因子结构是正确的:在排除三至五个项目并加入二至五个残差协方差后,所提出的参与频率(日常生活参与频率、行动参与频率、学习参与频率和社区参与频率)和独立性(日常生活独立性和社会参与独立性)因子结构与 FUNDES-Child-SE 的数据相吻合。在 "参与 "部分,发现了两个因子,分别名为 "参与非正式活动 "和 "参与正式活动"。在剔除一个项目并加上 10 个残差协方差后,因子结构与数据的拟合程度可以接受:结论:成分因子结构的差异表明,出席和参与是参与的两个不同方面。在临床环境中使用 FUNDES-Child-SE 的数字分数之前,应对其响应性和可解释性进行评估。
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引用次数: 0
“Still work?” Design and effect of interventions used to modify feeding problems in children with autism: A systematic review of studies employing group designs "仍然有效吗?用于改变自闭症儿童喂养问题的干预措施的设计和效果:对采用小组设计的研究进行系统回顾。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-16 DOI: 10.1111/cch.13307
Louisa Ming Yan Chung, Yuan Fang, Peggy Pui Lai Or, Fenghua Sun, Eric Tsz Chun Poon, Carmen Ka Man Chan

Background

Feeding problems in children with autism jeopardize the well-being of both children with autism and their families. Mixed findings were reported from previous interventions, which were mostly evaluated by single subject research design (SSRD) studies. Moreover, feasibility assessment and social validity measurement were unaddressed by these SSRD studies. To fill this substantial knowledge gap, the present review systematically summarized and evaluated feeding interventions implemented in children with autism, which were assessed by studies employing group designs.

Method

An extensive literature search in eight established online databases was conducted, and a total of 17 eligible studies published in 2009–2021 were included for further analysis. A descriptive account of the features of the investigations is provided, including assessment of study quality.

Results

A total of 449 children with autism and 203 parents/caregivers participated in the included studies. The multiple use of five strategic intervention components were highlighted in this review, including nutrition education/consultations, environmental modifications, sensory exposure, cognitive components, and behaviour interventions. The reviewed interventions showed a preliminarily positive effect for modifying feeding problems in children with autism. Furthermore, the evaluation based on the RE-AIM framework (reach, efficacy, adoption, implementation, and maintenance) demonstrated that an interdisciplinary multi-component intervention strategy may achieve high effectiveness and feasibility in improving feeding problems in a wide range of children with autism.

Conclusions

This review found that interventions achieved and maintained a positive effect on modification of feeding problems in groups of children with autism. Information and gaps identified and summarized in the implementation process may assist both researchers and stakeholders to further support these vulnerable children.

背景:自闭症儿童的喂养问题损害了自闭症儿童及其家庭的福祉。以往的干预措施大多采用单人研究设计(SSRD)进行评估,结果不一。此外,这些单人研究设计研究并未涉及可行性评估和社会有效性测量。为了填补这一巨大的知识空白,本综述系统地总结和评估了针对自闭症儿童实施的喂养干预措施,这些干预措施通过采用小组设计的研究进行评估:方法:在八个已建立的在线数据库中进行了广泛的文献检索,共纳入了 17 项 2009-2021 年间发表的符合条件的研究,并对其进行了进一步分析。结果:共有 449 名患有自闭症的儿童被纳入研究范围:共有 449 名自闭症儿童和 203 名家长/照顾者参与了所纳入的研究。本综述强调了五种策略性干预成分的多重使用,包括营养教育/咨询、环境改造、感官接触、认知成分和行为干预。综述的干预措施初步显示出对自闭症儿童喂养问题的积极改善效果。此外,基于RE-AIM框架(覆盖、疗效、采用、实施和维持)的评估表明,跨学科的多成分干预策略在改善各类自闭症儿童的喂养问题方面具有较高的有效性和可行性:本综述发现,干预措施对改善自闭症儿童群体的喂养问题取得并保持了积极效果。在实施过程中发现和总结的信息和差距可帮助研究人员和利益相关者进一步支持这些弱势儿童。
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引用次数: 0
‘There was nothing, just absolute darkness’: Understanding the needs of those caring for children and young people with complex neurodisability in a diverse UK context: A qualitative exploration in the ENCOMPASS study 什么都没有,只有绝对的黑暗":了解在英国多元化背景下照顾患有复杂神经残疾的儿童和青少年的人的需求:ENCOMPASS 研究中的定性探索。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-11 DOI: 10.1111/cch.13303
Kirsten Prest, Emma Wilson, Io Vassiliadou, Sayeeda Ali, Monica Lakhanpaul, Christopher Morris, Cally Tann, Phillip Harniess, Sasha Lewis-Jackson, Hannah Kuper, Michelle Heys

Background

Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges, which require complex packages of multidisciplinary care. Part of the holistic care required includes supporting the families and parents/caregivers. The aim of the wider study was to introduce a new programme (‘Ubuntu’) to parents/caregivers and healthcare professionals (HCPs) in order to test the feasibility and acceptability of the concept and content, with the goal of potential adaptation for the UK in mind. Data collection and analysis uncovered rich data on caregiving journeys, navigation of health services, and perceived service gaps. This paper focuses solely on these topics. Further papers will report on the feasibility and adaptation data.

Methods

Two rounds of semi-structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six HCPs from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open-ended questions to explore caregiving journeys, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data-driven inductive thematic analysis.

Results

Three themes were identified that related to the aim of understanding caregivers' experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) The Information Gap and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate.

Conclusions

The delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP.

背景:患有复杂性神经残疾的儿童和青少年(CYP)在身体、沟通、教育和社交方面面临多重挑战,需要复杂的多学科综合护理。所需的整体护理包括为家庭和父母/照顾者提供支持。这项广泛研究的目的是向父母/照顾者和医疗保健专业人员(HCPs)介绍一项新计划("Ubuntu"),以测试其概念和内容的可行性和可接受性,并考虑在英国进行可能的调整。通过数据收集和分析,我们发现了有关护理历程、医疗服务导航和服务差距的丰富数据。本文仅关注这些主题。后续论文将报告可行性和适应性数据:2020 年,我们从英国伦敦纽汉区的社区儿童健康服务机构招募了 12 名患有复杂神经残疾的儿童青少年的照顾者和 6 名来自不同学科的保健人员,对他们进行了两轮半结构化访谈。访谈内容包括开放式问题,以探讨护理历程、健康服务导航经验和感知到的服务差距。访谈记录采用数据驱动归纳式主题分析法进行分析:结果:我们确定了三个主题,这些主题与了解护理者的经历和与当前服务提供相关的未满足需求这一目标相关。这三个主题分别是:(1) 照顾者的心理健康;(2) 信息差距;(3) 全面支持的需求。据报告,精神健康方面存在困难,尤其是在诊断期间。优先需求包括提供有关诊断和所提供服务的明确信息、建立同伴支持网络的机会以及社区服务合作:结论:为患有神经系统残疾的儿童提供医疗服务时,除了满足儿童的临床需求外,还应考虑其家庭的广泛需求。
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引用次数: 0
No one really plans to have multiple sclerosis: Transition readiness and quality of life in paediatric multiple sclerosis 没有人真的打算患多发性硬化症:儿科多发性硬化症患者的过渡准备和生活质量。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-10 DOI: 10.1111/cch.13304
Estherline Thoby, Julissa Veras, Spandana Nallapati, Manuel E. Jimenez, Vikram Bhise

Aim

We sought to explore the experiences and perceptions of the quality of life of adolescents with pediatric-onset multiple sclerosis and assess their readiness for academic, employment and/or health care-related transitions.

Background

Adolescents with pediatric-onset multiple sclerosis face unique challenges in managing a chronic illness while navigating future scholastic, social and occupational goals. We conducted a qualitative study with in-depth, semi-structured interviews from July 2017 to March 2019. Adolescents with pediatric-onset multiple sclerosis were recruited from a pediatric neurology subspeciality practice until reaching data saturation. A total of 17 interviews were completed via telephone with participants ages 15 through 26.

Results

Through content analysis of the interviews, we identified five major themes: (1) receiving a new diagnosis; (2) adapting to life with pediatric-onset multiple sclerosis; (3) evaluating education/career transition preparedness; (4) adjusting within family life and establishing support systems; and (5) assessing current medical services and preparedness for adult medical care.

Conclusions

Autonomy in health care management, adequate control of physical symptoms and sufficient family support impacted perceptions of quality of life. Implementing a dedicated transition visit, including the parent(s) of those with pediatric-onset multiple sclerosis, early in adolescence may provide an avenue for appropriate anticipatory guidance regarding available services, independent medical management and continuity of care.

目的:我们试图探索患有小儿多发性硬化症的青少年对生活质量的体验和看法,并评估他们在学业、就业和/或医疗保健相关过渡方面的准备情况:背景:患有小儿多发性硬化症的青少年在管理慢性疾病的同时,还面临着实现未来学业、社会和职业目标的独特挑战。我们在 2017 年 7 月至 2019 年 3 月期间开展了一项定性研究,进行了深入的半结构式访谈。我们从一家儿科神经病学亚专科诊所招募了患有小儿多发性硬化症的青少年,直到数据达到饱和为止。通过电话共完成了 17 次访谈,参与者的年龄从 15 岁到 26 岁不等:通过对访谈内容的分析,我们确定了五大主题:(1) 接受新的诊断;(2) 适应小儿多发性硬化症患者的生活;(3) 评估教育/职业过渡准备情况;(4) 适应家庭生活并建立支持系统;(5) 评估当前的医疗服务并为成人医疗做好准备:结论:医疗保健管理的自主性、对身体症状的充分控制以及充分的家庭支持影响了对生活质量的看法。在青春期早期实施专门的过渡访视,包括儿科发病型多发性硬化症患者的父母,可以提供一个渠道,就可用服务、独立医疗管理和持续护理提供适当的预期指导。
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引用次数: 0
Pepea Pamoja:† Applying the Ecological Validity Framework to co-develop a wellbeing and behavioural training program for caregivers of young children with autism in low-resource settings of Kenya and the United States Pepea Pamoja:† 在肯尼亚和美国的低资源环境中,应用生态有效性框架为自闭症幼儿的看护者共同制定福利和行为培训计划。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-05 DOI: 10.1111/cch.13299
Rebecca McNally Keehn, Mandy Rispoli, Chelagat Saina, Amira Nafiseh, Eren Oyungu, Felicita Wangechi Omari, Barnabas Kigen, Tonia Hassinger, Laurel Stewart, Judith Gross, Megan McHenry

Background

Autism is a complex neurodevelopmental disability with global prevalence of one in 100 individuals. Poor access to interventions in both under-resourced regions of high-income countries and low- and middle-income countries has deleterious effects on the health and wellbeing of individuals with autism and their families. Our objective was to utilize a reciprocal innovation framework and participatory methods to adapt and co-develop a culturally grounded group-based wellbeing and naturalistic developmental behavioural intervention (NDBI) training program for caregivers of young children with autism to be implemented in Kenya and rural Indiana.

Methods

This study was conducted within the Academic Model Providing Access to Healthcare (AMPATH) program. An evidence-informed Naturalistic Developmental Behavioral Intervention (NDBI) previously utilized in Indiana was adapted and iteratively refined using the Ecological Validity Framework (EVF) by a team of US and Kenyan disability experts. Key adaptations to the program were made across the EVF domains of language, persons, metaphors/content, concepts, goals, methods, and context.

Results

Substantial cultural adaptations were made to the NDBI following the EVF model, including the addition of traditional Kenyan cultural practices, use of narrative principles, and focus on daily routines over play. Pepea, the adapted program, involves 10 group sessions covering content in basic education on autism, positive caregiver coping strategies, and behavioural skills training to promote child communication and reduce challenging behaviour. Key adaptations for Pepea were integrated back into a US NDBI caregiver training program.

Conclusions

This study fills a critical gap by detailing the adaptation process of a caregiver wellbeing and naturalistic developmental behavioural training program for caregivers of children with autism in low-resource settings. Our next steps are to report on mixed-methods outcomes from pilot implementation. Our long-term goal is to apply these insights to advance sustainable and scalable autism intervention services across the globe.

背景:自闭症是一种复杂的神经发育残疾,全球发病率为百分之一。在高收入国家资源匮乏的地区和中低收入国家,自闭症患者难以获得干预措施,这对自闭症患者及其家庭的健康和福祉产生了有害影响。我们的目标是利用互惠创新框架和参与式方法,为肯尼亚和印第安纳州农村地区的自闭症幼儿照顾者改编和共同开发一个基于文化的小组幸福感和自然发展行为干预(NDBI)培训项目:这项研究是在 "提供医疗保健服务的学术模式(AMPATH)"项目中进行的。由美国和肯尼亚残障专家组成的团队利用生态有效性框架(EVF)对之前在印第安纳州使用的循证自然发展行为干预(NDBI)进行了调整和反复改进。对该项目进行的主要调整涉及生态有效性框架的语言、人员、隐喻/内容、概念、目标、方法和背景等领域:结果:根据 EVF 模式,对 NDBI 进行了大量的文化调整,包括增加肯尼亚传统文化习俗、使用叙事原则以及将重点放在日常生活而非游戏上。经过调整的项目 Pepea 包括 10 节小组课程,内容涵盖自闭症基础教育、积极的照顾者应对策略以及行为技能培训,以促进儿童交流并减少挑战行为。Pepea 的主要改编内容又被整合到了美国 NDBI 护理人员培训计划中:这项研究填补了一个重要空白,详细介绍了在资源匮乏的环境中,针对自闭症儿童照顾者的照顾者福利和自然发展行为培训计划的调整过程。下一步,我们将报告试点实施过程中的混合方法成果。我们的长期目标是运用这些见解,在全球范围内推进可持续、可扩展的自闭症干预服务。
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引用次数: 0
Current and preferred services of specialized professionals in childcare settings in Quebec, Canada: A descriptive survey of childcare administrators' perspectives 加拿大魁北克省托儿所专业人员的现有服务和首选服务:对托儿所管理者观点的描述性调查。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-05 DOI: 10.1111/cch.13305
Gabrielle Pratte, Audrée Jeanne Beaudoin, Chantal Camden, Mélanie Couture

Background

Many challenges exist in promoting inclusion in childcare settings. Adequate support from specialized professionals is necessary to create inclusive childcare settings. Understanding which services are being delivered by specialized professionals in childcare contexts is an important first step. The aim of this study was to (1) describe the services currently being delivered by specialized professionals in childcare settings in Quebec (Canada) and (2) seek childcare administrators' perspectives on their preferred services.

Methods

An online province-wide descriptive survey was conducted with childcare administrators (n = 344). Questions focused on 11 service delivery dimensions (e.g. professionals involved, children served). Descriptive statistics were calculated.

Results

Childcare settings received services from a median of two specialized professionals (IQR [1–4]). Most services were delivered by early childhood special educators (61.3%), speech-language pathologists (57.6%), psycho-educators (43.6%) and occupational therapists (43.3%). Childcare administrators identified these four services as being particularly supportive. Professionals delivered a median of 0.4 h of service per week in each childcare setting (IQR [0.1–3.0]). A high percentage (91.2%) of administrators reported unmet needs for professional support in at least one developmental domain, with a high percentage (57.3%) of administrators identifying needs in the socio-emotional domain. Most (63.3%) expressed a desire to prioritize services for children without an established diagnosis but identified by early childhood educators as having needs for professional support. Most administrators (71.4%) also preferred in-context services.

Conclusions

Childcare administrators perceive an important role for specialized professionals in supporting inclusion in their settings. Recommendations emerging are based on the four main professional service needs identified: (1) increasing the intensity and stability of services; (2) providing services for undiagnosed children identified by early childhood educators as having unmet needs; (3) ensuring that services encompassing all developmental domains with a focus on the socio-emotional domain; and (4) prioritizing of in-context services.

背景:在促进儿童保育机构的全纳性方面存在许多挑战。要创建全纳儿童保育环境,就必须得到专业人员的充分支持。了解专业人员在儿童保育环境中提供哪些服务是重要的第一步。本研究的目的是:(1) 描述魁北克(加拿大)托儿所目前由专业人员提供的服务;(2) 征求托儿所管理人员对其首选服务的看法:方法:对全省范围内的托儿所管理者(n = 344)进行了在线描述性调查。问题主要集中在 11 个服务提供方面(如参与的专业人员、服务的儿童)。调查结果托儿所接受服务的专业人员中位数为两名(IQR [1-4])。大多数服务由幼儿特殊教育工作者(61.3%)、言语病理学家(57.6%)、心理教育工作者(43.6%)和职业治疗师(43.3%)提供。托儿所管理者认为这四种服务特别具有支持性。专业人员在每个托儿所每周提供的服务时间中位数为 0.4 小时(IQR [0.1-3.0])。有很高比例(91.2%)的管理者表示,他们在至少一个发展领域的专业支持需求未得到满足,其中有很高比例(57.3%)的管理者认为他们在社会情感领域有需求。大多数管理者(63.3%)表示希望优先为没有确诊但被幼儿教育工作者确定为需要专业支持的儿童提供服务。大多数管理者(71.4%)还倾向于提供情境服务:托儿所管理者认为,专业人员在支持托儿所的全纳工作中发挥着重要作用。根据所确定的四种主要专业服务需求,提出了一些建议:(1) 增加服务的强度和稳定性;(2) 为幼儿教育工作者发现的未确诊儿童提供服务,以满足他们的需要;(3) 确保服务涵盖所有发展领域,重点放在社会情感领域;(4) 优先提供情境服务。
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引用次数: 0
Interventions to improve executive functions in children aged 3 years and under: A systematic review 改善 3 岁及以下儿童执行功能的干预措施:系统回顾。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-03 DOI: 10.1111/cch.13298
Andrea F. Duncan, Gwyn J. Gerner, Mary Lauren Neel, Vera J. Burton, Rachel Byrne, Seth Warschausky

Background

Early executive functioning (EF) skills are foundational capabilities that predict school readiness, academic development and psychiatric risk. Early interventions enhancing these capabilities could have critical import in improving outcomes. However, to develop interventions, it is necessary to identify specific EF skills that will vary with child age. Thus, we aimed to examine the characteristics and efficacy of interventions targeting EF in infancy and early childhood up to age 3.

Methods

A comprehensive search of PubMed, Embase, CINAHL and APA PsycINFO databases was performed for studies published before December 2022. Randomized and non-randomized studies of interventions designed to improve at least one EF skill in children ≤3 years were included. EF skills included attentional control, inhibition/self-regulation, activity initiation, working memory, cognitive flexibility, planning ability, problem-solving and performance monitoring. We independently extracted data, used the revised Cochrane Risk-of-Bias tool to assess the quality of the evidence and conducted Synthesis Without Meta-analysis (SWiM). The overall quality of the evidence and the strength of recommendations was determined using elements of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results

Thirty-five studies met inclusion criteria (original n = 7467). Studies were highly variable in the EF skill targeted, target subject (i.e., child, parent and teacher), nature and dosage of the intervention, and timing of outcome assessment. Most interventions focused on improving impulse control and self-regulation. The overall quality of evidence was low to moderate with a high risk of bias, though six studies had low risk of bias but yielded mixed findings of efficacy.

Conclusions

The relatively small number of early EF intervention studies uses such variable methods that there is currently no converging evidence of efficacy to recommend a specific intervention. Thus, findings support the need for a more systematic, targeted approach to the design and implementation of early EF interventions for target populations.

背景早期执行功能(EF)技能是预测入学准备、学业发展和精神疾病风险的基础能力。加强这些能力的早期干预对改善结果至关重要。然而,要制定干预措施,就必须确定随儿童年龄而变化的特定执行功能技能。因此,我们旨在研究针对婴幼儿期(直至 3 岁)EF 的干预措施的特点和效果:我们对 PubMed、Embase、CINAHL 和 APA PsycINFO 数据库中 2022 年 12 月之前发表的研究进行了全面检索。研究纳入了旨在提高 3 岁以下儿童至少一项 EF 技能的干预措施的随机和非随机研究。EF技能包括注意力控制、抑制/自我调节、活动启动、工作记忆、认知灵活性、计划能力、问题解决和表现监测。我们独立提取数据,使用修订版 Cochrane 偏倚风险工具评估证据质量,并进行了无 Meta 分析综合(SWiM)。证据的总体质量和建议的力度采用建议评估、发展和评价分级(GRADE)方法的要素来确定:35 项研究符合纳入标准(原始 n = 7467)。这些研究在所针对的情商技能、目标对象(即儿童、家长和教师)、干预的性质和剂量以及结果评估的时间等方面存在很大差异。大多数干预措施侧重于改善冲动控制和自我调节。证据的总体质量为中低水平,偏倚风险较高,但有六项研究的偏倚风险较低,但得出的疗效结果不一:结论:早期幼儿情绪控制干预研究的数量相对较少,采用的方法也不尽相同,因此目前还没有一致的疗效证据来推荐特定的干预方法。因此,研究结果支持有必要采用更系统、更有针对性的方法来设计和实施针对目标人群的早期心肺功能干预。
{"title":"Interventions to improve executive functions in children aged 3 years and under: A systematic review","authors":"Andrea F. Duncan,&nbsp;Gwyn J. Gerner,&nbsp;Mary Lauren Neel,&nbsp;Vera J. Burton,&nbsp;Rachel Byrne,&nbsp;Seth Warschausky","doi":"10.1111/cch.13298","DOIUrl":"10.1111/cch.13298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early executive functioning (EF) skills are foundational capabilities that predict school readiness, academic development and psychiatric risk. Early interventions enhancing these capabilities could have critical import in improving outcomes. However, to develop interventions, it is necessary to identify specific EF skills that will vary with child age. Thus, we aimed to examine the characteristics and efficacy of interventions targeting EF in infancy and early childhood up to age 3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of PubMed, Embase, CINAHL and APA PsycINFO databases was performed for studies published before December 2022. Randomized and non-randomized studies of interventions designed to improve at least one EF skill in children ≤3 years were included. EF skills included attentional control, inhibition/self-regulation, activity initiation, working memory, cognitive flexibility, planning ability, problem-solving and performance monitoring. We independently extracted data, used the revised Cochrane Risk-of-Bias tool to assess the quality of the evidence and conducted Synthesis Without Meta-analysis (SWiM). The overall quality of the evidence and the strength of recommendations was determined using elements of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-five studies met inclusion criteria (original <i>n</i> = 7467). Studies were highly variable in the EF skill targeted, target subject (i.e., child, parent and teacher), nature and dosage of the intervention, and timing of outcome assessment. Most interventions focused on improving impulse control and self-regulation. The overall quality of evidence was low to moderate with a high risk of bias, though six studies had low risk of bias but yielded mixed findings of efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The relatively small number of early EF intervention studies uses such variable methods that there is currently no converging evidence of efficacy to recommend a specific intervention. Thus, findings support the need for a more systematic, targeted approach to the design and implementation of early EF interventions for target populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"50 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.13298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494346","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}
引用次数: 0
Centring children's lived experiences in understanding the importance of play in hospitals 以儿童的生活经验为中心,理解医院游戏的重要性。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-03 DOI: 10.1111/cch.13287
Kelsey Graber, Christine O'Farrelly, Paul Ramchandani

Background

Children have a right to participate in matters affecting their lives. With increasing regularity, children's perspectives are being sought regarding their health and health care experiences. Though there is evidence that children find play to be one of the ‘best’ aspects of hospitalisation, studies rarely focus on children's perspectives on play in hospital.

Methods

This qualitative study explored children's lived experiences of play during hospitalisation. Over five months, ethnographic observations were conducted on a paediatric oncology ward as well as interviews with 16 children ages 3–13 years.

Results

Using interpretative phenomenological analysis, children's expressions and experiences illuminated three key points: safety and comfort are integral to children feeling able to play in hospital; the value and efficacy of play is decided by children; and that play is a way for patients to be (and be treated as) children first.

Conclusion

Hospitals can only be child-friendly if children find them friendly. Listening to and integrating children's perspectives in the discourse around the importance of play in hospital is essential for respecting children's rights and delivering person-centred paediatric healthcare.

背景:儿童有权参与影响其生活的事务。人们越来越经常地征求儿童对其健康和医疗保健经历的看法。尽管有证据表明儿童认为游戏是住院的 "最好 "方面之一,但很少有研究关注儿童对住院游戏的看法:这项定性研究探讨了儿童在住院期间的游戏体验。在五个月的时间里,我们在儿科肿瘤病房进行了人种学观察,并对 16 名 3-13 岁的儿童进行了访谈:结果:通过解释性现象学分析,儿童的表达和体验揭示了三个关键点:安全和舒适是儿童在医院能够游戏的必要条件;游戏的价值和功效由儿童决定;游戏是病人首先成为儿童(并作为儿童对待)的一种方式:结论:只有当儿童觉得医院友好时,医院才能成为对儿童友好的医院。在讨论医院中游戏的重要性时,倾听儿童的观点并将其融入其中,对于尊重儿童权利和提供以人为本的儿科医疗保健服务至关重要。
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引用次数: 0
Effectiveness of therapeutic interventions on participation in children with cerebral palsy: A systematic review and meta-analysis 治疗干预对脑瘫儿童参与的有效性:系统回顾和荟萃分析。
IF 1.8 4区 医学 Q2 PEDIATRICS Pub Date : 2024-07-03 DOI: 10.1111/cch.13301
Rigas Dimakopoulos, Theodora Vakalaki, Arietta Spinou, Ioannis Michopoulos, Μarianna Papadopoulou

Background

Participation in life activities is an integral part of health and a main outcome of rehabilitation services for children and adolescents with disabilities. However, there is still no consensus on the most effective way to improve participation. The aim of this systematic review is to determine the effectiveness of therapeutic interventions on participation outcomes of children with cerebral palsy (CP).

Methods

A systematic review was conducted, searching the databases PubMed, Cochrane Library, Science Direct, Web of Science and Scopus for randomized controlled trials (RCTs), between 2001 and 2023. Studies were eligible for inclusion if they evaluated children with CP undergoing any intervention and using any tool measuring participation as an outcome measure. A meta-analysis of treatment effect was conducted. A sensitivity analysis was conducted to identify the effect on participation when intervention targeted different International Classification of Functioning (ICF) domains.

Results

A total of 1572 records were identified. Eight RCTs including 384 children (195 in the intervention group and 189 in the control group) were included in the systematic review and in the meta-analysis. A sensitivity analysis showed that interventions focusing on participation significantly improved participation; standardized mean difference (1.83; 95% CI: 1.33–2.32; Z = 7.21; P < 0.00001). When other types of interventions, that is, focusing on body functions and structures or activities, were used, then participation was not favourably affected.

Interpretation

Interventions primarily targeting barriers to participation across several ICF domains have a greater influence on enhancing participation. Interventions aimed at enhancing specific motor skills, including gross and fine motor function or strength, do not necessarily have a positive impact on participation.

背景:参与生活活动是健康的组成部分,也是残疾儿童和青少年康复服务的主要成果。然而,对于提高参与度的最有效方法仍未达成共识。本系统综述旨在确定治疗干预对脑瘫(CP)儿童参与结果的有效性:方法:我们在 PubMed、Cochrane Library、Science Direct、Web of Science 和 Scopus 等数据库中搜索了 2001 年至 2023 年间的随机对照试验 (RCT),并进行了系统性综述。如果研究对接受任何干预措施的 CP 儿童进行了评估,并使用任何测量参与度的工具作为结果测量指标,则符合纳入条件。对治疗效果进行了荟萃分析。还进行了一项敏感性分析,以确定针对不同国际功能分类(ICF)领域的干预对参与的影响:共找到 1572 条记录。系统综述和荟萃分析共纳入了 8 项研究性试验,其中包括 384 名儿童(干预组 195 人,对照组 189 人)。敏感性分析表明,以参与为重点的干预措施显著提高了参与度;标准化平均差(1.83;95% CI:1.33-2.32;Z = 7.21;P 解释:主要针对多个 ICF 领域的参与障碍的干预措施对提高参与度的影响更大。旨在提高特定运动技能(包括粗大和精细运动功能或力量)的干预措施并不一定会对参与产生积极影响。
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引用次数: 0
期刊
Child Care Health and Development
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