Search results for: irony comprehension in children

Authors: Sisay Shine, Frew Tadesse, Zemenu Shiferaw, Lema Mideksa

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Background: Stunting is one of the most important public health problems in Ethiopia with an estimated 44.4% of children less than five years of age are stunted. Thus, this study aimed to assess prevalence and associated factors of stunting among 6-59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia. Objective of the study: To assess prevalence and associated factors of stunting among 6-59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia, 2016. Methods: Community based cross sectional study design was done among 770 children in pastoral community of Korahay Zone. Systematic sampling techniques were used to select households and took child mother pair from each selected households. Data was collected using pre-tested and structured questionnaire. Odds ratio with 95% confidence interval was used to assess level of significance. Result: Prevalence of stunting among 6-59 months age children was 31.9%. Sex (AOR: 1.47, 95%CI 1.02, 2.11), age (AOR: 2.10, 95%CI 1.16, 3.80), maternal education (AOR: 3.42, 95%CI 1.58, 7.41), maternal occupation (AOR: 3.10, 95%CI 1.85, 5.19), monthly income (AOR: 1.47, 95%CI 1.03, 2.09), PNC visits (AOR: 1.59, 95%CI 1.07, 2.37), source of water (AOR: 3.41, 95%CI 1.96, 5.93), toilet availability (AOR: 1.71, 95%CI 1.13, 2.58), first milk feeding (AOR: 3.37, 95%CI 2.27, 5.02) and bottle feeding (AOR: 2.07, 95%CI 1.34, 3.18) were significant predictors of stunting. Conclusion and recommendations: Prevalence of stunting among 6-59 months children was high 31.9%. Lack maternal education, not feeding first milk, unsafe water supply, absence toilet availability and bottle feeding can increase the risk of stunting. So, educating mothers on child feeding practice, sanitation and important of first milk can reduce stunting.

Keywords: dietary, environmental, healthcare, socio-demographic, stunting

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Authors: Karolina Siejka, Monika Piekarska, Monika Zbroja, Weronika Cyranka, Maryla Kuczynska, Magdalena Grzegorczyk, Malgorzata Nowakowska, Agnieszka Brodzisz, Magdalena Maria Wozniak

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Crohn’s disease is one of chronic inflammatory bowel diseases. It is increasing in prevalence worldwide, especially with young people. The disease usually occurs in the second to the fourth decade of life. Traditionally is diagnosed by clinical indicates, endoscopic, and histological findings. Magnetic Resonance Enterography (MRE) can demonstrate mural and extramural inflammatory signs and complications, which make it a valuable diagnostic modality. The study included 76 adults and 36 children diagnosed with Crohn’s disease. Each patient underwent MRE with intravenous administration of a contrast agent. All the studies were performed using Siemens Aera 1.5T scanner according to a local study protocol. Whenever applicable, MR Enterography findings were verified with endoscopy. Forty adults and all 36 children had an active phase of Crohn’s disease; five adults had a chronic phase of the disease; one adult had both chronic and active inflammatory features. Thirty adults have no sings of pathology. In both adult and pediatric groups the most commonly observed manifestation of active disease was thickened edematous ileum wall (26 adults and 36 children). Adults had Bauhin’s valve edema in 58% cases (n=23) and mesenteric changes in 34% cases (n=9). To compare, 32 children had Bauhin’s valve edema (89%) and, in 23 cases, was found inflammatory infiltration of the peri-intestinal fat (64%). The involvement of the large intestine was more common among children (100%). Complications of Crohn’s disease were found commonly in adults (40% of adults, 22% of children). There were observed 18 fistulas (14 adults, four children) and six abscesses (2 adults, four children). MRE is a reliable method in the evaluation of Crohn’s disease activity, especially of its complications. The lack of radiations makes MRE well-tolerated modality, which can be often repeated, particularly in young patients. The disease had different medical sings depending on age – children often had a more active inflammatory process, but there were more complications in the adult group.

Keywords: Crohn's disease, diagnostics, inflammatory bowel disease, magnetic resonance enterography, MRE

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Authors: Abbas Nesayan

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Background: In recent years, autism has been under consideration in public and research area. Autistic children have dysfunction in communication, socialization, repetitive and stereotyped behaviors. In addition, they clinically suffer from difficulty in attention, challenge with familiar behaviors and sensory processing problems. Several variables are linked to sensory processing problems in autism, one of these variables is working memory. Working memory is part of the executive function which provides the necessary ability to completing multiple stages tasks. Method: This study has categorized in correlational research methods. After determining of entry criteria, according to purposive sampling method, 50 children were selected. Dunn’s sensory profile school companion was used for assessment of sensory processing patterns; behavioral rating inventory of executive functions was used (BRIEF) for assessment of working memory. Pearson correlation coefficient and linear regression were used for data analyzing. Results: The results showed the significant relationship between sensory processing patterns (low registration, sensory seeking, sensory sensitivity and sensory avoiding) with working memory in autistic children. Conclusion: According to the findings, there is the significant relationship between the patterns of sensory processing and working memory. So, in order to improve the working memory could be used some interventions based on the sensory processing.

Keywords: sensory processing patterns, working memory, autism, autistic children

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Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

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Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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Authors: Meryam Labyad, Karima Fakiri, Widad Lahmini, Ghizlane Draiss, Mohamed Bouskraoui, Nadia Ouzennou

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Background: Asthma is the most common chronic disease in children, affecting nearly 235 million people worldwide (OMS). In Morocco, asthma is much more common in children than in adults; the prevalence rate in children between 13 and 14 years of age is 20%.1 This pathology is marked by high morbidity, a significant impact on the quality of life and development of children 2 This requires a rigorous management strategy in order to achieve clinical control and reduce any risk to the patient 3 A search for aggravating factors is mandatory if a child has difficulty maintaining good asthma control. The objective of the present study is to describe asthma control during this confinement period in children aged 4 to 11 years followed by a pneumo-paediatric consultation. For children whose asthma is not controlled, a search for associations with promoting factors and adherence to treatment is also among the objectives of the study. Knowing the level of asthma control and influencing factors is a therapeutic priority in order to reduce hospitalizations and emergency care use. Objective: To assess asthma control and determine the factors influencing asthma levels in children with asthma during confinement following the COVID 19 pandemic. Method: Prospective cross-sectional study by questionnaire and structured interview among 66 asthmatic children followed in pediatric pneumology consultation at the CHU MED VI of Marrakech from 13/06/2020 to 13/07/2020, asthma control was assessed by the Childhood Asthma Control Test (C-ACT). Results: 66 children and their parents were included (mean age is 7.5 years), asthma was associated with allergic rhinitis (13.5% of cases), conjunctivitis (9% of cases), eczema (12% of cases), occurrence of infection (10.5% of cases). The period of confinement was marked by a decrease in the number of asthma attacks translated by a decrease in the number of emergency room visits (7.5%) of these asthmatic children, control was well controlled in 71% of the children, this control was significantly associated with good adherence to treatment (p<0.001), no infection (p<0.001) and no conjunctivitis (p=002) or rhinitis (p<0.001). This improvement in asthma control during confinement can be explained by the measures taken in the Kingdom to prevent the spread of COVID 19 (school closures, reduction in industrial activity, fewer means of transport, etc.), leading to a decrease in children's exposure to triggers, which justifies the decrease in the number of children having had an infection, allergic rhinitis or conjunctivitis during this period. In addition, the close monitoring of parents resulted in better therapeutic adherence (42.4% were fully observant). Confinement was positively perceived by 68% of the parents; this perception is significantly associated with the level of asthma control (p<0.001). Conclusion: Maintaining good control can be achieved through improved therapeutic adherence and avoidance of triggers, both of which were achieved during the containment period following the VIDOC pandemic 19.

Keywords: Asthma, control , COVID-19 , children

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Authors: Hilal Karakuş, Berrin Akman

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Preschool years are considered as critical years because of shaping the future lives of individuals. All of the knowledge, skills, and concepts are acquired during this period. Also, basis of academic skills is based on this period. As all of the developmental areas are the fastest in that period, the basis of mathematics education should be given in this period, too. Mathematics is seen as a difficult and abstract course by the most people. Therefore, the enjoyable side of mathematics should be presented in a concrete way in this period to avoid any bias of children for mathematics. This study is conducted to examine mathematics concept acquisition of children in terms of different variables. Screening model is used in this study which is carried out in a quantity way. The study group of this research consists of total 300 children, selected from each class randomly in groups of five, who are from public and private preschools in Çankaya, which is district of Ankara, in 2014-2015 academic year and attending children in the nursery classes and preschool institutions are connected to the Ministry of National Education. The study group of the research was determined by stage sampling method. The schools, which formed study group, are chosen by easy sampling method and the children are chosen by simple random method. Research data were collected with Bracken Basic Concept Scale–Revised Form and Child’s Personal Information Form generated by the researcher in order to get information about children and their families. Bracken Basic Concept Scale-Revised Form consists of 11 sub-dimensions (color, letter, number, size, shape, comparison, direction-location, and quantity, individual and social awareness, building- material) and 307 items. Subtests related to the mathematics were used in this research. In the “Child Individual Information Form” there are items containing demographic information as followings: age of children, gender of children, attending preschools educational intuitions for children, school attendance, mother’s and father’s education levels. At the result of the study, while it was found that children’s mathematics skills differ from age, state of attending any preschool educational intuitions , time of attending any preschool educational intuitions, level of education of their mothers and their fathers; it was found that it does not differ by the gender and type of school they attend.

Keywords: preschool education, preschool period children, mathematics education, mathematics concept acquisitions

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Authors: Adebusoye Michael, Okunola Olayinka, Owolabi Abdulateef, Jacob Anayo

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Introduction: Child undernutrition remains one of Africa’s most fundamental challenges for improved human development because the time and capacities of caregivers are limited; far too many children are unable to access effectively amenities they need for a healthy life. Methods and procedures: This cross-sectional, descriptive study evaluated the maternal care practices on nutritional status of pre-school children, 150 mothers were selected by systematic random sampling in Dass L.G.A., Bauchi-State, Nigeria. Information on relevant parameters were collected by questionaire, analysed by various indices of descriptive statistics using SPSS version 16.0.Spearman’s rank correlation was used to test for associations between the variables. Results: Thirty-five (23.3%) of the respondents were aged 21-25 years. Thirty-three (28.0%) had secondary education, while forty-nine (32.7%) were full housewives. Majority 79(52.7) earned NI,000- N10,000 monthly versus 10(6.7%) who earned N11,000- N20,000.113(75.3%) married while 7(4.7%) of respondents were separated. Sixty-one (40.7%) practiced exclusive breastfeeding within six months. Only seventy-one (47.3%) initiated breastfeeding between 7 and 13 months. Five (3.3%) of children were mildly underweight while nine (6.0%) were severely stunted. Conclusion: The outcome suggested that working time of mothers is a major determinant on their child nutritional status. However, there is a significant relationship on the working time of mothers, income level and educational level of mothers to the nutritional status of their children (P<0.05). Recommendation: Good policy programmes should aim at eradicating poverty, better child care practices that would reduce malnutrition among under-five children.

Keywords: maternal care, nutritional status, preschool children, Dass L.G.A.

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Authors: Jiabei Zhang

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Online programs developed for preparing qualified teachers have significantly increased over the years in the United States of America (USA). However, no online graduate programs for training adapted physical education (APE) teachers for children with significant developmental disabilities are currently available in the USA. The purpose of this study was to develop an online master’s degree program for the preparation of APE teachers to serve children with significant developmental disabilities. The characteristics demonstrated by children with significant developmental disabilities, the competencies required for certified APE teachers, and the evidence-based positive behavioral interventions (PBI) documented for teaching children with significant developmental disabilities were fully reviewed in this study. An online graduate program with 14 courses for 42 credit hours (3 credit hours per course) was then developed for training APE teachers to serve children with significant developmental disabilities. Included in this online program are five components: (a) 2 capstone courses, (b) 4 APE courses, (c) 4 PBI course, (d) 2 elective courses, and (e) 2 capstone courses. All courses will be delivered online through Desire2Learn administered by the Extended University Programs at Western Michigan University (WMU). An applicant who has a bachelor’s degree in physical education or special education is eligible for this proposed program. A student enrolled in this program is expected to complete all courses in 2.5 years while staying in their local area. This program will be submitted to the WMU curriculum committee for approval in the fall of 2018.

Keywords: adapted physical education, online program, teacher preparation, and significant disabilities

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Authors: Sona Lorencova

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The practice of kindergartens shows that the communication and cooperation of teachers and directors of kindergartens with parents, who come with different expectations and ideas about preschool education, is becoming an increasing problem, which leads to many misunderstandings in their mutual functioning. In practice, little attention is paid to communication and cooperation between kindergartens and families, whether in the professional development of educators, in professional articles and publications, or in the field of research. The approach of teachers to parents whose children attend kindergarten requires more and more skills on the part of educators, which is also related to the introduction of the institute of compulsory preschool education. Thus, the discrepancy in mutual expectations and requirements for children's preschool education on the part of the kindergarten and the family is increasing. The aim of the research was to look into the world of parents and learn about their subjective experience with preschool education of children in kindergarten. The findings could be useful in the search for appropriate strategies for mutual communication and cooperation between kindergartens and families in order to achieve more effective progress for children in education. The data were collected through the method of a constellation with figures, semi-structured interviews, and the use of a research diary. Through an interpretive phenomenological analysis, it was found that the parents' view of preschool education in kindergarten is connected to 6 basic topics - parenting with a preschooler, adaptation to kindergarten, professionalism of teachers, cooperation with kindergarten, and parents' satisfaction with preschool education. The conducted research also revealed that the determinants at the level of microsystem, mesosystem, exosystem, macrosystem, and chronosystem influenced parents' view of children's preschool education in kindergarten.

Keywords: preschool education, parents, kindergarten, interpretive phenomenological analysis, subjective experience

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Authors: Afsheen Masood, Sumaira Rashid, Shama Mazahir

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The main aim of this research is to evaluate the efficacy of a culturally adapted management program The Stepping Stones Positive Parenting Program (Tripple P; SSTP) for caregivers of children with autism spectrum disorders and Down syndrome. Positive psychology has catered new dimensions to the traditional perspectives of parenting. The current study was designed to determine the adoptions of positive parenting elements such as parenting styles, parental satisfaction, parental competency, and management of parental stress in alignment with behavioral problems of children with special needs after their parents get trained on Positive Parenting Techniques. This research study was devised in liaison with rehabilitation institute that is extending services for children with Autism Spectrum Disorder and Down syndrome. A Quasi experimental research design was employed with pre-test, post-test control group study in order to evaluate the changes in parenting patterns of parents with children (with Autism and Down syndrome). Caregivers of children diagnosed with Autism and Down syndrome between the age ranges of 25 to 45 years, n=20 from autism group and 20 from Down syndrome group (while their children with special needs in the age ranges of 8 to 14 years) participated in the current research. Parenting scale encompassing areas of parental efficacy, parental satisfaction was used in addition to Parenting Stress Index (SF), indigenously developed Child Behavior Problems Checklist and demographic sheet. Findings revealed statistically significant improvement for caregivers in intervention group from pretest to posttest situation. There was considerable decrease in reported mean behavioral issues of children with Down syndrome when parents in experimental group started practicing Positive Parenting Techniques with their special needs children. This change was somehow not recorded in parents of children with autism. Thus these findings establish the efficacy of culturally adapted parenting program that is evidence based and is established in western empirical research. This carries significant implication for practitioners in special needs domain and for school psychologists in Pakistan.

Keywords: Autism and Parenting, Downsyndrome and Parenting , Positive Parenting, Stepping Stone Positive Parenting Program, Mangement of Behavioral Problems with positive parenting

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Authors: Somayeh Sadat Hashemi Kamangar, Fatemeh Bakouie, Shahriar Gharibzadeh

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In this study, we target to exploit Maximum Spanning Trees (MST) of children's semantic networks to investigate their language development. To do so, we examine the graph-theoretic properties of word-embedding networks. The networks are made of words children learn prior to the age of 30 months as the nodes and the links which are built from the cosine vector similarity of words normatively acquired by children prior to two and a half years of age. These networks are weighted graphs and the strength of each link is determined by the numerical similarities of the two words (nodes) on the sides of the link. To avoid changing the weighted networks to the binaries by setting a threshold, constructing MSTs might present a solution. MST is a unique sub-graph that connects all the nodes in such a way that the sum of all the link weights is maximized without forming cycles. MSTs as the backbone of the semantic networks are suitable to examine developmental changes in semantic network topology in children. From these trees, several parameters were calculated to characterize the developmental change in network organization. We showed that MSTs provides an elegant method sensitive to capture subtle developmental changes in semantic network organization.

Keywords: maximum spanning trees, word-embedding, semantic networks, language development

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Authors: Gunendra Rathnawali Kumarihamy Dissanayake

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Research on parenting of both perpetrators and victims of domestic violence (DV) is growing but limited. Further, much of this research in the Asian context is limited to explorations of victim mothers' parenting capacities, not shedding much light on the parenting of the perpetrator fathers. The current qualitative study aimed to explore how both the perpetrators and victims of DV engaged in parenting in the Sri Lankan cultural context. Twenty case studies were conducted with a sample of help-seeking women aged 20 to 40 years representing working to upper-middle social class. Participants have interviewed about their own as well as their partners´ parenting behaviors. The majority of women reported that their partners were often aggressive, controlling and authoritarian, less consistent, and engaged in a variety of manipulative behaviors intending to harm the relationship between their child and them. Further, victim mothers' styles of parenting and authority as parents have been severely undermined by their partners through frequent criticism, ridicule, and insulting in front of the children. As a result, mothers experienced great difficulty specifically trying to discipline their adolescent children as the children have started to disregard the mothers' authority. Most of the children also have shown treatment similar to that of their fathers', treating the mother as a personal servant not worthy of being listened to, thereby increasing the mothers' parenting stress. The mothers were often blamed and held responsible for the problems of the children by their partners, encouraging the children to disrespect and blame the mother for their problems leading them to take the side of the father who had more power. Findings are similar to those of the western context. This study highlights the intersection between domestic violence and parenting, and specific implications and recommendations for DV service providers are offered.

Keywords: parenting, domestic violence, impact, children

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Authors: Saeyoung Lee

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As the enthusiasm for education in Korea is too much high, it is well known by others that children in Korea get good scores in Mathematics. However, behind of this good reputation, children in Korea are easy to get lose self-confidence, tend to complaint and rarely participate in the class because of too much competition which leads to lack of competences. In this regard, the main goals of this paper are, by applying the programme based on peer-communication on Mathematics education field, it would like to improve self-managemental competence to make children gain self-confidence, communicative competence to make them deal with complaint and communitive competence to make them participated in the class for the age of 10 children to solve this problem. 14 children the age of 10 in one primary school in Gangnam, Seoul, Korea had participated in the research from March 2018 to October 2018. They were under the programme based on peer-communication during the period. Every Mathematics class maintained the same way. Firstly a problem was given to children. Secondly, children were asked to find many ways to solve the problem as much as they could by themselves. Thirdly all ways to solve the problem by children were posted on the board and three of the children made a group to distinguish the ways from valid to invalid. Lastly, all children made a discuss to find one way which is the most efficient among valid ways. Pre-test was carried out by the questionnaire based on Likert scale before applying the programme. The result of the pre-test was 3.89 for self-managemental competence, 3.91 for communicative competence and 4.19 for communitive competence. Post-test was carried out by the same questionnaire after applying the programme. The result of the post-test was 3.93 for self-managemental competence, 4.23 for communicative competence and 4.20 for communitive competence. That means by applying the programme based on peer-communication on Mathematics education field, the age of 10 children in Korea could improve self-managemental, communicative and communitive competence. Especially it works very well on communicative competence by increasing 0.32 points as it marked. Considering this research, Korean Mathematics education based on competition which leads to lack of competences should be changed to cooperative structure to make students more competent rather than just getting good scores. In conclusion, innovative teaching methods which are focused on improving competences such as the programme based on peer-communication which was applied in this research are strongly required to be studied and widely used.

Keywords: competences, mathematics education, peer-communication, primary education

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Authors: Mohamed A. Eid, Sobhy M. Aly

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Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.

Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity

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Authors: Patsy Tan, Dana Baltutis

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This presentation demonstrates the effectiveness of music therapy in co-treatment with speech pathology and occupational therapy as an innovative way when working with children and adolescents with complex individual differences to facilitate communication, emotional, motor and social skills development. Each child with special needs and their carer has an individual profile which encompasses their visual-spatial, auditory, language, learning, mental health, family dynamic, sensory-motor, motor planning and sequencing profiles. The most common issues among children with special needs, especially those diagnosed with Autism Spectrum Disorder, are in the areas of regulation, communication, and social-emotional development. The ability of children living with challenges to communicate and use language and understand verbal and non-verbal information, as well as move their bodies to explore and interact with their environments in social situations, depends on the children being regulated both internally and externally and trusting their communication partners and understanding what is happening in the moment. For carers, it is about understanding the tempo, rhythm, pacing, and timing of their own individual profile, as well as the profile of the child they are interacting with, and how these can sync together. In this study, music therapy is used in co-treatment sessions with a speech pathologist and/or an occupational therapist using the DIRFloortime approach to facilitate the regulation, attention, engagement, reciprocity and social-emotional capacities of children presenting with complex individual differences. Documented changes in 10 domains of children’s development over a 12-month period using the Individual Music Therapy Assessment Profile (IMTAP) were observed. Children were assessed biannually, and results show significant improvements in the social-emotional, musicality and receptive language domains indicating that co-treatment with a music therapist using the DIRFloortime framework is highly effective. This presentation will highlight strategies that facilitate regulation, social-emotional and communication development for children and adolescents with complex individual profiles.

Keywords: communication, shared attention, regulation, social emotional

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Authors: Apurva Sapra

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The aim of this research was to study and compare the nature of expected, feared and hoped-for selves in institutionalized adolescent boys in two residential settings – an observation home with children in conflict with the law, and a children’s home with children in need of care and protection. The study uses a concurrent mixed methods design, in which eight adolescent boys from each group, aged 13-17, were asked to respond to a questionnaire, followed by an in-depth interview. The questionnaire looked into the total scores on current, probable and hoped-for/feared positive and negative self-descriptors. Possible selves of both groups were found to be influenced by their unique histories, such as with their experience of violence, interaction with the police and emphasis given on education. Expected selves and hoped-for selves were similar within the two groups. However, they were more concrete and attainable in the observation home and more ambitious in the children’s home. Quantitative results showed that on the positive self-descriptors, the participants in the observation home had a slightly lower total score on the current parameter as on the probable and hoped-for parameters. The participants in the children’s home showed similar results on current and probable positive self-descriptors, with higher scores on the hoped-for parameter. For most of the negative self-descriptors, the current score for the observation home group was lower than the expected score, and for the children’s home group, they were feared slightly more than they were expected. Along with the nature of possible selves, the study also looked into threats and support to desired and feared possible selves, as well as strategies to attain the desired possible selves and avoid feared possible selves. While threats to possible selves were identified as external and internal in both groups, the participants in the children’s home tended to identify threats as external. The categories of support were similar across the two groups, although the nature of support provided differed. Strategies adopted by participants in the observation home could be clearly divided as past, present and future strategies, while those adopted by participants in the children’s home had an overlap with past and future strategies. The institution was perceived as having a negative influence for the future in the observation home group, but positive in the children’s home group. Limitations of the study and recommendations for future research, policy setting and the counselling profession are discussed.

Keywords: adolescents, expected self, feared self, hoped-for self, institutions, possible selves

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Authors: Mona Alzahrani

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Microworld theories can help to define the many influences on female development. In this research, theories together with narratives have been used to discover the reality of children’s gender perceptions in Saudi Arabia. Today, Saudi Arabia is considered a ‘closed and conserved’ society due to tribal, cultural and religious factors. This study focuses on how young girls in Saudi Arabia learn about what is expected of them as females. Cultural beliefs and experiences contribute to children’s notions of identity. Moreover, significant others such as more experienced peers, teachers, parents, and other members of a society can influence a child’s development of knowledge through interactions within their social world. There are dominant influences from the Saudi State. These influences have very strong devices and perceptions of what or how a female should act and be. However, children may have other viewpoints, as it also needs to be considered that the Internet and other media sources could have an influence. Consequently, difficulties could exist for these young children to feel an authentic sense of belonging. The study gathered data using a multi-method approach that elicited the perspectives of the children using ‘multiple modes of expression’ such as observations, story-telling, picture prompt cards, group interviews, drawings and annotations. For this study, prompts and a book was devised, specifically, for use in a Saudi setting. It was found that Saudi young girls in preschool were heteronomous, mainly influenced by culture and society, in their perceptions of female gender and role.

Keywords: Saudi Arabia, pre-school, female, teachers, gender, identity, role

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Authors: Sedef Şahin, Meral Huri

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Cerebral Palsy (CP) represents the most frequent cause of physical disability in children with a rate of 2,9 per 1000 live births. The activity-focused intervention is known to improve function and reduce activity limitations and barriers to participation of children with disabilities. The aim of the study was to assess the effects of occupational therapy on level of fatigue, activity performance and satisfaction in children with Unilateral Cerebral Palsy. Twenty-two children with hemiparetic cerebral palsy (mean age: 9,3 ± 2.1years; Gross Motor Function Classification System ( GMFCS) level from I to V (I = 54%, II = 23%, III = 14%, IV= 9%, V= 0%), Manual Ability Classification System (MACS) level from I to V (I = 40%, II = 32%, III = 14%, IV= 10%, V= 4%), were assigned to occupational therapy program for 6 weeks.Visual Analogue Scale (VAS) was used for intensity of the fatigue they experienced at the time on a 10 point Likert scale (1-10).Activity performance and satisfaction were measured with Canadian Occupational Performance Measure (COPM).A client-centered occupational therapy intervention was designed according to results of COPM. The results were compared with nonparametric Wilcoxon test before and after the intervention. Thirteen of the children were right-handed, whereas nine of the children were left handed.Six weeks of intervention showed statistically significant differences in level of fatigue, compared to first assessment(p<0,05). The mean score of first and the second activity performance scores were 4.51 ± 1.70 and 7.35 ± 2.51 respectively. Statistically significant difference between performance scores were found (p<0.01). The mean scores of first and second activity satisfaction scores were of 2.30± 1.05 and 5.51 ± 2.26 respectively. Statistically significant difference between satisfaction assessments were found (p<0.01). Occupational therapy is an evidence-based approach and occupational therapy interventions implemented by therapists were clinically effective on severity of fatigue, activity performance and satisfaction if implemented individually during 6 weeks.

Keywords: activity performance, cerebral palsy, fatigue, occupational therapy

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Authors: Toby Gibbs, Glen Craigie, Suwaree Yordchim

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Using the Speexx Online Language Training Program with Thai students has allowed us to evaluate their learning comprehension and track their progression through the English language program. Speexx sets the standard for excellence and innovation in web-based language training and online coaching services. The program is designed to improve the business communication skills of language learners for Thai students. Speexx consists of English lessons, exercises, tests, web boards, and supplementary lessons to help students practice English. The sample groups are 191 Thai sophomores studying Business English with the department of Humanities and Social Science. The data was received by standard deviation (S.D.) value from questionnaires and samples provided from the Speexx training program. The results found that most Thai sophomores fail the Speexx training program due to their learning comprehension of the English language is below average. With persisted efforts on new training methods, the success of the Speexx Language Training Program can break through the cultural barriers and help future students adopt English as a second language. The Speexx results revealed four main factors affecting the success as follows: 1) Future English training should be pursued in applied Speexx development. 2) Thai students didn’t see the benefit of having an Online Language Training Program. 3) There is a great need to educate the next generation of learners on the benefits of Speexx within the community. 4) A great majority of Thai Sophomores didn't know what Speexx was. A guideline for self-reliance planning consisted of four aspects: 1) Development planning: by arranging groups to further improve English abilities with the Speexx Language Training program and encourage using Speexx every day. Local communities need to develop awareness of the usefulness of Speexx and share the value of using the program among family and friends. 2) Humanities and Social Science staff should develop skills using this Online Language Training Program to expand on the benefits of Speexx within their departments. 3) Further research should be pursued on the Thai Students progression with Speexx and how it helps them improve their language skills with Business English. 4) University’s and Language centers should focus on using Speexx to encourage learning for any language, not just English.

Keywords: ability, comprehension, sophomore, speexx

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Authors: Misagh Faezipour

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This paper explores the effects of screen time on children from a systems engineering perspective. We reviewed literature from several related works on the effects of screen time on children to explore all factors and interrelationships that would impact children that are subjected to using long screen times. Factors such as kids' age, parent attitudes, parent screen time influence, amount of time kids spend with technology, psychosocial and physical health outcomes, reduced mental imagery, problem-solving and adaptive thinking skills, obesity, unhealthy diet, depressive symptoms, health problems, disruption in sleep behavior, decrease in physical activities, problematic relationship with mothers, language, social, emotional delays, are examples of some factors that could be either a cause or effect of screen time. A systems engineering perspective is used to explore all the factors and factor relationships that were discovered through literature. A causal model is used to illustrate a graphical representation of these factors and their relationships. Through the causal model, the factors with the highest impacts can be realized. Future work would be to develop a system dynamics model to view the dynamic behavior of the relationships and observe the impact of changes in different factors in the model. The different changes on the input of the model, such as a healthier diet or obesity rate, would depict the effect of the screen time in the model and portray the effect on the children’s health and other factors that are important, which also works as a decision support tool.

Keywords: children, causal model, screen time, systems engineering, system dynamics

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Authors: Constance Singo, Choja Oduaran

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Child mental disorders are strongly associated with different forms of challenges, including behavioural problems. The burden of care for children with a mental disorder is high and put primary caregivers, parents in particular, at risk of poor mental wellbeing. Understanding the experience of parents of children with mental disorders is crucial to developing a relevant intervention to assist them to attain optimal mental wellbeing. The aim of this study was to explore the experiences of parents of children with conduct disorder by focussing on the psychological and social stress experience of the parents in raising and caring for their children with conduct disorder. A qualitative research approach, using in-depth interview was utilized in this study. Purposive and snowballing sampling techniques were used to select 9 parents of children with conduct disorder in Thulamela Municipality, Limpopo Province of South Africa. Participants comprising of 2 males and 7 females aged between 30 years and 49 years were interviewed individually at scheduled appointment in-home setting. Interviews were conducted in both English and Setswana language. Data collected in Setswana language were translated to English by 'expert in language translation'. Ethical approval was obtained from appropriate authority before data collection. Thematic analysis was conducted to analyse the collected data. The findings identified anger, fear, depressive symptoms, denial, and suicidal ideation as predominant psychological experiences of the parents. Furthermore, deteriorated interpersonal relationships with family and community members, financial stress, and stigma emerged as social problems being the experience of the parents. It was concluded that parents of children with conduct disorder are highly traumatized by the challenges of caring for their children. We recommend professional engagement in terms of counselling service to support the parents. There is also a need for massive enlightenment programmes for members of the community in order to support the parents of children with child mental disorders.

Keywords: conduct disorder, parents, psychosocial experiences, South Africa

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Authors: Neisha Shepherd

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In Australia, an independent children's lawyer is appointed to represent a child in parenting disputes in the Federal Circuit and Family Court of Australia, where there are complex issues such as child protection, family violence, high conflict, relocation, and parental alienation. The appointment of an Independent Children's Lawyer is to give effect in the family law proceedings of the United Nations Convention on the Rights of the Child, in particular Article 3.1, 12.1, and 12.2. There is a strong focus on alternative dispute resolution in the Australian Family Law jurisdiction in matters that are before the Court that has formed part of the case management pathways. An Independent Children's Lawyer's role is even more crucial in assisting families in resolving the most complex parenting disputes through mediation as they are required to act impartial and be independent of the Court and the parties. A child has the right to establish a professional relationship with the Independent Children's Lawyer. This relationship is usually established over a period of time, and the child is afforded the opportunity to talk about their views and wishes and participate in decisions that affect them. In considering the views and wishes of the child, the Independent Children's lawyer takes into account the different emotional, cognitive, and intellectual developmental levels, family structures, family dynamics, sibling relationships, religious and cultural backgrounds; and that children are vulnerable to external pressures when caught in disputes involving their parents. With the increase of child-inclusive mediations being used to resolve family disputes in the best interests of a child, an Independent Children's Lawyer can have a critical role in this process with the specialised skills that they have working with children in the family law jurisdiction. This paper will discuss how inclusive child mediation with the assistance of an Independent Children's Lawyer can assist in the resolution of some of the most complex parenting disputes by examining through case studies: the effectiveness and challenges of such an approach; strategies to work with child clients, adolescents, and sibling groups; ways to provide feedback regarding a child's views and wishes and express a child's understanding, actual experiences and perspective to parties in a mediation and whether it is appropriate to do so; strategies and examples to assist in developing parenting plans or orders that are in the best interest of a child that is workable and achievable; how to deal with cases that involve serious child protection and family violence and strategies to ensure that child safety is paramount; the importance of feedback to the child client. Finally this paper will explore some of the challenges for Independent Children's Lawyers in relation to child-inclusive mediations where matters do not resolve.

Keywords: child inclusive mediation, independent children's lawyer, family violence, child protection

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Authors: Simplejit Kaur Dhanoa, Manmohan Singh

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This study was done with the primary objective to evaluate the motor and mental developmental delays among children having neonatal Jaundice. A total sample of 300 neonates were collected; out of them, 150 were preterm neonates, and 150 were full term neonates from the hospital setting and follow up study was done with the help of the Developmental Assessment scale of the Indian Infant. The registered samples were assessed up to 2.6 years with a gap of 6 months. The outcomes of this study reveal that developmental delays were present among children who had preterm neonatal jaundice as compare to full term normal babies. Further, It was reported that both motor and mental development is affected due to neonatal hyperbilirubinemia in addition to preterm birth.

Keywords: hyperbinirubinemia, preterm neonates, developmental delays, preterm

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Authors: Larissa Pliska, Isabel Neitzel, Michael Buschermöhle, Olga Kunina-Habenicht, Ute Ritterfeld

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Visual preferences, which can be assessed using eye tracking technologies, are considered one of the defining hallmarks of Autism Spectrum Disorder (ASD). Specifically, children with ASD show a decreased preference for social images rather than geometric images compared to typically developed (TD) children. Such differences are already prevalent at a very early age and indicate the severity of the disorder: toddlers with ASD who preferred geometric images when confronted with social and geometric images showed higher ASD symptom severity than toddlers with ASD who showed higher social attention. Furthermore, the complexity of social pictures (one child playing vs. two children playing together) as well as the mode of stimulus presentation (video or image), are not decisive for the marker. The average age of diagnosis for ASD in Germany is 6.5 years, and visual preference data on this age group is missing. In the present study, we therefore investigated whether visual preferences persist into school age. We examined the visual preferences of 16 boys aged 6 to 11 with ASD and unimpaired cognition as well as TD children (1:1 matching based on children's age and the parent's level of education) within an experimental setting. Different stimulus presentation formats (images vs. videos) and different levels of stimulus complexity were included. Children with and without ASD received pairs of social and non-social images and video stimuli on a screen while eye movements (i.e., eye position and gaze direction) were recorded. For this specific use case, KIZMO GmbH developed a customized, native iOS app (KIZMO Face-Analyzer) for use on iPads. Neither the format of stimulus presentation nor the complexity of the social images had a significant effect on the visual preference of children with and without ASD in this study. Despite the tendency for a difference between the groups for the video stimuli, there were no significant differences. Overall, no statistical differences in visual preference occurred between boys with and without ASD, suggesting that gaze preference in these groups is similar at primary school age. One limitation is that the children with ASD were already receiving Autism-specific intervention. The potential of a visual preference task as an indicator of ASD can be emphasized. The article discusses the clinical relevance of this marker in elementary school children.

Keywords: autism spectrum disorder, eye tracking, hallmark, visual preference

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Authors: Carmen Pena-Díaz

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Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.

Keywords: child language brokering, community interpreting, healthcare, PSIT

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Authors: Muntanavadee Maytapattana

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The purposes of the study were to evaluate the effectiveness of the Parent Training Program for Obesity Reduction (PTPOR) on health behaviors of school-age children. An Ecological Systems Theory (EST) was approached the study and a randomized control trial was used in this study. Participants were school-age overweight or obese children and their parents. One hundred and one parent-child dyads were recruited and random assigned into the PTPOR (N=30), Educational Intervention or EI (N=32), and control group (N=39). The parents in the PTPOR group participated in five sessions including an educational session, a cooking session, aerobic exercise training, 2-time group discussion sessions, and 4-time telephoned counseling sessions. Repeated Measure ANCOVA was used to analyze data. The results presented that the outcomes of the PTPOR group were better than the EI and the control groups at 1st, 8th, and 32nd weeks after finishing the program such as child exercise behavior (F(2,97) = 3.98, p = .02) and child dietary behavior (F(2,97) = 9.42, p = .00). The results suggest that nurses and health care providers should utilize the PTPOR for child weight reduction and for the health promotion of a lifestyle among overweight and obese children.

Keywords: parent training program, obesity reduction, child health behaviors, school-age children

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Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf

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Studies of adults' episodic memory have found that enacted encoding not only improve recall performance but also retrieve faster during the recall period. The current study focused on exploring the temporal progression of different encoding conditions in younger and older school children. 204 students from two age group of 8 and 14 participated in this study. During the study phase, we studied action encoding in two forms; participants performed the phrases by themselves (SPT), and observed the performance of the experimenter (EPT), which were compared with verbal encoding; participants listened to verbal action phrases (VT). At test phase, we used immediate and delayed free recall tests. We observed significant differences in memory performance as function of age group, and encoding conditions in both immediate and delayed free recall tests. Moreover, temporal progression of recall was faster in older children when compared with younger ones. The interaction of age-group and encoding condition was only significant in delayed recall displaying that younger children performed better in EPT whereas older children outperformed in SPT. It was proposed that enactment effect in form of SPT enhances item-specific processing, whereas EPT improves relational information processing and this differential processes are responsible for the results achieved in younger and older children. The role of memory strategies and information processing methods in younger and older children were considered in this study. Moreover, the temporal progression of recall was faster in action encoding in the form of SPT and EPT compared with verbal encoding in both immediate and delayed free recall and size of enactment effect was constantly increased throughout the recall period. The results of the present study provide further evidence that the action memory is explained with an emphasis on the notion of information processing and strategic views. These results also reveal the temporal progression of recall as a new dimension of episodic memory in children.

Keywords: action memory, enactment effect, episodic memory, school-aged children, temporal progression

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Authors: Masaki Yamaguchi, Daimei Sasayama, Shinsuke Washizuka

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The goal of this study was to examine the possibility of salivary cytokines for the screening of attention deficit hyperactivity disorder (ADHD) in children. We carried out a case-control study, including 19 children with ADHD and 17 healthy children (controls). A multiplex bead array immunoassay was used to conduct a multi-analysis of 27 different salivary cytokines. Six salivary cytokines (interleukin (IL)-1β, IL-8, IL12p70, granulocyte colony-stimulating factor (G-CSF), interferon gamma (IFN-γ), and vascular endothelial growth factor (VEGF)) were significantly associated with the presence of ADHD (p < 0.05). An informative salivary cytokine panel was developed using VEGF by logistic regression analysis (odds ratio: 0.251). Receiver operating characteristic analysis revealed that assessment of a panel using VEGF showed “good” capability for discriminating between ADHD patients and controls (area under the curve: 0.778). ADHD has been hypothesized to be associated with reduced cerebral blood flow in the frontal cortex, due to reduced VEGF levels. Our study highlights the possibility of utilizing differential salivary cytokine levels for point-of-care testing (POCT) of biomarkers in children with ADHD.

Keywords: cytokine, saliva, attention deficit hyperactivity disorder, child

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Authors: Mustafa M. Donma, Orkide Donma

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Pediatric overweight and obesity need attention because they may cause morbid obesity, which may develop metabolic syndrome (MetS). Criteria used for the definition of adult MetS cannot be applied for pediatric MetS. Dynamic physiological changes that occur during childhood and adolescence require the evaluation of each parameter based upon age intervals. The aim of this study is to investigate the distribution of blood pressure (BP) values within diverse pediatric age intervals and the possible use and clinical utility of a recently introduced Diagnostic Obesity Notation Model Assessment Tension (DONMA tense) Index derived from systolic BP (SBP) and diastolic BP (DBP) [SBP+DBP/200]. Such a formula may enable a more integrative picture for the assessment of pediatric obesity and MetS due to the use of both SBP and DBP. 554 children, whose ages were between 6-16 years participated in the study; the study population was divided into two groups based upon their ages. The first group comprises 280 cases aged 6-10 years (72-120 months), while those aged 10-16 years (121-192 months) constituted the second group. The values of SBP, DBP and the formula (SBP+DBP/200) covering both were evaluated. Each group was divided into seven subgroups with varying degrees of obesity and MetS criteria. Two clinical definitions of MetS have been described. These groups were MetS3 (children with three major components), and MetS2 (children with two major components). The other groups were morbid obese (MO), obese (OB), overweight (OW), normal (N) and underweight (UW). The children were included into the groups according to the age- and sex-based body mass index (BMI) percentile values tabulated by WHO. Data were evaluated by SPSS version 16 with p < 0.05 as the statistical significance degree. Tension index was evaluated in the groups above and below 10 years of age. This index differed significantly between N and MetS as well as OW and MetS groups (p = 0.001) above 120 months. However, below 120 months, significant differences existed between MetS3 and MetS2 (p = 0.003) as well as MetS3 and MO (p = 0.001). In comparison with the SBP and DBP values, tension index values have enabled more clear-cut separation between the groups. It has been detected that the tension index was capable of discriminating MetS3 from MetS2 in the group, which was composed of children aged 6-10 years. This was not possible in the older group of children. This index was more informative for the first group. This study also confirmed that 130 mm Hg and 85 mm Hg cut-off points for SBP and DBP, respectively, are too high for serving as MetS criteria in children because the mean value for tension index was calculated as 1.00 among MetS children. This finding has shown that much lower cut-off points must be set for SBP and DBP for the diagnosis of pediatric MetS, especially for children under-10 years of age. This index may be recommended to discriminate MO, MetS2 and MetS3 among the 6-10 years of age group, whose MetS diagnosis is problematic.

Keywords: blood pressure, children, index, metabolic syndrome, obesity

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